To investigate the effects of long-term low dose hormone replacement therapy (HRT) on postmenopaosal women in homone level, cognition score, hippocampus volume, and magnetic resonance spectroscopy (MRS) parameters...To investigate the effects of long-term low dose hormone replacement therapy (HRT) on postmenopaosal women in homone level, cognition score, hippocampus volume, and magnetic resonance spectroscopy (MRS) parameters. Methods A total of 182 postmenopausal women aged 50-87 years were chosen at Peking Union Medical College Hospital and assigned to HRT group and control group. The volunteers of HRT group had taken low dose hormone [ estradiol (E2 ) 0. 5-1.0 mg and progesterone 0.5-2.0 mg, once a day ] for 4-33 years. The concentrations of E2, progesterone, and testosterone were measured using enzyme-linked immunosorbent assay (ELISA). The gene types of apolipoprotein E (ApoE) were measured by polymerase chain reaction, and the subjects with susceptible genes ( ApoE ε3/ε4) of Alzheimer's disease (AD) were screened. Their hippocampus volumes and MRS parameters were obtained through magnetic resonance imaging (MRI), and results in two groups were analyzed by statistical method. Results Compared with control group, the concentrations of E2 at each age stage in HRT group were significantly higher (P 〈0. 05) except the 80-89 years old subgroup; yet, there were no statistical differences in the concentrations of progesterone and testosterone between the two groups. There was no obvious difference in ApoE subtypes distribution between the two groups The results of hippocampus MRI for the subjects with susceptible genes ApoE ε3/ε4 (HRT group 14 cases, control group 11 cases) showed that the ratio of bilateral hippocampus volume to whole brain volume in HRT group (0. 406 ± 0.028) was signiticantlyhigher than control gronp (0.369±0.031, P〈0.05). Theresults of ^1H MRS for the subjects with susceptible genes ApoE ε3/ε4 ( HRT group 12 cases, control group 11 cases) showed that the N-acetylaspartate/total creatine at the area of hippocampus in HRT group ( 1.54±0. 08 ) were significantly higher than control group ( 1.45±0. 13, P 〈 0. 05). Conclusions For postmenopausal women, long-term low dose HRT can maintain the physiological concentration of E2 in plasma. Furthermore, the hippocampus MRI performed on those with ApoE ε3/ε3 genes shows that long-term low dose HRT can prevent hippocampus atrophy, which is beneficial to maintain the brain function and prevent AD.展开更多
Hot flushes, experienced by 75% of menopausal women, are associated with estrogen deprivation. Estrogen was shown to ameliorate hot flushes by interacting with monoamine neurotransmitters in the brain; reducing noradr...Hot flushes, experienced by 75% of menopausal women, are associated with estrogen deprivation. Estrogen was shown to ameliorate hot flushes by interacting with monoamine neurotransmitters in the brain; reducing noradrenaline and increasing serotonin. Hormone replacement therapy(HRT), the first treatment option, causes concerns over possible increased risks particularly breast cancer. Folic acid is involved in the biosynthesis of serotonin and nordrenaline, which is responsible for its effects on mood and cognition, and degrees of folate inadequacy, not severe enough to produce megaloblastic anaemia, were found to be associated with depression and cognitive malfunctioning. Also, increased age was observed to relate to reduced serum and cerebrospinal fluid folic acid levels. There is emerging evidence that folic acid supplementation ameliorates hot fl ushes by the same mechanism as estrogen. To explore this hypothesis, a multi-centre, double-blind, placebo-controlled randomized is being set up to compare the effect of 5 mg folic acid vs placebo in reducing the frequency and severity of hot fl ushes in postmenopausal women, and on the blood level of serotonin and noradrenaline. If folic acid supplementation is demonstrated to be effective, this will be a turning point in the clinical practice since it represents a cheap, safe and well-tolerated alternative to HRT.展开更多
Objective: Postmenopausal women with breast cancer are at increased risk of bone loss because of age related estrogen deficiency face which accelerated with the use of aromatase inhibitors (AIs). We aimed to study ...Objective: Postmenopausal women with breast cancer are at increased risk of bone loss because of age related estrogen deficiency face which accelerated with the use of aromatase inhibitors (AIs). We aimed to study the effect on bone mineral density (BMD) and bone formation biomarker osteocalcin level in postmenopausal breast cancer patients, for the first three years of adjuvant hormonal treatment of both groups Tamoxifen versus Anastrozol. Methods: One-hundered postmenopausal breast cancers were prospectively randomized to receive either Tamoxifen 20 rag/day (n = 50) or Anastrozole 10 mg (n = 50). Both BMD and osteocalcin were assessed initially before treatment and then at regular intervals for both groups. Results: Use of Tamoxifen was associated with significant annual decrease in osteocalcin (P = 0.001), whereas Anastrozole group had gradual increase of the annual levels (P 〈 0.01). BMD decreased significantly in Anastrozole versus Tamoxifen groups (2.6% vs. 0.4%, P 〈 0.001). Osteoporosis T 〈 -2.5 was reported significantly higher in Anastrozole group (P 〈 0.01). Women with initial osteopenia in Anastrozole group showed significant decrease in BMD (P 〈 0.05). The addition of bisphosphonate for patients with early osteoporosis markedly improved both osteocalcin level and BMD. Conclusion: Tamoxifen preserves BMD in postmenopausal breast cancer patients, whereas Anastrozole accelerates age associated fall in BMD especially in the first year of therapy, moreover, the addition of bisphosphonate can help to decrease the skeletal related events associated with treatment to ensure better quality of life with treatment.展开更多
Objective:To explore the therapeutic efficacy and mechanism of transcutaneous electrical acupoint stimulation(TEAS)for menopausal insomnia.Methods:A total of 80 patients with menopausal insomnia were randomly divided ...Objective:To explore the therapeutic efficacy and mechanism of transcutaneous electrical acupoint stimulation(TEAS)for menopausal insomnia.Methods:A total of 80 patients with menopausal insomnia were randomly divided into a control group and an observation group,with 40 cases in each group.The patients in the control group received conventional Western medication treatment,and the patients in the observation group received TEAS on the basis of conventional Western medication treatment.The treatment for both groups lasted for 4 weeks.Before and after treatment,Pittsburgh sleep quality index(PSQI)and modified Kupperman scale were evaluated,and the serum levels of estradiol(E2)and follicular stimulating hormone(FSH)were measured.The therapeutic efficacy was evaluated after treatment.Results:After treatment,the total effective rate of the observation group was significantly higher than that of the control group(P<0.05);in the control group,the improvement of PSQI score was significant(P<0.05),while the change of modified Kupperman score was insignificant(P>0.05);the PSQI and Kupperman scores in the observation group were significantly improved after treatment(both P<0.05),and there were significant differences between the observation group and the control group in PSQI and Kupperman scores(both P<0.05).After treatment,the serum E2 and FSH levels in the control group were not statistically different from those before treatment(both P>0.05);the serum E2 level was significantly increased(P<0.05),and the FSH level was decreased(P<0.05)in the observation group after treatment,and the between-group differences in serum levels of E2 and FSH were significant(both P<0.05).Conclusion:TEAS plus conventional Western medication in treating menopausal insomnia is effective,and can significantly improve the symptoms of insomnia and menopause,which may be related to the regulation of serum E2 and FSH levels.展开更多
Objective: In postmenopausal women, an increased leptin concentration and reduced levels of ghrelin and adiponectin were observed. The aim of this study was to evaluate the concentrations of the active form of ghreli...Objective: In postmenopausal women, an increased leptin concentration and reduced levels of ghrelin and adiponectin were observed. The aim of this study was to evaluate the concentrations of the active form of ghrelin, total ghrelin, leptin receptor, lipoprotein(a) (Lp(a)), and plasminogen activator inhibitor type 1 (PAl-l) in postmenopausal women who received oral or transdermal menopausal hormonal therapy (MHT). Methods: The study involved 76 healthy women: 46 women aged from 44 to 58 years who received oral (26) or transdermal (20) MHT; the control group consisted of 30 women aged from 44 to 54 years who did not receive MHT. The plasma concentrations of total ghrelin, the active form of ghrelin, Lp(a), and PAI-I:Ag were measured by enzyme-linked immunosorbent assay (ELISA). The concentration of the leptin receptor was measured by enzyme immunometric assay (EIA). Results: We observed a significantly higher concentration o~ total ghrelin and the active form of ghrelin in women who received transdermal MHT in comparison with those who took oral MHT. We also found a significantly lower concentration of total ghrelin in women who received oral MHT compared with the control group. A higher concentration of PAl-1 :Ag was found in the group of women who took transdermal MHT in comparison with those who took oral MHT and with the control group. The differences were statistically significant. Additionally, we found a significant negative correlation between the concentrations of total ghrelin and PAl-1 :Ag and a positive correlation between the concentrations of total ghrelin and leptin receptor in women who received transdermal MHT. Conclusions: The study showed that women who used transdermal MHT had higher levels of total ghrelin than women who took oral MHT. This indicates a beneficial effect of the transdermal route of MHT. However, transdermal therapy was associated with adverse effects with regard to the observed higher levels of PAl-1 :Ag, which in turn, can lead to a reduction in fibrinolytic activity.展开更多
文摘To investigate the effects of long-term low dose hormone replacement therapy (HRT) on postmenopaosal women in homone level, cognition score, hippocampus volume, and magnetic resonance spectroscopy (MRS) parameters. Methods A total of 182 postmenopausal women aged 50-87 years were chosen at Peking Union Medical College Hospital and assigned to HRT group and control group. The volunteers of HRT group had taken low dose hormone [ estradiol (E2 ) 0. 5-1.0 mg and progesterone 0.5-2.0 mg, once a day ] for 4-33 years. The concentrations of E2, progesterone, and testosterone were measured using enzyme-linked immunosorbent assay (ELISA). The gene types of apolipoprotein E (ApoE) were measured by polymerase chain reaction, and the subjects with susceptible genes ( ApoE ε3/ε4) of Alzheimer's disease (AD) were screened. Their hippocampus volumes and MRS parameters were obtained through magnetic resonance imaging (MRI), and results in two groups were analyzed by statistical method. Results Compared with control group, the concentrations of E2 at each age stage in HRT group were significantly higher (P 〈0. 05) except the 80-89 years old subgroup; yet, there were no statistical differences in the concentrations of progesterone and testosterone between the two groups. There was no obvious difference in ApoE subtypes distribution between the two groups The results of hippocampus MRI for the subjects with susceptible genes ApoE ε3/ε4 (HRT group 14 cases, control group 11 cases) showed that the ratio of bilateral hippocampus volume to whole brain volume in HRT group (0. 406 ± 0.028) was signiticantlyhigher than control gronp (0.369±0.031, P〈0.05). Theresults of ^1H MRS for the subjects with susceptible genes ApoE ε3/ε4 ( HRT group 12 cases, control group 11 cases) showed that the N-acetylaspartate/total creatine at the area of hippocampus in HRT group ( 1.54±0. 08 ) were significantly higher than control group ( 1.45±0. 13, P 〈 0. 05). Conclusions For postmenopausal women, long-term low dose HRT can maintain the physiological concentration of E2 in plasma. Furthermore, the hippocampus MRI performed on those with ApoE ε3/ε3 genes shows that long-term low dose HRT can prevent hippocampus atrophy, which is beneficial to maintain the brain function and prevent AD.
文摘Hot flushes, experienced by 75% of menopausal women, are associated with estrogen deprivation. Estrogen was shown to ameliorate hot flushes by interacting with monoamine neurotransmitters in the brain; reducing noradrenaline and increasing serotonin. Hormone replacement therapy(HRT), the first treatment option, causes concerns over possible increased risks particularly breast cancer. Folic acid is involved in the biosynthesis of serotonin and nordrenaline, which is responsible for its effects on mood and cognition, and degrees of folate inadequacy, not severe enough to produce megaloblastic anaemia, were found to be associated with depression and cognitive malfunctioning. Also, increased age was observed to relate to reduced serum and cerebrospinal fluid folic acid levels. There is emerging evidence that folic acid supplementation ameliorates hot fl ushes by the same mechanism as estrogen. To explore this hypothesis, a multi-centre, double-blind, placebo-controlled randomized is being set up to compare the effect of 5 mg folic acid vs placebo in reducing the frequency and severity of hot fl ushes in postmenopausal women, and on the blood level of serotonin and noradrenaline. If folic acid supplementation is demonstrated to be effective, this will be a turning point in the clinical practice since it represents a cheap, safe and well-tolerated alternative to HRT.
文摘Objective: Postmenopausal women with breast cancer are at increased risk of bone loss because of age related estrogen deficiency face which accelerated with the use of aromatase inhibitors (AIs). We aimed to study the effect on bone mineral density (BMD) and bone formation biomarker osteocalcin level in postmenopausal breast cancer patients, for the first three years of adjuvant hormonal treatment of both groups Tamoxifen versus Anastrozol. Methods: One-hundered postmenopausal breast cancers were prospectively randomized to receive either Tamoxifen 20 rag/day (n = 50) or Anastrozole 10 mg (n = 50). Both BMD and osteocalcin were assessed initially before treatment and then at regular intervals for both groups. Results: Use of Tamoxifen was associated with significant annual decrease in osteocalcin (P = 0.001), whereas Anastrozole group had gradual increase of the annual levels (P 〈 0.01). BMD decreased significantly in Anastrozole versus Tamoxifen groups (2.6% vs. 0.4%, P 〈 0.001). Osteoporosis T 〈 -2.5 was reported significantly higher in Anastrozole group (P 〈 0.01). Women with initial osteopenia in Anastrozole group showed significant decrease in BMD (P 〈 0.05). The addition of bisphosphonate for patients with early osteoporosis markedly improved both osteocalcin level and BMD. Conclusion: Tamoxifen preserves BMD in postmenopausal breast cancer patients, whereas Anastrozole accelerates age associated fall in BMD especially in the first year of therapy, moreover, the addition of bisphosphonate can help to decrease the skeletal related events associated with treatment to ensure better quality of life with treatment.
文摘Objective:To explore the therapeutic efficacy and mechanism of transcutaneous electrical acupoint stimulation(TEAS)for menopausal insomnia.Methods:A total of 80 patients with menopausal insomnia were randomly divided into a control group and an observation group,with 40 cases in each group.The patients in the control group received conventional Western medication treatment,and the patients in the observation group received TEAS on the basis of conventional Western medication treatment.The treatment for both groups lasted for 4 weeks.Before and after treatment,Pittsburgh sleep quality index(PSQI)and modified Kupperman scale were evaluated,and the serum levels of estradiol(E2)and follicular stimulating hormone(FSH)were measured.The therapeutic efficacy was evaluated after treatment.Results:After treatment,the total effective rate of the observation group was significantly higher than that of the control group(P<0.05);in the control group,the improvement of PSQI score was significant(P<0.05),while the change of modified Kupperman score was insignificant(P>0.05);the PSQI and Kupperman scores in the observation group were significantly improved after treatment(both P<0.05),and there were significant differences between the observation group and the control group in PSQI and Kupperman scores(both P<0.05).After treatment,the serum E2 and FSH levels in the control group were not statistically different from those before treatment(both P>0.05);the serum E2 level was significantly increased(P<0.05),and the FSH level was decreased(P<0.05)in the observation group after treatment,and the between-group differences in serum levels of E2 and FSH were significant(both P<0.05).Conclusion:TEAS plus conventional Western medication in treating menopausal insomnia is effective,and can significantly improve the symptoms of insomnia and menopause,which may be related to the regulation of serum E2 and FSH levels.
基金Project supported by the Collegium Medicum in Bydgoszcz,Nicolaus Copernicus University in Toruń (No.73/04),Poland
文摘Objective: In postmenopausal women, an increased leptin concentration and reduced levels of ghrelin and adiponectin were observed. The aim of this study was to evaluate the concentrations of the active form of ghrelin, total ghrelin, leptin receptor, lipoprotein(a) (Lp(a)), and plasminogen activator inhibitor type 1 (PAl-l) in postmenopausal women who received oral or transdermal menopausal hormonal therapy (MHT). Methods: The study involved 76 healthy women: 46 women aged from 44 to 58 years who received oral (26) or transdermal (20) MHT; the control group consisted of 30 women aged from 44 to 54 years who did not receive MHT. The plasma concentrations of total ghrelin, the active form of ghrelin, Lp(a), and PAI-I:Ag were measured by enzyme-linked immunosorbent assay (ELISA). The concentration of the leptin receptor was measured by enzyme immunometric assay (EIA). Results: We observed a significantly higher concentration o~ total ghrelin and the active form of ghrelin in women who received transdermal MHT in comparison with those who took oral MHT. We also found a significantly lower concentration of total ghrelin in women who received oral MHT compared with the control group. A higher concentration of PAl-1 :Ag was found in the group of women who took transdermal MHT in comparison with those who took oral MHT and with the control group. The differences were statistically significant. Additionally, we found a significant negative correlation between the concentrations of total ghrelin and PAl-1 :Ag and a positive correlation between the concentrations of total ghrelin and leptin receptor in women who received transdermal MHT. Conclusions: The study showed that women who used transdermal MHT had higher levels of total ghrelin than women who took oral MHT. This indicates a beneficial effect of the transdermal route of MHT. However, transdermal therapy was associated with adverse effects with regard to the observed higher levels of PAl-1 :Ag, which in turn, can lead to a reduction in fibrinolytic activity.