Comparison of risk profile in pre-menopausal and post-menopausal women with acute coronary syndrome

Background: The physiological changes associated with menopause are responsible for increase in cardiovascular disease after menopause. BMI, physical inactivity, metabolic syndrome, hypertension and diabetes mellitus increase in post-menopausal women which are all powerful predictors of cardiovascular events. The risk factor profile between pre-menopausal and post-menopausal women presenting with acute coronary syndrome was thus studied.Methods: This study was a prospective cross-sectional hospital based study and was conducted in the Department of Medicine and Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana wherein 50 pre-menopausal women and 50 post- menopausal women who presented with acute coronary syndrome were enrolled. The risk factor profile and angiography findings amongst the 2 groups were compared.Results: There was no difference in the incidence of Diabetes Mellitus and Hypertension among the pre & post-menopausal groups. The prevalence of family history of cardiovascular disease was higher in the pre-menopausal group. The post-menopausal women showed a significant decrease in physical activity due to sedentary lifestyle. Both the groups had high BMI and increased waist circumference. Lipid parameters did not show any significant difference between the two groups. However, pre-menopausal women had higher LDL-C and triglyceride levels and lower HDL-C levels. On analysis of the angiographic findings in diabetics and non-diabetics, of both the groups diabetes mellitus was much higher in subjects presenting with triple vessel disease suggesting extensive atherosclerosis.Conclusions: study showed physical inactivity as an important cardiovascular risk factor in post-menopausal women. Obesity is an important risk factor for coronary artery disease in both pre- and post-menopausal women.

Factores de riesgo para cáncer de endometrio en premenopáusicas con hemorragia uterina disfuncional / Risk factors for endometrial cancer in pre-menopausal women with dysfunctional uterine hemorrhage

El objetivo de la investigación fue establecer los factores de riesgo para cáncer de endometrio en premenopáusicas con diagnóstico de hemorragia uterina disfuncional. Se realizó un estudio observacional en mujeres con diagnóstico de hemorragia uterina disfuncional. Se evaluaron la asociación entre la histología endometrial y los factores de riesgo para el cáncer de endometrio, de ellos se analizaron: irregularidades del ciclo menstrual, diabetes mellitus, nuliparidad, hipertensión, obesidad y edad mayor de 40 años. La regresión logística se utilizó para investigar la importancia relativa de cada factor de riesgo. El estudio incluyó 266 mujeres con edad promedio de 41 años. La prevalencia de los factores de riesgo fue la siguiente: edad mayor de 40 años (67,2 %), menstruaciones irregulares (22,1 %), nuliparidad (16,9 %), obesidad (10,1 %), hipertensión (8,6 %) y diabetes (2,2 %). Los resultados de la biopsia endometrial incluyeron: 14 casos (5,2 %) de hiperplasia simple, 16 casos (6,0 %) de hiperplasia compleja y 4 casos (1,5 %) de hiperplasia con atipia. No se observaron casos de adenocarcinoma de endometrio. Se encontró que las menstruaciones irregulares eran el único factor de riesgo estadísticamente significativo asociado a alteración de la histología endometrial (p = 0,0132). En el grupo de pacientes con menstruaciones regulares y sin factores de riesgo, la incidencia de biopsia anormal observada fue inferior al 1 %. Las irregularidades del ciclo menstrual aumentan la probabilidad de un resultado anormal de la biopsia a un 14,2 %. Se concluye que las mujeres premenopáusicas diagnosticadas con hemorragia uterina disfuncional cuyos ciclos menstruales son regulares tienen un riesgo insignificante de desarrollar hiperplasia endometrial.

The objective of the research was to establish risk factors for endometrial cancer in pre-menopausal women with a diagnosis of dysfunctional uterine hemorrhage. An observational study was conducted in women with a diagnosis of dysfunctional uterine bleeding. The association between endometrial histology and risk factors for endometrial cancer analyzed were menstrual cycle irregularities, diabetes mellitus, nulliparity, hypertension, obesity and age over 40 years. Logistic regression was used to investigate the relative importance of each risk factor. The study included 266 women with an average age of 41 years. The prevalence of risk factors was the following: age over 40 years (67,2 %), irregular menses (22,1 %), nulliparity (16,9 %), obesity (10,1 %), hypertension (8,6 %) and diabetes (2,2 %). The results of the endometrial biopsy included: 14 cases (5,2 %) of simple hyperplasia, 16 cases (6,0 %) of complex hyperplasia and 4 cases (1,5 %) of complex hyperplasia with atypia. No cases of endometrial adenocarcinoma were observed. It was found that irregular menses were the only statistically significant risk factor associated with alteration of endometrial histology (p = 0.0132). In the group of patients with regular menses and without risk factors, the incidence of abnormal biopsy observed was less than 1 %. The irregularities of the menstrual cycle increases the probability of an abnormal result of the biopsy to 14,2 %. It is concluded that premenopausal women diagnosed with dysfunctional uterine bleeding whose menstrual cycles are regular have a negligible risk of developing endometrial hyperplasia.

Evaluation of the Prevalence and Correlated Factors for Decreased Bone Mass Density among Pre- and Post-menopausal Educated Working Women in Saudi Arabia.

Most of the previous studies on osteoporosis have focused on post-menopausal women, and more research is needed to evaluate its prevalence in pre-menopausal women. This study was carried out to evaluate the prevalence and correlated factors for decreased bone mass density among pre- and post-menopausal women. This was a cross-sectional study carried out in Applied Medical Sciences College under King Saud University. All pre- and post-menopausal women working there were invited to participate in the study. Measurement of bone mass density was done by quantitative ultrasound densitometry. One-fourth of the pre-menopausal females had osteopaenia. There was a significant correlation between having osteoporosis and increasing age, fertility period, parity, menopausal duration, gynaecological age, and presence of comorbidity, especially hypertension and diabetes mellitus. Pre-menopausal females had high prevalence of osteopaenia (24.8%), and it is recommended to implement health education campaigns demonstrating the preventive measures of osteoporosis.

Discussion on clinical characteristics analysis and nursing care of menopause depression / 中国医学装备

Objective:To analyze the depression incidence in premenopausal or postmenopausal women, find out the countermeasures to control or eliminate depression. Methods:Randomly divided the menopause group and premenopausal group in 724 patients who were assessed using Zung depression scale and venous blood determination of endocrine hormone FSH, LH, E2. Zung score≥40 points can diagnose depression. Results:The incidence in premenopausal group of climacteric depression was 13.3%, and postmenopausal group was 5.6%. The incidence of climacteric depression premenopausal group was obviously higher than that after menopause (x2=12.797, P<0.05). Conclusion:Menopause depression patients often have some physical or mental factors as incentive, spirit and body disease, etc.;Patients often change in physical and psychological. So the comprehensive care in the biological, psychological and social are necessary.

Comparison of cardiac autonomic activity between pre and post menopausal women using heart rate variability.

Ageing is associated with a decline in short-term indexes of heart rate variability (HRV). But there is little evidence regarding the extent to which age-related changes in HRV depend on simultaneous changes in levels of estrogen and body composition as it occurs from pre menopausal state to postmenopausal state. The purpose of this study was (i) to compare HRV between pre and postmenopausal women, (ii) to determine whether difference in age, estrogen level and body composition could account for the difference in HRV between these two groups. HRV was assessed using spectral. analysis and estrogen level was estimated using radioimmunoassay technique. The body composition, in terms of percent fat, was assessed using measurement of skin fold thickness. Data was analyzed both before and after adjusting for age, estrogen level and body composition. It was found that the total power, high frequency (HF) and the low frequency (LF) power spectrum of HRV in absolute units were significantly lower (P<0.001) in postmenopausal women compared to that of premenopausal women. Postmenopausal women had significantly lower HF (P<0.01) and higher LF (P<0.01) when expressed in normalized units. The ratio of LF/HF, the index of sympathovagal balance was significantly higher (P<0.01) among postmenopausal women. Analysis after adjusting for age, revealed that age was one of the important confounder, responsible for the differences in all the components of power spectrum between the two study groups. Difference in estrogen level contributed for the difference in relative values of HF and LF components of HRV. Difference in body composition did not explain the difference in HRV between the groups. The study concludes that both ageing and declined estrogen levels are associated with the autonomic alterations seen among postmenopausal women.

Prevalência de lesões endometriais em mulheres obesas assintomáticas / Prevalence of endometrial injury in asymptomatic obese women

OBJETIVOS: A obesidade representa importante fator de risco para alterações endometriais. O presente estudo teve por objetivo avaliar a prevalência de lesões endometriais, como pólipos, hiperplasia e câncer de endométrio em mulheres obesas assintomáticas, assim como reconhecer os fatores de risco associados. MÉTODOS: Entre dezembro de 2004 e fevereiro de 2006, em estudo transversal foram avaliadas 94 mulheres obesas (índice de massa corpóreo >30Kg/m²), divididas em dois grupos com 47 participantes cada: em idade reprodutiva e após a menopausa. Foram analisados: história clínica, exame físico (antropométrico/ginecológico), determinações bioquímicas e avaliação do endométrio por ultra-sonografia endovaginal, biópsia e histeroscopia (para confirmar patologia endometrial). RESULTADOS: Nas mulheres em idade reprodutiva foram encontrados 12,8 por cento de casos de patologia endometrial, que se associaram significativamente com as elevações da idade, hipertensão arterial (HAS), colesterol e LDL-c. Após a menopausa, foram identificadas 40,4 por cento de lesões endometriais que se associaram significativamente com pressão arterial sistólica (PAS) > 140mmHg, elevação do LDL-c e da estrona. Dois casos de câncer de endométrio foram constatados, sendo um em cada grupo. CONCLUSÃO: O aumento de incidência da obesidade nos últimos anos tem elevado os fatores de risco para o câncer de endométrio. Na idade reprodutiva tivemos um pequeno tamanho amostral de alterações endometriais; com isso, poderíamos apenas sugerir, uma maior atenção àquelas com idade superior a 40 anos, que apresentem HAS e/ou elevação do LDL-c. O status menopausal eleva o risco de lesão endometrial; associado com elevações da PAS, LDL-c e/ou estrona, elas se tornarão candidatas à biópsia de endométrio, visando o diagnóstico precoce do câncer, decisivo para o prognóstico favorável da mulher.

OBJECTIVE: Obesity represents the most important risk factor for endometrial pathology. This study aimed to evaluate the prevalence of endometrial injuries, such as polyps, hyperplasia and endometrial cancer in asymptomatic obese women, as well as to recognize the associated risk factors . METHODS: A cross-sectional study was conducted between December 2004 and February 2006. Ninety-four obese (body mass index > 30 kg/m²) women were evaluated, divided in two groups of 47 participants each: pre-menopausal and postmenopausal women. Clinical characteristics, physical exams (anthropometric and gynecological), blood count and endometrial assessment by vaginal ultrasonography, biopsy, and hysteroscopy (only for confirmed endometrial pathology), were the variables appraised. RESULTS: In pre-menopausal women, 12.8 percent of cases had endometrial pathology statistically associated to age, hypertension, hypercholesterolemia and LDL-c increase. In the post-menopausal women, 40.4 percent of cases had a pathology identified as statistically associated with hypertension, LDL-c and estrone increase. Two cases of endometrial cancer were identified, one in each group. CONCLUSIONS: The increased incidence of obesity over recent years has increased risk factors of endometrial cancer. In pre-menopausal women only a small number of cases with endometrial alterations was observed. Therefore, it is suggested that greater attention be given to those over 40 years of age, associated with hypertension and/or higher LDL-c . The menopausal status increases risk of endometrial injury, and when associated with hypertension, LDL-c and/or estrone increase, women become candidates to biopsy aiming for an early diagnosis of cancer, a decisive factor for a favorable prognosis.

The Ecological Factors Related to Completion of Weight Reduction Program in the Obese Premenopausal Women / 대한지역사회영양학회지

The objective of this study is to improve the health related quality of life through the efficient weight reduction by analyzing the ecological factors related to completion of weight reduction program in the obese premenopausal women aged 20-29 years. The factors influencing completion of obesity management programs in the obese women were the preferences of sweet and salt taste, health related quality of life (general health, role emotional), eating attitude scores, and regularity of mealtime scores. The finding that the completion of obese management programme were improved if the health-related quality of life was high and the physiological status related symptoms of stress, depress, and eating disorder were good has implications for the treatment of obesity. The questionnaire used this study can be available to develop the obesity assessment sheets which is required the exploration of the characteristics of obese women and the tailored multi-disciplinary obesity management program. Moreover, the obesity assessment sheets will make a contribution to determine types of the programs that is suitable for obesity women before starting an obesity management program.