SARS-Cov-2 Infection in Postmenopausal Women. New Data on Menopause Hormone Therapy

ObjectiveTo address the factors involved in hospital admission and medical follow up in postmenopausal women with COVID-19 diagnosis.MethodsRetrospective observational study. Postmenopausal women aged between 40-70 years since September 2020 until June 2021 with COVID-19 diagnosis were included. Of the 300 women cohort, 50 were receiving menopause hormone therapy (MHT)Results 288 patients were analyzed. The mean age was 56.20 years (+/-6.06y SD). Age (p=0.030), High blood pressure (HBP) (p=0.002), respiratory disorders (p=0.003), depression (p=0.028) and fibromyalgia (p=0.030) were associated with a greater risk for hospital admission, while MHT was found as a protective factor (p=0.042). Being a health professional (p<0.001), HBP (p=0.029), respiratory disorders (p=0.022), vitamin D deficiency (p=0.010), depression (p=0.005) and fibromyalgia (p=0.001) were related with a longer follow up while MHT was related with a shorter one (p=0.010). Regression analysis showed that HBP and respiratory disorders acted as independent factors for hospital admission while MHT and fibromyalgia were for the length of follow up. ConclusionsMHT has a positive impact in postmenopausal women with SARS-CoV-2 infection. HBP and respiratory disorders are associated with a higher risk of hospital admission of these patients.

Reference Interval for Serum Concentration of Small Dense LDL Cholesterol in the Healthy Japanese Population

Background: Small dense low-density lipoprotein (sdLDL), a smaller and denser subfraction among whole LDL particles, is known to be highly atherogenic. The reference interval (RI) is not strictly defined for serum concentration of sdLDL-cholesterol (sdLDL-C) in Japan. The purpose of this study is to set the RI for sdLDL-C in healthy subjects. Methods: The population of this cross-sectional study were consisted of 40,862 individuals who had annual health checkups, and healthy subjects were extracted based on exclusion criteria such as medical history, social history, and blood sampling test results. Their serum sdLDL-C values were statistically analyzed and the RIs were set in men, premenopausal women, and postmenopausal women separately. Results: The mean values of serum sdLDL-C in healthy subjects were 23.9 mg/dL in men, 20.0 mg/dL in premenopausal women and 23.7 mg/dL in postmenopausal women, and the RIs were 12.6-45.3 mg/dL in men, 11.4-35.1 mg/dL in premenopausal women and 14.6-38.6 mg/dL in postmenopausal women. Serum sdLDL-C values were significantly higher in men than in women. Besides, sdLDL-C values were significantly higher in postmenopausal women than in premenopausal women. In both genders, sdLDL-C values tended to increase with age. Conclusion: These results suggest that the RIs for sdLDL-C are recommended as follows: 13-45 mg/dL in men, 11-35 mg/dL in premenopausal women, and 15-39 mg/dL in postmenopausal women, respectively. Aside from these RIs, it is also necessary to define clinical cutoff values graded according to individual risk levels for atherosclerotic cardiovascular diseases.

Relationship of Inflammatory Markers and Metabolic Syndrome in Postmenopausal Women

The increased deposition of visceral fat in the postmenopause period increases the production of inflammatory cytokines and the release of tumor necrosis factor- α (TNF-α), interleukin-6 (IL-6), and decrease in IL-10. This study investigated the relationship between inflammatory biomarkers and metabolic syndrome (MS) in postmenopausal women considering different diagnostic criteria. We conducted a cross-sectional observational study based on STROBE. Data were collected regarding the diagnostic criteria for MS (International Diabetes Federation; NCEP (International Diabetes Federation (IDF), National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP-III), and Harmonized criteria), body composition, comorbidities, time without menstruation, values of IL-6, IL-10, and TNF-α. ANOVA, Kruskal–Wallis, Levene tests, ROC, and odds ratio were performed to analyze the data. The results showed no significant difference between the methods and no interaction between the method and the presence of MS. However, for the values of WC, body fat percentage, TNF-α, and IL-10/TNF-α ratio, a significant effect of MS was observed. In subjects with MS, lower values of body fat percentage and TNF-α and higher values of the IL-10/TNF-α ratio were also observed. The higher IL-10/TNF-α ratio in the MS group is related to the greater anti-inflationary action of IL-10. The IL-10/TNF-α ratio showed significant accuracy to discriminate patients with MS according to the NCEP-ATP III criteria.

Efficacy of Yigu® versus Aclasta® in Chinese postmenopausal women with osteoporosis: a multicenter prospective study

Summary Zoledronic acid (ZOL) is a therapy inhibiting bone resorption. In this study, generic ZOL (Yigu®) showed its clinical efficacy consistency with original ZOL (Aclasta®) in Chinese postmenopausal women with osteoporosis. This study provides a practical basis for the application of Yigu® in Chinese population. Introduction Yigu® has been approved its bioequivalence to Aclasta®. However, the clinical efficacy and safety of Yigu® have not been evaluated yet. Here, we compared the effectiveness and safety between Yigu® and Aclasta® in Chinese postmenopausal women with osteoporosis and assessed the efficacy of intravenous infusion of ZOL. Methods This was a randomized open-label, active-controlled study in postmenopausal women with osteoporosis of 14 clinical centers in China. Postmenopausal women with osteoporosis were recruited and randomized to receive a single infusion of 5 mg Yigu® or Aclasta®. The primary endpoint was the percentage change in bone mineral density (BMD) at lumbar spine after 12 months of treatment and was assessed for equivalence. The secondary endpoint was the percentage change in BMD at proximal femur after 12 months. Additional secondary endpoints were percentage changes in BMD at the above sites after 6 months of treatment and changes in bone turnover biomarkers during ZOL treatment. Safety was also evaluated and compared between two groups. Results A total of 458 postmenopausal women with osteoporosis were enrolled (n = 227, Yigu®; n = 231, Aclasta®). The mean percentage change in the BMD had no statistical difference at the lumbar spine (5.32% vs 5.18%), total hip (2.72% vs 2.83%), and femoral neck (2.37% vs 2.81%) between Yigu® and Aclasta® groups after 12 months of treatment. The mean difference of BMD change at the lumbar spine after 12 months between two groups was 0.15% (95% CI: − 0.71 to 1.00, equivalence margin: − 1.5%, 1.5%), demonstrating the treatments were equivalent. Meanwhile, the decreases in the P1NP and β-CTX showed no difference between two groups after 14 days and 6 and 12 months of treatment. As regards the whole sample, BMD significantly increased after 12 months of treatment. Also, serum C-terminal telopeptide of type 1 collagen (β-CTX) and procollagen 1 N-terminal peptide (P1NP) significantly decreased at each visit period. The overall adverse events were comparable and quite well between two groups. Conclusion Intravenous infusion of zoledronic acid achieved the potent anti-resorptive effects which led to significant increase in BMD of Chinese postmenopausal women with osteoporosis. Yigu® was equivalent to Aclasta® with respect to efficacy and safety.

On the Relationship Between Intimate Partner Violence and Quality of Life Among Menopausal Women

Background: This study aimed to assess the relationship between intimate partner violence (IPV) and quality of life (QOL) among menopausal women. Methods: The present cross-sectional study was conducted on 202 postmenopausal women admitted to different healthcare centers. The primary data collection tools were the revised Conflict Tactics Scale (CTS2) and Menopause-Specific Quality of Life (MENQOL). Results: The participants encompassed 202 postmenopausal women with the mean age of 52.14 ± 5.93 years. The analysis revealed that 70.8% of women were 45 - 55 years, 29.2% of women were 56 - 65 years, and 62.7% of the participants had more than two children. Compared to the non-smoking participants, the smoking women reported more injury violence (P = 0.008). In this study, the effect of the husband and wife’s level of education on IPV was not significant. The menopausal women or their spouses experienced more psychological (P = 0.008) and injury (P = 0.01) violence following their second marriage. The present findings suggested that three types of violence, including psychological (P < 0.001), physical (P = 0.003), and injury (P < 0.001), reported higher levels of psychological symptoms. The women experiencing psychological (P < 0.001) and sexual (P = 0.012) violence reported more severe physical problems than those with no history of violence in menopause. Conclusions: This study provided more profound insights into the relationship between menopause-related quality of life and types of violence among menopausal women. The quality of life in postmenopausal women is significantly declined under domestic violence. Healthcare providers are recommended to be trained on detecting and managing IPV and the corresponding physical and psychological problems.