Tsutomu Douchi

A longitudinal study of the effect of vitamin K2 on bone mineral density in postmenopausal women a comparative study with vitamin D3 and estrogen-progestin therapy.

OBJECTIVESnTo investigate the effect of vitamin K2 treatment for a year on spinal bone mineral density (BMD) in postmenopausal women, comparing with vitamin D3 hormone replacement therapy and to determine the factors which affect the efficacy of vitamin K2 therapy.nnnSUBJECTS AND METHODSnSeventy-two postmenopausal women were randomized into four groups and treated with respective agents. Before the therapy, 6 and 12 months after the treatment, their lumbar spine BMD were measured by dual energy X-ray absorptiometry. The rates of change in BMD (delta BMD) were calculated. Correlations of BMD with age, year since menopause and the initial BMD were determined.nnnRESULTSnVitamin K2 suppressed the decrease in spinal BMD as compared with no treatment group. BMD in women treated with vitamin K2 was inversely correlated with their age (r = -0.54; P < 0.05).nnnCONCLUSIONSnVitamin K2 therapy may be a useful method for preventing postmenopausal spinal bone mineral loss. In addition, the therapy should be started early in postmenopausal period.

The effect of body composition on bone density in pre- and postmenopausal women

OBJECTIVESnTo investigate the relative contribution of body composition (lean and fat) to bone mineral density (BMD), 196 premenopausal and 128 postmenopausal Japanese women were enrolled.nnnMETHODSnTotal fat mass, total lean mass, lumbar BMD (L2-L4), and total body BMD were measured by dual-energy X-ray absorptiometry (DEXA, Hologic QDR 2000, MA. USA). Physical characteristics were also recorded for each subject. Correlation between BMD and variables were calculated for each of the two groups in single and stepwise regression analyses.nnnRESULTSnTotal lean mass was significantly higher in premenopausal women than postmenopausal women (P < 0.0001), while body weight, body mass index, and total fat mass were not different between the two groups. In stepwise regression analysis, total lean mass was the most powerful determinant of lumbar BMD and total body BMD in premenopausal women. In postmenopausal women, total fat mass was the most significant determinant of lumbar BMD, while total lean mass was the most significant determinant of total body BMD.nnnCONCLUSIONSnThese findings suggest that there is a difference between pre- and postmenopausal women in the relative contribution of lean and fat mass. Total lean mass is the most significant determinant of BMD in premenopausal women. On the other hand, total fat mass may have some advantages in maintaining BMD in postmenopausal women.

The effect of menopause on regional and total body lean mass

OBJECTIVESnTo investigate the effect of menopause on regional and total body lean mass.nnnMETHODSnEvaluation of 123 healthy premenopausal women (40.6 +/- 10.8 years) and 123 healthy postmenopausal women (61.8 +/- 7.5 years). All subjects were right side dominant. Regional (head, bilateral arms, trunk, and bilateral legs) and total body lean mass were measured using whole-body scanning by dual-energy X-ray absorptiometry. Baseline characteristics including age, height, weight, and menopausal state were recorded. These variables were compared between pre- and postmenopausal women. In all subjects, correlations between regional or total body lean mass and baseline characteristics were investigated using univariate and multiple regression analyses.nnnRESULTSnHeight, and lean mass of the trunk, bilateral legs and total body were significantly lower in postmenopausal women than in premenopausal women, while lean mass of the bilateral arms did not differ between the two groups. On univariate regression analysis, bilateral arms lean mass was positively correlated with height (P < 0.001). Trunk, bilateral legs, and total body lean mass were inversely correlated with age and menopausal state (P < 0.001), but were positively correlated with height (P < 0.001). After adjusting for age and height, trunk lean mass was still correlated with menopausal state (P < 0.01).nnnCONCLUSIONSnMenopause induces lean mass loss, independent of aging and height. Trunk lean mass is more prone to decline with menopause than lean mass of other sites.

The contribution of menopause to changes in body-fat distribution.

Objective: To investigate whether menopause contributes to changes in body‐fat distribution, irrespective of aging or obesity.

Effect of non–weight-bearing body fat on bone mineral density before and after menopause

Objective To investigate the difference in the effect of non–weight-bearing body fat mass on bone mineral density between premenopausal and postmenopausal women. Methods We studied 252 regularly menstruating pre-menopausal women and 213 postmenopausal women with right side dominance. Age, years since menopause (in post-menopausal women), height, weight, and body mass index were recorded. Bone mineral density of non–weight-bearing sites (ie, arms), weight-bearing sites (ie, lumbar spine including L2–4 and legs), and body fat mass were measured by whole-body scanning with dual-energy x-ray absorptiometry. Body fat mass was also measured by dual energy x-ray absorptiometry. Results Body fat mass did not differ between groups. In postmenopausal women, body fat mass correlated positively with bone mineral density of the left leg (r = .41, P < .001), right leg (r = .36, P < .001), left arm (r = .31, P < .001), and lumbar spine (r = .27, P < .001). The correlation between body fat mass and bone mineral density of the left arm remained significant after adjusting for age, years since menopause, and height. In premenopausal women, body fat mass correlated positively with bone mineral density of left leg (r = .37, P < .001) and right leg (r = 0.31, P < .001), but correlated weakly with bilateral arms (r ≤ .19) and lumbar spine bone mineral density (r = 0.13, P < .05). Conclusion The effect of non–weight-bearing body fat on bone mineral density was greater in postmenopausal than premenopausal women.

Lean mass as a significant determinant of regional and total body bone mineral density in premenopausal women

Abstract: We investigated the relations of body composition to regional and total body bone mineral density (BMD) in 275 healthy Japanese premenopausal women (mean age, 37.1 ± 9.2 years; range, 16–55 years). In all subjects, the right side was dominant. BMD of the head, bilateral arms, lumbar spine (L2–L4), bilateral legs, and total body were measured using whole-body scanning by dual-energy X-ray absorptiometry (DXA). Total fat mass, total lean mass, regional lean mass, and regional fat mass were measured by DXA. Baseline characteristics including age, height, body weight, and body mass index were recorded for each subject. Possible correlations between regional or total body BMD with variables were determined on univariate and stepwise multiple regression analysis. BMD, lean mass, and fat mass were compared between the bilateral extremities. Total lean mass for the right arm, regional lean mass for the left arm, total lean mass for the lumbar spine, body weight for the bilateral legs, and total lean mass for the whole body were the most significant determinants of BMD on stepwise multiple regression analysis. Right-arm BMD was significantly higher than left-arm BMD. However, no significant difference was observed between BMD in the right and left legs. We concluded that lean mass is a more significant determinant of regional and total body BMD than fat mass in premenopausal women.

Bone mineral density in postmenopausal women with endometrial cancer

OBJECTIVEnThe aim of the study was to investigate the relationship between endometrial cancer and bone mineral density (BMD).nnnMATERIALS AND METHODSnA total of 55 postmenopausal Japanese women with well-differentiated adenocarcinoma and 284 age-matched healthy women were studied. Baseline characteristics including age, age at menopause, years since menopause (YSM), weight, height, body mass index (BMI), prior menstrual history, parity, and fertility were recorded for each subject. Lumbar spine BMD (L2-4), and body fat indices including body fat mass amount and percent body fat were measured by dual-energy X-ray absorptiometry. These variables were compared between the two groups. In all subjects (n = 339), correlations of BMD with the presence of endometrial cancer, baseline characteristics, and body fat indices were investigated, using univariate and multiple regression analyses.nnnRESULTSnBMD, weight, BMI, body fat mass amount, and percent body fat were significantly higher in women with endometrial cancer. Other baseline characteristics did not differ between the two groups. Age at menopause, height, weight, BMI, percent body fat, and body fat mass amount were positively correlated with BMD, while age and YSM were inversely correlated with BMD. After adjusting for age, YSM, and height, the presence of endometrial cancer was still correlated with BMD (P < 0.05). However, after adding body fat mass amount to these three adjusted variables, there was no correlation between the presence of endometrial cancer and BMD.nnnCONCLUSIONnWomen with endometrial cancer have a high BMD. This is attributable to high body fat mass amount in this disease.

Relationship between body mass index and transvaginal ultrasonographic endometrial thickness in postmenopausal women

OBJECTIVEnTo investigate the relationship between body mass index (BMI) and transvaginal ultrasonographic endometrial thickness.nnnMATERIALS AND METHODSnTwo hundred and twelve postmenopausal Japanese women (mean age, 62.1+/-8.0 years; range 47-85) with histologically proven normal endometrium and with endometrial thickness more than 1.0 mm were studied. Baseline characteristics including age, years since menopause, and BMI were recorded for each subject. The relationship between sonographic endometrial thickness and baseline characteristics was assessed in each subject.nnnRESULTSnBMI was significantly correlated with endometrial thickness (r=0.40, p<0.001), but age and years since menopause were not correlated. On stepwise regression analysis only BMI was still associated with endometrial thickness (R2=0.16, p<0.001).nnnCONCLUSIONnSonographic endometrial thickness differs with BMI in postmenopausal women. Higher BMI is associated with greater endometrial thickness.

The Relationship between Maternity Blues and Thyroid Dysfunction

Objective: To investigate whether there is evidence of thyroid dysfunction in women with maternity blues.

Predictors of bone mineral loss in patients with ovarian cancer treated with anticancer agents

Objective To identify factors predicting bone mineral loss during anticancer chemotherapy. Methods Fifteen women (mean age 38.2 ± 7.8 years; range 30–46 years) with ovarian cancer who had been treated with cisplatin-adriamycin-cyclophosphamide for six cycles every 4 weeks following surgical cytoreduction were studied. Bone mineral density (BMD) of the lumbar spine (L2-L4) was measured by dual-energy x-ray absorptiometry before and after chemotherapy. Fifteen age-matched women whose ovaries had been removed surgically for other reasons served as controls. None of the patients had received hormonal treatment. The two groups were compared for percentage change of BMD (BMD%) over the same period. In the chemotherapy group, total fat mass, body fat ratio, total lean mass, percent lean, and ratio of trunk fat to leg fat were measured by dual-energy x-ray absorptiometry. Lean loss during chemotherapy was also calculated. These variables were compared before and at the end of chemotherapy. Possible correlations of baseline variables with BMD% were determined in univariate and stepwise regression analysis. Results Mean (± standard deviation) BMD decreased to 87.4 ± 2.1% after six cycles of chemotherapy and 97.6 ± 0.4% after 6 months in controls, but the greatest decrease was observed in the chemotherapy group (P < .001). Although baseline lean mass, baseline BMD, body weight, and lean loss during chemotherapy were correlated with BMD% in univariate analysis, baseline lean mass was still significant in stepwise regression analysis. Conclusion Baseline lean mass predicts bone mineral loss with anticancer chemotherapy.