Effect of menopausal hormone therapy on components of the metabolic syndrome (original) (raw)
Related papers
The Emergence of the Metabolic Syndrome with Menopause
2003
Women with the metabolic syndrome (central obesity, insulin resistance, and dyslipidemia) are known to be at especially high risk for cardiovascular disease (CVD). The prevalence of the metabolic syndrome increases with menopause and may partially explain the apparent acceleration in CVD after menopause. The transition from pre-to postmenopause is associated with the emergence of many features of the metabolic syndrome, including 1) increased central (intraabdominal) body fat; 2) a shift toward a more atherogenic lipid profile, with increased low density lipoprotein and triglycerides levels, reduced high density lipoprotein, and small, dense low density lipoprotein particles; 3) and increased glucose and insulin levels. The emergence of these risk factors may be a direct result of ovarian failure or, alternatively, an indirect result of the metabolic consequences of central fat redistribution with estrogen deficiency. It is unclear whether the transition to menopause increases CVD risk in all women or only those who develop features of the metabolic syndrome. This article will review the features of the metabolic syndrome that emerge with estrogen deficiency. A better understanding of these metabolic changes with menopause will aid in the recognition and treatment of women at risk for future CVD, leading to appropriate interventions. (J Clin Endocrinol
Prevalence of Metabolic Syndrome and Effect of Hormone Profile in Postmenopausal Patients
Journal of Academic Research in Medicine, 2016
Objective: The purpose of this study was to evaluate the prevalence and connection with hormonal changes of metabolic syndrome and its components in postmenopausal women based on a literature survey. Methods: The medical records of 138 postmenopausal patients were retrospectively reviewed between January 2013 and March 2014. Patients with surgical menopause and those who underwent hormone replacement therapy, chemotherapy, and radiotherapy were excluded. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Patients' demographic data, menopausal status, medical history, and physical examination and clinical laboratory data were analyzed. Data were evaluated statistically. Results: In total, 128 patients were included in this study. The menopausal age of patients in the metabolic syndrome group was 50.06±2.93 and that in the non-metabolic syndrome group was 45.16±4.4 years. The prevalence of metabolic syndrome was observed in 43.4% patients in this study. A statistically significant negative high correlation (p<0.05) was observed between waist circumference and the number of metabolic components with FSH-LH levels. Conclusion: The prevalence of metabolic syndrome among postmenopausal women is high, and abdominal obesity and low HDL levels are strong predictors. These components can lead to an increase in cardiovascular diseases. Thus, it is encouraging to adopt lifestyle changes that reduce the prevalence of metabolic syndrome.
Menopause and the metabolic syndrome
Menopause is the period in a woman's life when she is undergoing hormonal and metabolic changes. Metabolic syndrome or syndrome X comprises of a set of cardiovascular risk factors: obesity, elevated blood pressure, hyperglycemia or insulin resistance and dyslipidemia. Menopause is the point in the timeline of a woman where she is exposed to risk factors for cardiac ill health. The preferential central pattern of fat deposition in obese post-menopausal women is associated with a higher risk of diabetes, hypertriglyceridemia, hypertension and cardiac disease. Hormone therapy improves the altered lipid profile in women with metabolic syndrome and these effects are more pronounced in post-menopausal women. It is important to have more efforts for regular lipid screening and educational programs for a healthy life style for an obese post-menopausal woman.
Emergence of Metabolic Syndrome Out of Menopausal Box!!!
Journal of SAFOMS
Metabolic syndrome is the constellation of risk factors that predisposes to increased risk of cardiovascular diseases (CVD) and type 2 diabetes mellitus that is increasingly coming to light in menopausal females, thereby raising the morbidity and mortality. Declining estrogen levels along with genetic susceptibility and central obesity adversely affect the lipid metabolism, making postmenopausal females vulnerable to metabolic syndrome. Early identification of the various risk factors and appropriate preventive strategies (lifestyle modification and use of statins in selective cases) may decrease the emergence of metabolic syndrome in such females, thereby improving the longevity. Screening of risk factors for metabolic syndrome in postmenopausal females should be routinely done and therefore incorporated and inculcated in every postmenopausal clinic so that suitable candidates can be referred to cardiologists for expert advice and proper intervention if required.
Diabetes, Obesity …, 2006
The authors concluded that hormone-replacement therapy reduced a number of components of the metabolic syndrome in diabetic and non-diabetic postmenopausal women. However, oral agents presented certain adverse effects on Creactive protein and protein S. A number of limitations, such as uncertainty regarding the quality of the included studies and the poor reporting of review methodology, limit any robust conclusions. Authors' objectives To examine the effects of hormone-replacement therapy (HRT) on components of the metabolic syndrome in diabetic and non-diabetic postmenopausal women. Searching MEDLINE, EMBASE, CINAHL and the Cochrane CENTRAL Register were searched from April 1966 to October 2004; the search terms were not reported. Study selection Randomised controlled trials (RCTs) comparing HRT with placebo or no hormone therapy, with a treatment duration of at least 8 weeks, in postmenopausal women were eligible for inclusion. Crossover trials with a treatment duration of less than 12 weeks were required to include a 4-week washout period. Studies reporting measures of the metabolic syndrome were eligible for inclusion. Such measures included abdominal obesity (lean body mass, waist circumference, abdominal fat), insulin resistance and diabetes (fasting glucose, fasting insulin, new-onset diabetes), lipids and lipoproteins (high-and low-density lipoprotein cholesterols, triglyceride, lipoprotein(a)), blood-pressure, inflammatory components (C-reactive protein, E-selectin) and thrombotic components (fibrinogen, plasminogen activator inhibitor-1, or protein C or S). The included studies assessed the following forms of HRT in diabetic and non-diabetic postmenopausal women: conjugated equine oestrogen, oral esterified oestrogens or transdermal oestrogen, alone or in combination with a progestin, administered as a low (0.625 mg) or high (1.25 mg) dose. The controls included placebo, calcium supplementation or no treatment. The mean treatment duration was 1 year and 6 months (range: 0.15 to 5 years). The mean baseline age was 60.3 years for women receiving HRT and 61.5 years for controls. The included studies also reported measures of intercellular adhesion molecule, vascular cell-adhesion molecule, factor VII, tissue plasminogen activator, antithrombin III and von Willebrand factor. The authors did not state how the papers were selected for the review, or how many reviewers performed the selection. Assessment of study quality Validity was assessed using the following criteria: randomisation and allocation concealment; blinding of the patients and investigators; and the reporting of drop-out rates and use of intention-to-treat analysis. The studies were evaluated separately and each criterion was assessed using a 3-point scale. The authors did not state how many reviewers performed the validity assessment. Data extraction Two investigators extracted the data on each outcome for non-diabetic women, but only data on fasting glucose and fasting insulin for women with diabetes. Dichotomous data relating to new-onset diabetes were extracted, according to the definitions used in the included studies, in order to calculate the relative risks (RRs). Mean values with standard deviations or median values and percentage change were extracted for continuous outcomes to obtain the percentage change in mean group values from baseline to follow-up, ultimately to calculate the net treatment effect.
Metabolic syndrome in menopausal transition: Isfahan Healthy Heart Program, a population based study
Diabetology & Metabolic Syndrome, 2010
INTRODUCTION: There is a remarkable increase in cardiovascular disease after menopause. On the other hand, metabolic syndrome as a collection of risk factors has a known effect on cardiovascular diseases. Hormone changes are considered as one of the main relevant factor regarding cardiovascular disease as well as some recognized relationship with metabolic syndrome's components. This study was carried out in
Postmenopause and Metabolic Syndrome
Eastern Journal Of Medicine, 2017
In this review, the causes and results of the metabolic syndrome and the relationship between vasomotor symptoms like hot flashes, night sweats, which started with the termination of ovarian activity in the postmenopausal period, were compared. The pathophysiology of the postmenopausal and metabolic syndrome has been examined in parallel. Vasomotor symptoms have been shown to be more severe in postmenopausal women with metabolic syndrome.
Archives of Gynecology and Obstetrics, 2010
Objectives The aim of this study was to evaluate the eVects of hormone replacement therapy (HRT) on carbohydrate and lipid metabolisms and cardiovascular risk parameters in healthy postmenopausal women. Methods Forty women receiving and 38 women not receiving HRT were included and baseline and sixth month blood pressure, weight, body mass index, waist/hip ratio, blood lipid proWle, inXammatory markers (homocysteine, C-reactive protein (CRP) and Wbrinogen), hemoglobin A1c (HbA1c) and insulin, and oral glucose tolerance test (OGTT) results were evaluated. Results The mean age was 52.6 § 4.9 and 52.2 § 5.0 years in the HRT and Control Groups, respectively. Whereas there was no change in the Controls, the weight, waist/hip ratio, and BMI increased and diastolic blood pressure decreased in the HRT patients. LDL-c, VLDL-c and lipoprotein (a) levels were signiWcantly higher in the HRT Group in the sixth month; however, total cholesterol and LDL-c increased in the Controls but VLDL-c and lipoprotein (a) did not. CRP and homocysteine signiWcantly increased and Wbrinogen decreased, whereas in the Control Group no signiWcant change was detected. A signiWcant improvement in HbA1c and OGTT was found in both the groups, whereas a signiWcant reduction was measured only in the HRT Group. Conclusions In response to 6 months of HRT, there was an increase in weight, BMI, and waist/hip ratio as known cardiovascular risk factors, but no signiWcant impact on lipid proWle and glucose metabolism could have been clearly demonstrated. A mixed eVect proWle of HRT on the state of inXammation (increase in CRP and homocysteine, decrease in Wbrinogen) was observed.