The relationship between serum leptin level and metabolic syndrome in postmenopausal women / 대한산부인과학회지

OBJECTIVE: Menopause status may lead to increases of body fat, abdominal obesity, and the incidence of metabolic syndrome (MS). Leptin is an adipokine that is secreted by adipocytes and plays an important role in regulating energy homeostasis and the reproductive system. This study examined the relationship among obesity, MS, and serum leptin levels in pre- and postmenopausal women. METHODS: We divided 168 women who visited St. Vincent Hospital of the Catholic University of Korea in 2006 and 2007 into premenopausal vs. postmenopausal, obese vs. non-obese groups based on their body mass index (BMI) and the presence of MS. We measured serum follicle-stimulating hormone (FSH) level, serum estradiol level, BMI, the waist-hip ratio (WHR) and visceral fat area (VFA), serum fasting glucose, lipid profile, blood pressure, and serum leptin level. RESULTS: Of 56 premenopausal and 112 postmenopausal women, there were 21 (37.5%) premenopausal and 51 (45.5%) postmenopausal women with MS. In the non-obese premenopausal and postmenopausal women, there were positive correlations between FSH, markers of abdominal obesity such as WHR and VFA, and serum leptin after adjusting for BMI in postmenopausal women. In the MS group, only WHR was correlated with the serum leptin level after adjusting for BMI in all groups. CONCLUSION: Increased serum FSH level and abdominal obesity lead to an increased serum leptin level in postmenopausal women. Further studies are needed to clarify the relationship between leptin and the metabolic syndrome, risk of cardiovascular disease in postmenopausal women.

Bioidentical Hormone Therapy in Postmenopausal Women / 대한폐경학회지

Bioidentical hormone therapy (BHT) refers to the use of hormones that are molecularly and chemically identical to endogenous hormones for purposes of hormone replacement therapy. The specific hormones used in BHT include estrone, estradiol, estriol, progesterone and testosterone. Since the result of the Women's Health Initiative (WHI) trial documented the increased risk of breast cancer, cardiovascular disease and stroke in users of conventional hormone therapy (CHT), use of CHT has declined and there has been increased interest in BHT. Bioidentical hormones have some distinctly different physiologic effects compared with synthetic hormones. Synthetic progestin is associated with an increased risk for breast cancer and cardiovascular disease, while natural progesterone is associated with a decreased risk of breast cancer and cardiovascular disease. Estriol has some unique physiologic effects, which differentiate it from estrone and estradiol. Estriol is associated with a lower risk of breast cancer and would be expected to prevent breast cancer, but few randomized controlled trials have been documented. Some clinical data demonstrate that BHT is associated with a lower risk of breast cancer and cardiovascular disease, and is more efficacious than synthetic hormones. However, there is little evidence in support of this claim. Moreover, estriol has not been approved by the U.S. Food and Drug Administration (FDA). Further studies are needed to confirm the safety and efficacy of BHT.

Bioidentical Hormone Therapy in Postmenopausal Women / 대한폐경학회지

Bioidentical hormone therapy (BHT) refers to the use of hormones that are molecularly and chemically identical to endogenous hormones for purposes of hormone replacement therapy. The specific hormones used in BHT include estrone, estradiol, estriol, progesterone and testosterone. Since the result of the Women's Health Initiative (WHI) trial documented the increased risk of breast cancer, cardiovascular disease and stroke in users of conventional hormone therapy (CHT), use of CHT has declined and there has been increased interest in BHT. Bioidentical hormones have some distinctly different physiologic effects compared with synthetic hormones. Synthetic progestin is associated with an increased risk for breast cancer and cardiovascular disease, while natural progesterone is associated with a decreased risk of breast cancer and cardiovascular disease. Estriol has some unique physiologic effects, which differentiate it from estrone and estradiol. Estriol is associated with a lower risk of breast cancer and would be expected to prevent breast cancer, but few randomized controlled trials have been documented. Some clinical data demonstrate that BHT is associated with a lower risk of breast cancer and cardiovascular disease, and is more efficacious than synthetic hormones. However, there is little evidence in support of this claim. Moreover, estriol has not been approved by the U.S. Food and Drug Administration (FDA). Further studies are needed to confirm the safety and efficacy of BHT.

Relationship between metabolic syndrome and bone mineral density in the postmenopausal women / 대한산부인과학회지

OBJECTIVE: Observational studies suggest that osteoporosis is associated with cardiovascular disease, although another study found that metabolic syndrome (MS) has protective effects on bone. Therefore, this study examined the relationship between metabolic syndrome and bone mineral density (BMD) in postmenopausal women. METHODS: We divided postmenopausal women who visited St. Vincent Hospital of the Catholic University of Korea in 2006 and 2007 into groups with and without MS and measured their body mass index (BMI), waist-hip ratio (WHR), blood pressure, serum fasting glucose, lipid profile, and BMD of the lumbar spine and femoral neck. RESULTS: Of the 151 subjects, 66 (43%) had MS and 85 (57%) did not. The women with MS had a higher BMD at the lumbar spine and femoral neck, although after adjusting for age and BMI, this correlation was lost. Significant positive correlations were observed between BMD of the lumbar spine and both high-density lipoprotein (HDL) cholesterol and serum fasting glucose, and BMD of the femoral neck was positively correlated with serum fasting glucose level. The components of MS were not correlated with BMD in these postmenopausal women after adjusting for age and BMI. CONCLUSION: In our study, the higher BMD in MS was explained by the higher BMI in postmenopausal women. After adjusting for age and BMI, however, MS had no protective effect on bone mass. MS may be another risk factor for postmenopausal osteoporosis.

Adipokines, the obesity and metabolic complications in the postmenopausal women / 대한산부인과학회지

During the menopausal transition there are changes in body fat and its disrtribution, and central adiposity is associated with the metabolic complications such as insulin resistance and dyslipidemia. Adipose tissue is increasingly recognized as an endocrine organ with many secretory products and a part of the innate immune system. With obesity, macrophages infiltrate into adipose tissue, and numerous adipokines and cytokines are secreted by both macrophages and adipocytes. The adipokines play important roles in the pathogenesis of metabolic complications such as insulin resistance, dyslipidemia, hypertension, ectopic fat accumulation, type 2 diabetes, and cardiovascular disease. It has been shown that adipocytes secrete several proteins including tumor necrosis factor-alpha (TNF-alpha), IL-6 and adipokines such as leptin, adiponectin, resistin, retinol binding protein 4, visfatin. Adiponectin improves insulin sensitivity, but leptin, resistin, pro-inflammatory cytokines increase insulin resistance. It is well known that menopause is associated with notable change in levels of the adipokines toward the direction to increase of metabolic complications, but the influence of menopause on adipokine levels is still poorly understood. Further studies are needed to understand the relationship of adipokines and metabolic syndrome, cardiovascular disease in the postmenopausal women.

Association of Fas, Fas-ligand gene polymorphisms with bone mineral desity and bone resposiveness to hormone therapy in postmenopausal women / 대한산부인과학회지

OBJECTIVE: To investigate the relationship between Fas gene & Fas-ligand gene polymorphisms, and bone mineral density (BMD) after hormone therapy (HT) in postmenopausal women. METHODS: Restriction fragment length polymorphisms at the Fas A670G, G1377A gene site and Fas-ligand C843T, IVS3nt169 (T/delT) gene site and BMD at the lumbar spine and proximal femur were analyzed in 229 postmenopausal women receiving sequential HT for 1 year. BMD were measured by DEXA. The subjects were divided in normal, osteopenic and osteoporotic on the basis of the T-score values according to the classification of the World Health Organization (WHO). RESULTS: After adjusting for potential confounding factors such as age, BMI, and menopause duration, A670G polymorphism was significantly associated with BMD at the lumbar spine, the femur neck and trochanter in osteopenic and osteoporotic groups, and G1377A polymorphism was significantly associated with BMD at lumbar spine and the femur neck in osteopenic group. C843T polymorphism was significantly associated with BMD at lumbar spine and ward triangle in osteoporotic group, IVS3nt169 (T/delT) was not associated with BMD. In osteoporotic group after HT in postmenopausal women, A670G polymorphism A/A, G1377A polymorphism G/G, C843T polymorphism T/T were associated with significant annual bone mineral density change, compared with other polymorphism at the same gene. CONCLUSION: These findings suggest that Fas, Fas-ligand gene polymorphisms may be an important contributor to the variation of BMD among postmenopausal women. and that a specific Fas, Fas-ligand polymorphisms are associated with significant BMD change in postmenopausal women after HT.

Association of Osteoprotegerin Gene Polymorphisms with bone Mass in Postmenopausal Korean Women / 대한산부인과학회잡지

OBJECTIVE: To examine the relationship between Osteoprotegerin gene polymorphisms, and bone mineral density (BMD). METHODS: Restriction fragment length polymorphisms at the Osteoprotegerin A163G, T950C, G1181C gene site, and BMD at the lumbar spine and proximal femur were analyzed in 229 postmenopausal Korean women (81 normal, 111 osteopenic and 37 osteoporotic patients). BMDs were measured by DEXA. The subjects were divided in normal, osteopenic and osteoporotic on the basis of the T-score values according to the classification of the World Health Organization (WHO). RESULTS: The genotype distribution of A163G, T950C and G1181C polymorphisms in all postmenopausal women was as follows: AA 54.6%, AG 37.1%, GG 8.3%, T/T 17.5%, T/C 44.1%, C/C 38.4%; GG 52.4%, GC 38.0%, CC 9.6%, respectively. Significant differences in the distribution of A/A and A/G genotype among osteoporotic group were observed. No significant differences in the distribution of T950C and G1181C genotypes among three groups were observed. After adjusting for potential confounding factors such as age, BMI, and menopause duration, A163G polymorphism was significantly associated with BMD at the lumbar spine in normal and osteoporotic patients and BMD at the femur neck and wards triangle in normal patients, and G1181C polymorphism BMD at the trochanter in all groups and BMD at the femur neck in osteopenic and osteoporotic patients, and BMD at the wards triangle and trochanter in osteoporotic patients. But There was no relationship between T950C gene polymorphism, and BMD. CONCLUSION: These findings suggest that osteoprotegerin gene polymorphisms may be an important contributor to the variation of BMD among postmenopausal Korean women.

Association of Osteoprotegerin Gene A163G, G1181C Polymorphisms with Bone Mass in Postmenopausal Korean Women / 대한산부인과학회잡지

OBJECTIVE: To examine the relationship between Osteoprotegerin gene polymorphisms, and bone mineral density (BMD). METHODS: Restriction fragment length polymorphisms at the Osteoprotegerin A163G (promoter), G1181C (exon 1) gene site, and BMD at the lumbar spine and proximal femur were analyzed in 229 postmenopausal Korean women (81 normal, 111 osteopenic and 37 osteoporotic patients). BMDs were measured by DEXA. RESULTS: The distribution of A163G and G1181C polymorphisms in all postmenopausal women was as follows: AA 54.6%, AG 37.1%, GG 8.3%; GG 52.4%, GC 38.0%, CC 9.6%, respectively. After adjusting for potential confounding factors such as age, BMI, and menopause duration, A163G polymorphism was significantly associated with BMD at the lumbar spine and G1181C polymorphism BMD at the trochanter in all postmenopausal women. A163G polymorphism was significantly associated with BMD at the lumbar spine in normal and osteoporotic patients, and BMD at the femur neck and wards triangle in normal patients. G1181C polymorphism was significantly associated with BMD at the femur neck in osteopenic and osteoporotic patients, and BMD at the wards triangle and trochanter in osteoporotic patients. CONCLUSION: These findings suggest that osteoprotegerin gene polymorphisms may be an important contributor to the variation of BMD among postmenopausal Korean women.

Association of Vitamin D Receptor, Estrogen Receptor, Transforming Growth Factor-beta1 and Interleukin-6 Gene Polymorphism with Bone Mass in Postmenopausal Korean Women / 대한산부인과학회잡지

OBJECTIVE: To evaluate the relationship between vitamin D receptor (VDR), estrogen receptor (ER), transforming growth factor-beta1 (TGF-beta1) and interleukin-6 (IL-6) gene polymorphism, and bone mineral density (BMD). MATERIALS AND METHODS: Restriction fragment length polymorphisms at the VDR Fok I, ER Pvu II, TGF-beta1 T869C and IL-6 G174C gene sites, and BMD at the lumbar spine, proximal femur were analyzed in 161 postmenopausal Korean women. The subjects were divided in normal, osteopenic, and osteoporotic on the basis of the T-score values according to the classification of the World Health Organization (WHO). RESULTS: The genotype distribution of VDR, ER, TGF-beta1 and IL-6 gene polymorphism was as follows: FF 32.9%, Ff 50.9%, ff 16.2%; PP 13.6%, Pp 48.4%, pp 38.0%; T/T 74.1%, T/C 12.4%, C/C 13.1%; G/G 99.4%, G/C 0.6%. Significant differences in the distribution of FF genotype among normal, osteopenic and osteoporotic group were observed. No significant differences in the distribution of ER and TGF-beta1 genotypes among three groups were observed. BMD at all sites in the FF genotype was significantly higher than in the Ff and ff genotypes. There was no relationship between ER and TGF-beta1 gene polymorphism, and BMD. By combining VDR, ER and TGF-1 genotypes, BMD at lumbar spine, femur neck and ward triangle in the FFPp genotype was significantly higher than in the FfPp, Ffpp and ffpp genotypes, and BMD at femur neck and ward triangle in the FFTT genotype was significantly higher than in the FfTT and ffTT genotypes. CONCLUSION: The results suggest that VDR Fok I polymorphisms, singly and in relation to ER Pvu II and TGF-beta1 T869C polymorphism, may influence bone mass in postmenopausal Korean women.