Jun Young Hur

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.

Correlation between estrogens and serum adipocytokines in premenopausal and postmenopausal women.

Objective:The purpose of this study was to investigate the association between serum adipocytokines (adiponectin, resistin, leptin, and tumor necrosis factor &agr; [TNF-&agr;]) and endogenous estrogen (estrone and estradiol) levels in healthy premenopausal and postmenopausal women. Design:This study included 53 healthy premenopausal women, 45 healthy postmenopausal women, and 10 postmenopausal women with the metabolic syndrome who were participating in general health examinations. A secondary analysis was performed on levels of adiponectin, resistin, leptin, TNF-&agr;, estrone (E1), and estradiol (E2). Results:After accounting for body mass index, TNF-&agr; was significantly increased (1.5 ± 0.1 vs 2.0 ± 0.1 pg/mL, P < 0.05) in healthy postmenopausal women as compared with healthy premenopausal women, whereas leptin was decreased (5.6 ± 1.1 vs 4.0 ± 1.1 ng/mL). Estrogen (E1 and E2) was positively correlated with leptin in only healthy premenopausal women, whereas estrogen did not correlate with any adipocytokine in healthy postmenopausal women. In the multiple regression analysis, only leptin significantly contributed to insulin resistance. Combining healthy premenopausal and postmenopausal women, E1 correlated negatively with TNF-&agr; (r = −0.23, P < 0.05) and positively with leptin (r = 0.35, P < 0.01) and did not correlate with resistin. E2 correlated negatively with TNF-&agr; (r = −0.24, P < 0.05) and positively with leptin (r = 0.34, P < 0.01); it did not correlate with adiponectin or resistin. Leptin might stimulate the increase of plasma gonadotropin-releasing hormone levels, which could result in a positive correlation with estrogen in premenopausal women but not in postmenopausal women. Conclusions:Estrogen deficiency resulted in increased TNF-&agr; levels. Serum leptin levels correlated positively with estrogen levels in premenopausal women. However, the increase in obesity in postmenopausal women increased leptin, which increases insulin resistance.

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

OBJECTIVES The aim of this study was to investigate the relationship between thyroid stimulating hormone (TSH) and metabolic syndrome (MetS) in euthyroid postmenopausal women. METHODS We 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. RESULTS TSH 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. CONCLUSION We 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.

Role of Estrogen Receptor-α and -β) in Regulating Leptin Expression in 3T3-L1 Adipocytes

We investigated the effects of the estrogen receptor‐α (ERα) and ‐β (ERβ) in the regulation of leptin, resistin, and adiponectin expression in 3T3‐L1 adipocytes. Mature adipocytes were exposed to estradiol (E2), ERα agonist (PPT (4,4′,4″‐(4‐propyl‐[1H]‐pyrazole‐1,3,5‐triyl)trisphenol)), ERβ agonist (DPN (2,3‐bis(4‐Hydroxyphenyl)‐propionitrile)), E2 with ERα antagonist (MPP (1,3‐Bis(4‐hydroxyphenyl)‐4‐methyl‐5‐[4‐(2‐piperidinylethoxy)phenol]‐1H‐pyrazole dihydrochloride)), and E2 with ERβ antagonist (R, R‐THC ((R, R)‐5,11‐diethyl‐5,6,11,12‐tetrahydro‐2,8‐chrysenediol)) at different concentrations. To clarify the expression and regulation of adipokines by ER subtypes, total RNA was extracted from cells and measured using quantitative PCR. Western blot analysis was performed to evaluate the protein expression of adipokines, ERα, and ERβ. The leptin expression was significantly increased in the cells treated with high concentrations (10−5 and 10−6 mol/l) of the PPT (P < 0.01, P < 0.05). By contrast, the leptin expression decreased in a dose‐dependent manner in the MPP‐treated groups (P < 0.05). High concentrations (10−5 mol/l) of R, R‐THC with E2 (10−7 mol/l) caused a significant increase of the leptin expression (P < 0.01). The leptin mRNA levels were positively correlated with the ERα mRNA levels (r = 0.584, P < 0.01) and negatively correlated with the ERβ mRNA levels (r = −0.236, P = 0.03) in the adipocytes. The ratio of the ERα to ERβ mRNA levels in the adipocytes was significantly associated with leptin mRNA levels (r = 0.454, P < 0.01). ERα induced leptin expression and ERβ inhibited its expression in 3T3‐L1 adipocytes. The ratio of the ERα‐to‐ERβ expression in 3T3‐L1 adipocytes may be an important potential regulatory factor in leptin expression.

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

Objective  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.

Association of body mass index with severity of endometriosis in Korean women

To investigate the relationship between endometriosis severity and body mass index (BMI).

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. Uric 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. We 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. On 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. Increased 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.