[The frequency and structure of cardiac rhythm disturbances in the women presenting with abdominal obesity during the postmenopausal period].

We have studied the frequency and structure of cardiac rhythm (CR) disturbances in the women presenting with abdominal obesity (AO) in the postmenopausal period. The single-step study involved 210 postmenopausal women (median age 57 years) who were examined by 24-hour ECG monitoring, measurement of arterial pressure, body mass index, and the relationship between waist and hip circumferences. CR disturbances were revealed in all 159 women with abdominal obesity, ischemia in 16.9%, supraventricular extrasystole in 89.3%, ventricular extrasystole (VE) in 58.5%, high-grade extrasystole in 23.9%, paroxysms of supraventricular tachycardia in 1.9%, periods of asystole in 1.3%, synoatrial and atrioventricular blockade in 9.9%, His bundle branch block in 3.3%, sinus tachycardia in 48.8%, and sinus brachycardia in 23.9% of the patients. The risk of development of VE in the women with AO increased by 3.8 times in the presence of concomitant coronary heart disease and by 2.9 times in case of chronic cardiac failure. The frequency of VE was significantly higher in the patients with abdominal obesity than without it (odds ratio 2.2). It is concluded that women presenting with abdominal obesity during the postmenopausal period are characterized by the high frequency of cardiac rhythm disturbances and ischemia, with each fourth patient being at high risk of sudden death. The elevated risk of ventricular extrasystole in the postmenopausal period is associated with AO, coronary heart disease, and chronic heart failure. The frequency of VE is unrelated to ulcer disease, chronic cholecystitis, cholelithiasis, chronic pancreatitis, and impaired function of the thyroid gland.

[Metabolic syndrome and decreased bone mineral density in climacteric women].

The objective of this work was to evaluate the influence of insulin resistance on the development of syndrome of osteopenia. The case-control study included 124 women with osteopenia and osteoporosis of the distal forearm segment diagnosed by X-ray densitometry in accordance with the WHO criteria (DTX 200). One group of the patients comprised 62 women with metabolic syndrome (MS) by the criteria of NCPE ATP III. The other group consisted of 62 women without MS. Parameters measured in the study included antropometric parameters, blood glucose level, and characteristics of lipid metabolism. The fraction of women with osteoporosis (OP) in group 1 was smaller than in the women without MS (chi2 = 4.501; df=1; p = 0.034). The two groups were not significantly diferent as regards the non-traumatic fracture rate (chi2 = 0.278; df=2; p = 0.870). Nor did they differ in terms of the frequency of cardiovascular complications. It is concluded that disturbances of carbohydrate metabolism and cardiovascular pathology may be associated with reduced bone mineral density (BMD) while combination of these disorders in a single patient should be regarded as a manifestation of polymorbidity characteristic of this group of women.

[Frequency of diagnosis of postmenopausal osteoporosis of the spine, distant radius and extravertebral fractures in women with normal body mass, overweight and obesity].

AIM: To assess features and peculiarities of postmenopausal osteoporosis (OP) in women with normal body mass, overweight and obesity. MATERIAL AND METHODS: Dual energy X-ray absorptiometry of the lumbal spine (Lunar DPX) and distal radius X-ray absorptiometry (DTX 200) were performed during cross-section study of 730 symptomatic postmenopausal women. RESULTS: OP was diagnosed in 253 (34.7%) women, 30.5% of them had normal body mass, 43.2% had overweight and 26.3% were obese. Among them 227 had atraumatic fractures at the age over 50 years. Obese OP patients had significantly higher frequency of arterial hypertension, chronic heart failure, osteoarthritis and glucose metabolism disorders than osteoporotic patients with normal body mass. Fracture frequency did not differ between groups with normal body mass, overweight and obesity. CONCLUSION: Excessive body mass did not decrease fracture risk in women with postmenopausal OP.

[The evaluation of cardiovascular risk in postmenopausal women with osteopenia].

The purpose of the study was to evaluate the prevalence of the most important cardiovascular risk factors in postmenopausal women in correlation with bone mineral density (BMD). A hundred and fifty postmenopausal women were included in a case control study. The subjects were distributed into three equal groups: normal bone mass; osteopenia; non-complicated osteoporosis. BMD was measured with lumbar double-energy X-ray absorptiometry. Cardiovascular risk factors were assessed. The level of triglycerides was significantly higher in patients with osteoporosis vs. subjects with normal BMD. Arterial hypertension and a 10-year fatal risk of more than 0% were significantly more prevalent in the group with normal BMD. Osteoporosis presents an independent cardiovascular risk factor. Postmenopausal women with decreased BMD should be considered to have a higher risk of cardiovascular events, because standard risk scales do not take BMD into account.

[Osteoarthrosis of the knee joints in climacteric women with excessive body weight or obesity].

The purpose of the study was to evaluate body weight (BW) effect on the frequency and clinical manifestations of knee joint osteoarthrosis (KJOA) in climacteric women with excessive BW or obesity. The subjects of this case control study were divided into three groups: group 1 consisted of 283 climacteric women with normal BW; group 2 consisted of 283 women with excessive BW; 283 obese women constituted group 3. All the three groups were comparable by age and menopause duration. The diagnosis of KJOA was established according to American Rheumatology Association criteria. Joint pain intensity was assessed using 100-mm visual analog scale. Lequesne algofunctional index was used to determine functional limitations. Lipid and carbohydrate exchange parameters were studied as well. The frequency of KJOA was significantly higher in group 2 (47.3%) and group 3 (56.1%) vs. group 1 (39.9%). Abdominal obesity was significantly more frequent in patients with KJOA (32.2%). Obesity was associated with an increased risk of KJOA (relative risk = 1.91; 95% confidence interval = 1.37-2.67), but not other variants of osteoarthrosis. Thus, in Russian population of climacteric women the frequency of KJOA was significantly higher in those with excessive body weight or obesity vs. women with normal body weight. Abdominal obesity was found to be an independent risk factor of KJOA, but not other localizations of osteoarthrosis.

[Magnesium deficit in climacteric women].

The aim of the study was to assess the prevalence of magnesium deficit (MD) in climacteric women and its effect on the severity of climacteric syndrome (CS). This cross-sectional study included 165 women with typical CS manifestations. Patients with arterial hypertension were excluded. Blood levels of magnesium and calcium as well as lipid exchange variables in blood serum were studied. The degree of CS was determined using modified menopausal index (MMI). MD was revealed in 62.4% of the patients. The frequency of obesity and excessive body mass was significantly higher in MD women vs. women whose magnesium levels were normal (chi2 = 4.477; p = 0.034). MD was associated with a higher risk of peripheral bone fractures (OR = 2.28; 95% CI 1.06-4.93). Normal magnesium levels were found in less than 50% of women with clinical manifestations of DM. MD was associated with a higher frequency of abdominal obesity and bone fractures of extremities.

[Osteopenia and osteoporosis of the distal forearm in menopausal females].

AIM: To estimate the frequency of decreased bone mineral density (BMD) in the distal forearm of the females visiting a specialized city consultative center for menopausal pathology, by using dual energy X-ray absorptiomentry (DEX4) and to assess risk factors for osteoporosis. MATERIALS AND METHODS: The cross-sectional study included 681 females (mean age 54.8 +/- 5.81 years) who had filled in the questionnaire of the National Osteoporosis Risk Factor Study Program. The severity of the menopausal syndrome was evaluated by means of the modified menopausal index. Distal forearm BMD was diagnosed by DEXA on a DTX 200 apparatus (Denmark). RESULTS: Osteopenia and osteoporosis were detected in 187 (27.5%) and 53 (7.8%) of the examinees, respectively. The females with osteopenic syndrome had a lower body mass. Arterial hypertension was more frequently detected among the patients with OP. The distal forearm was the most common site of fractures. Irrespective of the state of BMD, the proportion of those who regularly ate dairy products was extremely low. CONCLUSION: A rapid BMD reduction is observed in menopausal females. The proportion of antihypertensive patients was significantly higher among the women with osteopenic syndrome.

[Hyperinsulinemia and insulin-resistance in climacteric women with metabolic syndrome].

The purpose of the study was to evaluate the peculiarities of carbohydrate and lipid dysmetabolism in climacteric women with metabolic syndrome (MS). The subjects of this case-control study were 124 women. The main group consisted of 62 women with MS according to A TP III classification; the control group included 62 women without MS. Anthropometric parameters, blood levels of glucose and immunoreactive insulin, and lipid exchange indices were measured. Thirty-three patients in the main group were obese, and 12 had an excessive body weight; in the control group these conditions were found in 6 and 23 patients, respectively. Patients in the main group developed insulin resistance (IR) significantly more often than the controls did (33 and 15 cases, respectively); the frequency of arterial hypertension, differed significantly between the groups, too. High incidence of IR and carbohydrate dysmetabolism in climacteric women suffering from MS is associated with lipid exchange disturbances, the latter being an independent risk factor of coronary heart disease.