Impacto de la obesidad en la salud de la mujer adulta mayor

La población mundial ha envejecido y se está haciendo más femenina. La mujer adulta mayor sufre el impacto negativo del envejecimiento y la falla ovárica, con niveles bajos de estrógenos por la menopausia. Incrementa hasta en 33% de ellas el peso corporal, en rango de sobrepeso u obesidad, con redistribución de la grasa en la región visceral y disminución de la masa magra. Ello la predispone a todas las comorbilidades asociadas con la obesidad así como las enfermedades metabólicas y cardiovasculares, además de mortalidad a edad más temprana que sus pares que cursan con peso normal. Se ha incrementado la esperanza de vida. Por tanto sería ideal añadir a estos años calidad, viviendo libre de enfermedades crónicas e invalidantes y hasta donde sea posible lograr que ellas sean autosuficientes e independientes. Hay que intervenir para buscar la pérdida de peso intencional en aquellas que lo tienen incrementado y así reducir la morbimortalidad que se aumenta con la obesidad.

The world's population has aged and is becoming more feminine. The adult women suffer the negative impact of ageing and ovarian failure, with low levels of estrogen in the menopause. In up to 33% of them the body weight increases in range of overweight or obesity, with redistribution of fat in the visceral region and reduction of lean mass. This predisposes it to all comorbidities associated with obesity as well as metabolic and cardiovascular diseases and mortality at younger age than their peers with normal weight. Life expectancy has increased. Therefore it would be ideal to add to these quality years, living free of chronic and disabling illnesses and as much as possible to make them self-sufficient and independent. We should intervene to find intentional weight loss in those who have it increased, reducing mortality and morbidity that increase with obesity.

Estrogen Attenuates the Pressor Response Mediated by the Group III Mechanoreflex

PURPOSE: We investigated the effects of group III mechanoreceptors to cardiovascular responses in both pre-menopausal woman and post-menopausal woman during passive ankle dorsiflexion (PAD). METHODS: Twenty healthy volunteers (10 post-menopausal women and 10 pre-menopausal women) were recruited for this study. Stroke volume (SV), heart rate (HR), cardiac output (CO), and total vascular conductances (TVC) were measured continuously throughout the experiment. To stimulate the group III mechanoreceptors, PAD was performed for one minute. RESULTS: The results showed that mean arterial pressure (MAP) mediated by the mechanoreflex activation was significantly increased in both groups. However, this pressor response was significantly higher in post-menopausal women. This reflex significantly increased both SV and CO in pre-menopausal women, while there were no differences in post-menopausal women. There was no difference in HR in either group. The mechanoreflex significantly decreased TVC in post-menopausal woman, while there was no difference in pre-menopausal woman. CONCLUSION: The results indicate that the excessive pressor response mediated by the mechanoreflex occurs due to overactivity of group III mechanorecptors and the mechanism is produced mainly via peripheral vasoconstriction in post-menopausal women.

Calcium Intake, Vitamin D and Bone Health Status of Post-menopausal Chinese Women in Kuala Lumpur

Bone health status was investigated in 178 free-living Chinese post-menopausal women in Kuala Lumpur. Body mass index (BMI), body composition (using whole body DXA), calcium intake and serum 25-OH vitamin D status were measured along with biochemical markers of bone turnover, that is, pro-collagen Type 1 N-terminal peptide (P1NP), osteocalcin (OC) and C-telopeptide ß cross link of Type 1 collagen (CTX- β). Bone mineral density (BMD) was measured using DXA (Hologic, USA) at the lumbar spine, femoral neck and total hip. Results showed that osteopenia was present in 50% of the subjects at the spine and 57.9% at the femoral neck. Osteoporosis was diagnosed in 10% of the subjects at both the femoral neck and spine. A total of 29.3% of the subjects had high levels of CTX- ß. Mean serum level of 25-OH vitamin D was 60.4+15.6 nmol/L and 50.6% of the subjects had hypovitaminosis D (defined as <50 nmol/l). Mean total calcium intake of the subjects was 497 + 233 mg, of which only 14% met the RNI for calcium with the additional intake of calcium supplements. Body fat was also significantly correlated (r=0.181, p<0.05) with BMD at the spine but not BMD at the femoral neck. Lean body mass was positively correlated with BMD at the spine (r=0.289, p<0.001) and femoral neck (r=0.295, p<0.001). CTX-β was negatively correlated with BMD at the spine (r= -0.235, p<0.001), whereas P1NP (r=-0.215, p<0.001) and osteocalcin (r=-0.265, p<0.001) were both negatively correlated with BMD at the femoral neck. Generally, the study found that women with osteopenia had higher levels of bone turnover markers, less lean body mass and lower calcium intake than women with normal BMD. In conclusion, this study demonstrated that the majority of free living Chinese post-menopausal women in Kuala Lumpur have low calcium intake, low 25-OH vitamin D status and low bone mass and elevated biochemical markers of bone turnover.