Index In Postmenopausal Women Research Articles

Crosstalk between neurovegetative control, bone status and physical exercise: clinical use of a unitary autonomic nervous system index in postmenopausal women with osteoporosis

Crosstalk between neurovegetative control, bone status and physical exercise: clinical use of a unitary autonomic nervous system index in postmenopausal women with osteoporosis

Bone mineral density and muscle mass associated with healthy eating index in postmenopausal women; results from RaNCD cohort study

BackgroundThe Healthy Eating Index 2015 (HEI-2015) is a tool for checking the quality of diet. This index is used to examine how well people’s dietary behavior fits certain criteria for achieving a healthy diet in Dietary Guidelines for Americans 2015-2020. We look at the possible association between the HEI-2015 and bone mineral density (BMD) and muscle strength in postmenopausal women.MethodsThis research included 1012 postmenopausal women from the recruitment phase of the Ravansar Noncommunicable Diseases (RaNCD) cohort study in Kermanshah-Iran. A standardized and repeatable food-frequency questionnaire (FFQ) that contains 118 items was used to quantify dietary consumption. Anthropometric indices measured via Bio-Impedance Analyzer BIA (Inbody 770, Inbody Co, Seoul, Korea).ResultThe mean age of postmenopausal women was (56.41 ± 5.31) years. Participants in the highest quartile had a more daily energy intake compared to the lowest quartile (2329.89 ± 837.59), (P < 0.001). Women in the upper quartiles had greater Skeletal Muscle Mass (SMM) than those in the lower quartiles (21.61 ± 2.80 vs 20.52 ± 3.13; p = 0.0002). The linear model didn’t show a significant relationship between HEI score and greater BMD (β = 0.0014, P = 0.169).ConclusionA diet of high quality followed by a high HEL-2015 score was shown to be strongly connected to increased BMD and muscle mass in Kurdish postmenopausal women.

Effectiveness of Orthopantomograms as a Screening Tool for Osteoporosis: A Case-Control Study.

Introduction Osteoporosis is a disease that is characterised by low bone mineral density (BMD), and loss of structural and biomechanical properties that are essential in maintaining bone homeostasis. Osteoporosis is diagnosed by clinical measurement of BMD and is the best predictor of osteoporosis. The study was conducted with the aim of assessing the effectiveness of orthopantomogram (OPG) as a screening tool for osteoporosis in postmenopausal women and chronic drug users. Objectives The primary objective of the current study was to assess the mandibular cortical width and antegonial index in postmenopausal women and chronic drug users, the secondary objective was to compare the mandibular cortical width and antegonial index of postmenopausal women and chronic drug users with that of the control group (healthy individual). Methods Three groups were taken in this study with a sample size of 300 with 100 OPG in each group. The groups categorised in the study were postmenopausal women, patients under drugs (glucocorticoids, proton pump inhibitor, anti-epileptic drugs, selective serotonin reuptake inhibitor) and the control group and the parameters assessed were antegonial index and mandibular cortical width. Results Results were tabulated and analysed using Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 26.0, Armonk, NY). The normality tests Kolmogorov-Smirnov and Shapiro-Wilks test results reveal that the variables (both indices) follow the normal distribution. The mandibular cortical width was 3.44, 2.66 and 2.96 in the normal, postmenopausal women and women on drugs respectively. The antegonial index was 163.5, 157.2 and 158.8 in the normal, postmenopausal women and women on drugs respectively. Conclusion From the above results, it is evident that there is a statistically significant reduction in antegonial index and mandibular cortical width in postmenopausal women compared to normal individuals.Alterations of this value are suggestive that early pre-clinical changes of osteoporosis can be detected in the high-risk group using OPG.

Lipid profile of postmenopausal women

Objectives: The main objectives of the research are to examine the incidence of hyperlipoproteinemia in postmenopausal women and to determine the differences in lipid profile considering age, duration of menopause and body mass index in postmenopausal women. Respondents and methods: The research is structured as cross-sectional with historical data. The research used data collected during regular check-ups in primary health care clinics in Osijek Health Center from November 2021 to March 2022. Collected data: demographic data, information on the duration of menopause, body mass, body height, body mass index, values of total, LDL, HDL cholesterol and triglycerides, and data on associated diseases. Results: 98 postmenopausal women were included in the research, of which over 50% had elevated total and LDL cholesterol values, and 39.8% had elevated triglyceride values. Subjects aged 45 to 65 years and subjects with a duration of menopause of 10 or more years had significantly higher values of total and LDL cholesterol while no difference was observed in the lipid profile with regard to the body mass index. Using the SCORE2 table, it was estimated that 65% of the subjects had a very high cardiovascular risk, and only 6% of the subjects achieved the target values of LDL cholesterol in accordance with the cardiovascular risk. Conclusion: There is a very high incidence of hyperlipoproteinemia in postmenopausal women, and the age and duration of menopause have an impact on the poorer achievement of the target values of the lipid profile, while the body mass index showed no impact. Given the high prevalence of subjects with a very high cardiovascular risk (SCORE 2 tables), intensive interventions are needed at all levels of health care, especially at the primary level of health care, which include non-pharmacological and pharmacological methods of treating hyperlipoproteinemia.

The presence of dynapenia is associated with higher values of Fibrosis-4 score index in postmenopausal women

Introduction: The menopausal transition has been associated with an accrual of cardiometabolic risk factors, which contribute to the risk for non-alcoholic fatty liver disease (NAFLD) and low handgrip strength (HGS). NAFLD-indexes, like NAFLD fibrosis score (NFS) and Fibrosis-4 (Fib-4) score can be used for the exclusion of advanced fibrosis. We aimed to assess the possible relation between HGS-values and Fib-4 score and NFS, in a sample of postmenopausal women.

Assessment of risk of overall and late distant recurrence by Breast Cancer Index in postmenopausal women with early-stage, HR+ breast cancer in the TEAM trial.

509 Background: Individual risk assessment of distant recurrence (DR) is particularly relevant for early-stage HR+ breast cancer patients, as they face a prolonged risk of recurrence even after adjuvant endocrine therapy. Previously, we have shown that the Breast Cancer Index (BCI) and BCIN+ risk groups are significantly prognostic for risk of overall (0-10y) and late (5-10y) distant recurrence in N0 and N1 breast cancer patients, respectively, enrolled in the Tamoxifen and Exemestane Adjuvant Multinational (TEAM) trial. Here, the prognostic performance of BCI and BCIN+ as a continuous risk score for overall and late distant recurrence was evaluated in the TEAM trial. Methods: BCI testing was performed blinded to clinical outcome with BCI/BCIN+ risk scores calculated as previously described. Cox proportional hazard models adjusted for age, tumor size, grade and treatments were used to estimate hazard ratios (HRs) and the associated 95% confidence intervals (CIs) for BCI/ BCIN+ continuous risk scores. The 10y risk of overall and late DR were estimated as a function of risk scores from the Cox models using Breslow estimates. Results: Continuous risk curves for overall and late DR were obtained in patients who did not receive adjuvant chemotherapy and those who remained DR-free at 5 years regardless of chemotherapy, respectively, to reflect the two key time points for breast cancer treatment decision-making. InN0 patients not treated with chemotherapy (N = 1197), BCI was significantly prognostic for overall DR with a HR of 1.39 (95% CI 1.25-1.54; p &lt; 0.001), while BCIN+ was significantly prognostic in N1 patients who did not receive chemotherapy (N = 1319) with a HR of 4.29 (95% CI 2.93-6.28; p &lt; 0.001). Among patients who remained DR-free at 5 years, in the N0 subset (N = 1285), BCI was significantly prognostic for late DR with a HR of 1.23 (95% CI 1.07-1.42; p &lt; 0.001), while BCIN+ remained to be significantly prognostic in the N1 subset (N = 1762) with a HR of 2.78 (95% CI 1.75-4.43; p &lt; 0.001). Similar results were observed in the HER2- subset for both overall and late DR. Continuous risk curves for BCI and BCIN+ for overall and late DR showed an increasing risk of DR with higher BCI/BCIN+ scores. Conclusions: Results from this largest BCI study to date further support the use of BCI to provide individualized risk estimates for both overall and late DR in women with HR+ breast cancer to aid in personalized decision-making for adjuvant therapy. [Table: see text]

Plasma fatty acid composition and some markers of dietary habits are associated with cardiovascular disease risk determined by an atherogenic plasma index in postmenopausal women

It is hypothesized that plasma proportion of selected fatty acids (FAs) and dietary habits are linked with the risk of cardiovascular disease (CVD) in postmenopausal women. Therefore, this study was designed to determine the association of plasma FA composition and markers of dietary habits with an atherogenic index of plasma (AIP), a predictor of CVD risk in postmenopausal women. In total, 87 postmenopausal women with an average age of 57 ± 7 years were recruited and their dietary intake, anthropometric and biochemical parameters, and FA status in total plasma lipid proportions were determined, showing that 65.5% of the participants had a high risk of CVD according to their AIP value. After adjusting for some confounders (age, body mass index, and physical activity level), the risk of CVD was only positively associated with the frequency of consumption of animal fat spreads (butter and lard) of terrestrial origin. Regarding the FA profile, CVD risk was positively associated with the percentages of vaccenic acid, dihomo-γ-linolenic acid, and monounsaturated fatty acids (MUFA; mainly n-7) in total FA, as well as the MUFA/SFA ratio in total plasma and stearoyl-CoA desaturase-16 activity (16:1/16:0 ratio). In contrast, the risk of CVD was negatively associated with percentages of α-linolenic acid, total polyunsaturated fatty acids (PUFA), and PUFA/MUFA ratio in total plasma lipid, and the estimated activity of Δ5-desaturase (20:4/20:3 n-6 ratio). These results support the current recommendations to decrease the frequency of animal fat spread intake because it is associated with a reduced CVD risk based on AIP in postmenopausal women. In accordance with these plasma percentages of ALA, vaccenic acid, dihomo-γ-linolenic acid, PUFA, PUFA/MUFA ratio, and 16:1/16:0 ratio may be important parameters in CVD risk assessment.

Correlation Between Coronary Artery Calcium Score and Triglyceride-Glucose Index in Post-menopausal Women.

To clarify the correlation between coronary artery calcium score (CACS) and triglyceride-glucose (TyG) index in post-menopausal women. Post-menopausal women who underwent computed tomography angiographywith the suspicion of acute coronary syndrome were included in the study. Patients were categorized into three groups (CACS < 100 as group 1, CACS = 100-300 as group 2, and CACS > 300 as group 3). Groups were compared with regardto demographic characteristics, laboratory test outcomes, electrocardiogram findings, and the TyG index. The study was conducted by examining the data of 228 patients. Median TyG index was 9.0 and median CACS was 79.5. The median age was significantly lower in group 1 (p = 0.001). Diabetes mellitus rate and smoking rate were higher in group 3 compared to the other groups (p = 0.037 and p = 0.032). The glucose level was significantly higher for group 3 (p = 0.001). Additionally, the TyG index was 9.3 in group 3 and was statistically significantly higher than the values in group 1 and group 2 (8.9 and 9.1, respectively) (p = 0.005). There was a moderate correlation between CACS and age (correlation coefficient (CC): 0.241, p = 0.001). Also, there was a significant correlation between glucose level and CACS (CC: 0.307, p = 0.001). A high correlation was found between the TyG index and CACS (CC: 0.424, p = 0.001). Our study demonstrated for the first time that there was a strong correlation between the TyG index and CACS in post-menopausal patients. In addition, patients with increased age, patients with higher glucose levels, and diabetic patients had significantly higher CACS.

The Relationship between Bone Mineral Densitometry and Visceral Adiposity Index in Postmenopausal Women.

It was aimed to compare visceral adiposity index (VAI) levels in patients with normal bone mineral density (BMD), osteopenia, and osteoporosis. One hundred twenty postmenopausal women (40 with normal BMD, 40 with osteopenia, and 40 with osteoporosis) between the ages of 50 to 70 years were included in the study. For females, the VAI was calculated using the formula (waist circumference [WC]/[36.58 + (1.89 x body mass index (BMI))]) x (1.52/High-density lipoprotein [HDL]-cholesterol [mmol/L]) x (triglyceride [TG]/0.81 [mmol/L]). The time of menopause from the beginning was similar in all groups. Waist circumference was found to be higher in those with normal BMD than in the osteopenic and osteoporotic groups (p = 0.018 and p < 0.001, respectively), and it was also higher in the osteopenic group than in the osteoporotic group (p = 0.003). Height and body weight, BMI, blood pressure, insulin, glucose, HDL-cholesterol, and homeostasis model assessment-insulin resistance (HOMA-IR) levels were similar in all groups. Triglyceride levels were found to be higher in the normal BMD group, compared with the osteoporotic group (p = 0.005). The level of VAI was detected as higher in those with normal BMD, compared with the women with osteoporosis (p = 0.002). Additionally, the correlation analysis showed a positive correlation between dual-energy X-ray absorptiometry (DXA) spine T-scores, WC, VAI, and a negative correlation between DXA spine T-scores and age. In our study, we found higher VAI levels in those with normal BMD, compared with women with osteoporosis. We consider that further studies with a larger sample size will be beneficial in elucidating the entity.

Clinical observation of menopause hormone therapy in postmenopausal women with euthyroid and mild subclinical hypothyroidism

BackgroundTo evaluate the endocrine hormone and metabolic indices in postmenopausal women with euthyroid and mild subclinical hypothyroidism after menopause hormone therapy (MHT).MethodsA retrospective study of 587 postmenopausal women receiving MHT was conducted. Median (25–75th percentile) age was 52 (49–54) years. According to thyroid stimulating hormone (TSH) levels at initial diagnosis, the patients were divided into three groups: I (euthyroid with low normal TSH range, n = 460), II (euthyroid with upper normal TSH range, n = 106) and III (mild subclinical hypothyroidism, n = 21). After a continuous oral MHT regimen using the same estradiol potency for 6–18 month cycles, serum endocrine hormone and metabolic indices were reassessed.ResultsCompared with baseline, serum TSH levels in groups I and II significantly changed but all values were within the normal range. No significant difference was observed in serum TSH levels in group III. After treatment, all serum free tri-iodothyronine and free thyroxine levels were within the normal range. Serum total cholesterol, triglyceride, fasting plasma glucose, fasting insulin levels and homeostasis model assessment of insulin resistance index had significantly decreased in group I. There were no significant differences in all observed lipid and glucose parameters in group III, before and after treatment.ConclusionMHT did not affect thyroid function in postmenopausal women with euthyroid and mild subclinical hypothyroidism. MHT led to an improvement in lipid and glucose indicators in euthyroid women with low normal TSH range.

Associations of Biomarker-Calibrated Healthy Eating Index-2010 Scores with Chronic Disease Risk and Their Dependency on Energy Intake and Body Mass Index in Postmenopausal Women

Prior studies examined associations between the Healthy Eating Index (HEI) and chronic disease risk based on self-reported diet without measurement error correction. Our objective was to test associations between biomarker calibration of the food-frequency questionnaire (FFQ)-derived HEI-2010 with incident cardiovascular disease (CVD), cancer, and type 2 diabetes (T2D) among Women's Health Initiative (WHI) participants. Data were derived from WHI postmenopausal women (n = 100,374) aged 50-79 y at enrollment (1993-1998) at 40 US clinical centers, linked to nutritional biomarker substudies and outcomes over subsequent decades of follow-up. Baseline or year 1 FFQ-derived HEI-2010 scores were calibrated with nutritional biomarkers and participant characteristics (e.g., BMI) for systematic measurement error correction. Calibrated data were then used in HR models examining associations with incidence of CVD (total, subtypes, mortality), cancer (total, subtypes, mortality), and T2D in WHI participants with approximately 2 decades of follow-up. Models were multivariable-adjusted with further adjustment for BMI and doubly labeled water (DLW)-calibrated energy. Multivariable-adjusted HRs modeled a 20% increment in HEI-2010 score in relation to outcomes. HRs were modest using uncalibrated HEI-2010 scores (HRs = 0.91-1.09). Using biomarker-calibrated HEI-2010, 20% increments in scores yielded multivariable-adjusted HRs (95% CIs) of 0.75 (0.60, 0.93) for coronary heart disease; 0.75 (0.61, 0.91) for myocardial infarction; 0.96 (0.92, 1.01) for stroke; 0.88 (0.75, 1.02) for CVD mortality; 0.81 (0.70, 0.94) for colorectal cancer; 0.81 (0.74, 0.88) for breast cancer; 0.79 (0.73, 0.87) for cancer mortality; and 0.45 (0.36-0.55) for T2D. Except for cancer mortality and T2D incidence, results became null when adjusted for DLW-calibrated energy intake and BMI. Biomarker calibration of FFQ-derived HEI-2010 was associated with lower CVD and cancer incidence and mortality and lower T2D incidence in postmenopausal women. Attenuation after adjustment with BMI and DLW-calibrated energy suggests that energy intake and/or obesity are strong drivers of diet-related chronic disease risk in postmenopausal women. The Women's Health Initiative is registered at clinicaltrials.gov at NCT00000611.

The effect of tibolone treatment on fasting blood sugar, insulin, insulin resistance and endothelial function in postmenopausal women: A meta-analysis of randomized controlled trials.

The menopause is associated in females with the presence of dysglycemia, insulin resistance and with the development of endothelial dysfunction. Tibolone (TIB) is a synthetic steroid compound with selective oestrogenic and, to a lesser extent, progestogenic and androgenic properties prescribed to postmenopausal women to alleviate the symptoms of the climaterium and to prevent the development of osteoporosis. However, the impact of TIB on fasting blood sugar (FBS), insulin, Homeostatic Model Assessment-Insulin Resistance (HOMA-IR) index and flow-mediated dilation (FMD) in women has not been evaluated so far. Thus, to investigate this research question, we conducted the present systematic review and meta-analysis. Two independent reviewers searched the Scopus, Web of Science, PubMed/Medline and Embase databases up to 20 December 2020. The weighted mean differences (WMDs) and the 95% confidence intervals (CI) were calculated using the DerSimonian and Laird random effects models between the TIB and control groups and included in the forest plot. The overall findings were generated from 12 eligible randomized controlled trials. As compared to controls, TIB administration resulted in a significant reduction of FBS (WMD: -3.06mg/dL, 95% CI: -5.30 to -0.82, P=0.007), and of the HOMA-IR index (WMD: -0.61, 95% CI: -1.11 to -0.11, P=0.01). However, treatment with TIB did not lead to significant changes of the FMD (WMD: 0.78%, 95% CI: -0.20 to 1.77, P=0.12) or of insulin levels (WMD: -0.10 mIU/L, 95% CI: -2.04 to 1.83, P=0.91). TIB administration can decrease FBS and the HOMA-IR index in postmenopausal women. However, the use of TIB does not influence insulin levels or FMD.

Appendicular Skeletal Muscle Mass Index and Physiological Performance in Post-Menopausal Women with Total Thyroidectomy

Sarcopenia is prevalent in postmenopausal women but is inconclusive in total thyroidectomy and under levothyroxine replacement. We aim to analyze the determinants of sarcopenia and investigate the early detection of sarcopenia in this group. Fifty postmenopausal women with total thyroidectomy were measured for body composition via Dual-energy X-ray Absorptiometry (DXA) and Appendicular Skeletal Muscle mass divided by the height square (ASM/ht2). Handgrip strength and gait speed and Geriatric Nutritional Risk Index (GNRI) were calculated. Eight determinants associated with sarcopenia include GNRI (β, 0.042; 95% confidence interval (CI), 0.021 to 0.064), femoral neck BMD (β, 0.989; 95% CI, 0.049 to 1.929), TSH (β, 0.192; 95% CI, 0.027 to 0.357), and thyroglobulin Ab (0.657; 95% CI, 0.210 to 1.103) for ASM/height2; menopausal years (β, −3.112; 95% CI, −5.661 to −0.563) and ASM/height2 (β, 2.669; 95% CI, 1.073 to 4.265) for handgrip strength; and GNRI (β, 0.062; 95% CI, 0.019 to 0.105), T3 (β, −3.541; 95% CI, −7.019 to −0.063), and age (β, 0.043; 95% CI, 0.003 to 0.084) for gait speed. Our study confirmed a high prevalence of low skeletal muscle mass index in postmenopausal women with total thyroidectomy and revealed a number of determinants that could help early diagnosis and management this disease in daily clinical practice.

Bone Mineral Density and Body Mass Index in Postmenopausal Women

Osteoporosis is a typical medical issue that overwhelmingly influences postmenopausal women. A bone density test is the only test that can diagnose osteoporosis before a broken bone occurs. The aims of this study was to find out the relationship between bone mineral density (BMD) and body mass index (BMI) in postmenopausal females. This cross sectional descriptive study was carried out in the Institute of Nuclear Medicine and Allied Sciences (INMAS), Sylhet. Study subjects comprised of 117 postmenopausal women between ages 45 to 85 years, with a mean age of 60.8 ± 9.2 years, who underwent BMD scan from January 2018 to June 2019. Duration of the study was 5 months ( march 2019 to august 2019). BMD was measured by the MedilinkMedix DR system. Findings of BMD of right femur showed osteopenia and osteoporosis (low BMD) in most of the women with under weight (81.0%) about one third (32.3%) of normal body weight and few (16.7%) of them over weight. Contrarily in left femur, low BMD was found in 08 (80.0%), 25 (40.3%) and 6 (16.7%) among underweight, normal, overweight patients respectively. According to BMI compare to the lumbar spine, low BMD was found in 48 (77.4%), 10 (100 %), 20 (55.6%), 03 (33.3%) among normal, underweight, overweight, and obese patients respectively. Relationship among BMD and BMI was found statistically significant in the both femurs (p &lt; 0.001) and lumbar spine (p = 0.02). Low BMD was more severe in the 65-74 years’ age group in both femurs 65.4% and 65-85 years’ age group in lumbar spine 84.6% compare to other groups. The findings of this study reveal that low BMI and aging are associated with bone loss. Routine BMD checking in postmenopausal women might be important to initiate an early clinical intervention for osteoporosis.&#x0D; Bangladesh Med J. 2020 Sept; 49(3) : 22-28

Correlation of serum magnesium levels with body mass index in post-menopausal women: an observational study

Background: Obesity and overweight status based on body mass index among post-menopausal women is common finding. Micro-nutrient deficiencies like magnesium have also been summarised in the post-menopausal syndrome. With this background we planned this study to correlate serum magnesium levels with body mass index in post-menopausal women.Methods: A prospective observational study was conducted on the post-menopausal women attending the department of medicine in a tertiary care hospital of Maharashtra. We recruited 60 cases that fitted our eligibility criteria taken from the duration of 4 months in our institute. Data was collected using pre-designed and pre-tested questionnaire which had demographic variables, anthropometric measurements like height, weight, body mass index etc and serum magnesium levels of the patients. Serum magnesium levels were tested in blood using commercial kit for quantative measurement (Xylidyl Blue method) using automated analyser. Body mass index was calculated using the standard formula and classified based on the WHO guidelines.Results: The mean serum magnesium levels among obese/overweight post-menopausal women was 1.43±0.23 and among non-obese/overweight post-menopausal women it was 2.59±0.31(p&lt;0.001). We found a high inverse correlation between serum magnesium levels with body mass index in the present study. (r=-0.83, p&lt;0.001)Conclusions: The serum magnesium levels were significantly lower among the obese/overweight subjects when compared to normal subjects in the present study. There was significant high negative correlation between the serum magnesium levels and body mass index in the present study.

Clinical Significance of the Cardio-Ankle Vascular Index in Postmenopausal Women With Hypercholesterolemia

Background: The cardio-ankle vascular index (CAVI) is a physiological indicator of arterial elasticity. However, limited information regarding the clinical significance of the CAVI in patients with hypercholesterolemia is available. This cross-sectional study aimed to elucidate the clinical significance of the CAVI for the primary prevention of cardiovascular disease (CVD) among postmenopausal women with hypercholesterolemia. Methods: A total of 168 untreated postmenopausal hypercholesterolemic women (low-density lipoprotein cholesterol levels ≥ 140 mg/dL, mean age ± standard deviation, 63 ± 10 years) with no history of CVD events were enrolled. The CAVI was measured using commercial devices, after which, its relationships with various clinical parameters, such as carotid artery ultrasonography findings and CVD biomarkers, were examined. Results: A significant positive correlation was observed between the CAVI and maximum intima-media thickness of the common carotid artery (max-C-IMT), which was evaluated using carotid artery ultrasonography (r = 0.49, P < 0.001). Regarding CVD biomarkers, the CAVI was significantly correlated with estimated glomerular filtration rate (r = -0.18, P < 0.001), high-sensitivity C-reactive protein (r = 0.36, P < 0.001), whole blood passage time as a marker of blood rheology (r = 0.41, P < 0.001), and skin autofluorescence as a marker of advanced glycation end products in tissues (r = 0.46, P < 0.001), although no significant correlation was noted between serum lipid parameters and the CAVI. Multiple regression analysis identified max-C-IMT (β = 0.35, P < 0.001), whole blood passage time (β = 0.18, P = 0.007), skin autofluorescence (β = 0.17, P = 0.011), and age (β = 0.16, P = 0.018) as variables independently associated with CAVI. Conclusion: The present study indicated that the CAVI is an essential CVD risk factor among postmenopausal women with hypercholesterolemia. Moreover, impaired blood rheology and increase of skin autofluorescence were associated with elevated CAVI in such patients. J Clin Med Res. 2021;13(5):276-282 doi: https://doi.org/10.14740/jocmr4509

Association between sleep duration and augmentation index in post-menopausal women: A moderating role of depressive symptoms

Objectives: Physiological and psychological changes, including sleep disturbance and mood changes, frequently occur in post-menopausal women. We explored associations between sleep duration/quality and arterial stiffness, as well as the moderating role of depressive symptoms, in post-menopausal women. Study design: This cross-sectional study utilized data obtained from 1687 post-menopausal women in the Cardiovascular and Metabolic Diseases Etiology Research Center cohort study. Main outcome measures: Self-reported sleep was classified into short (<6 h/day), normal, and long (≥ 8 h/day) sleep durations. Poor sleep quality was operationally defined using the fatigue-related Berlin questionnaire. Depressive symptoms were assessed using the Beck Depression Index-II (BDI-II). Arterial stiffness was evaluated using the augmentation index (AI) and the HEM-9000AI system. The associations between sleep and AI were examined using generalized linear models, followed by a path model to investigate whether depressive symptoms act as an effect modifier. Results: AI (%) values for participants with poor sleep quality were higher than those for participants with normal sleep quality (β=1.53, standard error [SE]=0.59, p = 0.009). Although overall sleep duration was not associated with AI values, the severity of depressive symptoms altered the association (p-for interaction=0.021). The magnitude of the positive association between sleep duration and AI was amplified in participants with higher BDI-II scores. In participants with severe depressive symptoms (BDI-II ≥20), a long sleep duration was significantly associated with elevated AI values (β=4.80, SE=1.56, p = 0.003) compared with those with a normal sleep duration. Conclusion: In post-menopausal women, poor sleep quality appears to result in an increase in arterial stiffness, and depressive symptoms seem to modify the association between sleep duration and AI. This modifying role for mental health should be considered in the association between sleep and cardiovascular health in post-menopausal women.

Clinical Significance of the Cardio-Ankle Vascular Index in Postmenopausal Women With Hypercholesterolemia.

BackgroundThe cardio-ankle vascular index (CAVI) is a physiological indicator of arterial elasticity. However, limited information regarding the clinical significance of the CAVI in patients with hypercholesterolemia is available. This cross-sectional study aimed to elucidate the clinical significance of the CAVI for the primary prevention of cardiovascular disease (CVD) among postmenopausal women with hypercholesterolemia.MethodsA total of 168 untreated postmenopausal hypercholesterolemic women (low-density lipoprotein cholesterol levels ≥ 140 mg/dL, mean age ± standard deviation, 63 ± 10 years) with no history of CVD events were enrolled. The CAVI was measured using commercial devices, after which, its relationships with various clinical parameters, such as carotid artery ultrasonography findings and CVD biomarkers, were examined.ResultsA significant positive correlation was observed between the CAVI and maximum intima-media thickness of the common carotid artery (max-C-IMT), which was evaluated using carotid artery ultrasonography (r = 0.49, P < 0.001). Regarding CVD biomarkers, the CAVI was significantly correlated with estimated glomerular filtration rate (r = -0.18, P < 0.001), high-sensitivity C-reactive protein (r = 0.36, P < 0.001), whole blood passage time as a marker of blood rheology (r = 0.41, P < 0.001), and skin autofluorescence as a marker of advanced glycation end products in tissues (r = 0.46, P < 0.001), although no significant correlation was noted between serum lipid parameters and the CAVI. Multiple regression analysis identified max-C-IMT (β = 0.35, P < 0.001), whole blood passage time (β = 0.18, P = 0.007), skin autofluorescence (β = 0.17, P = 0.011), and age (β = 0.16, P = 0.018) as variables independently associated with CAVI.ConclusionThe present study indicated that the CAVI is an essential CVD risk factor among postmenopausal women with hypercholesterolemia. Moreover, impaired blood rheology and increase of skin autofluorescence were associated with elevated CAVI in such patients.

Imaging approach to find Osteoporosis in Pre &amp; Post Menopausal Women in Urban &amp; Rural Area

Background: The number of women with osteoporosis i.e. with reduced bone mass and disruption of bone architecture is gradually increasing in the Indian subcontinent and has been reported throughout the country. This condition majorly affects post-menopausal females and very often remains undiagnosed leading to various complications later. This study was therefore planned to ascertain the role of panoramic radiographs as a screening tool for osteoporosis using radio morphometric indices in postmenopausal women.&#x0D; Materials and Methods: The study comprised a study group of 60 post‑menopausal women, divided into 2 sub‑groups (Urban &amp; Rural), each comprising of 30 individuals, depending on their occupation and domicile. The panoramic radiographs of all the study subjects were recorded for evaluation of 3 radio-morphometric indices viz. Mandibular Cortical Index (MCI), Mental Index (MI) &amp; Panoramic Mandibular Index (PMI).&#x0D; Result: Statistical analysis revealed higher significant values for all the radio-morphometric indices in rural than in urban postmenopausal women.&#x0D; Conclusion: The study suggests that a panoramic radiograph can be used as an effective screening tool for osteoporosis using various radio-morphometric indices.

Vitamin D Metabolites and Sex Steroid Indices in Postmenopausal Women with and without Low Bone Mass.

While the independent roles of vitamin D and sex hormones in skeletal health are well established, the associations of vitamin D and its metabolites to sex hormones and their indices are less investigated. In this observational study, clinical information of 189 Saudi postmenopausal women aged ≥50 years old [N = 80 with normal bone mineral density (BMD), aged 53.3 ± 7.7 years with body mass index (BMI)= 34.1kg/m2 ± 5.8, and N = 109 with low BMD (T-score −1.0 to −2.5), aged 57.0 ± 8.2 years, BMI = 32.4kg/m2 ± 6.2] was extracted from an existing capital-wide osteoporosis registry in Riyadh, Saudi Arabia. Data included were BMD scores, serum total 25(OH)D, sex hormones, and bone turnover markers which were measured using commercially available assays. Age- and BMI-adjusted comparisons revealed significantly higher parathyroid hormone (PTH) levels as well as significantly lower testosterone and bioavailable testosterone in the low BMD group than the normal BMD group (p-values 0.04, 0.02, and 0.03, respectively). Stepwise linear regression showed that circulating testosterone levels accounted for 9.7% and 8.9% of the variances perceived in bioavailable 25(OH)D and free 25(OH)D, respectively (p < 0.01), independent of other sex hormones, sex hormone indices, and bone turnover markers. Our study suggests that androgens are significantly associated with non-conventional vitamin D metabolites and these associations may have clinical relevance in assessing risk for low BMD and osteoporosis in Arab postmenopausal women.