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BACKGROUND: The measurement of physical performance constitutes an indicator of the physical functional capacity of older adults with and without frailty. AIM: To present a synthesis of knowledge on the effect of exercise programs on physical performance in older adults with and without frailty in the community. METHOD: A systematic review was carried out in accordance with the PRISMA-2020 criteria. The search for articles was made until 4 May 2023 in PubMed, Scopus, Web of Science, Cochrane Library, SciELO and LILACS. The outcome variable was physical performance, measured through the SPPB (Short Physical Performance Battery). The mean difference (MD) was estimated to evaluate the effect. RESULT: We found 2483 studies, of which 12 met the eligibility criteria for the systematic review and 9 for the meta-analysis. The effect of exercise on SPPB scores was significantly higher in the exercise group compared to control in non-frail older adults with MD = 0.51 [95% CI, 0.05 to 0.96, p < 0.05]. Likewise, in older adults with frailty, the effect of exercise on the global SPPB score was significantly higher in the exercise group compared to the control with MD = 0.66 [95% CI, 0.09 to 1.24, p < 0.05]. CONCLUSION: Our findings suggest that exercise programs are effective in increasing and/or maintaining physical performance in older adults with and without frailty, whose effect is more evident in older adults with frailty, probably due to the greater margin of recovery of intrinsic capacity. This systematic review shows the differentiated effect of exercise training on physical performance in older adults with and without frailty. Scientific evidence reinforces the importance of implementing physical exercise programs in all older adults, including those who are frail. However, it is necessary to specify the types and doses (duration, frequency and intensity), for individualized groups, previously grouped according to the SPPB score.
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Resumen OBJETIVO: Identificar los factores sociodemográficos, patológicos, psicosociales y de estilo de vida relacionados con la edad a la que inicia la menopausia. MATERIALES Y MÉTODOS: Estudio secundario de corte transversal de la ronda 2018 del Estudio Nacional de Salud y Envejecimiento en México (ENASEM) que cuenta con 17,114 registros de sujetos de uno y otro sexo provenientes de toda la República Mexicana. Criterios de inclusión: mujeres de 40 años, con información de las variables: edad al inicio de la menopausia, lugar de residencia, estado civil, escolaridad, peso, estatura, tabaquismo, ingesta de alcohol, sedentarismo, depresión, hipertensión arterial, diabetes mellitus, algún tipo de cáncer e histerectomía. Se hizo un análisis comparativo de la edad a la menopausia con cada uno de los factores y un análisis multivariado para determinar los factores asociados. Las mujeres con histerectomía, y un grupo de mujeres con ≤ 6 años en la posmenopausia, se analizaron aparte. RESULTADOS: De 9017 mujeres registradas (con límites de edad de 40 y 90 años), 7132 (81%) conservaban el útero y los ovarios. El promedio de edad a la menopausia, sin ajuste, fue 47.8 ± 4.5 años. La histerectomía la anticipa en 2.3 años y la escolaridad mayor a la secundaria la retrasa 5 meses. La edad ajustada fue 48.0 ± 4.3 años y en el grupo con menopausia reciente 50.0 ± 2.8 años. CONCLUSIÓN: La menopausia natural se inicia entre los 48 y 50 años, la histerectomía la adelanta hasta dos años y la escolaridad de secundaria y superior la retrasa 6 meses por cada incremento de nivel escolar. El hecho de vivir en una zona rural o urbana también influye en el tiempo en que comienza la menopausia natural.
Abstract OBJECTIVE: To identify sociodemographic, pathological, psychosocial, and lifestyle factors associated with age at menopause onset. MATERIALS AND METHODS: Secondary cross-sectional study of the 2018 round of the National Study of Health and Aging in Mexico (ENASEM), with 17,114 records of male and female subjects from all over Mexico. Inclusion criteria: women aged 40 years with information on the following variables: age at onset of menopause, place of residence, marital status, education, weight, height, smoking, alcohol consumption, sedentary lifestyle, depression, hypertension, diabetes mellitus, any type of cancer and hysterectomy. A comparative analysis of age at menopause was made with each of these factors and a multivariate analysis was performed to determine the associated factors. Women with hysterectomy and a group of women ≤ 6 years postmenopausal were analyzed separately. RESULTS: Of 9017 women enrolled (with age limits of 40 and 90 years), 7132 (81%) retained uterus and ovaries. The mean age at menopause without adjustment was 47.8 ± 4.5 years. Hysterectomy brought it forward by 2.3 years and education beyond high school delayed it by 5 months. The adjusted age was 48.0 ± 4.3 years and in the recent menopause group 50.0 ± 2.8 years. CONCLUSION: Natural menopause occurs between 48 and 50 years of age, hysterectomy brings it forward by up to two years, and secondary and higher education delays it by 6 months for each additional year of schooling. Living in a rural or urban area also influences the time of onset of natural menopause.
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BACKGROUND: The advanced activities of daily living (AADLs) in old age is a key indicator of the mobility domain for the intrinsic capacity of older adults living in the community; for this reason, it is relevant to know the prevalence and risk factors related to performing fewer AADLs in different populations. AIM: To determine the prevalence and factors associated with the ability to perform AADLs in older adults reported in the Mexican Study of Health and Aging (MSHA 2018). METHODS: A secondary cross-sectional analysis of the MSHA 2018 data was carried out, including a convenience sample of 6474 subjects ≥ 60 years of age, for both sexes, without cognitive deficits. Nine questions related to AADLs were selected from the database. Multiple logistic regression analysis was performed to determine factors associated with <3 AADLs, including sociodemographic, lifestyle, and health status factors. RESULTS: The prevalence of the ability to perform <3 AADLs was 63%. Age is the most important risk factor for <3 AADLs, which increases by the decade, followed by sedentary lifestyle (OR = 2.15, 95% CI: 1.91-2.42, p < 0.0001). CONCLUSIONS: Our findings suggest that age, schooling, urban residence, sedentary lifestyle, and comorbidity are the main risk factors for <3 AADLs in older Mexican adults.
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Biological aging has an abrupt beginning in women, changing their body and perceptions, which are not accepted easily because the actual stereotypes are focused on youth and anti-aging. Our interest was to explore what the self-perception of aging (SPA) is in middle-aged women throughout the reproductive aging stages and their association with the quality of life. A cross-sectional study was conducted with 240 women (40−69 years) living in Mexico City, who were separated according to their reproductive aging stage. An electronic version of the Spanish version of the Self-rated Attitudes Towards Old Age (SATO) and the WHO Quality of Life-Bref (WHOQoL) was applied to these women and was sent by WhatsApp or email. Seventeen women of the total sample (7%) had a negative self-perception of aging. There is an association between SATO and WHOQoL (r = −0.273, p < 0.0001), but in the menopausal transition stage, the association is strong in the psychological subscale, and after menopause, early and late postmenopausal women show a better association in the social subscale. Negative SPA impacts the WHOQoL psychological dimension and not the total WHOQoL score. Our findings suggest an association between SPA and quality of life in different reproductive aging stages.
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Menopausa , Qualidade de Vida , Adolescente , Envelhecimento/psicologia , Estudos Transversais , Feminino , Humanos , Menopausa/psicologia , México , Pessoa de Meia-Idade , Qualidade de Vida/psicologia , Autoimagem , Inquéritos e QuestionáriosRESUMO
Oxidative stress (OS) increases during the human aging process, and the sedentary lifestyle could be a prooxidant factor. In this study, we determine the effect of sedentary lifestyle on OS during the aging process in Mexican women. A longitudinal study of two-year follow-up was carried out with 177 community-dwelling women (40-69 y) from Mexico City. We measured as OS markers plasma malondialdehyde, erythrocyte glutathione peroxidase (GPx) and superoxide dismutase (SOD), total plasma antioxidant status, uric acid level, antioxidant gap, and SOD/GPx ratio. To define OS using all the markers, we defined cut-off values of each parameter based on the 90th percentile of young healthy subjects and, we calculated a stress score (SS) ranging from 0 to 7, which represented the intensity of the marker modifications. All the women answered a structured questionnaire about prooxidant factors, including physical activity specially the type of activity, frequency, and duration, and they answered Spanish versions of self-assessment tests for establishing dysthymia and insomnia as potential confounders. Principal component and Poisson regression analysis were used as statistical tools, being two-year OS the primary outcome. The OS was considerate as SS ≥ 4 and sedentary lifestyle as <30 min/day of physical activity, beside several prooxidant factors and age that were covariables. SS is higher in sedentary lifestyle women after the two-year follow-up; although, the difference was statistically significant only in older women. Four principal components were associated with the OS, and 7 out of 8 prooxidant factors were important for the analysis, which were included in the Poisson model. The predictive factors for OS were the sedentary lifestyle (adjusted PR = 2.37, CI95%: 1.30-4.30, p < 0.01), and age, in which the risk increases 1.06 (CI95%:1.02-2.11, p < 0.01) by each year of age. Our findings suggest that a sedentary lifestyle increases the OS during the aging in Mexican women.
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Envelhecimento , Antioxidantes/metabolismo , Transtorno Distímico/epidemiologia , Exercício Físico , Estresse Oxidativo , Comportamento Sedentário , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Adulto , Idoso , Biomarcadores/metabolismo , Feminino , Humanos , Estudos Longitudinais , México/epidemiologia , Pessoa de Meia-IdadeRESUMO
Gestational diabetes mellitus (GDM) is the most common metabolic complication in pregnancy, which affects the future health of both the mother and the newborn. Its pathophysiology involves nutritional, hormonal, immunological, genetic and epigenetic factors. Among the latter, it has been observed that alterations in DNA (deoxyribonucleic acid) methylation patterns and in the levels of certain micro RNAs, whether in placenta or adipose tissue, are related to well-known characteristics of the disease, such as hyperglycemia, insulin resistance, inflammation and excessive placental growth. Furthermore, epigenetic alterations of gestational diabetes mellitus are observable in maternal blood, although their pathophysiological roles are completely unknown. Despite this, it has not been possible to determine the causes of the epigenetic characteristics of GDM, highlighting the need for integral and longitudinal studies. Based on this, this article summarizes the most relevant and recent studies on epigenetic alterations in placenta, adipose tissue and maternal blood associated with GDM in order to provide the reader with a general overview of the subject and indicate future research topics.
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Diabetes Gestacional/genética , Epigênese Genética/genética , Tecido Adiposo/metabolismo , DNA/química , Metilação de DNA/genética , Diabetes Gestacional/metabolismo , Epigênese Genética/fisiologia , Epigenômica/métodos , Feminino , Humanos , MicroRNAs/genética , Placenta/metabolismo , Gravidez , GestantesRESUMO
BACKGROUND: This study aimed to synthesize the evidence of the effect of practicing Tai Chi on oxidative stress markers (OxSM). METHODS: This systematic review and meta-analysis was conducting using the MEDLINE, Cochrane Library, ScienceDirect, Scopus, Epistemonikos, Lilacs, and Ovid databases to identify randomized (RCT) and non-randomized (NRCT) clinical trials that evaluated the Tai Chi effect on OxSM compared to sedentary behavior, walking or yoga. Pooled mean differences (MDs) with 95% confidence intervals (95%CI) were estimated using the inverse variance method to determine the effect of Tai Chi on OxSM. PROSPERO register: CRD42019138362. RESULTS: Five RCT and five NRCT were included. Compared to sedentary behavior, regular Tai Chi practice increases the levels of the enzymes superoxide dismutase (MD = 34.97 U/mL, (95%CI, 9.45 to 60.48), 344 participants) and catalase (MD = 15.63 U/mL, (95%CI, 4.05 to 27.22), 110 participants), as well as reducing the levels of lipoperoxides (MD = -0.02 µmol/L, (95%CI, -0.04 to -0.00), 234 participants). For comparisons with walking or yoga, only one study per activity was identified comparing the effect on OxSM. CONCLUSIONS: Regular Tai Chi practice increases the levels of superoxide dismutase and catalase, as well as reducing the levels of lipoperoxides. More studies are necessary to determine the effect of Tai Chi on OxSM when compared to other physical activities.
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Meditação , Tai Chi Chuan , Humanos , Estresse Oxidativo , Qualidade de Vida , CaminhadaRESUMO
Low bone mineral density (BMD) on postmenopausal women causes bone fragility and fracture risk. Tibolone seems to prevent bone loss. Therefore, this systematic review with meta-analysis synthesizes the tibolone effect on BMD percent change in lumbar spine (LS), femoral neck (FN), and total hip (TH) in postmenopausal women. Controlled trials that provided tibolone evidence on the efficacy of tibolone in preventing loss of BMD were included. Regarding the included studies, a pooled mean difference (MD) with 95% confidence intervals (95%CI) was estimated to determine the BMD percentage change. Eleven studies were identified and eight were included in the quantitative analysis. Tibolone at a dose of 2.5 mg increased BMD compared with non-active controls at 24 months in LS (MD 4.87%, 95%CI: 4.16-5.57, and MD 7.35%, 95%CI: 2.68-12.01); and FN (MD 4.85%, 95%CI: 1.55-8.15, and 4.21%, 95%CI: 2.99-5.42), with Hologic and Lunar scanners, respectively. No difference was observed when tibolone 2.5 mg dose was compared with estrogen therapy (ET) at 24 months, LS (MD -0.58%, 95%CI: -3.77-2.60), FN (MD -0.29%, 95%CI: -1.37-0.79), and TH (MD -0.12%, 95%CI: -2.28-2.53). Therefore, tibolone increases BMD in LS and FN compared to non-active controls, and there was no showed difference with ET.
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PURPOSE: Hypomagnesemia has been associated with febrile neutropenia (FN) in pediatric patients receiving cisplatin-based chemotherapy (CDDPBC). The primary aim was to determine whether oral magnesium supplementation reduces FN episodes in pediatric patients with solid tumors treated with CDDPBC. METHOD: This randomized clinical trial, with open-label, single-center, parallel group and superiority design was conducted in Hospital Infantil de Mexico Federico Gomez at Mexico City. Children ≥ 9 years with solid tumors that were to receive a CDDPBC cycle were invited to participate. Each chemotherapy cycle with CDDPBC was randomly assigned to receive oral magnesium supplementation (250 mg/day) or not receive magnesium supplementation (control group). Efficacy was determined by relative risks (RR) with 95% confidence intervals (95% CI) as well as with numbers needed to treat (NNT). Active surveillance was conducted to assess safety in both groups. Analyses were carried out by intention to treat. ClinicalTrials.gov number NCT03449693. RESULTS: One hundred and one chemotherapy cycles with CDDPBC were analyzed (50 in the magnesium supplement arm and 51 in control group). Baseline clinical characteristics were similar comparing both groups. Oral magnesium supplementation reduces FN episodes compared to control group [RR 0.53, (95% CI 0.32-0.89), NNT = 4]. In the supplemented group, patients had fewer episodes of septic shock secondary to FN [RR 0.43, (95% CI 0.02-0.94), NNT = 6] and FN appeared on average 5 days later (p = 0.031). Hypomagnesemia episodes and adverse events were similar across both groups. CONCLUSION: Oral supplementation with magnesium reduces FN episodes neutropenia in pediatric patients with solid tumors treated with CDDPBC.
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Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Suplementos Nutricionais/efeitos adversos , Neutropenia Febril/prevenção & controle , Magnésio/administração & dosagem , Neoplasias/tratamento farmacológico , Administração Oral , Adolescente , Criança , Cisplatino/efeitos adversos , Neutropenia Febril/epidemiologia , Neutropenia Febril/etiologia , Filgrastim/administração & dosagem , Seguimentos , Humanos , Magnésio/efeitos adversos , Masculino , MéxicoRESUMO
Oxidative stress (OS) is the imbalance between oxidant and antioxidant molecules, in favor of oxidants, that causes aging and disease. Many studies have been published that demonstrate the relationship between OS and human health and disease; however, the following questions arise: (i) how are we sure that the OS is present in a biological process? (ii) Is the OS reported in the different investigations equivalent? (iii) What are the best oxidant and antioxidant markers for OS diagnosis? (iv) Can we establish the types and the intensity of the OS? (v) Does OS index could be useful for research and/or application in clinical medicine? In this regard, several indexes have been proposed to measure OS in humans relative to the state of health and disease, among which the following can be highlighted: Oxidative Stress Index (OSI), Tiol Ratios (-SH/TT, -SS/-SH, and-SS/TT), Glutathione Ratio (GSSG/GSH), Oxidative Stress Score (OSS), and OXY-index. Therefore, the aim of this review is to present the state of the art of knowledge about OS indexes for diagnosis of health or disease in humans. We searched for articles in English or Spanish in the PubMed/MEDLINE and Scopus electronic databases published up until May 2019. The keywords used were "oxidative stress," "index," and "oxidative stress index." It was identified 11479 records in both databases, and 490 articles were analyzed. Our review suggests that all indexes analyzed allow diagnose and differentiate the OS related to human health and disease. Also, the studies on OSI, Oxy-score, and OSS indexes have proven to be reliable, practical, and with clinical utility. However, it is necessary to continue with longitudinal studies, especially assess the usefulness of the indexes in the clinical prognosis, and make comparative studies between the different indexes.
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Doenças Cardiovasculares/diagnóstico , Infecções/diagnóstico , Estresse Oxidativo , Antioxidantes/química , Antioxidantes/metabolismo , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/patologia , DNA/química , DNA/metabolismo , Glutationa/química , Humanos , Infecções/metabolismo , Infecções/patologia , Lipídeos/química , Proteínas/química , Proteínas/metabolismo , Compostos de Sulfidrila/químicaRESUMO
OBJECTIVE: To assess the association between hot flashes (HFs) severity and oxidative stress (OS) in Mexican postmenopausal women. METHODS: A cross-sectional study was carried out with perimenopausal women aged 40-59 years community-dwelling from Mexico City, Mexico. They participated in Menopause and Oxidative Stress Project. The baseline sample consisted of 476 women recruited to participate; 161 women were excluded due to different reasons. Hence, 315 women were selected to establish two groups, a) 145 premenopausal women (yet with menstrual bleeding), and b) 170 postmenopausal women (without menses). All women were free of cardiovascular, kidney, hepatic or cancer disease, and without antioxidant supplement intake for at least six months prior to the beginning of the study; none had previously received hormone therapy. As OS markers, we measured plasma malondialdehyde using the TBARS assay, erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (GPx), uric acid, and total antioxidant status; also, we calculated SOD/GPx ratio, antioxidant gap and an oxidative stress score ranging from 0 to 7. The HFs were evaluated using the Menopause Rating Scale. The women completed Spanish version of the Athens Insomnia Scale, Zung Self-Rating Anxiety Scale and Zung Self-Rating Depression Scale and a questionnaire of pro-oxidant factors. RESULTS: Stress score increased with HFs severity (mild 2.7±0.17, moderate 2.9±0.20 and severe 3.7±0.20, p = 0.001) in postmenopausal women. We observed a positive correlation between HFs severity and stress score, r = 0.247 (p = 0.001) in postmenopausal women; other test scores were not correlated. Severe HFs were a risk factor for OS (OR = 5.12, 95%CI: 1.99-13.17, p<0.05) in an adjusted multivariate analysis by different postmenopausal symptoms and pro-oxidant factors; we did not see any association in premenopausal women. CONCLUSION: Our findings suggest an association between HFs severity and OS in Mexican postmenopausal women.
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Fogachos/sangue , Estresse Oxidativo , Pós-Menopausa/sangue , Adulto , Feminino , Glutationa Peroxidase/sangue , Fogachos/epidemiologia , Fogachos/fisiopatologia , Humanos , Malondialdeído/sangue , México , Pessoa de Meia-Idade , Pós-Menopausa/fisiologia , Superóxido Dismutase/sangue , Ácido Úrico/sangueRESUMO
INTRODUCTION: Subclinical thyroid dysfunction is a possible risk factor for cognitive impairment in old age, but results are inconsistent. Aim of the present study was to evaluate the prevalence of thyroid dysfunction among older community-dwelling adults and to see whether thyroid function impacts the cognitive status of the elderly. METHODS: We included 1750 participants from the Study on Aging and Dementia in Mexico (SADEM). All subjects were evaluated clinically via specific interviews. TSH levels were analyzed by chemiluminescent immunometry assay. We classified participants into five thyroid state groups: (1) normal TSH levels (0.40-4.0 IU/L) were considered euthyroid; (2) Overt hyperthyroidism: TSH <0.3 IU/l and FT4 >23 pmol/l; (3) Overt hypothyroidism: TSH >4.8 IU/l, FT4 <13 pmol/l; (4) Subclinical hyperthyroidism: TSH <0.3 IU/l, FT4: 13-23 pmol/l; (5) Subclinical hypothyroidism: TSH >4.8 IU/l, FT4: 13-23 pmol/l. RESULTS: The overall estimated prevalence of thyroid dysfunction in Mexican population was 23.7% (95% CI, 22.66-26.77). Of these, 15.4% older adults were classified as subclinical hypothyroidism, 7.2% overt hypothyroidism, 0.5% subclinical hyperthyroidism, and 0.6% overt hyperthyroidism. The association of thyroid dysfunction with cognitive impairment was most evident in overt hypothyroidism OR = 1.261 (1.185-1.343). CONCLUSIONS: The present study demonstrated a high prevalence of thyroid dysfunction in Mexican elderly people living in the community. A relationship between cognitive impairment and the presence of hypothyroidism was also shown, and to a lesser degree in hyperthyroidism.
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Envelhecimento/psicologia , Cognição/fisiologia , Demência/epidemiologia , Demência/psicologia , Doenças da Glândula Tireoide/epidemiologia , Doenças da Glândula Tireoide/psicologia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/sangue , Escalas de Graduação Psiquiátrica Breve , Transtornos Cognitivos/sangue , Transtornos Cognitivos/epidemiologia , Transtornos Cognitivos/psicologia , Demência/sangue , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Doenças da Glândula Tireoide/sangue , Glândula Tireoide/metabolismoRESUMO
BACKGROUND: Menopause is the onset of aging in women. During this process, some women experience physical changes that may impact upon their psychological and social status, also affecting their quality of life. Furthermore, several psychological changes following menopause have been shown to act as pro-oxidant, but the association between the psychological status that modify the quality of life and oxidative stress in postmenopausal women is still unclear. The aim of this study was to determinate the relationship between oxidative stress with psychological disturbances, low self-esteem, depressive mood and anxiety, and quality of life in the postmenopausal women. METHODS: We carried out a cross-sectional study with101 premenopausal and 101 postmenopausal women from Mexico City. As markers of oxidative stress we measured plasma lipoperoxide levels, erythrocyte superoxide dismutase and glutathione peroxidase activities, and total antioxidant status. We calculate a stress score as global oxidative stress status, with cut-off values for each parameter; this score range from 0 to 6, representing the severity of markers modifications. All the women were rated using the Coopersmith Self-Esteem Inventory, the Zung Self-Rating Anxiety and the Zung Self-Rating Depression Scales, and the WHO Quality of Life-brief. RESULTS: The postmenopausal women with low quality of life in the WHO Quality of Life-brief and their subscales had higher stress score compared with premenopausal women with high quality of life (p < 0.05). We found a positive correlation among lipoperoxide levels and Zung Self-Rating Anxiety and Zung Self-Rating Depression score (r = 0.226 and r = 0.173, respectively, p < 0.05), and a negative correlation with WHO Quality of Life-brief scores (r = -0.266, p < 0.01) in postmenopausal women. Multiple linear regression analysis revealed that average lipoperoxide levels increase by 0.0007 µmol/L for every 1-point increase in the Coopersmith Self-Esteem Inventory and by 0.001 µmol/L for every 1-point decrease in the WHO Quality of Life-brief, after adjusted for pro-oxidant factors. Zung Self-Rating Anxiety and Zung Self-Rating Depression Scales scores also contribute to increase lipoperoxides levels, but not significant. CONCLUSION: Our findings suggest that oxidative stress is increased in postmenopausal women with psychological disturbances and low quality of life.
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Menopausa/psicologia , Estresse Oxidativo , Qualidade de Vida/psicologia , Adulto , Ansiedade/complicações , Ansiedade/psicologia , Estudos Transversais , Transtorno Distímico/complicações , Transtorno Distímico/psicologia , Feminino , Glutationa Peroxidase/análise , Glutationa Peroxidase/sangue , Humanos , Peróxidos Lipídicos/análise , Peróxidos Lipídicos/sangue , Menopausa/metabolismo , México , Pessoa de Meia-Idade , Psicometria/instrumentação , Psicometria/métodos , Autoimagem , Autorrelato , Superóxido Dismutase/análise , Superóxido Dismutase/sangue , Inquéritos e QuestionáriosRESUMO
The aim of this study was to determine the effect of oral hormone therapy (HT) on oxidative stress (OS) in postmenopausal women with metabolic syndrome (MetS). A randomized, double blind, placebo-controlled trial was carried out. We formed four groups of 25 women each; healthy (HW) and MetS women (MSW) were assigned to HT (1 mg/day of estradiol valerate plus 5 mg/10 day of medroxiprogesterone) or placebo. We measured plasma lipoperoxides, erythrocyte superoxide dismutase and glutathione peroxidase, total plasma antioxidant status and uric acid, as OS markers. Alternative cut-off values of each parameter were defined and a stress score (SS) ranging from 0 to 7 was used as total OS. MetS was defined according to National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) criteria. Participants were seen at baseline, 3 and 6 months. After 6 months, MetS decreased in MSW-HT (48%), their triglycerides and high-density lipoprotein cholesterol (HDL-c) improved; in the other groups no difference was found. SS in MSW-HT decreased (3.8 ± 0.3 to 1.7 ± 0.3, p < 0.05) and OS was also reduced (44%), this effect was evident since 3 mo. HW-HT with high OS also decreased (40%). In placebo groups there was no change. Our findings suggest that HT improve lipids and OS associated to MetS in postmenopausal women.
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Estradiol/uso terapêutico , Medroxiprogesterona/uso terapêutico , Síndrome Metabólica/tratamento farmacológico , Síndrome Metabólica/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Glicemia/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , HDL-Colesterol/sangue , Método Duplo-Cego , Feminino , Glutationa Peroxidase/sangue , Humanos , Peróxidos Lipídicos/sangue , Síndrome Metabólica/sangue , Pessoa de Meia-Idade , Pós-Menopausa , Superóxido Dismutase/sangue , Triglicerídeos/sangue , Ácido Úrico/sangueRESUMO
BACKGROUND: Oxidative stress is a serious imbalance between the reactive oxygen species (ROS) produced and the antioxidant systems, and has been identified to cause metabolic syndrome. Postmenopausal women (POS) with severe symptoms have higher oxidative stress; therefore it is possible to observe higher oxidative stress in postmenopausal women with metabolic syndrome and severe menopause related symptoms. OBJECTIVE: To determinate if the severe postmenopausal symptoms increased oxidative stress in women with metabolic syndrome. METHODS: We carry out a cross-sectional study with POS, 48 with metabolic syndrome and 52 healthy. Control group was defined as women heealthy and without severe symptoms (H-SS). Metabolic syndrome was defined according to criteria established by NCEP-ATPIII. We measured lipoperoxides by the TBARS assay as oxidative stress marker. All women answered the Menopause Rating Scale (MRS) that evaluates the severity of global symptoms in three dimensions: psychological, somatic and urogenital; and the Athens Insomnia Scale (AIS). In each questionnaire was used a cutoff value to determine the severity of symptoms and alternative cut-off value for lipoperoxides > or =0.320 mol/L. RESULTS: The prevalence of high plasma lipoperoxides levels was higher in women with metabolic syndrome (WMS), 39 [81%] vs. 33 [64%], p < 0.05. The WMS, independent of severe symptoms (SS), had high lipoperoxides levels, similar to H+SS, except in urogenital MRS dimen- sion and AIS. The risk of higher lipoperoxides increased with MS and severe symptoms RM=6.32, 95% CI: 1.32-30.20, p < 0.05, adjusted by others pro-oxidants factors. CONCLUSION: Our findings suggest that the severity of menopausal related symptoms increased oxidative stress in women with metabolic syndrome.
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Síndrome Metabólica/metabolismo , Estresse Oxidativo , Pós-Menopausa , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Índice de Gravidade de DoençaRESUMO
OBJECTIVE: The aim of this study was to determine the influence of menopause (hypoestrogenism) as a risk factor for oxidative stress. METHODS: We carried out a cross-sectional study with 187 perimenopausal women from Mexico City, including 94 premenopausal (mean ± SD age, 44.9 ± 4.0 y; estrogen, 95.8 ± 65.7 pg/mL; follicle-stimulating hormone, 13.6 ± 16.9 mIU/mL) and 93 postmenopausal (mean ± SD age, 52.5 ± 3.3 y; estrogen, 12.8 ± 6.8 pg/mL; follicle-stimulating hormone, 51.4 ± 26.9 mIU/mL) women. We measured lipoperoxides using a thiobarbituric acid-reacting substance assay, erythrocyte superoxide dismutase and glutathione peroxidase activities, and the total antioxidant status with the Randox kit. An alternative cutoff value for lipoperoxide level of 0.320 µmol/L or higher was defined on the basis of the 90th percentile of young healthy participants. All women answered the Menopause Rating Scale, the Athens Insomnia Scale, and a structured questionnaire about pro-oxidant factors, that is, smoking, consumption of caffeinated and alcoholic beverages, and physical activity. Finally, we measured weight and height and calculated body mass index. RESULTS: The lipoperoxide levels were significantly higher in the postmenopausal group than in the premenopausal group (0.357 ± 0.05 vs 0.331 ± 0.05 µmol/L, P = 0.001). Using logistic regression to control pro-oxidant variables, we found that menopause was the main risk factor for oxidative stress (odds ratio, 2.62; 95% CI, 1.35-5.11; P < 0.01). We also found a positive correlation between menopause rating score, insomnia score, and lipoperoxides, and this relationship was most evident in the postmenopausal group (menopause scale, r = 0.327 [P = 0.001]; insomnia scale, r = 0.209 [P < 0.05]). CONCLUSIONS: Our findings suggest that the depletion of estrogen in postmenopause could cause oxidative stress in addition to the known symptoms.
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Menopausa/sangue , Estresse Oxidativo , Adulto , Antioxidantes/análise , Índice de Massa Corporal , Estudos Transversais , Eritrócitos/enzimologia , Estrogênios/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Glutationa Peroxidase/análise , Humanos , Peróxidos Lipídicos/sangue , México , Pessoa de Meia-Idade , Fatores de Risco , Superóxido Dismutase/análiseRESUMO
AIM: To determine the relationship between metabolic syndrome (MetS) components and oxidative stress (OxS) in elderly community-dwelling Mexicans. METHODS: We carried out a comparative cross-sectional study on 113 elderly subjects (> or =60 years old); 50 of them did not have MetS and 63 did have MetS (based on Adult Treatment Panel III criteria). We measured total antioxidant status (TAS), plasma lipid peroxidation (LPO), antioxidant activity of superoxide dismutase (SOD) and glutathione peroxidase (GPx), and calculated the SOD/GPx ratio. High blood pressure (HBP) was defined as systolic blood pressure (SBP) > or =140 mm Hg and/or diastolic blood pressure (DBP) > or =90 mm Hg. RESULTS: We found a statistically significant increase in the percentage of cases of severe OxS in elderly subjects with MetS in comparison to healthy elderly (17 vs. 8%, OR: 7.33, 95% CI: 1.38-42.39; p < 0.01). It was observed that subjects with 5 MetS components had a 10-fold higher risk of developing OxS than subjects with 1 component (OR: 11.00, 95% CI: 1.72-115.17; p < 0.01). A positive correlation between SBP and LPO (r = 0.202, p < 0.05), and a negative correlation of SBP and DBP with TAS activity (r = -0.232, p < 0.05; r = -0.211, p < 0.05) were also observed. CONCLUSION: Our findings suggest that MetS is linked to severe OxS, that the number of metabolic syndrome components is a significant risk factor in the development of OxS, and that HBP is the most important metabolic syndrome component linked to OxS in the elderly.
Assuntos
Idoso/fisiologia , Síndrome Metabólica/metabolismo , Estresse Oxidativo/fisiologia , Antropometria , Análise Química do Sangue , Pressão Sanguínea/fisiologia , Estudos Transversais , Eritrócitos/enzimologia , Feminino , Glutationa Peroxidase/sangue , Humanos , Lipídeos/sangue , Masculino , México , Pessoa de Meia-Idade , Fatores de Risco , Superóxido Dismutase/sangue , Substâncias Reativas com Ácido Tiobarbitúrico/metabolismoRESUMO
OBJECTIVE: To determine the relationship between undernutrition and oxidative stress as risk factors for high blood pressure (HBP) in older Mexican adults. We carried out a case-control study in a convenience sample of 62 older adults, 60-80 years of age; 32 without HBP (mean age 75.8 +/- 5.1 years) and 30 with HBP (mean age 65.2 +/- 6.8 years). METHODS: We measured serum lipoperoxide (LPO) levels, antioxidant enzymes, total antioxidant activity and lipid profile; in addition, we evaluated the nutritional status with anthropometric measurements, the Mini Nutritional Assessment and food intake frequency. Data were analyzed with Student t and odds ratio (OR) statistical tests. RESULTS: We observed significantly higher LPO levels in subjects with HBP than in normotensive subjects (0.303 +/- 0.10 vs. 0.256 +/- 0.06 micromol/l; p < 0.05). With respect to risk factors for HBP, we found an OR of 12.2 (95% CI 1.9-76.4, p < 0.01) in subjects with high LPO levels (> or = 0.320 micromol/l) and an OR of 5.0 (95% CI 1.1-23.0, p < 0.05) in those with undernutrition. CONCLUSION: Our findings suggest that high LPO levels and undernutrition are significant risk factors for HBP.
Assuntos
Envelhecimento/sangue , Hipertensão/sangue , Hipertensão/epidemiologia , Desnutrição/sangue , Estado Nutricional , Estresse Oxidativo , Idoso , Idoso de 80 Anos ou mais , Antropometria , Antioxidantes/metabolismo , Pressão Sanguínea/fisiologia , Estudos de Casos e Controles , Feminino , Avaliação Geriátrica , Humanos , Peroxidação de Lipídeos , Lipídeos/sangue , Masculino , México , Pessoa de Meia-Idade , Avaliação Nutricional , Razão de Chances , Fatores de RiscoRESUMO
BACKGROUND: Oxidative stress (OxS) has recently been linked with osteoporosis; however, we do not know the influence of OxS as an independent risk factor for this disease. METHODS: We conducted a case-control study in 94 subjects > or =60 years of age, 50 healthy and 44 with osteoporosis. We measured total antioxidant status, plasma lipid peroxides, antioxidant activity of superoxide dismutase and glutathione peroxidase (GPx), and calculated the SOD/GPx ratio. Bone mineral density was obtained at the peripheral DXA in calcaneus using a portable Norland Apollo Densitometer. Osteoporosis was considered when subjects had a BMD of 2.5 standard deviations or more below the mean value for young adults. RESULTS: GPx antioxidant activity was significantly lower in the group of subjects with osteoporosis in comparison with the group of healthy subjects (p < 0.01); in addition, the SOD/GPx ratio was significantly higher in the group of individuals with osteoporosis (p < 0.05). In logistic regression analysis, we found OxS to be an independent risk factor for osteoporosis (odds ratio [OR] = 2.79; 95% confidence interval [95% CI] = 1.08-7.23; p = 0.034). CONCLUSION: Our findings suggest that OxS is an independent risk factor for osteoporosis linked to increase of SOD/GPx ratio.
Assuntos
Osteoporose/enzimologia , Estresse Oxidativo/fisiologia , Idoso , Antioxidantes/análise , Índice de Massa Corporal , Densidade Óssea , Estudos de Casos e Controles , Feminino , Glutationa Peroxidase/sangue , Humanos , Peróxidos Lipídicos/sangue , Masculino , México , Pessoa de Meia-Idade , Fatores de Risco , Superóxido Dismutase/sangueRESUMO
Oxidative stress has been reported to increase with aging; however, the scientific evidence is controversial. We therefore aimed to analyze the relationship between aging and some markers of oxidative stress. A cross-sectional and comparative study was carried out in a sample of 249 healthy subjects: (i) 25-29 years (n = 22); (ii) 30-39 years (24); (iii) 40-49 years (30); (iv) 50-59 years (48); (v) 60-69 years (60), and (vi) >or= 70 years (65). We measured lipoperoxides and total antioxidant status in plasma and superoxide dismutase and glutathione peroxidase activities in erythrocytes. There was an age-related increase in lipoperoxides, which was evident in the comparison of the group of 25-29 years (0.22 0.11 micromol/l) with the group of 60-69 years (0.38 +/- 0.18 micromol/l, p < 0.01) and >or= 70 years (0.42 +/- 0.19, p < 0.001). Conversely, the total antioxidant status showed an age-related decrease (25-29 years, 1.4 +/- 0.31 mmol/l vs 60-69 years, 1.1 +/- 0.21 and >or= 70 years, 1.1 +/- 0.22, p < 0.05 for each). In erythrocytes, glutathione peroxidase activity showed an age-related decrease (25-29 years, 7,966 +/- 1,813 UI/l vs 60-69 years, 6,193 +/- 2,235 and >or= 70 years, 6,547 +/- 2,307, p < 0.001 for each), whereas superoxide dismutase activity was similar in all age groups. Importantly, there was no age-related change in oxidative stress markers in subjects of < 60 years. These findings suggest that age of >or= 60 years may be associated with increased oxidative stress.