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RELATION OF BODY FAT DISTRIBUTION TO FEMORAL NECK BONE DENSITY AND ENDOMETRIAL THICKNESS IN POSTMENOPAUSAL WOMEN

Oktem DGYE-2009-0167.r1 [ID 463729] 5 PAG

Objective: Menopause is associated with accelerated bone loss, a decrease in lean mass, an increase and redistribution of fat mass in the trunk region. Trunk obesity has been considered as a risk factor for endometrial cancer. We aimed to determine if body composition and fat distribution are determinants of femoral neck bone mineral density (BMD) and endometrial thickness in healthy postmenopausal women.
Study Design: Subjects were 40 healthy postmenopausal women with biopsy proven atrophic endometrium. Anthropometrical variables (total fat mass, trunk and leg fat masses, lean body mass and femoral neck BMD) were measured by dual energy x-ray absorptiometry (DEXA).
Results: Femoral neck BMD was positively correlated with BMI, total fat mass, trunk fat mass, leg fat mass and endometrial thickness, and negatively correlated with age, years since menopause and FSH levels. Trunk fat and age remained significant determinants of femoral neck BMD (R2=32.9 %, p<. 001) and endometrial thickness was significantly associated with femoral neck BMD and estradiol levels (R2= 46.5%, p<. 0001) on regression analysis.
Conclusion: Truncal adiposity rather than overall adiposity or lean mass are more closely associated with femoral neck BMD and there is no relationship between subcutaneous fat mass and endometrial thickness in postmenopausal women.

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THE ESTROGEN RECEPTOR-ALPHA IN OSTEOCLASTS MEDIATES THE PROTECTIVE EFFECTS OF ESTROGENS ON CANCELLOUS BUT NOT CORTICAL BONE.

1) Mol Endocrinol. 2010 Feb;24(2):323-34.

Martin-Millan M, Almeida M, Ambrogini E, Han L, Zhao H, Weinstein RS, Jilka RL, O’Brien CA, Manolagas SC.

Estrogens attenuate osteoclastogenesis and stimulate osteoclast apoptosis, but the molecular mechanism and contribution of these effects to the overall antiosteoporotic efficacy of estrogens remain controversial. We selectively deleted the estrogen receptor (ER)alpha from the monocyte/macrophage cell lineage in mice (ERalpha(LysM)(-/-)) and found a 2-fold increase in osteoclast progenitors in the marrow and the number of osteoclasts in cancellous bone, along with a decrease in cancellous bone mass. After loss of estrogens these mice failed to exhibit the expected increase in osteoclast progenitors, the number of osteoclasts in bone, and further loss of cancellous bone. However, they lost cortical bone indistinguishably from their littermate controls. Mature osteoclasts from ERalpha(LysM)(-/-) were resistant to the proapoptotic effect of 17beta-estradiol. Nonetheless, the effects of estrogens on osteoclasts were unhindered in mice bearing an ERalpha knock-in mutation that prevented binding to DNA. Moreover, a polymeric form of estrogen that is not capable of stimulating the nuclear-initiated actions of ERalpha was as effective as 17beta-estradiol in inducing osteoclast apoptosis in cells with the wild-type ERalpha. We conclude that estrogens attenuate osteoclast generation and life span via cell autonomous effects mediated by DNA-binding-independent actions of ERalpha. Elimination of these effects is sufficient for loss of bone in the cancellous compartment in which complete perforation of trabeculae by osteoclastic resorption precludes subsequent refilling of the cavities by the bone-forming osteoblasts. However, additional effects of estrogens on osteoblasts, osteocytes, and perhaps other cell types are required for their protective effects on the cortical compartment, which constitutes 80% of the skeleton.

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Effects of Ipriflavone on Postmenopausal Syndrome and Osteoporosis

Zhang, Xin

Abstract: Objective. To investigate the therapeutic effects of Ipriflavone on postmenopausal syndrome and osteoporosis of women. Methods. A randomized and double-blind study was conducted. Sixty postmenopausal women with osteoporosis were chosen and they were randomly divided into three groups: Treatment group I was given oral compound calcium acid chelate and Vitamin AD guttate; Treatment group II was given oral compound calcium acid chelate, Vitamin AD guttate and ipriflavone; Control group were given placebo and compound calcium acid chelate. The postmenopausal syndrome, bone mineral density and bone biochemical markers were assessed 6 and 12 months after the treatment. Results. In treatment group II, hot flush and ostalgia syndromes were dramatically relieved, bone mineral density and serum calcium level increased markedly and ALP, PTH and TRAP decreased markedly, comparing with treatment group I and control group (P<0.05). Conclusion. Ipriflavone could inhibit bone resorption and promote bone formation. It is an effective drug for the prevention and treatment to menopausal syndrome and osteoporosis. Ipriflavone could be used as a supplement to estrogen replacement treatment.

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Natural Hormone Therapy for Menopause

Mahmud, Khalid

Abstract: Menopausal women are deficient in estrogen, progesterone, and frequently in testosterone and DHEA. Hormone replacement therapy [HRT] in the United States has generally consisted of one or two agents, typically equine estrogen and medroxyprogesterone, with increased risk of heart attack, stroke, dementia and breast cancer [WHI trials]. Bioidentical hormones [chemically identical to endogenous hormones] have gained popularity and can be mixed according to physicians orders by compounding pharmacists in the United States. However, there is little published information about the use of such hormones. This paper reports a 12 plus months follow up on 189 patients who were administered natural estrogen plus progesterone with or without DHEA or testosterone according to a rationalized protocol described below. Ninety-seven percent of the patients experienced varying degrees of symptom control, while three had minimal or questionable benefit. Mental symptoms experienced upon presentation improved in 90% of the patients. Sixty percent of the patients, who had gained weight during menopause, lost an average of 14.8 lbs. [SD 11.98 lbs]. Complications described with traditional HRT did not develop in this group of patients. These findings point out a need for larger controlled trials of similar protocols in the management of menopause

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MENOPAUSE, AGEING AND HORMONAL THERAPIES

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The use of HRT and other drugs for prevention and treatment of osteoporosis
Gambacciani M.

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Intervertebral discs and the Menopause and HRT
Brincat M.

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Menopause, ageing and cardiovascular disease
Pines A.

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Menopause, ageing and cognitive function and neurodegenerative disorders
Genazzani A.R.

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