Mariusz Gujski

Estrogen receptor alpha polymorphisms, estradiol level, and occurrence of atherosclerosis risk factors in healthy postmenopausal women.

Background The objective of the study was to analyze the relationship between interaction of polymorphisms in the estrogen receptor alpha gene (Erα) and estradiol (E2), and the occurrence of selected atherosclerosis risk factors in postmenopausal women without the diagnosis of a cardiovascular disease. Material/Methods The study covered 210 women, a minimum of 2 years after menopause, with FSH >30 mlU/ml, aged 50–60 years, with no chronic diseases diagnosed. In the women examined, the levels of estradiol, total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides were determined, as well as height, waist circumference (W), hip circumference (R), and arterial hypertension. The BMI and W/H ratio were calculated. Genotyping of the ER-α polymorphism was performed using a polymerase chain reaction and restriction enzymes (PCR-RFLP). The alleles of the XbaI polymorphism were defined as A and G: heterozygote AG, wild type GG and homozygote AA. The alleles of PvuII polymorphism were defined as T and C: heterozygote TC, homozygote TT, and wild type CC. Results The concentration of endogenous estradiol and ERα XbaI and PuvII polymorphisms as independent parameters did not significantly affect the BMI, waist circumference, W/H ratio, levels of CHOL, HDL, LDL, TG, or LDL/HDL, nor the systole and diastole in the postmenopausal women in the study. Conclusions The presented study suggests that ERα XbaI AA polymorphism may intensify the beneficial effect of estradiol on the distribution of fatty tissue after menopause; ERα XbaI GG and PuvII TC genotypes may intensify the beneficial effect of estradiol on HDL level; ERα PuvII TT genotype unfavorably modifies the relation between concentration of estradiol and systolic pressure after menopause.

State of Health and Quality of Life of Women at Advanced Age

Background Evaluation of the state of health, quality of life, and the relationship between the level of the quality of life and health status in a group of women at an advanced age (90 years of age and older) in Poland. Material/Methods The study was conducted in 2014 in an all-Polish sample of 870 women aged 90 years and older. The research instruments were: the authors’ questionnaire and several standardized tests: Katz Index of Independence in Activities of Daily Living (Katz ADL), Abbreviated Mental Test Score (AMTS), and the World Health Organization Quality of Life (WHOQOL)-BREF. The results of the study were statistically analyzed using significant t-test for mean and regression analysis. Results The majority of women at an advanced age suffered from chronic pain (76%) and major geriatric problems such as hypoacusis (81%), visual disturbances (69%) and urinary incontinence (60%); the minority of women at an advanced age suffered from falls and fainting (39%), stool incontinence (17%), severe functional impairment (24%), and cognitive impairment (10%). On a scale of 1 to 5, women at an advanced age assessed positively for overall quality of life (mean 3.3), social relationships (3.5), and environment (3.2), but negatively for general health, physical health, and psychological health (2.7, 2.7, and 2.8, respectively). The presence of chronic pain and geriatric problems, including urinary and stool incontinences, falls and faint ing, visual disturbances and hypoacusis, significantly decreased overall quality of life; general health, physical health, psychological health, social relationships, and environment. Overall quality of life, general health, physical health, psychological health, social relationships, and environment was correlated with functional and cognitive impairments. Conclusions Quality of life of women at an advanced age decreased if chronic pain, major geriatric problems, or functional or cognitive impairments occurred.

Cognitive Functions, Concentration of Endogenous Estradiol, Estrogen Receptor α (ERα) Polymorphism in Postmenopausal Women

Background The goal of this study was to investigate the relationship between cognitive functions and the level of endogenous estradiol in postmenopausal women, according to which estrogen receptor α (ERα) polymorphism the woman carries. Material/Methods The study group consisted of 210 women. The inclusion criteria were: minimum 2 years after the last menstruation, FSH concentration 30 U/ml, and no dementia signs on Montreal Cognitive Assessment (MoCA). A computerized battery of Central Nervous System Vital Signs (CNS VS) test was used to diagnose cognitive functions. Genotyping of the ERα polymorphism was performed using a polymerase chain reaction and restriction enzymes (PCR-RFLP). Blood plasma was tested for FSH and estradiol (E2). Statistical analysis was performed using STATISTICA software. Results A relationship was confirmed between standard scores for 3 cognitive functions: general memory, verbal memory, and processing speed, and the XbaI polymorphism in the women in the study. In the group of women with genotype TT PvuII, significant positive relationships were observed between the concentration of E2 and the standard scores of 3 cognitive functions: general memory, verbal memory, and processing speed. In the group of women with genotype TC PvuII, significant negative correlations were found between the concentration of E2 and the standard scores of 4 cognitive functions: NCI, general memory, verbal memory, and processing speed. Conclusions ERα polymorphism exerted an effect on the interaction between the concentration of estradiol and the results for cognitive functions. The concentration of estradiol did not depend on Xba1 and PvuII polymorphisms. The results for cognitive functions depended on which Xba1 polymorphism the woman carried.

Interaction between C-reactive protein and cognitive functions according to APOE gene polymorphism in post-menopausal women

Introduction A potential factor increasing the risk of the development of cognitive impairment with age is apolipoprotein E (APOE) ε4 carrier status. A subsequent factor which may increase the risk of development of cognitive impairment at an older age is the concentration of C-reactive protein (CRP). The objective of the study was to examine the relationship between cognitive functions and the concentration of CRP in post-menopausal women who were carriers of particular apolipoprotein E gene (APOE) polymorphisms. Material and methods A group of 402 women was recruited to the study. The inclusion criteria were: minimum two years after the last menstruation, follicle-stimulating hormone (FSH) concentration 30 U/ml, no dementi signs on Montreal Cognitive Assessment (MoCA). The computerized battery of the Central Nervous System Vital Signs (CNS VS) test was used to diagnose cognitive functions. APOE genotyping was performed by multiplex PCR. The blood plasma CRP levels were determined. Statistical analysis was performed using Statistica software. Results The level of neurocognitive index (NCI) and cognitive functions in post-menopausal women depends on apolipoprotein E gene polymorphism (p < 0.001) and the concentration of CRP (p < 0.05). A negative correlation was found between CRP and NCI (p = 0.018), and the reaction time (p = 0.008) of women with APOE ε2/ε3. A positive correlation was observed between CRP and visual memory (p = 0.025) in women with APOE ε3/ε3, and verbal memory (p = 0.023) in women with APOE ε3/ε4 or ε4/ε4. Conclusions Apolipoprotein E gene polymorphism may modify the relationship between CRP concentration and cognitive functions in post-menopausal women.

Functional Status of Thyroid and Cognitive Functions after Menopause

Background Thyroid activity plays a role in cognition. However, the relation between the functional state of thyroid and neuropsychiatric changes proceeding with age among people without clinical symptoms of thyroid dysfunction is still unknown. The aim of this study was analysis of cognitive function levels in reference to thyroid examination: thyroid-stimulating hormone (TSH), total thyroxin (TT4), triiodothyronine (TT3), free thyroxin (FT4), free triiodothyronine (FT3), thyroperoxidase antibodies (TPO-AB), and thyroglobulin antibodies (Tg-AB), TSH receptor antibodies (AB-TSHR) in women after menopause. Material/Methods A group of 383 women was recruited for the study. The inclusion criteria were: minimum two years after the last menstruation and no dementia signs on Montreal Cognitive Assessment (MoCA). Computerized battery of Central Nervous System Vital Signs (CNS VS) test was used to diagnostic cognitive functions. The blood plasma values were determined: TSH, FT3, FT4, TT3, TT4, TPO-AB, Tg-AB, and AB-TSHR. Statistical analysis was performed using Pearson’s correlation coefficient and analysis of variance in STATISTICA software. Results In women after menopause, TSH was negatively correlated with NCI results, executive functions, complex attention, and cognitive flexibility. FT4 was positively correlated with results of psychomotor speed. TT3 and TT4 were negatively correlated with results of memory and verbal memory. Furthermore, TT4 was negatively correlated with NCI, executive functions, and cognitive flexibility. TPO-AB was negatively correlated with results of memory, verbal memory, and psychomotor speed. Tg-AB was positively correlated with results of reaction time. AB-TSHR was negatively correlated with NCI results, memory, executive functions, psychomotor speed, complex attention, and cognitive flexibility. Conclusions Our study supports the importance of thyroid functionality in cognitive functioning in a group of women after menopause. The values of TSH, TT3, TT4, TPO-AB, and AB-TSHR were higher and FT4 was lower in examined women. The results were poorer in examination of cognitive functions measured with a battery of CNS-VS tests.

Diabetes mellitus and congestive heart failure: the prevalence of congestive heart failure in patients with and without diabetes in Poland

Introduction: Diabetes mellitus is a systemic disease and has a negative effect on the cardiovascular system. This paper aimed to present a retrospective analysis of morbidity associated with heart failure in subgroups of patients with and without diabetes in Poland in 2012. Material and methods: Data from the National Health Fund were used for the study. In general, 656,937 patients with heart failure, including 281,538 males and 375,354 females, were studied. In this population, additionally, 201,043 patients with heart failure (main diagnosis) and diabetes were studied, including 82,117 males and 118,926 females. Results: The mean index of morbidity associated with heart failure in the whole subpopulation of diabetes patients was 9.03%; 8.42% for males and 9.50% for females. Morbidity associated with heart failure in the population of patients diagnosed with diabetes in Poland in 2012 was seven times higher compared to morbidity associated with heart failure in non-diabetes patients. Morbidity associated with heart failure in females was significantly higher compared to morbidity in males in the whole population, in both the subpopulations of patients with and without diabetes. Conclusions: Diabetes mellitus significantly increases risk of heart failure in both women and men. The risk is significantly high after the age of 60 years and higher in females.

Serum Lipid, Vitamin D Levels, and Obesity in Perimenopausal and Postmenopausal Women in Non-Manual Employment

Background Increasing age, increased body mass index (BMI), and abnormal lipid profiles contribute to an increased risk of vitamin D deficiency. Women who have a perimenopausal and postmenopausal reduction in estrogen levels are a high-risk group for vitamin D deficiency. The aims of this study were to compare the serum vitamin D levels, lipid profile, and BMI between perimenopausal and postmenopausal women in non-manual employment, and to determine whether there were any interdependent factors. Material/Methods Three hundred women in non-manual employment, aged between 44–66 years, were divided into three groups: early perimenopausal; late perimenopausal; and postmenopausal. Laboratory tests included measurement of serum lipid profiles and vitamin D levels, the BMI, waist-hip ratio (WHR) and body fat were measured. Statistical analysis included F-test analysis of variance and the least significance difference (LSD) test was used for multiple comparisons. Results For the 300 women who were in non-manual employment, and in the early and late perimenopausal and postmenopausal periods, serum vitamin D levels were reduced (mean 16.8±8.7 ng/mL); 29% of women had abdominal obesity; 41% had excessive body fat accumulation; and 56% had an increased body mass index (BMI) (>25 kg/m2) with raised total cholesterol, low-density lipoprotein (LDL) cholesterol, LDL/high-density lipoprotein (HDL), and total cholesterol/HDL ratios (p<0.05). Conclusions The findings of this study showed that in perimenopausal and postmenopausal women in non-manual employment, serum vitamin D levels were associated with serum lipid profile and degrees of obesity.

Stress at the place of work and cognitive functions among women performing intellectual work during peri- and post-menopausal period

OBJECTIVES The analysis of the relationship between stress at work and results of cognitive functions amongst women, at peri- and post-menopausal age, performing intellectual work. MATERIAL AND METHODS The study group included women, aged 45-66 years old, employed as intellectual workers. Research instruments were: the Montreal Cognitive Assessment; computer tests of the CNS Vital Signs; the Subjective Work Characteristics Questionnaire, and a questionnaire designed by the author. The results were statistically analyzed. RESULTS Nearly a half of respondents experienced high stress at the place of work; 1/3 - on the average level, on a low level - every fifth. The largest number of respondents experienced stress caused by social contacts. Among a half of the women, stress was caused by the lack of awards at work, followed by the lack of support. Slightly fewer of them experienced stress caused by the feeling of psychological load related to the complexity of work or the feeling of uncertainty caused by the organization of work. Every third woman experienced stress due to the sense of responsibility or the lack of control. The smallest number experienced stress caused by physical arduousness, the sense of threat and unpleasant working conditions. The examined women obtained the best results with respect to simple attention, the worst results - with respect to the reaction time. The results concerning the remaining 9 cognitive functions were ranked in the middle of the aforementioned results. The intensity of stress at work and factors which caused this stress, negatively correlated with simple attention of women in the early peri-menopausal period, while positively correlating with the psychomotor and processing speed of women in the late peri-menopausal period. Among the post-menopausal women, negative correlations were observed between the majority of cognitive functions and the intensity of stress at work, and the majority of factors which caused this stress. CONCLUSIONS Cognitive functions of the examined women remained within the range of average evaluations, and were correlated with stress-inducing factors at the place of work. Int J Occup Med Environ Health 2017;30(6):943-961.

Models of cognitive functions with respect to selected parameters of functional state of the thyroid gland in post-menopausal women

INTRODUCTION The objective of the study was the development of models of cognitive functions in a group of post-menopausal women, according to the concentration of the selected laboratory parameters evaluating the functional state of the thyroid gland. MATERIAL AND METHODS The study was conducted during 2012-2014, and covered women aged 50-65 years, minimum two years after the last menstruation, without chronic diseases, cancerous diseases, mental disorders, addiction to drugs or alcohol, and who did not use hormone replacement therapy. At the stage of qualification, a brief MoCA test was performed; 383 women were qualified for the study. Blood was collected for the determination of such parameters as: TSH, TT4, fT4, anti-TPO, anti-Tg, and AB-TSHR. Assessment of cognitive functions was performed using the diagnostic instrument Central Nervous System - Vital Signs (CNS-VS) (Polish version). The results were statistically analysed. RESULTS The mean age of the women in the study was 56.4 ± 3.4; the mean TSH was 1.91 ± 1.35 mU/L, fT4 14.76 ± 2.34 pmol/L, and TT4 99.12 ± 16.98 nmol/L. Mean values were: 64.74 IU/L for anti-TPO, 100.69 IU/L for anti-Tg, and 1.40 IU/L for AB-TSHR. The examined women obtained the neurocognitive index (NCI) on the level of 84.4 scores, on average. The lowest results were obtained in tests assessing cognitive flexibility (mean 78.64 scores), processing speed (mean 79.25 scores), and executive functions (mean 79.75 scores). In the tests evaluating complex attention, the mean values were 82.24 scores, psychomotor speed - mean 83.42 scores, and reaction time - mean 86.87 scores. The women examined obtained the best results in tests assessing memory (mean 90.15 scores), including verbal (mean 91.22 scores), and visual (mean 93.37 scores). The NCI and cognitive function models were assessed from the aspect of thyroid gland examinations in post-menopausal women. Based on the analyses performed, the following conclusions were drawn: The developed models of cognitive functions indicate a considerable effect of TSH, fT4, AB-TSHR, and anti-TPO, as well as TT4 and anti-Tg, on the level of cognitive functions after menopause in the group examined. The conducted study suggests the need for examination of the functional state of the thyroid gland in post-menopausal women who show cognitive function disorders.

Does genetic testing for ERα gene polymorphisms provide new possibilities of treatment for cognitive function disorders in postmenopausal women

It is commonly considered that cognitive abilities decrease with age, especially with respect to processing and psychomotor speed. It is an interesting issue whether, apart from the ageing process, the undergoing of menopause itself deteriorates cognitive functions, compared to women at reproductive age. Hopes for improvement of cognitive functions were pinned on the use of menopausal hormone therapy. However, the results of studies concerning the effect of hormone replacement therapy on cognition proved to be contradictory. It seems that the essence of the problem is more complicated than only estrogen deficiency. It is suggested that estrogen receptor α (ERα) polymorphism may be responsible for the differences in the effect of estrogens on cognitive processes. The article presents current knowledge concerning the effect of estrogens on the central nervous system, especially the role of ERα polymorphism, with respect to foreseeing benefits from the use of exogenous estrogens for cognitive functions. At the present stage of research, ERα appears to be poorly specific; nevertheless, it may be an important instrument for the classification of peri- and post-menopausal patients in the group where therapy with the use of estrogens may bring about benefits in terms of prevention and treatment of cognitive disorders. It also seems necessary to conduct prophylactic, screening examination of cognitive functions in post-menopausal women, in order to identify those at risk of the development of dementia.