scholarly journals Menopause modulates the circulating metabolome: evidence from a prospective cohort study

2021 ◽  
Author(s):  
Jari E Karppinen ◽  
Timo Tormakangas ◽  
Urho M Kujala ◽  
Sarianna Sipila ◽  
Jari Laukkanen ◽  
...  
Keyword(s):  
Hormone Therapy ◽  
Particle Concentration ◽  
Cardiovascular Health ◽  
Ldl Cholesterol ◽  
Follicle Stimulating Hormone ◽  
Menopausal Hormone Therapy ◽  
Particle Count ◽  
Female Sex Hormones ◽  
Serum Hormone

Aims: We studied the changes in the circulating metabolome and their relation to the menopausal hormonal shift in 17β-oestradiol and follicle-stimulating hormone levels among women transitioning from perimenopause to early postmenopause. Methods and Results: We analysed longitudinal data from 218 Finnish women, 35 of whom started menopausal hormone therapy during the study. The menopausal transition was monitored with menstrual diaries and serum hormone measurements. The median follow-up was 14 months (interquartile range: 8–20). Serum metabolites were quantified with targeted nuclear magnetic resonance metabolomics. The model results were adjusted for age, follow-up duration, education, lifestyle, and multiple comparisons. Menopause was associated with 84 metabolite measures. The concentration of apoB (0.17 standard deviation [SD], 99.5% confidence interval [CI] 0.03–0.31), VLDL triglycerides (0.25 SD, CI 0.05–0.45) and particles (0.21 SD, CI 0.05–0.36), LDL cholesterol (0.17 SD, CI 0.01–0.34) and particles (0.17 SD, CI 0.03–0.31), HDL triglycerides (0.24 SD, CI 0.02–0.46), glycerol (0.32 SD, CI 0.07–0.58) and leucine increased (0.25 SD, CI 0.02–0.49). Citrate (-0.36 SD, CI -0.57 to -0.14) and 3-hydroxybutyrate concentrations decreased (-0.46 SD, CI -0.75 to -0.17). Most metabolite changes were associated with the menopausal hormonal shift. This explained 10% and 9% of the LDL cholesterol and particle concentration increase, respectively. Menopausal hormone therapy was associated with increased medium-to-large HDL particle count and decreased small-to-medium LDL particle and glycine concentration. Conclusions: Menopause is associated with proatherogenic circulating metabolome alterations. Female sex hormones levels are connected to the alterations, highlighting their impact on women's cardiovascular health.

Abstract T MP67: Physical Activity Reduces Stroke Risk Among Women in the California Teachers Study Cohort

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Sophia S Wang ◽  
Kamakshi Lakshminarayan ◽  
Mitchell Elkind ◽  
Jenna Voutsinas ◽  
James Lacey ◽  
...  
Keyword(s):  
Physical Activity ◽  
Hormone Therapy ◽  
Stroke Risk ◽  
Menopausal Hormone Therapy ◽  
Study Cohort ◽  
Prevention Strategies ◽  
Stroke Risk Factors ◽  
Increased Risk ◽  
Post Menopausal

Background: Major modifiable stroke risk factors are well-established, yet strategies for effective prevention remain challenging. Developing stroke prevention strategies for women is critical due to: (i) the higher fatality and disability rate that women suffer compared to men, (ii) the unique risks to women such as from post-menopausal hormone therapy use, and (iiii) the aging female population. We evaluated three important modifiable stroke risk factors- obesity, hormone therapy, and physical activity, in the California Teachers Study cohort to identify potential stroke prevention strategies. Methods: The California Teachers Study comprises 133,479 women who enrolled in 1995 and have since been continuously followed. Using linked California state hospitalization data from 1996-2010, 3126 stroke events were defined as ischemic (N=2416; ICD-9 433, 434, 436) or hemorrhagic (N=710; ICD-9 430-432, excluding 432.1) and were validated by medical record review. Information about obesity, physical activity, hormone therapy, and medical history was collected at baseline and in follow-up questionnaires. Multivariable-adjusted hazards ratios and 95% confidence intervals were estimated by fitting Cox proportional hazards models with follow-up through 2010. Results: Consistent with previous reports, current post-menopausal hormone therapy use was associated with a 1.3-fold increased risk for stroke (95% CI=1.03-4.85). Moderate to strenuous physical activity in the 3 years before enrollment (but not lifetime activity) decreased stroke risk by 20% (HR=0.79, 95% CI=0.71-0.98). This decreased risk among physically active women was similar among current hormone therapy users, and appears to counteract the increased risk observed with current hormone therapy use. We found no association between obesity and stroke that was independent of diabetes. Conclusions: Recent physical activity reduces stroke risk and appears to counteract the increased risk associated with post-menopausal hormone therapy use.

scholarly journals Risks, Benefits, and Treatment Modalities of Menopausal Hormone Therapy: Current Concepts

2021 ◽  
Vol 12 ◽  
Author(s):  
Jaya Mehta ◽  
Juliana M. Kling ◽  
JoAnn E. Manson
Keyword(s):  
Hormone Therapy ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Menopausal Hormone Therapy ◽  
Treatment Modalities ◽  
Prescribing Practices ◽  
Post Intervention ◽  
Comprehensive Overview ◽  
Risks And Benefits

Menopausal hormone therapy (HT) prescribing practices have evolved over the last few decades guided by the changing understanding of the treatment’s risks and benefits. Since the Women’s Health Initiative (WHI) trial results in 2002, including post-intervention analysis and cumulative 18-year follow up, it has become clear that the risks of HT are low for healthy women less than age 60 or within ten years from menopause. For those who are experiencing bothersome vasomotor symptoms, the benefits are likely to outweigh the risks in view of HT’s efficacy for symptom management. HT also has a role in preventing osteoporosis in appropriate candidates for treatment. A comprehensive overview of the types, routes, and formulations of currently available HT, as well as HT’s benefits and risks by outcomes of interest are provided to facilitate clinical decision making.

Complementary Effects of Multivitamin and Omega-3 Fatty Acid Supplementation on Indices of Cardiovascular Health in Individuals with Elevated Homocysteine

2012 ◽  
Vol 82 (1) ◽  
pp. 41-52 ◽  
Author(s):  
P. Earnest ◽  
S. Kupper ◽  
M. Thompson ◽  
Guo ◽  
S. Church
Keyword(s):  
Risk Factors ◽  
Cardiovascular Health ◽  
Omega 3 Fatty Acids ◽  
Omega 3 ◽  
C Reactive Protein ◽  
Fatty Acid Supplementation ◽  
Omega 3 Fatty Acid ◽  
Reactive Protein ◽  
Daily Ingestion

Homocysteine (HCY), C-reactive protein (hsCRP), and triglycerides (TG) are risk factors for cardiovascular disease (CVD). While multivitamins (MVit) may reduce HCY and hsCRP, omega-3 fatty acids (N3) reduce TG; yet, they are seldom studied simultaneously. We randomly assigned 100 participants with baseline HCY (> 8.0 umol/L) to the daily ingestion of: (1) placebo, (2) MVit (VitC: 200 mg; VitE: 400 IU; VitB6: 25 mg; Folic Acid: 400 ug; VitB12: 400 ug) + placebo, (3) N3 (2 g N3, 760 mg EPA, 440 mg DHA)+placebo, or (4) MVit + N3 for 12 weeks. At follow-up, we observed significant reductions in HCY (umol/L) for the MVit (- 1.43, 95 %CI, - 2.39, - 0.47) and MVit + N3 groups (- 1.01, 95 %CI, - 1.98, - 0.04) groups, both being significant (p < 0.05) vs. placebo (- 0.57, 95 %CI, - 1.49, 0.35) and N3 (1.11, 95 % CI, 0.07, 2.17). hsCRP (nmol/L) was significantly reduced in the MVit (- 6.00, 95 %CI, - 1.04, - 0.15) and MVit + N3 (- 0.98, 95 %CI, - 1.51, - 0.46) groups, but not vs. placebo (- 0.15, 95 %CI, - 0.74, 0.43) or N3 (- 0.53, 95 %CI, - 1.18, 0.12). Lastly, we observed significant reductions in TG for the N3 (- 0.41, 95 %CI, - 0.69, - 0.13) and MVit + N3 (- 0.71, 95 %CI, - 0.93, - 0.46) groups, both significant vs. placebo (- 0.10, 95 %CI, - 0.36, 0.17) and MVit groups (0.15, 95 %CI, - 12, 0.42). The co-ingestion of MVit + N3 provides synergistic affects on HCY, hsCRP, and plasma TG.

Menopausal hormone therapy and uterine cancer: the acceptability of the tandem

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 42-47
Author(s):  
O V Yakushevskaya ◽  
S V Yureneva ◽  
A E Protasova ◽  
G N Khabas ◽  
M R Dumanovskaya
Keyword(s):  
Hormone Therapy ◽  
Uterine Cancer ◽  
Menopausal Hormone Therapy ◽  
Medical Rehabilitation ◽  
Cytostatic Treatment ◽  
Systematic Analysis ◽  
Strict Adherence ◽  
Patient Profile ◽  
The Past

The aim of the work is to conduct a systematic analysis of the available research results on the possibility of using menopausal hormone therapy (MHT) in patients who successfully completed the treatment of endometrial cancer (EC). Materials and methods. The review includes data from foreign articles published in PubMed and Medline, and domestic works published on elibrary.ru over the past 40 years. Results. The results obtained allow us to consider MHT as an independent method of medical rehabilitation for women who have undergone EC. A clear patient profile should be established, allowing the use of this method, with strict adherence to health monitoring. Conclusion Patients who have successfully completed the treatment of EC require the creation of special rehabilitation conditions in the interests of maintaining health and quality of life and should be under the close attention of the doctor. Argumented approaches to the appointment of MHT in such patients will avoid complications associated with estrogen deficiency after surgery, radiation with or without systemic (cytostatic) treatment methods.

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