Hyun Tae Park

Postmenopausal status according to years since menopause as an independent risk factor for the metabolic syndrome

Objective: Features of the metabolic syndrome such as abdominal adiposity, insulin resistance, and dyslipidemia develop with the transition from pre- to postmenopausal status in women. We investigated the effects of postmenopausal status on the prevalence of the metabolic syndrome according to years since menopause. Design: We studied 1,002 women, 618 premenopausal and 384 postmenopausal, who participated in annual health examinations at Anam Hospital in Seoul, Korea. Results: Using multivariate logistic regression analysis, we determined that postmenopausal status was an independent risk factor for the metabolic syndrome. Moreover, after controlling for age and body mass index, postmenopausal women had an increased risk of the metabolic syndrome (odds ratio, 2.93; 95% CI, 1.62-5.33) and the abnormalities of its individual components. The risk for the metabolic syndrome increased up to 14 years since menopause, then decreased. For its individual components, postmenopausal women with 5 to 9 years since menopause had the highest risk of high blood pressure; postmenopausal women with less than 5 years since menopause had an increased risk of abdominal obesity and high glucose. With 10 to 14 years since menopause, postmenopausal women had an increased risk of high triglycerides. Conclusions: Postmenopausal status is an independent risk factor for the metabolic syndrome and all of its individual components. The risk for the metabolic syndrome increased up to 14 years since menopause. In addition, postmenopausal status has effects during different periods since menopause for each of these components.

Age at menarche in a Korean population: secular trends and influencing factors

This study was designed to identify the secular trend in the age at menarche and to investigate the possible factors that influence the age at menarche using representative Korean data from the 2005 Korean National Health and Nutrition Survey. Three thousand five hundred sixty-two women born between 1920 and 1985 were enrolled to identify secular trends in the age at menarche and 620 girls born between 1986 and 1995 were recruited to evaluate the factors influencing the age at onset of menarche. Mean age at menarche decreased from 16.90u2009±u20091.25xa0years for women born between 1920 and 1925 to 13.79u2009±u20091.37xa0years for those born between 1980 and 1985, indicating a downward trend of 0.68xa0years per decade (95% CI, 0.64–0.71) in age at menarche. Mean age at menarche of girls born between 1986 and 1995 was 13.10u2009±u20090.06xa0years as estimated by the Kaplan–Meier method. Among girls born between 1986 and 1995, menarcheal girls had a larger waist circumference, a higher body mass index (BMI), and lower maternal menarcheal age and maternal age at birth than premenarcheal girls. The energy and nutrient intake of protein, sugar, fiber, ash, phosphate, natrium, thiamine, riboflavin, and niacin were greater for menarcheal girls than for premenarcheal girls. These data indicate a decreasing secular trend of age at menarche in a Korean population born between 1920 and 1995. Furthermore, maternal menarcheal age, BMI, maternal age at birth, and nutrition are important variables that appear to influence age at menarche in Korean girls.

Thyroid stimulating hormone is associated with metabolic syndrome in euthyroid postmenopausal women

OBJECTIVESnThe aim of this study was to investigate the relationship between thyroid stimulating hormone (TSH) and metabolic syndrome (MetS) in euthyroid postmenopausal women.nnnMETHODSnWe conducted a cross-sectional study of 2205 Korean postmenopausal women. Subjects who were not euthyroid were excluded. Fasting TSH, free thyroxine (FT4), insulin, glucose, and the level of insulin resistance, estimated by the homeostasis model assessment for insulin resistance (HOMA-IR) were measured. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria.nnnRESULTSnTSH levels were associated with total cholesterol, LDL-cholesterol, triglycerides and diastolic blood pressure. Using a multiple linear regression analysis, LDL-cholesterol, and triglycerides levels were identified as independently associated with TSH. Multivariate logistic regression analysis determined that TSH levels strongly contributed to MetS. Compared with the lower most quartile (TSH, 0.3-1.44 mIU/L), the adjusted odds ratio for MetS was 1.95 in the upper most quartile (TSH, 2.48-4.00 mIU/L). The prevalence of MetS increased as the TSH quartile showed a gradual increase.nnnCONCLUSIONnWe found a close relationship between TSH and MetS in euthyroid postmenopausal women. Therefore, more attention should be focused on postmenopausal women with high normal TSH levels for the management of cardiovascular disease.

Association of insulin resistance with anti‐Mullerian hormone levels in women without polycystic ovary syndrome (PCOS)

Objectiveu2002 To explore the relationship of insulin resistance (IR) and adipokines (leptin, adiponectin, RBP4) to anti‐Mullerian hormone (AMH) levels in women without polycystic ovary syndrome (PCOS).

The relationship between reproductive factors and metabolic syndrome in Korean postmenopausal women: Korea National Health and Nutrition Survey 2005.

Objective: Postmenopausal women are known to have a higher prevalence of metabolic syndrome compared with premenopausal women. However, there are few studies that have investigated the effects of reproductive factors on metabolic syndrome in postmenopausal women. The objective of this study was to evaluate the association between reproductive factors and metabolic syndrome in postmenopausal women. Methods: A total of 892 postmenopausal women who participated in the 2005 Korean National Health and Nutrition Examination Survey were included. We determined an association between reproductive factors and metabolic syndrome. Results: Using a multivariate logistic regression analysis, it was found that age at first birth was negatively associated with metabolic syndrome. Having the first baby at a later age was associated with a decreased risk of having metabolic syndrome (odds ratio, 0.95; 95% CI, 0.90-0.99). However, other reproductive factors including age at menarche, age at menopause, parity, lifetime estrogen exposure, years since menopause, number of pregnancies, history of lactation, and oral contraceptives or hormone therapy use were not associated with metabolic syndrome. Conclusions: Among various reproductive factors, age at first birth was negatively associated with metabolic syndrome in Korean postmenopausal women.

The relationship between fat depot‐specific preadipocyte differentiation and metabolic syndrome in obese women

Objectiveu2002 Obesity is strongly associated with metabolic syndrome, but not all obese individuals display a clustering of metabolic risk factors. Recent studies have shown that in vitro subcutaneous (SC)‐preadipocyte differentiation is negatively associated with obesity. These results suggest that impaired adipogenesis is an important factor linking obesity to metabolic disorders. We examined whether in vitro preadipocyte differentiation is associated with metabolic syndrome, independent of obesity.

Calcium intake is inversely associated with metabolic syndrome in postmenopausal women: Korea National Health and Nutrition Survey, 2001 and 2005.

Objective: Calcium intake is known to be associated with the risk of having metabolic syndrome. However, the previous studies did not take into account the fact that intestinal absorption and urinary excretion of calcium are estrogen dependent, and intestinal absorption efficiency and renal conservation of calcium deteriorate after menopause. Therefore, we performed a menopause status-specific analysis of the association between calcium intake and metabolic syndrome. Methods: A total of 9,341 participants (4,118 men, 3,359 premenopausal women, and 1,864 postmenopausal women) from the Korean National Health and Nutrition Examination Survey 2001 and 2005 were included in the study. Results: Calcium and energy intake were significantly higher in men than in women and were lowest in postmenopausal women. On multivariate logistic regression analysis, postmenopausal women with calcium intake in the fourth quartile had a lower risk of having metabolic syndrome (odds ratio, 0.637; 95% CI, 0.452-0.898) compared with women with intake in the first quartile after adjustment for age, body mass index, marital status, education level, alcohol intake, smoking history, exercise, hormone therapy use, and energy intake. However, no association was detected in men and premenopausal women. Conclusions: Calcium intake is inversely associated with the risk of having metabolic syndrome in postmenopausal women. Prospective or longitudinal studies concerning sex and menopause status are necessary to evaluate an association between calcium intake and metabolic syndrome.

The relationship between blood mercury level and osteoporosis in postmenopausal women

ObjectivePostmenopausal women have a higher prevalence of osteoporosis compared with premenopausal women. Postmenopause status has been found to be an independent risk factor for osteoporosis. Several studies have reported that heavy metals, including lead (Pb), mercury (Hg), cadmium (Cd), and arsenic (As), have detrimental effects on bone. The aim of this study was to evaluate the association among heavy metals, including Pb, Hg, Cd, and As, bone mineral density, and osteoporosis in postmenopausal Korean women. MethodsWe conducted a cross-sectional study of 481 postmenopausal women, all of whom were enrolled in the Korean National Health and Nutrition Examination Survey in 2008. Bone mineral density was measured using dual-energy x-ray absorptiometry. Blood Pb, Hg, and Cd and urinary As levels were measured. ResultsPostmenopausal women with higher blood Hg levels were more likely to be younger and have higher vitamin D levels, fish consumption, and prevalence of osteoporosis. On multivariate logistic regression analysis, postmenopausal women with blood Hg levels in the fourth quartile had a 0.36-fold decreased risk of having osteoporosis compared with those with levels in the first quartile, after adjustments for age, body mass index, alcohol intake, smoking history, exercise, use of oral contraceptive pills, hormone therapy, intake of caloric energy and calcium, fish consumption, and vitamin D level. However, there was no association between other heavy metals and osteoporosis. ConclusionsHigh blood Hg levels were associated with a lower risk of having osteoporosis in postmenopausal women. Because biomarkers of all four metals measured in this study reflect recent exposures, further studies are necessary to clarify the association of osteoporosis with the level of heavy metals in biomarkers for long-term exposure such as hair or fingernail.

Serum ferritin levels are associated with metabolic syndrome in postmenopausal women but not in premenopausal women.

Objective:Ferritin, a marker of total body iron stores, is known to be associated with the risk of having metabolic syndrome and has been demonstrated to increase after the onset of menopause. Postmenopause status is an important determinant of metabolic syndrome. The aim of this study was to perform a menopause status-specific analysis of the association between ferritin levels and metabolic syndrome. Methods:We conducted a cross-sectional study of 3,082 participants (1,691 premenopausal women and 1,391 postmenopausal women), all of whom were enrolled in the Korean National Health and Nutrition Examination Survey 2007. Results:Premenopausal and postmenopausal women with metabolic syndrome had higher ferritin levels than did those without metabolic syndrome. After adjustments for age; body mass index; alcohol intake; smoking history; exercise; hormone therapy use; hemoglobin, aspartate aminotransferase, and alanine aminotransferase levels; and intake of energy and iron, multivariate logistic regression analysis revealed that postmenopausal women with ferritin levels in the third tertile had an increased risk of having metabolic syndrome (odds ratio, 1.62; 95% CI, 1.04-2.81) compared with postmenopausal women with levels in the first quartile. No such association was detected in premenopausal women. Conclusions:Increased ferritin levels may be a determinant for metabolic syndrome in postmenopausal women but not in premenopausal women.

Relationship between uric acid and metabolic syndrome according to menopausal status

Objective.u2003Uric acid, the levels of which have been shown to increase after menopause, has been associated with metabolic syndrome. The prevalence of metabolic syndrome has also been determined to increase after menopause. Therefore, we surmised that menopausal status-specific analyses for the characterisation of the relationship between uric acid and the metabolic syndrome were warranted. Methods.u2003We included 1644 patients: 1018 premenopausal women and 626 postmenopausal women, all of whom participated in annual health examinations at Anam Hospital in Seoul, Korea, from January 2008 through December 2008. Results.u2003On the multivariate logistic regression analysis, uric acid was identified as an independent risk factor for metabolic syndrome in both premenopausal and postmenopausal women. Uric acid levels had different relationships with blood pressure based on menopausal status, however, no such relationships with fasting glucose or age were found. Conclusions.u2003Increased uric acid levels were associated with increased risk for metabolic syndrome in both premenopausal and postmenopausal women. In studies regarding uric acid and metabolic syndrome in women, the effects of menopausal status should be considered.