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OBJECTIVE:To compare the efficacy and safety of terlipatide and bisphosphate in the treatment of postmenopausal osteoporosis fractures through a Meta-analysis. METHODS:By searching PubMed,Cochrane Library,EMbase,CNKI,WanFang and VIP databases,18 randomized controlled studies on terlipatide and bisphosphate in the treatment of postmenopausal osteoporosis fractures were included according to inclusion and exclusion criteria.Endnote X9 software was used to manage the literature and Revman 5.3 software was used to perform a Meta-analysis on the extracted data.The incidences of vertebral fracture,non-vertebral fracture and adverse reaction in postmenopausal osteoporosis patients treated with terlipatide and bisphosphate were analyzed. RESULTS:A total of 18 randomized controlled studies were included,of which 10 were of medium and high quality and 8 were of low quality.Meta-analysis results showed that the fracture incidence in the teriparatide group[risk ratio(RR)=0.56,95%confidence interval(CI):0.48-0.66,P＜0.000 01]was lower than that in the bisphosphonate group,and teriparatide was superior to alendronate in preventing fractures in postmenopausal women with osteoporosis(RR=0.50,95%CI:0.35-0.69,P＜0.000 1)and other bisphosphonates(RR=0.58,95%CI:0.49-0.70,P＜0.000 01).During the follow-up over 18 months,teriparatide was superior to bisphosphonates in preventing fractures in postmenopausal women with osteoporosis(RR=0.56,95%CI:0.48-0.69,P＜0.000 01).In addition,we found that teriparatide was superior to bisphosphonates in preventing vertebral fractures(RR=0.48,95%CI:0.37-0.62,P＜0.000 01)and non-vertebral fractures(RR=0.63,95%CI:0.51-0.78,P＜0.000 1)in postmenopausal women with osteoporosis.Teriparatide was superior to bisphosphonates in increasing lumbar bone density[odds ratio=4.16,95%CI:2.96-5.36,P＜0.000 1)and femoral neck bone density(odds ratio=1.02,95%CI:0.04-2.01,P=0.04).There was no significant difference in adverse reactions between teriparatide and bisphosphonates(RR=0.95,95%CI:0.85,1.06,P=0.37). CONCLUSION:Teriparatide is superior to bisphosphonates in preventing vertebral and non-vertebral fractures in postmenopausal women with osteoporosis,but the safety and adverse drug reactions of teriparatide and bisphosphonates are basically similar.Teriparatide is superior to bisphosphonate in preventing fracture and improving lumbar and femoral neck bone density regardless of short-term(＜18 months)or long-term(≥18 months)use.
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BACKGROUND:The specific mechanism of Gushukang,as a Chinese traditional patent medicine for the treatment of postmenopausal osteoporosis of kidney deficiency and blood stasis,needs further studies. OBJECTIVE:To investigate the effect of Gushukang on serum sex hormones,bone microstructure and estrogen receptor in postmenopausal osteoporosis. METHODS:Firstly,network pharmacological analysis was performed.The active ingredients and action targets of Gushukang and the targets of postmenopausal osteoporosis were obtained respectively.Cytoscape was used to construct the active ingredient-target network.STRING database and Cytoscape were used for protein-protein interaction analysis and screening of core targets.DAVID database was used for Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses of intersection targets.Then the ovariectomized Sprague-Dawley rats were used in the animal experiment.Gushukang was administered by gavage for 3 months.The serum estrogen level was detected by ELISA,the bone microstructure was detected by microCT,and the protein expression of estrogen receptor α and estrogen receptor β in bone tiusse was detected by western blot. RESULTS AND CONCLUSION:The network pharmacological research results identified 132 active ingredients and 150 targets of Gushukang and 1155 targets of postmenopausal osteoporosis.After intersections with 1155 postmenopausal osteoporosis targets,87 targets of active ingredients of Gushukang against postmenopausal osteoporosis were obtained.By constructing the active ingredient-target network,it was found that the active ingredients at the core were quercetin,kaempferol,luteolin,naringin and isorhamnetin,and the targets at the core were NCOA2,ESR2,AR,F2,ESR1 and PTGS1.The final targets obtained after the protein-protein interaction analysis and screening included MAPK8,ESR1,JUN,R3C1,RELA and FOS,of which ESR1 was the common core target obtained from the two analyses.KEGG enrichment analysis showed estrogen,tumor necrosis factor,apoptosis and other signaling pathways.Therefore,animal experiments focused on the effect of Gushukang on different subtypes of estrogen receptors in the estrogen signaling pathway.The results showed that in the Gushukang group,bone microstructure was significantly improved,serum estrogen level had no significant change,but the protein expression of estrogen receptor α and β in bone tissue was significantly increased.All the findings indicate that the mechanism of Gushukang in the treatment of postmenopausal osteoporosis may be related to its hormone-like effect and the enhancement of estrogen receptor expression.
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BACKGROUND:In recent years,research on the interaction mechanism between the immune system and the skeleton in postmenopausal osteoporosis has become a hot topic.However,the impact of changes in key immune-related cytokine expression on postmenopausal osteoporosis remains unclear and requires further exploration. OBJECTIVE:To investigate the differential expression of immune-related cytokines in bone marrow mesenchymal stem cells of mice with postmenopausal osteoporosis by bioinformatics methods. METHODS:Postmenopausal osteoporosis mouse model was established through ovariectomy.Bone marrow mesenchymal stem cells were obtained by the whole bone marrow adherence method and passaged to passage 2.RayBio L-Series Mouse Antibody Array 308 Glass Slide Kit immune-related factor antibody chip was used to detect the differentially expressed proteins in bone marrow mesenchymal stem cells from ovariectomy and sham-operation mice.Gene ontology,Kyoto Encyclopedia of Genes and Genomes enrichment analysis,and protein-protein interaction network analysis were performed to screen common Hub genes by MCC,EPC,and MNC algorithms. RESULTS AND CONCLUSION:This study identified a total of 68 differentially expressed genes.Gene ontology analysis revealed that the differentially expressed genes were enriched in terms including"immune system processes","extracellular regions",and"signal receptor binding".Kyoto Encyclopedia of Genes and Genomes pathway analysis revealed that the differentially expressed genes were mainly enriched in"cytokine-cytokine receptor interactions","tumor necrosis factor signaling pathways",and"chemokine signaling pathways".Further screening was performed by constructing a protein-protein interaction network analysis of these 68 differentially expressed genes to identify 8 Hub genes.The violin plot and correlation matrix showed that the expression levels of these 8 Hub genes were significantly down-regulated in the ovariectomy group compared to the sham-operation group.These results demonstrated that there was differential expression of immune-related factors in bone marrow mesenchymal stem cells of postmenopausal osteoporosis mice,and key genes involved in cytokine-cytokine receptor interactions,immune system-related processes,and potential targeted signaling pathways and cellular biological processes were identified,providing new promising targets for the diagnosis,treatment,and prevention of postmenopausal osteoporosis.
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BACKGROUND:Punicalagin has a wide range of effects and high safety,but its effect on osteoblasts and postmenopausal osteoporosis is unknown. OBJECTIVE:To investigate the effect of punicalagin on osteoblasts and postmenopausal osteoporosis. METHODS:The effect of punicalagin on the proliferation of MC3T3-E1 cells was detected.Punicalagin was added to the osteogenic induction medium to detect its effect on osteogenic differentiation.Punicalagin was used to treat ovariectomized rats and Micro CT scan and serum procollagen type 1 N-terminal propeptide test were performed after 3 months to detect the therapeutic effect. RESULTS AND CONCLUSION:Cell counting kit-8 assay showed that punicalagin could promote the proliferation of osteoblasts(P＜0.05).The results of qRT-PCR and western blot showed that punicalagin could promote the mRNA and protein expressions of alkaline phosphatase and Runx2 in osteoblasts(P＜0.05).The results of Micro CT scan and serological test showed that punicalagin could improve bone mineral density,bone volume fraction,trabecular thickness,trabecular number and procollagen type 1 N-terminal propeptide level of ovariectomized rats.To conclude,punicalagin can promote osteoblast proliferation and differentiation,and have therapeutic effects in postmenopausal osteoporosis rats.
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BACKGROUND:Ferroptosis and pyroptosis may play a role in the development of postmenopausal osteoporosis.There may be relevant biomarkers for the diagnosis of postmenopausal osteoporosis. OBJECTIVE:To search for the key genes related to ferroptosis and pyroptosis in postmenopausal osteoporosis using bioinformatics so as to further elucidate their biological mechanisms. METHODS:The data sets GSE56815 and GSE7429 of postmenopausal osteoporosis were downloaded from the GEO database,the national comprehensive gene expression database of the United States,and the two data sets were preprocessed.The differential expression analysis of the data was carried out by the limma package of R software,and the enrichment analysis was performed by DIVID and KOBAS.The protein-protein interaction network was mapped by STRING and Cytoscape,the Hub gene was selected by CytoHubba,and the key genes were screened by the ferroptosis database and pyroptosis database.The CIBERSORT package was used to determine the immune infiltration of postmenopausal osteoporosis samples and to analyze the correlation between key genes and immune cells RESULTS AND CONCLUSION:A total of 30 differential genes of postmenopausal osteoporosis were screened in the experimental samples,of which 9 genes were up-regulated and 21 genes were down-regulated.The enrichment of GO and KEGG pathways showed that the differences were mainly in"serine-type endopeptidase activity,""innate immune response,""special particle lumen,"and"renin secretion."The protein-protein interaction network showed the correlation of differential genes and the top 10 Hub genes with"Degree"value were selected using CytoHubba.Hub gene was intersected with the FerrDb database and cell pyroptosis dataset to obtain key genes ELANE and LCN2.Receiver operating characteristic curve and box diagram showed that the expression of ELANE and LCN2 in serum samples of postmenopausal osteoporosis was significantly lower than that in normal samples,indicating a good diagnostic value.Immune infiltration analysis showed that ELANE may be related to memory resting CD4+ T cells,M0 and M2 macrophages.LCN2 may be related to M0 macrophages.
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BACKGROUND:Resistance training and weight-bearing exercise are recommended modes for patients with osteoporosis to improve bone health.High-intensity interval training is a high-impact weight-bearing exercise with obvious time-efficient characteristics;however,little attention has been paid to its impact on bones. OBJECTIVE:To observe the effect of high-intensity interval training on the bone health of ovariectomized rat models. METHODS:Thirty-six female Sprague-Dawley rats were randomly divided into sham group,model group and model exercise group(n=12 per group).Bilateral ovariectomy was used to prepare an osteoporosis rat model in the latter two groups.Six weeks after modeling,the model exercise group was subjected to a high-intensity interval training on an electric treadmill at 90%peak running speed for 2 minutes and 50%peak running speed for 1 minute as one session,a total of nine sessions,3 days per week,for 6 weeks.Rats in the sham and model groups were raised quietly in the mouse cage during the same period.The relevant indexes were tested 48-72 hours after the final training. RESULTS AND CONCLUSION:Compared with the sham group,bone mineral density,maximal load,stiffness,elasticity,trabecular volume fraction,and trabecular number decreased(P<0.05),while trabecular separation increased(P<0.05);the level of irisin in the serum,gastrocnemius and femur decreased(P<0.05);the expression of peroxisome proliferator-activated receptor γ coactivator-1α protein and fibronectin type Ⅲ domain-containing protein 5 mRNA and protein in the gastrocnemius muscle decreased(P<0.05);the expression of type I collagen,Osterix,and Runx2 mRNA in the femur decreased(P<0.05);and the expression of anti-tartrate acid phosphatase,receptor activator of nuclear factor κB ligand,and osteoclast-associated receptor mRNA increased in the model group(P<0.05).Compared with the model group,bone mineral density,fracture load,maximal load,stiffness,elasticity,average trabecular thickness,and trabecular number increased(P<0.05),and trabecular separation decreased(P<0.05);the level of irisin in the serum,gastrocnemius and femur increased(P<0.05);the expression of peroxisome proliferator-activated receptor γ coactivator-1α protein and fibronectin type Ⅲ domain-containing protein 5 mRNA and protein in gastrocnemius increased(P<0.05);the expression of type I collagen,Osterix,and Runx2 mRNA in the femur increased(P<0.05);and the expression of anti-tartrate acid phosphatase,receptor activator of nuclear factor κB ligand,and osteoclast-associated receptor mRNA decreased in the model exercise group(P<0.05).To conclude,short-term high-intensity interval training may improve bone health of ovariectomized rats through up-regulating the irisin level.
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BACKGROUND:Bibliometrics and visual analyses based on thematic literature are particularly important for understanding the foundation and frontiers of postmenopausal osteoporosis research. OBJECTIVE:To perform bibliometric,citation,and visualization analyses of highly cited SCI papers in postmenopausal osteoporosis research over the last 20 years. METHODS:The top 100 highly cited papers on postmenopausal osteoporosis published between 2003 and 2022 included in SCI-EXPANDED catalog of the Web of Science database were obtained for bibliometric measure and visual analysis using CiteSpace software. RESULTS AND CONCLUSION:The top 100 highly cited papers have a total of 67 377 citations in the Web of Science Core Collection,with an annual average of 49.17 citations per paper.Postmenopausal osteoporosis research primarily involves medical,engineering,biological,and multidisciplinary fields.The subcategories are dominated by endocrinology and metabolism,and medicine:internal medicine.Stable and close cooperative network relationships have been formed globally.United States,University of California System,Cummings,and Steven R are the country,research institution,and author,respectively,with the most highly-cited publications.The frontiers of postmenopausal osteoporosis research mainly include calcium and vitamin D supplementation and fracture risk,clinical studies of bisphosphonates in the treatment of postmenopausal osteoporosis,atypical femur fracture,clinical studies of new drugs and sequential treatment of postmenopausal osteoporosis,predictors of fracture risk,mid-and long-term follow-up of osteoporotic vertebral compression fractures,genetic polymorphisms and hereditary factors,formulation and updating of clinical practice guidelines for postmenopausal osteoporosis.Large cohort studies,high-quality randomized controlled trials,systematic reviews,meta-analyses,and clinical practice guidelines are the great engines that drive the development of clinical research in postmenopausal osteoporosis.We should make efforts in the above areas to improve China's international influence in the field of osteoporosis.
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Objectives:To investigate the impact of baseline non-high-density lipoprotein cholesterol(non-HDL-C)levels on new-onset cardiovascular disease(CVD)in postmenopausal women. Methods:This prospective cohort study selected 8 893 postmenopausal women who participated from 2006 to 2018 employee health examination of Kailuan Group and had complete total cholesterol(TC)and HDL-C data and no history of CVD.Participants were followed up to 31 December,2021.The primary endpoint was the occurrence of CVD or death.According to the Chinese Lipid Management Guidelines(2023),the participants were divided into non-HDL-C<4.1 mmol/L group(n=6 079),4.1 mmol/L≤non-HDL-C<4.9 mmol/L group(n=1 824)and non-HDL-C≥4.9 mmol/L group(n=990).The cumulative incidence of CVD in different groups of non-HDL-C levels was calculated using the Kaplan-Meier method and tested by log-rank analysis.Multivariate Cox regression model was used to analyze the effects of different non-HDL-C levels on CVD. Results:The mean follow-up time was(10.78±4.48)years,the cumulative incidence of CVD in different non-HDL-C level groups was 1.82%,3.24%and 2.89%,respectively.Kaplan-Meier survival curve showed a statistically significant difference in cumulative incidence among the three groups(log-rank P<0.0001).The results of Cox regression analysis showed that after adjusting for confounding factors such as age and sex,the HR(95%CI)values for CVD in the 4.1≤non-HDL-C<4.9 mmol/L group and the non-HDL-C≥4.9 mmol/L group were 1.40(1.13-1.74)and 1.35(1.03-1.78),respectively. Conclusions:High non-HDL-C levels are an independent risk factor for new-onset CVD in postmenopausal women.
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Objective:To investigate the diagnosis of dual-energy X-ray absorptiometry(DXA)for osteoporosis(OP)of postmenopausal patients with rheumatoid arthritis(RA)in Qinghai region and the risk factors of them.Methods:A total of 200 postmenopausal female RA patients who admitted to Qinghai Hospital of Traditional Chinese Medicine from May 2022 to April 2023 were selected.All patients were tested for bone mineral density(BMD)after admission,and lumbar spines L1-L4,whole lumbar,large trochanter,Ward's triangle area,whole body and whole forearm were measured by DXA.According to the results of BMD test,patients whose BMD T values of all body parts-2.5 SD were less or equal to-2.5 were included in the OP group(121 cases),and patients whose BMD T value of all body parts were larger than-2.5 SD were included in the non-OP group(79 cases).The BMD T value of different body parts between two groups of RA patients were compared and analyzed.The area under curve(AUC)of receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficiency of BMD T value for OP.The logistic regression method was adopted to analyze the risk factors that postmenopausal RA patients of Qinghai region occurred OP.Results:The BMD T values of L1,L2,L3,L4,whole lumbar,large trochanter,Ward's triangular area,whole body and whole forearm of OP group were obviously lower than those of the non-OP group.In analysis of ROC curve,the sensitivities of BMD T values of L1,L2,L3,L4,whole lumbar,large trochanter,Ward's triangle area,whole body and forearm were respectively 96.20%,95.22%,90.16%,96.03%,92.01%,89.36%,99.26%,90.02% and 96.03% in diagnosing OP,and the specificities of them were respectively 81.00%,82.19%,85.22%,83.06%,83.06%,90.22%,80.06%,86.23%,83.09%,and the AUC values of them were respectively 0.908,0.905,0.896,0.906,0.903,0.879,0.918,0.901 and 0.906.The results of the logistic-regression analysis showed that advanced age,long disease course,rheumatic activity scores of 28 joints,erythrocyte sedimentation rate and Calcium supplementation were the risk factors of occurring OP in postmenopausal RA patients in Qinghai region.Conclusion:The DXA method that detects BMD of RA patients who occur OP can be used as gold standard to assess OP,and there are many risk factors that affect the occurrence of OP in postmenopausal RA patients of Qinghai region.The clinical work should combine with relative factors to formulate reasonable measure so as to reduce the incidence of OP.
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Objective:To investigate the correlation between fat distribution and the composite indices of femoral neck strength in obese postmenopausal women.Methods:A total of 293 postmenopausal women with non-low body weight were selected, laboratory tests, body composition analyzer test and double-energy X-ray absorptiometry scan were performed. Based on the body mass index(BMI), they were divided into three groups, the normal BMI group(18.5 kg/m 2≤BMI<24.0 kg/m 2, n=91), the overweight group(24.0 kg/m 2≤BMI<28.0 kg/m 2, n=115), and the obese group(BMI≥28.0 kg/m 2, n=87). The measurement results were analyzed. Results:In the obese group, bone mineral density(BMD) of all sites was higher than that in the normal BMI group and overweight group( P<0.005), compression strength index(CSI), bending strength index(BSI), and impact strength index(ISI) were significantly lower than those in the normal BMI group( P<0.001, P=0.008, P=0.001). In the obese group, waist circumference, waist-hip ratio, total fat mass, appendicular fat mass, and trunk fat mass were risk factors for CSI, BSI and ISI independent of age, fasting blood glucose, and BMI( P<0.05). Visceral fat grade and Chinese visceral adiposity fat index were the risk factors for CSI, BSI, and ISI( P<0.05). Conclusion:The composite indices of femoral neck strength decreased in obese postmenopausal women, and both subcutaneous fat and visceral fat were negatively associated with the composite indices of femoral neck strength.
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[Objective]To explore the intervention effect of β-sitosterol,an effective monomer component of Eucommia ulmoides,on postmenopausal osteoporosis in mice and its potential mechanism.[Methods]Twenty-four female C57BL/6J mice of 12 weeks old were randomly divided into sham operation group,model group and β-sitosterol intervention group,with 8 mice in each group.The model of postmenopausal osteoporosis was established by bilateral ovariectomy.Mice in sham group and model group were given 0.9％sodium chloride solution and β-sitosterol intervention group was given β-sitosterol.Eight weeks after operation,all the mice were sacrificed and samples were collected.Micro-computed tomography(Micro-CT)was used to observe the protective effect of the β-sitosterol intervention on postmenopausal bone loss and trabecular bone breakage.Hematoxylin-eosin(HE)staining was used to analyze the bone histomorphology of the distal femur.The tartrate-resistant acid phosphatase(TRAP)staining and the alkaline phosphatase(ALP)staining were used to evaluate bone resorption and bone formation respectively.Then the expression level of β-catenin in each group was detected by immunohistochemistry.[Results]Micro-CT scanning showed that β-sitosterol could reduce bone loss and bone microstructure destruction in postmenopausal mice.HE staining also confirmed that β-sitosterol could effectively maintain the number and morphology of trabecular bone and inhibit abnormal fat accumulation caused by estrogen deficiency.TRAP staining also showed that β-sitosterol treatment did not affect osteoclast formation,while immunohistochemical results showed that β-sitosterol could significantly promote the expression of osteogenic marker ALP.Moreover,β-sitosterol can increase the expression of β-catenin in the distal femur to promote bone formation.[Conclusion]β-sitosterol treatment could enhance osteogenic differentiation and promote bone formation to relieve postmenopausal osteoporosis by upregulating β-catenin expression in vivo.
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ObjectiveTo explore the possible mechanism of Osteoking （OK） on postmenopausal osteoporosis （PMOP）. MethodForty adult female mice were randomly divided into a sham operation （Sham） group， osteoporosis model （OVX） group， estradiol intervention （E2） group， and OK group， with 10 mice in each group. The modeling was completed by conventional back double incision ovariectomy， and the corresponding drugs were given one week later. After 12 weeks， the body mass and uterine index of mice were measured， and the pathological changes of bone tissue and the number of osteoclasts （OCs） were determined by hematoxylin-eosin （HE） and tartrate-resistant acid phosphatase （TRAP） staining， respectively. Bone mineral density （BMD）， trabecular number （Tb.N）， trabecular separation （Tb.Sp）， and bone volume fraction （BV/TV） were measured by microcomputed tomography （Micro-CT）. The maximum load of the femur was detected by a three-point bending test. The contents of tumor necrosis factor-α （TNF-α） and bone resorption marker C-terminal telopeptide of type Ⅰ collagen （CTX-1） were measured by enzyme linked immunosorbent assay （ELISA）. The protein expression levels of nuclear factor-kappa B p65 （NF-κB p65）， phosphorylated nuclear factor-kappa B p65 （p-NF-κB p65）， nuclear factor kappa B inhibitor alpha （IκBα）， phosphorylated nuclear factor kappa B alpha （p-IκBα）， nuclear factor of activated T cells 1 （NFATc1）， and proto-oncogene （c-Fos） were detected by Western blot. The mRNA expressions of OCs-related specific genes matrix metalloproteinase-9 （MMP-9）， NFATc1， TRAP， cathepsin K （CTSK）， and c-Fos were detected by real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. ResultCompared with the Sham group， the uterine index decreased significantly in the OVX group， and the body mass （BMI） increased significantly. The structure of bone trabeculae was completely damaged， and the number of OCs increased. BMD， Tb.N， BV/TV， and maximum load decreased， while Tb.Sp was up-regulated. The levels of TNF-α and CTX-1 in serum were up-regulated. The protein expressions of c-Fos， p-NF-κB p65/NF-κB p65， NFATc1， and p-IκBα/IκBα were increased. The mRNA expressions of NFATc1， c-Fos， CTSK， TRAP， and MMP-9 were up-regulated （P<0.05， P<0.01）. Compared with the OVX group， the body mass of the OK and E2 groups decreased， and the uterine index increased. The bone trabeculae increased， and the number of OCs decreased. BMD， Tb.N， BV/TV， and maximum load increased， while Tb.Sp decreased. The levels of TNF-α and CTX-1 in serum were decreased. The protein expressions of c-Fos， p-NF-κB p65/NF-κB p65， NFATc1， and p-IκBα/IκBα were decreased， and the mRNA expressions of NFATc1， c-Fos， CTSK， TRAP， and MMP-9 were decreased （P<0.05， P<0.01）. ConclusionOK can inhibit the NF-κB/NFATc1 signaling pathway and reduce bone mass loss by reducing the level of inflammatory injury factors in PMOP mice， which is one of the mechanisms for treating PMOP.
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Resumen Durante la menopausia se producen cambios metabólicos que favorecen la ganancia de peso y la obesidad abdominal, lo cual facilita el desarrollo de dislipidemias y aumenta el riesgo cardiovascular. El propósito del estudio fue comparar el perfil lipídico y los índices de riesgo cardiometabólico (IRCM) entre mujeres posmenopáusicas del Municipio Naguanagua, Estado Carabobo, Venezuela, clasificadas de acuerdo con su grado de adiposidad. El estudio fue de corte transversal, descriptivo, en el cual participaron 205 mujeres con una mediana de edad de 56 años. Se evaluaron indicadores de adiposidad: índice de masa corporal (IMC), porcentaje de grasa corporal (PGC), circunferencia de cintura (CC), e índice cintura/talla (ICT); así como el perfil lipídico y los IRCM. Se encontraron altos porcentajes de exceso de peso (80%), exceso de grasa corporal (92%), obesidad abdominal (61%) y riesgo metabólico de acuerdo con el ICT (69%). Las mujeres con obesidad mostraron los valores más bajos de cHDL, y aquellas con grasa muy alta, obesidad abdominal y riesgo metabólico de acuerdo con el ICT, los valores más elevados del índice TG/HDL. Se recomiendan otros estudios en este grupo poblacional para comprender mejor la asociación encontrada entre el grado de adiposidad y las alteraciones en el metabolismo de los lípidos con el fin de tomar acciones preventivas en estos trastornos relacionados con el síndrome metabólico.
Abstract During menopause, metabolic changes occur that promote weight gain and abdominal obesity, facilitating the development of dyslipidemias and increasing cardiovascular risk. The purpose of the study was to compare the lipid profile and the cardiometabolic risk indexes (IRCM) among postmenopausal women from the Naguanagua Municipality, Carabobo State, Venezuela, classified according to their degree of adiposity. It was a cross-sectional, descriptive study in which 205 women with a median age of 56 years participated. Adiposity indicators were evaluated: body mass index (BMI), percentage of body fat (PBF), waist circumference (WC), and waist-to-height ratio (WHtR); as well as the lipid profile and the IRCM. High percentages of excess weight (80%), excess body fat (92%), abdominal obesity (61%) and metabolic risk according to the WHtR (69%) were found. Women with obesity showed the lowest values of HDL-C, and those with very high fat, abdominal obesity, and metabolic risk according to the WHtR, the highest values of the TG/HDL index. Other studies are recommended on this population group to better understand the association found between the degree of adiposity and alterations in lipid metabolism to take preventive actions in these disorders related to the metabolic syndrome.
Resumo Durante a menopausa ocorrem alterações metabólicas que favorecem o ganho de peso e a obesidade abdominal, facilitando o desenvolvimento de dislipidemias e aumentando o risco cardiovascular. O objetivo do estudo foi comparar o perfil lipídico e os índices de risco cardiometabólico (IRCM) entre mulheres na pós-menopausa do município de Naguanagua, estado de Carabobo, Venezuela, classificadas de acordo com seu grau de adiposidade. O estudo foi transversal, descritivo, do qual participaram 205 mulheres com mediana de idade de 56 anos. Foram avaliados os indicadores de adiposidade: índice de massa corporal (IMC), percentual de gordura corporal (PGC), circunferência da cintura (CC) e índice cintura/estatura (ICE); bem como o perfil lipídico e o IRCM. Foram encontrados altos percentuais de excesso de peso (80%), excesso de gordura corporal (92%), obesidade abdominal (61%) e risco metabólico segundo o ICE (69%). Mulheres com obesidade apresentaram os menores valores de cHDL, e aquelas com muito alto teor de gordura, obesidade abdominal e risco metabólico segundo o ICE, os maiores valores da relação TG/HDL. Outros estudos neste grupo populacional são recomendados para melhor entender a associação encontrada entre o grau de adiposidade e as alterações no metabolismo lipídico, a fim de tomar ações preventivas nesses distúrbios relacionados com a síndrome metabólica.
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Background: Menopause is a natural reproductive period that affects women's lives between the ages of 45 and 55 due to various physical and mental changes. It usually happens when a lady is in her late 40s to early 50s (Barkha D et al., 2018). Many women see the menopausal transition as distressing (The North American Menopause Society, 2016). Menopausal women in rural locations may experience higher physical, psychological, and social stress. They also have more medical issues and worse self-esteem than males. The objective of present is to measure the stress experienced by pos Objective: tmenopausal women living in rural areas of the Bhagalpur district of Bihar. A cross-sectional survey method is used to measure stre Method: ss level of postmenopausal women. total 100 postmenopausal women were selected using simple random sampling within the age range of 45-55 years. The level of stress was measured by using a structured self-administered schedule. The result of this study revealed that most pos Result: tmenopausal women (70%) reported severe stress levels, 28% had moderate stress levels, whereas only 2% reported low-stress levels. Alt Conclusion: hough this is a short study but it offers a beginning for the future mapping of stress levels on menopause timing. Researchers looking into the stress experienced by postmenopausal women can also use this knowledge.
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Introduction: During menopause, women experience various psychological or physical changes which need adequate attention. Moreover, women don’t seek help for these problems due to their hesitancy, lack of awareness, socio-cultural, financial constraints or as they feel this is a natural-phenomenon. The study aims to explore the postmenopausal experiences faced by women during menopause and to elicit the constraints faced by them in seeking health-care services. Methodology: This was a qualitative study with phenomenological approach conducted among post-menopausal women (≥45 years) from Oct 2022-Jan 2023 with the help of In-Depth-Interview guide in four villages of Bhatar Block, Purba-Bardhaman District. Considering the availability of the study participants, they were selected purposively from the list prepared by ASHA of each village and recruitment done till the point of data-saturation. Inductive thematic-analysis was used to identify codes and themes. Results: During menopause, women experienced physical and psychological changes in the body, changes in social life and for these changes they had to adjust to cope-up. They felt various needs like empathy from hus-bands, children, peers. On the other hand, they did not seek help from health-care services due to their knowledge gap, dissatisfaction from previous-visit, cost-issue and unavailability of resources in health-care delivery system. Conclusion: Majority of the post-menopausal women faced various problems associated with menopause, but very few had sought help. So, health care providers have an important role to generate awareness among post-menopausal women regarding physical and mental changes during this phase.
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Background: Loss of estrogenic support may put postmenopausal women at higher risk of cardiovascular diseases. Aims and Objectives: This study aimed to examine premenopausal and postmenopausal woman to provide pertinent data on some of the cardiovascular risk factors and to know approximately the period which is under protection of estrogen and the period from which a woman is affected by changes in cardiovascular risk factors. Materials and Methods: This cross-sectional study was conducted in RIMS Ranchi from February 2018 to August 2019. A total of 262 apparently healthy women in the age group of 35–60 years were assessed for cardiovascular risk factors. Parameters assessed in premenopausal and postmenopausal women were heart rate, blood pressure (Systolic and Diastolic Blood Pressure), body mass index (BMI), waist circumference, hip circumference, blood sugar level, and lipid profile of the subjects. Results: Out of 262 participants, 132 were in the premenopausal group with mean age of 39.76 years and 130 were in the postmenopausal group with mean age of 50.8. Except BMI, all other cardiovascular risk parameters showed significant difference between premenopausal and postmenopausal women. Conclusion: We concluded that adverse changes in lipid profile and blood sugar along with significant increase in other cardiac risk factors in postmenopausal women as compared to premenopausal group of the study predisposed this group of women at increased risk of having cardiovascular disease in near future. Hence, preventive measures against cardiovascular disease risk should be started in premenopausal period only.
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Introdução: A osteoporose é uma das principais causas de morbimortalidade, principalmente em idosos e mulheres na pós-menopausa, devido ao aumento da fragilidade óssea e maior suscetibilidade a fraturas. Objetivo: Avaliar a eficácia e segurança do romosozumabe, comparado aos tratamentos farmacológicos atualmente disponíveis no Sistema Único de Saúde para o manejo de mulheres na pós-menopausa com osteoporose grave e alto risco de fraturas. Métodos: Foi realizada uma busca seguida por meta-análises indiretas, por ensaios clínicos randomizados (ECR) nas bases PubMed Central e Medline, Embase e Cochrane Library e por busca manual. O risco de viés (RoB 2.0) e a qualidade da evidência (GRADE) foram analisados. Meta-análises indiretas foram realizadas para desfechos de fraturas, densidade mineral óssea e eventos adversos. Resultados: Sete ECR (n= 19.951 mulheres) foram incluídos nesta revisão. Romosozumabe seguido de alendronato reduziu risco de fraturas não vertebrais em 12 meses (RR: 0,64, IC 95%: 0,49-0,84; alta certeza de evidência) e em 24 meses (RR: 0,52, IC 95%: 0,43-0,64; (alta certeza de evidência) na comparação ao alendronato. Achados semelhantes foram identificados para outros desfechos. Ácido zoledrônico foi associada a maior risco de descontinuação por evento adverso que placebo (RR: 1,02, IC 95%: 1,01-1,03). Conclusão: Foi identificado que romosozumabe ou romosozumabe seguido por alendronato são eficazes e seguros na comparação com alendronato.
Background: Osteoporosis is a major cause of morbidity and mortality, especially in the elderly and postmenopausal women, due to increased bone fragility and greater susceptibility to fractures. Objective: To evaluate the efficacy and safety of romosozumab, compared to pharmacological treatments currently available in the Unified Health System of Brazil for the management of postmenopausal women with severe osteoporosis and high risk of fractures. Methods: A search was carried out followed by indirect meta-analyses, randomized controlled trials (RCTs) in PubMed Central and Medline, EMBASE, and Cochrane Library databases and manual search. Risk of bias (RoB 2.0) and quality of evidence (GRADE) were assessed. Indirect frequentist meta-analyses were carried out for outcomes related to fractures, bone mineral density, and adverse events. Results: Seven RCTs (n= 19,951 woman) were included in this review. Romosozumab followed by alendronate reduced the risk of non-vertebral fractures at 12 months (RR: 0.64, 95% CI: 0.49-0.84; high certainty of evidence) and at 24 months (RR: 0.52, CI 95 %: 0.43-0.64; (high certainty of evidence) in comparison to alendronate. Similar findings were identified for other outcomes. Zoledronic acid was associated with a higher risk of discontinuation due to adverse events than placebo (RR: 1.02, 95% CI: 1.01-1.03). Conclusion: This review identified that romosozumab or romosozumab followed by alendronate are effective and safe compared to alendronate.
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Abstract Objective It was aimed to compare visceral adiposity index (VAI) levels in patients with normal bone mineral density (BMD), osteopenia, and osteoporosis. Methods One hundred twenty postmenopausal women (40 with normal BMD, 40 with osteopenia, and 40 with osteoporosis) between the ages of 50 to 70 years were included in the study. For females, the VAI was calculated using the formula (waist circumference [WC]/[36.58 + (1.89 x body mass index (BMI))]) x (1.52/High-density lipoprotein [HDL]-cholesterol [mmol/L]) x (triglyceride [TG]/0.81 [mmol/L]). Results The time of menopause from the beginning was similar in all groups. Waist circumference was found to be higher in those with normal BMD than in the osteopenic and osteoporotic groups (p = 0.018 and p < 0.001, respectively), and it was also higher in the osteopenic group than in the osteoporotic group (p = 0.003). Height and body weight, BMI, blood pressure, insulin, glucose, HDL-cholesterol, and homeostasis model assessment-insulin resistance (HOMA-IR) levels were similar in all groups. Triglyceride levels were found to be higher in the normal BMD group, compared with the osteoporotic group (p = 0.005). The level of VAI was detected as higher in those with normal BMD, compared with the women with osteoporosis (p = 0.002). Additionally, the correlation analysis showed a positive correlation between dual-energy X-ray absorptiometry (DXA) spine T-scores, WC, VAI, and a negative correlation between DXA spine T-scores and age. Conclusion In our study, we found higher VAI levels in those with normal BMD, compared with women with osteoporosis. We consider that further studies with a larger sample size will be beneficial in elucidating the entity.
Resumo Objetivo O objetivo foi comparar os níveis de índice de adiposidade visceral (IVA) em pacientes com densidade mineral óssea (DMO) normal osteopenia e osteoporose. Métodos Cento e vinte mulheres na pós-menopausa (40 com DMO normal 40 com osteopenia e 40 com osteoporose) com idades entre 50 e 70 anos foram incluídas no estudo. Para o sexo feminino o VAI foi calculado pela fórmula (circunferência da cintura [CC]/[36 58 + (1 89 x índice de massa corporal (IMC))]) x (1 52/lipoproteína de alta densidade [HDL]-colesterol [mmol/L]) x (triglicerídeo [TG]/0 81 [mmol/L]). Resultados O tempo de menopausa desde o início foi semelhante em todos os grupos. A circunferência da cintura foi maior naqueles com DMO normal do que nos grupos osteopênicos e osteoporóticos (p = 0 018 e p < 0 001 respectivamente) e também foi maior no grupo osteopênico do que no grupo osteoporótico (p = 0 003) . Altura e peso corporal IMC pressão arterial insulina glicose HDL-colesterol e os níveis de avaliação do modelo de homeostase-resistência à insulina (HOMA-IR) foram semelhantes em todos os grupos. Os níveis de triglicerídeos foram maiores no grupo DMO normal em comparação com o grupo osteoporótico (p = 0 005). O nível de VAI foi detectado como maior naquelas com DMO normal em comparação com as mulheres com osteoporose (p = 0 002). Além disso a análise de correlação mostrou uma correlação positiva entre a absorciometria de raios-X de dupla energia (DXA) nas pontuações T da coluna CC VAI e uma correlação negativa entre as pontuações T da coluna DXA e a idade. Conclusão Em nosso estudo encontramos níveis mais elevados de VAI naquelas com DMO normal em comparação com mulheres com osteoporose. Consideramos que novos estudos com maior tamanho amostral serão benéficos na elucidação da entidade.
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Humanos , Femenino , Persona de Mediana Edad , Anciano , Osteoporosis , Enfermedades Óseas Metabólicas , Adiposidad , ObesidadRESUMEN
Objective: This study has evaluated risk factors, especially dyslipidemia, for an acute myocardial infarction (AMI) in postmenopausal women. Materials and Methods: This was a hospital-based, observational, single-center study among 100 postmenopausal women admitted to the medicine ward with AMI. They were categorized based on lipid profile groups, viz., dyslipidemic group and non-dyslipidemic group. All clinical parameters were studied between the groups. Results: Among anthropometric profiles, in the comparison of mean height (cm), weight (kg), body mass index (BMI) (kg/m2 ), and waist circumference (WC) (cm) for the dyslipidemic group and non-dyslipidemic group, only WC was statistically significant (P < 0.001). Most patients were hospitalized between 6 and 12 h after the onset of symptoms. At the time of hospitalization, most patients from both groups were observed to have diabetes and hypertension with poor control of postprandial blood sugar, glycated hemoglobin, and diastolic blood pressure (DBP) (P < 0.05). The dyslipidemic group’s mean C-reactive protein was higher (P < 0.05). The comparison of mean total cholesterol, triglyceride (TG), low density lipoprotein-cholesterol in mg/dL, and TG: high density lipoprotein was significantly increased (P < 0.001), while high density lipoprotein-cholesterol (mg/ dL) was significantly decreased (P < 0.001) in the dyslipidemic group. ST-segment elevation myocardial infarction is standard in both groups. The maximum patient has regional wall motion abnormality in echocardiography after day 3 of admission. Among the dyslipidemic group, ejection fraction was on the lower side, and the predominant complication was in the left ventricular failure (LVF) (P < 0.05). Conclusion: WC has a positive association with patients with AMI who have dyslipidemia and can be used as an indicator of the risk of AMI when BMI is normal. WC is a surrogate marker of abdominal fat mass (subcutaneous and intra-abdominal); increased WC is a significant component marker of metabolic syndrome and insulin resistance related to cardiovascular mortality. There was poor glycemic control and blood pressure (mainly DBP) among the dyslipidemic patients. Hypertriglyceridemia is the most common lipid abnormality, followed by hypercholesterolemia among the dyslipidemic group. LVF is the most common complication in dyslipidemic patients.
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OBJECTIVE To evaluate the cost-effectiveness of denosumab and teriparatide in the treatment of postmenopausal osteoporosis in Chinese women， and provide reference for relevant decision-making. METHODS From the perspective of health system in China， Excel 2003 was used to establish Markov model， and cost-utility analysis was used to evaluate the cost- effectiveness of denosumab or teriparatide combined with Calcium carbonate D3 tablets in the treatment of postmenopausal osteoporosis in Chinese women. Pharmacotherapy effects were obtained with network meta-analysis， and cost and health utility value data were obtained from published literature. The model cycle was 1 year， and the simulation time limit was the patient’s lifetime. Univariate sensitivity analysis and probabilistic sensitivity analysis were used to evaluate the effects of model parameter changes on the robustness of the results. Through scenario analysis， the cost-effectiveness of domestic drug cost used as drug cost of terlipatide group was discussed； the influence of residual effects of teriparatide on the results and the cost-effectiveness of sequential use of desumamab after terlipatide withdrawal were also discussed. RESULTS The effect of denosumab regimen was better than that of terlipatide regimen [13.24 quality-adjusted life years （QALYs） vs. 12.96 QALYs]， with lower cost （51 224.64 yuan vs. 167 102.67 yuan）， denosumab regimen was the absolutely superior regimen. The results of single factor sensitivity analysis showed that the cost and discount rate of Terlipatide injection had greater impact on the results. The results of probability sensitivity analysis showed that when three times of China’s per capita gross domestic product （GDP） in 2021 was used as the threshold of willingness to pay， the probability of cost-effectiveness of denosumab regimen was 93.5%. The results of scenario analysis showed that， whether the drug cost of terlipatide regimen which was replaced by domestic drugs， or the residual effect of terlipatide was considered， or desulmonab was used sequentially after two years of terlipide treatment， denosumab regimen was always the absolute advantage regimen. CONCLUSIONS Denosumab combined with Calcium carbonate D3 tablets is more cost-effective than teriparatide combined with Calcium carbonate D3 tablets in the treatment of postmenopausal osteoporosis in Chinese women.