The metabolic syndrome is associated with carotid atherosclerosis and arterial stiffness in asymptomatic, nondiabetic postmenopausal women.

The menopause transition is associated with adverse changes in cardiometabolic risk factors. We aimed to examine the association of the metabolic syndrome (MS) and its features with indices of vascular structure and function in a population of asymptomatic postmenopausal women. A total of 473 informed-consenting, nondiabetic postmenopausal women were included in the study. The MS was defined according to the Joint Definition. We evaluated the association between the presence of MS and indices of vascular structure (carotid artery intima-media thickness (IMT); atherosclerotic plaques) and function (flow-mediated dilatation (FMD); pulse wave velocity (PWV)). The mean age of women was 56.4 ± 6.7 and the mean menopausal age was 7.91 ± 6.31. The MS was present in 17.3% of our population. Mean values of PWV increased linearly with the accumulation of features of the MS. IMT was higher in women with the MS compared to women without the MS (0.78 ± 0.12 mm vs. 0.74 ± 0.11, p = .003). Multivariate analysis showed that the presence of the MS was independently associated with common carotid artery IMT (b = 0.149, p = .001), PWV (b = 0.114, p = .012) as well as central systolic and diastolic blood pressure (b = 0.293, p < .001 and b = 0.163, p < .001 respectively). The presence of the MS is associated with subclinical atherosclerosis already in the first postmenopausal decade of this sample of asymptomatic, nondiabetic women. Additional evidence is required to support the causative effect of these associations.

Myofibroblastoma of the Breast: Diagnostic Challenges of a Rare Benign Tumor.

Breast myofibroblastomas (MFBs) are rare benign tumors that have recently been recognized as a distinct entity. They are more common in men and often coexist with gynecomastia. Fine needle aspiration cytology or core biopsy should always be performed for triple assessment; however, due to the multiple variants of the tumor, final diagnosis can be safely accomplished only postoperatively with the aid of immunohistochemistry. The main histological characteristic that differentiates MFBs from the majority of malignant mesenchymal breast lesions is the presence of spindle cells in a collagenous background. Low mitotic activity and vimentin and CD34 positivity have been reported as well. Surgical excision retains a pivotal diagnostic and curative role. Local resection is sufficient, but mastectomy can also be advocated either in cases of male patients with coexisting gynecomastia or in females with large tumors. Into this retrospective survey, three cases of breast MFB were consecutively enrolled. Two patients were postmenopausal females and one was male. Relevant literature is briefly reviewed. Clinical features, histogenesis, morphological, and immunochemical findings are discussed, while the role of the current diagnostic and therapeutic management of this uncommon neoplasm is emphasized.

Arterial stiffness is increased in asymptomatic nondiabetic postmenopausal women with a polycystic ovary syndrome phenotype.

OBJECTIVE: The metabolic dysfunction accompanying the polycystic ovary syndrome (PCOS) may increase the risk of hypertension and cardiovascular disease (CVD). Although menopause per se may be an additional risk factor of CVD, the association between PCOS in postmenopausal women and cardiovascular risk has not been adequately investigated. We aimed to evaluate the effect of PCOS on markers of subclinical atherosclerosis in nondiabetic postmenopausal women. METHODS: This cross-sectional study included 286 postmenopausal women with intact ovaries. PCOS phenotype was defined if three of the following were present: insulin resistance, current hyperandrogenism or history of clinical androgen excess, history of infertility, central obesity and history of irregular menses. Traditional CVD risk factors, as well as indices of arterial structure (intima-media thickness, atheromatous plaques presence) and function [flow-mediated dilation, pulse wave velocity (PWV), augmentation index] were compared between women with a PCOS phenotype and the rest of the sample, who served as controls. RESULTS: Women with the PCOS phenotype (N=43) had higher SBP and triglycerides and lower high-density lipoprotein (HDL)-cholesterol than controls. Mean values of PWV differed significantly between PCOS cases and controls (9.46±1.74 vs. 8.60±1.51 m/s, P=0.001, univariate). Multivariate regression analysis showed that the PCOS phenotype, age and SBP were the only independent predictors of PWV. CONCLUSION: Arterial stiffness is increased in asymptomatic, nondiabetic women with a putative PCOS phenotype, independently of age, BMI or blood pressure. This might present one mechanism through which PCOS increases the risk of CVD and hypertension later in life.

Determinants of quality of life in Greek middle-age women: a population survey.

OBJECTIVES: The aim of the present study was to evaluate how sociodemographic parameters, lifestyle indicators and intensity of climacteric symptoms affect the quality of life (QOL) of Greek community dwelling middle-aged women. STUDY DESIGN: This population survey included 1140 middle-aged women aged 45-65 who represented 1% of the whole female population of this age group in Greece, stratified by residential area. MAIN OUTCOME MEASURES: Participants were asked to complete a questionnaire concerning sociodemographic and anthropometric parameters, medical history, the Utian quality of life (QOL) scale and the Greene climacteric scale rating menopausal symptoms. RESULTS: In the univariate analysis, normal body mass index, married status, higher education, employment, good financial status, physical exercise and a high calcium diet were associated with higher total QOL scores (p-value<0.001). Multivariate regression analysis showed that higher total QOL scores were predicted by being married (separated/divorced/widowed: beta=-3.17, p-value=0.008), by physical exercise (beta=4.84 and beta=4.57 for 1-3h and >3h per week respectively, p-value<0.001) and by a good financial status (beta=7.05, p-value<0.001), while a higher score in the Greene scale resulted in lower total QOL scores (beta=-0.77, p-value<0.001). Women with a better QOL were more health conscious and more probable to have utilized the public health preventive resources. CONCLUSIONS: Menopause as a life event has no effect on the QOL of Greek middle-aged women. On the contrary, the presence and intensity of climacteric symptoms have a negative impact on all aspects of QOL. Marital and financial status, as well as physical exercise, are also significant predictors of QOL.