Random Sample Of Postmenopausal Women Research Articles

Vertebral fracture in postmenopausal Chinese women: a population-based study.

We aimed to describe the prevalence and develop a model for prediction of radiographic vertebral fractures in a large random sample of postmenopausal Chinese women. We enrolled 1760 women from an age-stratified random sample of postmenopausal women in Beijing, China. The presence of vertebral fracture was assessed by semi-quantitative grading of lateral thoracolumbar radiographs, risk factors by interview, bone mineral density (BMD) of the proximal femur and lumbar spine by dual x-ray absorptiometry (DXA), and markers of bone turnover from a fasting blood sample. Associations of these factors were analyzed in logistic models and discrimination by areas of receiver operating characteristics curves (AUC). The prevalence of vertebral fracture, ranged from 13.4% ages 50 to 59years old to 58.1% at age 80years or older. Older age, a history of non-vertebral fracture, lower femoral neck BMD T-score, body mass index (BMI), height loss, housework, and less than half an hour of outdoor activity were significantly associated with increased probability of having a vertebral fracture. A model with those seven factors had a similar AUC with or without BMD and performed better than a simple model with three factors. This study is from a true random sample of postmenopausal women in urban China with high response rate. The prevalence of vertebral fractures in postmenopausal women in Beijing increases from 13% under age 60 to over 50% by age 80years. A model with seven clinical risk factors with or without BMD is better than simple models and may guide the use of spine x-rays to identify women with vertebral fractures. More than half an hour of outdoor activity might correlate with lower risk of vertebral fracture in this population.

Performance of simple calculated osteoporosis risk estimation in a sample of women with suspected osteoporosis in the turkish population

The aim of this study was to evaluate the performance of the simple calculated osteoporosis risk estimation (SCORE) in a random sample of postmenopausal women. We collected data on 177 consecutive patients aged over 45 years. Bone mineral density (BMD) measurements were taken at the hip and lumbar spine. The test performance cut-off value was evaluated according to scores of 5, 6, 7, 8 and age distribution. When all groups were evaluated, SCORE 6 sensitivity (Sn), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) were 86.7, 59.1, 63, 82.5%, respectively. In the age ranged 45-49, we determined SCORE 6 results of Sn 85, Sp 100%. The test was able to identify women not requiring detailed densitometric investigation in this age group to a high level of accuracy. At SCORE 6 receiver operating characteristic (ROC) analysis, the area under the curve (AUC) was 0.6. We determined that the SCORE questionnaire performance in estimating those women with low BMD in the Turkish population was limited. However, since it is a simple, economical and practical pre-test, a SCORE 6 cut-off value can be used together with the physician's clinical analysis in sending patients with suspected low BMD for dual energy X-ray absorptiometry (DEXA) measurement.

Esterified Estrogen and Conjugated Equine Estrogen and the Risk of Incident Myocardial Infarction and Stroke

Clinical trials of conjugated equine estrogen (CEE) or estradiol vs placebo in postmenopausal women have found no effect or an elevated risk of myocardial infarction (MI) and stroke. The association of these end points with the use of esterified estrogen (EE) is unknown. We examined the risk of MI and stroke associated with current use of CEE, use of EE, or nonuse of hormones in a population-based case-control study in a health maintenance organization. Cases were all postmenopausal women with an incident MI (n = 1644) or stroke (n = 1080). Controls (n = 4205) consisted of a random sample of postmenopausal women without MI or stroke. Current use of postmenopausal hormones was assessed using a computerized pharmacy database. There was no difference in risk of MI or stroke associated with current use of CEE or EE compared with nonuse or for current use of CEE compared with EE. In analyses restricted to hormone users, there was a suggestion of higher ischemic stroke risk associated with CEE alone (without progestin) compared with EE alone (odds ratio, 1.57; 95% confidence interval, 0.98-2.53). There was also a suggestion that when initiated in the previous 6 months, CEE was associated with a higher risk of MI than EE (odds ratio, 2.33; 95% confidence interval, 0.93-5.82). Further study may be warranted of the effects of EE on the risk of cardiovascular end points.

Serum lipid levels and the risk of venous thrombosis.

Lipids, through effects on the coagulation and fibrinolytic systems, may contribute to the development of venous thrombosis. This association has been investigated in a few studies, with conflicting results. We conducted a population-based, case-control study at a health maintenance organization in Washington State, to assess the association of serum lipid levels with the risk of venous thrombosis. Cases were 477 postmenopausal women with a first venous thrombosis during January 1995 through December 2001. Control subjects (1986) were a random sample of postmenopausal women. Medical records, computerized pharmacy databases, and a cancer registry served to collect data on lipid levels and risk factors for thrombosis. Total cholesterol levels were not associated with venous thrombosis. Only high HDL cholesterol levels were associated with a decreased risk of venous thrombosis after adjustment for hospitalization, malignancy, height and weight, postmenopausal hormone therapy, and vascular disease (for high-density lipoprotein [HDL] cholesterol levels >1.79 mmol/L versus those <1.79 mmol/L; odds ratio [OR], 0.71; 95% confidence interval [CI], 0.52 to 0.97). In contrast, elevated triglyceride levels were associated with an increased risk (OR, 2.13; 95% CI, 1.34 to 3.37) for women with triglyceride levels >1.05 mmol/L compared with women with lower levels. Elevated triglyceride levels were associated with a doubling of risk of venous thrombosis in postmenopausal women, whereas elevated HDL cholesterol levels were associated with a decreased risk.

Association of visceral fat with coronary risk factors in a population-based sample of postmenopausal women.

To investigate in a population-based random sample of postmenopausal women the adjusted association of visceral adipose tissue (VAT) with coronary risk factors. Cross-sectional population-based random sample study. Ninety-eight postmenopausal women (age 50-65 y). Visceral and subcutaneous fat areas by computer axial tomography, anthropometry, lipid profile, fasting glucose and insulin, diet, physical activity, smoking status and alcohol intake. Compared to women with low VAT, women with high VAT (>117.8 cm(2)) had a less favorable metabolic profile with significantly higher fasting glucose (120+/-50 vs 98+/-39), insulin (7.9+/-10 vs 5+/-8), triglycerides (172+/-69 vs 127+/-72), apolipoprotein B (119+/-24 vs 98+/-32) and significantly lower HDL-C (38+/-10 vs 46+/-14) values in the whole sample (n=98). A similar profile was found in women without diabetes and hypertension (n=39). In multiple regression models, VAT explained a portion of the variance of TG (6.2%) in the entire sample and of total cholesterol (12.4%), LDL-C (15.8%), triglycerides (16.3%), apolipoprotein B (11.6%), and fasting glucose (28.4%) in the group of non-diabetic or hypertensive women. Our VAT cut-off point of 117.8 cm(2) corresponded to a waist circumference of 84 cm. Our results in a random population-based sample of postmenopausal women confirm the association of VAT with most coronary risk factors. These associations persisted after adjusting for diet, physical activity, smoking status and alcohol intake.

Factors associated with endometrial thickness and uterine size in a random sample of postmenopausal women

Objective: To investigate factors possibly associated with endometrial thickness and uterine size in a random sample of postmenopausal women.Study design: A random sample (n = 1000) of the total population of women aged 45–80 years resident in the city of Göteborg was invited to attend for a transvaginal sonography examination. Eight hundred and twenty‐seven women accepted the invitation and underwent a gynecological and a transvaginal sonographic examination with measurement of endometrial thickness and uterine size. The women's height and weight were measured and a blood sample for analysis of serum estradiol and follicle stimulating hormone was taken. The women also provided information regarding previous medical and gynecological history, possible medication and smoking habits.Results: Five‐hundred and fifty‐nine women were postmenopausal and 183 of them were taking some form of hormonal substitution (33%). Factors associated with endometrial thickness and uterine size were analyzed using univariate and stepwise multiple regression analyses. The current use of hormone replacement treatment was the most important factor associated with both endometrial thickness and all the uterine size parameters studied. The presence of fibroids was also associated with endometrial thickness. Other factors shown to be associated with uterine size were age, parity, smoking, hypertension and diabetes mellitus.Conclusions: Several of the known risk factors for endometrial cancer were shown to be associated with endometrial thickness and uterine size parameters.

Factors associated with endometrial thickness and uterine size in a random sample of postmenopausal women

Objective: The objective of this study was to investigate factors possibly associated with endometrial thickness and uterine size in a random sample of postmenopausal women. Study Design: A random sample (n = 1000) of the total population of women 45 to 80 years of age, resident in the city of Göteborg, was invited to attend for a transvaginal sonography examination. Eight hundred twenty-seven women accepted the invitation and underwent a gynecologic and a transvaginal sonography examination with measurement of endometrial thickness and uterine size. The women's weight and height were measured and a blood sample for analysis of serum estradiol and follicle-stimulating hormone was taken. The women also provided information regarding previous medical and gynecologic history, possible medication, and smoking habits. Results: Five hundred fifty-nine women were postmenopausal, and 183 (33%) of the postmenopausal women were taking some form of hormonal substitution. Factors associated with endometrial thickness and uterine size were analyzed by means of univariate and stepwise multiple regression analyses. The current use of hormone replacement therapy was the most important factor associated with both endometrial thickness and all the uterine size parameters studied. The presence of fibroids was also associated with endometrial thickness. Other factors shown to be associated with uterine size were age, parity, smoking, hypertension, and the presence of diabetes mellitus. Conclusions: Several of the known risk factors for endometrial cancer were shown to be associated with endometrial thickness and uterine size parameters. (Am J Obstet Gynecol 2001;185:386-91.)

Visceral adipose tissue has a different association with coronary risk factors in a population-based random sample of postmenopausal women

Visceral adipose tissue has a different association with coronary risk factors in a population-based random sample of postmenopausal women

Low density lipoprotein particle size is not independently associated with visceral adipose tissue in a population-based random sample of postmenopausal women

Low density lipoprotein particle size is not independently associated with visceral adipose tissue in a population-based random sample of postmenopausal women

Postmenopausal estrogens and risk of myocardial infarction in diabetic women.

The effect of hormone replacement therapy on the risk of myocardial infarction in diabetic women has not been well studied. We conducted a case-control study of postmenopausal estrogen use and risk of incident myocardial infarction (MI) in pharmacologically treated diabetic women enrolled at Group Health Cooperative of Puget Sound, a large health maintenance organization in the state of Washington. Case subjects (n = 212) were all postmenopausal women with treated diabetes who sustained an incident fatal or nonfatal MI between July 1986 and December 1994. Control subjects (n = 122) were treated diabetic women drawn from a stratified random sample of postmenopausal women without prior MI. Computerized pharmacy data and medical records were used to measure use of estrogens. Cardiovascular risk factors recorded from medical records, computerized pharmacy and laboratory data, and telephone interviews were used as adjustment variables. In this study 8.5% of case and 13.9% of control subjects were current users of estrogens. The relative risk (RR) of MI for current estrogen users was 0.51 (95% CI 0.22-1.15) relative to never users, adjusted for age, study year, weight, angina, and duration of treated diabetes. Among current estrogen users, risk of MI tended to decline with each additional year of estrogen use (adjusted RR = 0.78, 95% CI 0.56-1.08). Of those studied, 45.3% of case and 37.7% of control subjects were past users of estrogens (adjusted RR = 1.22, 95% CI 0.71-2.09). This study suggests that use of postmenopausal estrogens does not increase risk of MI in diabetic women and that sustained use may be of benefit.

Duration of Estrogen Replacement Therapy in Relation to the Risk of Incident Myocardial Infarction in Postmenopausal Women

There is little information about whether an increasing duration of estrogen replacement therapy is associated with a declining risk for myocardial infarction in postmenopausal women. To conduct a population-based, case-control study among enrollees of the Group Health Cooperative (GHC) of Puget Sound, Seattle, Wash. Case subjects were all post-menopausal women who were enrolled in the GHC with an incident fatal or nonfatal myocardial infarction from July 1986 through December 1993. Control subjects were a stratified random sample of postmenopausal women who were enrolled in the GHC without myocardial infarction and matched to case subjects by age and calendar year. We reviewed the medical records of the 850 case subjects and 1974 control subjects and conducted telephone interviews with consenting survivors. Use of estrogen or estrogen and progestin was assessed using GHC's computerized pharmacy database. Among women who were currently using estrogen, a longer duration of use was inversely associated with a risk for myocardial infarction after adjustment for age, year of identification, diabetes mellitus, angina, and smoking. For categories of increasing duration of estrogen use (never, > 0-< 1.8 years, 1.8-< 4.2 years, 4.2-< 8.2 years, and > or = 8.2 years), the odds ratios for myocardial infarction were 1.00 (reference), 0.91, 0.70, 0.65, and 0.55 (for trend among the current users, P = .05). Among women who had used estrogen in the past, there was no evidence of decreasing risk with increasing duration of estrogen use. In this study, a long duration of hormone replacement therapy among women currently using estrogen was associated with a reduced risk for first myocardial infarction.

P039 Prevalence of vertebral osteoporosis in relation to its risk factors in random sample of post-menopausal women

P039 Prevalence of vertebral osteoporosis in relation to its risk factors in random sample of post-menopausal women