Population Of Postmenopausal Women Research Articles

Menopause-specific quality of life across varying menopausal populations with conjugated estrogens/bazedoxifene

ObjectiveDescribe the effects of conjugated estrogens/bazedoxifene (CE/BZA), a new treatment for vasomotor symptoms (VMS) and osteoporosis prevention, on menopause-specific quality of life (MSQOL) across different patient population types in phase 3 clinical trials. DesignMSQOL was prospectively evaluated in 4 randomized, double-blind, placebo-controlled studies. The populations studied included healthy, non-hysterectomized postmenopausal women with symptomatic VMS or vulvar–vaginal atrophy (VVA) and general postmenopausal women (eligible regardless of symptoms). Menopause-specific Quality of Life (MENQOL) questionnaire total and domain scores for CE 0.625mg/BZA 20mg and CE 0.45mg/BZA 20mg were evaluated and compared with established thresholds for clinically important differences (CID). ResultsSignificant improvements compared with placebo were found with both CE/BZA doses in MENQOL vasomotor domain (−0.61 to −2.23 over 3–24 months) and total scores (−0.24 to −0.94) in the general and symptomatic VMS/VVA populations. Significant improvement compared with placebo in sexual domain (−0.11 to −0.72) was observed with the higher dosage for all populations, and with the lower dosage in the VVA (−0.71 at month 3) and general populations (−0.4 at months 12 and 24). Improvements in vasomotor domain exceeded the CID with both doses in symptomatic VMS populations and with the higher dosage in women with symptomatic VVA; for total MENQOL, the CID was exceeded with the higher dose in symptomatic VMS populations. ConclusionsCE/BZA significantly improved overall and vasomotor-related MSQOL across populations of postmenopausal women with varying baseline symptom statuses. Women with greater menopausal symptoms at baseline were more likely to experience clinically meaningful changes.

Bridging analysis of the efficacy and safety of bazedoxifene in Japanese and global populations of postmenopausal women with osteoporosis

This study examined whether the global clinical data for bazedoxifene could be extrapolated to a Japanese population by evaluating the results of a phase 2 study in postmenopausal Japanese women with osteoporosis as compared to those of a pivotal, phase 3 study. The efficacy of bazedoxifene 20 and 40mg versus placebo on lumbar spine bone mineral density (BMD), bone turnover markers, lipid profile, incidence of fractures, and safety parameters was compared between the Japanese phase 2 study (N=429) and the global phase 3 study (N=7,492) during a 2-year period. In the primary population for assessment of bridging, differences in the mean percent change from baseline in lumbar spine BMD at 2years relative to placebo were greater for women treated with bazedoxifene 20 and 40mg in the phase 2 study than in the phase 3 study. BMD changes in the bazedoxifene groups were confirmed to be similar between the phase 2 study population and a subset of the phase 3 study population with similar baseline characteristics. The effects of bazedoxifene on incidence of fractures, bone turnover markers, and lipid metabolism were similar between studies. There were no major differences in safety parameters between studies. The greater improvement in lumbar spine BMD and similar results in bone turnover markers, fracture incidence, and safety profile observed with bazedoxifene in the phase 2 study compared with the phase 3 study confirmed the feasibility of extrapolating the global clinical data to a Japanese population.

Association between magnesium-deficient status and anthropometric and clinical-nutritional parameters in posmenopausal women.

During menopause occurs weight gain and bone loss occurs due to the hormone decline during this period and other factors such as nutrition. Magnesium deficiency suggests a risk factor for obesity and osteoporosis. To evaluate the clinical and nutritional magnesium status in a population of postmenopausal women, assessing intake and serum levels of magnesium in the study population and correlation with anthropometric parameters such as body mass index (BMI) and body fat, and biochemical parameters associated. The study involved 78 healthy women aged 44-76, with postmenopausal status, from the province of Grenade, Spain. The sample was divided into two age groups: group 1, aged < 58, and group 2 aged ≥ 58. Anthropometric parameters were recorded and nutritional intake was assessed by 72-hour recall, getting the RDAs through Nutriber® program. To assess the biochemical parameters was performed a blood sample was taken. Magnesium was analyzed by flame atomic absorption spectrophotometry (FAAS) in erythrocyte and plasma wet-mineralized samples. Our results show that 37.85% of the total subjects have an overweight status. Magnesium intake found in our population is insufficient in 36% of women, while plasma magnesium deficiency corresponds to 23% of the population and 72% of women have deficient levels of magnesium in erythrocyte. Positive correlations were found between magnesium intake and dietary intake of calcium, of phosphorus, and with prealbumin plasma levels, as well as with a lower waist / hip ratio. Magnesium levels in erythrocyte were correlated with lower triglycerides and urea values. It is important to control and monitor the nutritional status of magnesium in postmenopausal women to prevent nutritional alterations and possible clinical and chronic degenerative diseases associated with magnesium deficiency and with menopause.

A 2-Stage Ovarian Cancer Screening Strategy Using the Risk of Ovarian Cancer Algorithm (ROCA) Identifies Early-Stage Incident Cancers and Demonstrates High Positive Predictive Value

Diagnosis of ovarian cancer at an early stage is associated with a rate of survival of 75% or higher. Most women with this cancer are diagnosed at a late stage when long-term cure rates are less than 30%. Currently, there are no proven screening strategies for the early detection for ovarian cancer. A definitive diagnosis requires invasive surgery and removal of the ovaries. Any screening strategy for this cancer must minimize false positives to decrease the number of unnecessary operations. Measurement of fixed cut-point levels of carbohydrate antigen 125 (CA-125), an ovarian tumor marker, and an abnormal transvaginal ultrasound (TVS) finding have been used as a screening strategy for ovarian cancer; however, neither has sufficient specificity. Recent studies have shown that the sensitivity and specificity of screening with CA-125 can be improved when rising CA-125 levels, even within a reference range, are used to prompt TVS. The Risk of Ovarian Cancer Algorithm (ROCA) is a computer algorithm that quantifies the risk of developing ovarian cancer in postmenopausal women at normal risk who are screened for this cancer. The aim of this single-arm prospective study was to determine if a 2-step strategy that incorporates change of CA-125 levels over time and age has sufficient specificity and positive predictive value for estimating the risk of ovarian cancer in a population of postmenopausal women at normal risk. A small fraction of women with high-risk ROCA scores were referred for TVS as the second step of this strategy. Participants had an annual CA-125 blood test. Based on the ROCA score, women were triaged into the 1 of following 3 groups: a low-risk group (which would require return in 1 year for a CA-125 test), an intermediate-risk group (which would require women to repeat their CA-125 test in 3 months), or a high-risk group (which would require TVS and referral to a gynecologic oncologist). The decision for surgery was made by the gynecologic oncologist. The final study sample was composed of 4051 participants who were evaluated over 11 years (2001–2011). The average annual rate for triage to a CA-125 test in 3 months (intermediate-risk group) was 5.8%, and the average annual rate for triage to TVS and review by a gynecologic oncologist (high-risk group) was 0.9%. Ten women with suspicious TVS findings underwent surgery: 3 of these women had benign ovarian tumors, 2 had stage I ovarian serous tumors of low malignant potential, 4 had early-stage high-grade invasive ovarian cancers, and 1 patient was subsequently found to have endometrial cancer. The specificity with the 2-stage screening strategy was 99.9% (95% confidence interval [CI], 99.7%–100%). All 4 of the invasive ovarian cancers were found in women with normal, low-risk ROCA scores who had returned for annual CA-125 tests for at least 3 years prior to the rising CA-125 values. These data show that ROCA followed by TVS identifies early-stage incident ovarian cancer with excellent specificity and positive predictive value in a population of postmenopausal women at normal risk for ovarian cancer.

Body mass index and breast cancer risk according to postmenopausal estrogen-progestin use and hormone receptor status.

To assess the joint relationships among body mass index, menopausal status, and breast cancer according to breast cancer subtype and estrogen-progestin medication use, we conducted a meta-analysis of 89 epidemiologic reports published in English during 1980-2012 identified through a systematic search of bibliographic databases. Pooled analysis yielded a summary risk ratio of 0.78 (95% confidence interval (CI): 0.67, 0.92) for hormone receptor-positive premenopausal breast cancer associated with obesity (body mass index (weight (kg)/height (m)(2)) ≥30 compared with <25). Obesity was associated with a summary risk ratio of 1.39 (95% CI: 1.14, 1.70) for receptor-positive postmenopausal breast cancer. For receptor-negative breast cancer, the summary risk ratios of 1.06 (95% CI: 0.70, 1.60) and 0.98 (95% CI: 0.78, 1.22) associated with obesity were null for both premenopausal and postmenopausal women, respectively. Elevated postmenopausal breast cancer risk ratios associated with obesity were limited to women who never took estrogen-progestin therapy, with risk ratios of 1.42 (95% CI: 1.30, 1.55) among never users and 1.18 (95% CI: 0.98, 1.42) among users; too few studies were available to examine this relationship according to receptor subtype. Future research is needed to confirm whether obesity is unrelated to receptor-negative breast cancer in populations of postmenopausal women with low prevalence of hormone medication use.

Breast density changes in a randomized controlled trial evaluating bazedoxifene/conjugated estrogens

Breast density is associated with an increased risk of breast cancer. This study assessed changes in mammographic breast density after 24 months of treatment with bazedoxifene (BZA)/conjugated estrogens (CE) in postmenopausal women. This was an ancillary study in a subset of nonhysterectomized postmenopausal women enrolled in a randomized, double-blind, placebo-controlled, and active-controlled phase 3 study. Treatments evaluated were BZA 20 mg/CE 0.45 mg, BZA 20 mg/CE 0.625 mg, raloxifene 60 mg, and placebo. Women who were eligible for participation in the ancillary study must have completed 24 months of treatment and have mammograms at baseline and 24 months. The left craniocaudal views from each mammogram pair were digitized and analyzed by a radiologist who was blinded to treatment arm and mammogram date. The percent breast density was determined using validated software. Mammogram pairs were obtained from 507 evaluable participants (mean age range, 55.2-56.3 y). The mean changes (95% CI) in mammographic breast density from baseline to 24 months were comparable among groups (-0.39% [-0.69 to -0.08], -0.05% [-0.38 to 0.27], -0.23% [-0.54 to 0.08], and -0.42% [-0.72 to -0.11] for BZA 20 mg/CE 0.45 mg, BZA 20 mg/CE 0.625 mg, raloxifene 60 mg, and placebo, respectively). These reductions from baseline were statistically significant for BZA 20 mg/CE 0.45 mg and placebo. The effect of both BZA/CE doses on breast density was generally consistent among subgroups based on age, body mass index, and years since menopause. Treatment with BZA 20 mg/CE 0.45 mg or BZA 20 mg/CE 0.625 mg for 24 months did not affect mammographic breast density in this population of postmenopausal women.

The importance of diet in osteoporosis

The knowledge of risk factors associated with the development of osteoporosis (OP) is vital in the prevention strategy of this disease and its physical and economic consequences. The epidemiological characteristics of our population of postmenopausal women exhibit a pattern similar to that described in other studies, showing a proportional relationship between the magnitude of the risk factor and the severity of osteopenia/osteoporosis. Moreover, we observed protective effects for several dietary factors, such as the consumption of fruits, vegetables, and cereals; the moderate consumption of fish, alcohol, and dairy products; and the low intake of red meat, on spinal bone mineral density (BMD). Only the intake of grains and vegetables exerted protective effects on hip BMD.

Abstract ED01-02: Methodologic considerations for large-scale prevention trials: Lessons from the Women's Health Initiative

Abstract The Women's Health Initiative was one of the premiere primary prevention trials of its era. The core component was a partial factorial randomize trial designed to test three chronic disease prevention hypotheses in over 68,000 postmenopausal women: hormone therapy (HT) for the prevention of coronary heart disease; a low fat diet for the prevention of breast cancer and colorectal cancer, and calcium/vitamin D supplements for hip fracture risk reduction. This large diverse program provides useful lessons for many of the issues that arise in the design, implementation, analysis and interpretation of large-scale public health trials. The greatest public health impact of WHI has come from the two HT trials. The estrogen plus progestin trial in women with an intact uterus was stopped early, in 2002, based on an increased risk in breast cancer and overall health risks exceeding benefits. In 2004, the estrogen alone trial in women with prior hysterectomy, was stopped for an increased risk in stroke. These results were immediately translated into a public health message that had a rapid impact on HT use, followed shortly by a reduction in national breast cancer incidence rates. The HT trial results were considered highly controversial, however, because of their failure to show benefit for coronary heart disease, a hypothesis supported by numerous observational studies, animal studies, and randomized trials with intermediate outcomes. These contradictory findings fueled a persistent debate about the interpretation and integrity of the trial. Many of the purported flaws in the trial were easily refuted, owing to the strength of the trial's design, implementation and analyses. The design required excellent power for conservative projections of intervention effects. Key implementation factors included multicenter recruitment directly from the general population of postmenopausal women using broadly inclusive eligibility criteria, well-established, commonly used interventions, double-blinded trial conduct, ongoing support for adherence to interventions, broad-spectrum but prioritized outcomes ascertainment processes, standard of care safety monitoring including requirements for regular mammography, and a written trial monitoring plan to address the multiple testing for the numerous trial outcomes and interim analyses. To address these discrepancies between observational and randomized trial data directly, joint analyses of the WHI Observational Study (OS) and the HT trials were conducted. While the usual analysis of HT effects in the OS led to inferences similar to the preceding observational studies, analyses that carefully controlled for multiple confounders and took into account time from initiation of therapy and for breast cancer, time between menopause and first use of HT, yielded good alignment between the WHI HT trial and observational studies. These analyses yielded opposite trends with time for CHD and breast cancer, that is early initiators tended to have lower CHD risk but greater breast cancer risk than later initiators, providing some support for the so-called “timing hypothesis” yet confirming the limited utility of these agents for chronic disease prevention. Citation Format: Garnet L. Anderson. Methodologic considerations for large-scale prevention trials: Lessons from the Women's Health Initiative. [abstract]. In: Proceedings of the Eleventh Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2012 Oct 16-19; Anaheim, CA. Philadelphia (PA): AACR; Cancer Prev Res 2012;5(11 Suppl):Abstract nr ED01-02.

Relation of body mass index with carotid intima-media thickness and diameter is independent of metabolic syndrome in postmenopausal Mediterranean women

The aim of this study was to evaluate whether overweight and obesity are associated with arterial abnormalities in postmenopausal women and the contribution of the metabolic syndrome. A total of 390 postmenopausal women (mean age, 63.1 ± 7.7 y) living in the metropolitan area of Naples, Southern Italy, and participating in a population-based cohort study (Progetto Atena) were offered an ultrasound examination of the carotid arteries; 370 women accepted. Blood pressure, serum high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, fasting glucose, insulin, apolipoprotein B, and high-sensitivity C-reactive protein were measured in all participants. Women in the second and third tertiles of body mass index showed a greater common carotid intima-media thickness compared with those in the first tertile (tertile II vs I, odds ratio, 2.15; P = 0.013; tertile III vs I, odds ratio, 2.24; P = 0.018), adjusted for age and metabolic syndrome. Obese and overweight postmenopausal women showed greater common carotid lumen diameters as compared with lean postmenopausal women (mean ± SD, 6.36 ± 0.86, 6.16 ± 0.65, and 5.96 ± 0.59 mm, respectively; P < 0.001 [obese vs lean] and P = 0.04 [overweight vs lean]); no statistical difference in carotid lumen diameter was found between obese and overweight postmenopausal women. The statistical significance between obese and lean postmenopausal women was retained even after adding the components of the metabolic syndrome as covariates. These findings indicate an association between overweight, obesity, and preclinical carotid artery abnormalities, independently of the metabolic syndrome, in a population of postmenopausal women.

Do muscle strengthening exercises improve performance in the 6-minute walk test in postmenopausal women?

Walking speed seems to be related to aerobic capacity, lower limb strength, and functional mobility, however it is not clear whether there is a direct relationship between improvement in muscle strength and gait performance in early postmenopausal women. To evaluate the effect of muscle strengthening exercises on the performance of the 6-minute walk test in women within 5 years of menopause. The women were randomized into control group (n=31), which performed no exercise, and exercise group (n=27), which performed muscle strengthening exercises. The exercises were performed twice a week for 3 months. The exercise protocol consisted of warm-up, stretching, and strengthening of the quadriceps, hamstring, calf, tibialis anterior, gluteus maximus, and abdominal muscles, followed by relaxation. Muscular strength training started with 60% of 1MR (2 series of 10-15 repetitions), reaching 85% until the end of the 3-month period (4 series of 6 repetitions each). The between-group comparisons pre- and post-intervention did not show any difference in distance walked, heart rate or blood pressure (p>0.05), but showed differences in muscle strength post-intervention, with the exercise group showing greater strength (p The results suggest that muscle strengthening of the lower limbs did not improve performance in the 6-minute walk test in this population of postmenopausal women.

Study of a population of postmenopausal women: evaluation after 10 years of the cohort of albacete (Spain). Initial analysis of the evolution of ctx

Study of a population of postmenopausal women: evaluation after 10 years of the cohort of albacete (Spain). Initial analysis of the evolution of ctx

Study of a population of postmenopausal women: Evaluation after 10 years of the cohort of Albacete (Spain). Initial analysis of epidemiological data

Study of a population of postmenopausal women: Evaluation after 10 years of the cohort of Albacete (Spain). Initial analysis of epidemiological data

Recommendations for antiresorptive therapy in postmenopausal patients with breast cancer: Marburg AIBL Guideline Evaluation Study (MAGES)

Postmenopausal women with hormone-receptor-positive breast cancer usually receive aromatase inhibitor (AI) therapy at some point in their disease management. Accelerated bone loss during AI therapy poses a problem, especially in postmenopausal women who may already have age-related osteopenia or several fracture-related risk factors. Guidelines and algorithms have been developed to identify women at risk for fractures from low bone mineral density and to provide recommendations for antiresorptive treatment. However, the factors used to calculate fracture risk and the thresholds for antiresorptive treatment vary among the current guidelines and algorithms, potentially leading to inconsistent recommendations for or against antiresorptive treatment. The present study analyzed antiresorptive treatment decisions in a population of postmenopausal women with hormone-receptor-positive breast cancer receiving AI therapy using five different guidelines/algorithms (World Health Organization Fracture Risk Assessment tool [FRAX], expert consensus, German Dachverband Osteologie, American Society of Clinical Oncology, and World Health Organization). The consistency of a recommendation for antiresorptive treatment among the five methods was low (4%). The consistency of a recommendation against antiresorptive treatment among the five methods was higher (57%), but left approximately 40% of patients with an inconsistent recommendation. The consequences of overtreatment (unnecessary exposure to adverse events) and undertreatment (increased risk of fractures and possibly decreased disease-free survival) make it imperative that the existing guidelines and algorithms be improved. Moreover, evidence-based outcomes from antiresorptive treatment decisions are required to validate guidelines and algorithms.

Effects of administration of hormone therapy or raloxifene on the immune system and on biochemical markers of bone remodeling

Over the last few years, conclusive evidence of the involvement of the immune system in the regulation of bone metabolism has been identified. Consequently, one question that should be formulated concerns the possible effects of antiresorptive therapies on the immune system. Therefore, the purpose of the present work was to evaluate both the functionality of the immune system and bone turnover in women receiving antiresorptive therapies, such as hormone therapy (HT; n = 33) and raloxifene (RLX; n = 66), acting through estrogen receptors. To that end, this study analyzed bone turnover markers in a population of postmenopausal women before and after beginning therapy and compared these with data of women not treated (NT; n = 102). In a subgroup of participants (NT = 33, RLX = 24, and HT = 26), we analyzed the effects of treatments on immune system parameters such as serum levels of interleukin (IL)-6, tumor necrosis factor α, and IL-1β; lymphocyte subpopulations; cell proliferation by peripheral blood mononuclear cells (PBMCs); in vitro production of IL-1β by PBMCs; and the expression of receptor activator of nuclear factor-κB ligand, transforming growth factor β, and IL-4 genes by PBMCs. The results showed that bone resorption was inhibited strongly in women in the RLX and HT groups when compared with women in the NT group. Interestingly, the administration of RLX inhibited the production of the Wnt/β-catenin signaling pathway inhibitor Dickkopf Homolog-1 (P < 0.05) and tended to increase the levels of the osteoclastogenesis inhibitor osteoprotegerin at month 6 (P = 0.059). With regard to the immune system, the different treatments did not markedly perturb the parameters analyzed, with the exception of the increase in serum IL-1β detected in the HT group at month 6 (P < 0.05). The main conclusions of the present work were that HT or RLX do not disturb the immune system and that both treatments have a similar antiresorptive power.

Mechanism of action study to evaluate the effect of rosiglitazone on bone in postmenopausal women with type 2 diabetes mellitus: rationale, study design and baseline characteristics

Objectives:Post-hoc analyses have shown an increase incidence of fractures among type 2 diabetes (T2DM) patients treated with thiazolidinediones (TZDs). The mechanisms by which TZDs may be associated with increased fracture risk is not well understood.This article describes the study design and baseline characteristics for a prospective, randomized, double-blind, active-controlled trial to evaluate the effects of rosiglitazone on changes in measures of skeletal structure, surrogates of bone strength and metabolism.Methods:Postmenopausal women without osteoporosis and diagnosed with T2DM were randomized in a double-blind design to either rosiglitazone or metformin for 52 weeks, then all subjects received open-label metformin for 24 weeks. Study endpoints included changes in bone mineral density (BMD), quantitative computed tomography (QCT), digitized hip radiography (HXR) and high resolution magnetic resonance imaging (hrMRI). Serum markers of bone metabolism and indices of glycemic control were assessed within and between treatment groups.Results:A total of 226 subjects were randomized. Baseline characteristics included: age 63.8 ± 6.5 years; years postmenopausal 16.9 ± 8.4; duration of diabetes 3.5 (1.8–7.8) years; body mass index (BMI) 31.4 ± 5.9 kg/m2; and glycated hemoglobin (HbA1c) 6.4 ± 0.65%. At baseline, mean T-scores were −0.95 ± 0.91 at the femoral neck, −0.02 ± 0.97 at the total hip and −0.55 ± 1.25 at the total spine.Since there are no well recognized techniques to determine bone mass and structure at the distal limbs (cortical bone sites where fractures were reported in RSG subjects), using the femoral neck as a surrogate for these areas may be a potential limitation of the study.Conclusion:This is the first randomized trial utilizing multiple techniques to evaluate bone mass, structure, serum markers of bone remodeling, and potential reversibility of changes after discontinuation of rosiglitazone. This study will provide information about RSG bone effects in a population of postmenopausal women at risk for bone loss and subsequent fracture.ClinicalTrials.gov numberNCT00679939

Educational difference in the prevalence of osteoporosis in postmenopausal women: a study in northern Iran

BackgroundOsteoporosis is the most common metabolic bone disease in the world and it is rapidly increasing in Iran. In this study the relationship between educational levels and osteoporosis was investigated among Iranian postmenopausal women.Method and subjectsSeven hundred and six women aged 50-75 years old were randomly recruited from urban (n = 440) and rural (n = 266) areas in Guilan. Osteoporosis was diagnosed by quantitative ultrasound technique and dual X-ray absorptiometry. Serum 25(OH) D3, body weight and height were measured in all subjects. Other data including age, educational level, menopause age, medications and history of illness were also collected.ResultsWe found that the prevalence of osteoporosis was significantly greater among women with low educational level than women with high educational status (18.0% vs 3.8% P < 0.0001). However, women with low educational level had higher mean serum level of vitamin D than women with high educational level. Osteoporosis was significantly more prevalent among women living in rural areas than women living in urban areas (19.1% v.s 13.3%, P < 0.0001).ConclusionThis study showed that educational level is associated with bone health in this population of postmenopausal women with significantly higher osteoporosis found in lower social groups. Therefore, we suggest that women with low social level should be carefully evaluated for signs of osteoporosis during routine physical examinations.

Endocannabinoid type 1 receptor gene (CNR1) polymorphisms (rs806381, rs10485170, rs6454674, rs2023239) and cardiovascular risk factors in postmenopausal women

Introduction. The risk of cardiovascular diseases (CVD) in women increases with menopausal stage. Obesity with metabolic disorders is the most important risk factor for CVD. The incidence of this phenotype of obesity increases in postmenopausal women. The endocannabinoid system plays an important role in regulation of several metabolic pathways. The aim of this work was to investigate whether genetic variations in the cannabinoid receptor gene (CNR1) can affect cardiovascular risk factors (e.g. fat distribution, obesity, fasting glucose, lipid profile, blood pressure, and free androgen and estrogen indexes) in postmenopausal women.Methods. The rs806381, rs10485170, rs6454674, and rs2023239 polymorphisms of the CNR1 gene were genotyped in 384 randomly selected postmenopausal Polish women (aged 50–60) using the minisequencing technique.Results. The rs806381, rs10485170, rs6454674, and rs2023239 polymorphisms were not significantly associated with anthropometric measures (waist circumference, carbohydrate and lipid metabolism, body mass index [BMI], total fat, glucose, insulin, fasting insulin resistance index [FIRI]). However, the rs2023239 polymorphism was associated with the free androgen index (p = 0.03).Discussion. It seems that further genotyping of the endocannabinoid receptor gene cannot be used as a significant marker of predisposition to CVD in postmenopausal women, but it would be interesting to study this interrelation on a larger population of postmenopausal women.

Persistent Chest Pain in Absence of Angiographic Significant Coronary Artery Disease is Associated with Permanent Myocardial Perfusion Defects in Magnetic Resonance Imaging in Post-menopausal Women

We studied a population of post-menopausal women with persistent chest pain (PChP) in order to investigate the relationship between myocardial perfusion at rest and during a stress test using magnetic resonance imaging (MRI). Our goals were to document whether transient myocardial perfusion is induced by dipyridamole infusion and if perfusion defects are also present at rest. The study population consisted of 45 consecutive women (mean age 57.6±8.7 years), who reported chest pain symptoms. PChP was defined as self-reported continuing chest pain after one year. We compared the results of the perfusion MRI studies in subgroups with and without obstructive coronary artery disease (CAD). The latest tools and technologies of Synapse™ Cardiovascular – Fujifilm’s cardiovascular (CV) image and information management system – helped us to achieve clear and comprehensive outcomes. In the group of women with PChP and non-obstructive CAD, 16 of 34 (48%) showed a well-evident left ventricular perfusion defect at baseline (four in one segment; eight in two segments and four in three or more segments). The localisation of the perfusion defects – seen using Synapse Cardiovascular – were anteroapical (n=6); septal (n=10); and inferoor inferolateral (n=4). These defects were ‘permanent’ or ‘fixed’, i.e. were present at rest and were neither induced nor modified by the administration of dipyridamole. In any of the women with CAD we found these anomalies. ‘Fixed’ perfusion defects at MRI – probably due to permanent damage of the coronary microcirculation – suggest a disease state typical for post-menopausal women with PChP.

Prevalence of cholelithiasis in a Turkish population sample of postmenopausal women.

Gallstone disease is a global health problem worldwide. Potential risk factors for gallstone disease have not been well established except for age and gender. We aimed to investigate the prevalence and potential risk factors for gallstone disease in a population of postmenopausal women. A detailed Turkish questionnaire was prepared, and 474 of 502 postmenopausal women seen at the menopause clinic of Dr. Zekai Tahir Burak Hospital were included in the study. Sociodemographic, medical and reproductive characteristics were analyzed. Subjects were divided into two groups. The gallstone disease group (Group 1, n=73) was defined by both prior histories of gallstones diagnosis or cholecystectomy in the postmenopausal period and the presence of current sonographically diagnosed gallstones; Group 2 (n=401) included women with no gallstone disease. The present study found a 15.4% prevalence rate of cholelithiasis in a Turkish population sample of postmenopausal women. The demographic characteristics were similar between the two groups. The mean gravidity was 5.25 in Group 1 and 4.9 in Group 2. The number of subjects with past oral contraceptive use was 17 (23.3%) in Group 1 and 56 (13.9%) in Group 2. The number of women who took hormone replacement therapy was 40 (54.8%) in Group 1 and 222 (55.3%) in Group 2. There was no significant difference related to mean total cholesterol levels (216.5±44.9 mg/dl versus 215.9±44.3 mg/dl; p=0.915) and mean triglycerides (134.5±54.8 mg/dl versus 143.2±77 mg/dl; p=0.202) between the two groups. No risk factors for developing gallstones were determined among the evaluated parameters in postmenopausal women.

25-Hydroxyvitamin D concentration, vitamin D intake and joint symptoms in postmenopausal women

Introduction Low 25-hydroxyvitamin D (25(OH) D) concentrations have been associated with radiologic worsening of osteoarthritis in some reports. However, the results are mixed and few studies have evaluated associations between 25(OH) D concentrations and both total vitamin D intake and clinical joint symptoms. Study design Cross-sectional analyses of information from a subset of 1993 postmenopausal women obtained at baseline entry in the Women's Health Initiative Calcium plus Vitamin D clinical trial. Main Outcome Measures 25(OH) D concentration, total vitamin D intake (diet plus supplements), presence and severity of joint pain and joint swelling. Results The 25(OH) D levels were commonly low with 53% having deficient (<50 nmol/L) and only 17% having sufficient (>72 nmol/L) levels. Joint pain (reported by 74%) and joint swelling (reported by 34%) were also commonly reported. 25(OH) D concentrations were modestly correlated with total vitamin D intake ( R = 0.29, p < 0.0001); however, considerable variability in 25(OH) D concentrations for a given vitamin D intake was seen. In adjusted linear regression models, lower serum 25(OH) D concentrations were associated with higher average joint pain score ( P = 0.01 for trend) with differences most apparent in the lowest 25(OH) D levels sextile. Conclusions Relatively low 25(OH) D levels and a high frequency of joint symptoms were common in this population of postmenopausal women. Total vitamin D intake was only modestly associated with 25(OH) D. Low serum 25(OH) D concentrations were associated with higher joint pain scores. These findings can inform the design of future intervention trials.