Comparison of anthropometric measures as predictors of cancer incidence: a pooled collaborative analysis of 11 Australian cohorts

Obesity is a risk factor for cancer. However, it is not known if general adiposity, as measured by body mass index (BMI) or central adiposity [e.g., waist circumference (WC)] have stronger associations with cancer, or which anthropometric measure best predicts cancer risk. We included 79,458 men and women from the Australian and New Zealand Diabetes and Cancer Collaboration with complete data on anthropometry [BMI, WC, Hip Circumference (HC), WHR, waist to height ratio (WtHR), A Body Shape Index (ABSI)], linked to the Australian Cancer Database. Cox proportional hazards models assessed the association between each anthropometric marker, per standard deviation and the risk of overall, colorectal, post-menopausal (PM) breast, prostate and obesity-related cancers. We assessed the discriminative ability of models using Harrell's c-statistic. All anthropometric markers were associated with overall, colorectal and obesity-related cancers. BMI, WC and HC were associated with PM breast cancer and no significant associations were seen for prostate cancer. Strongest associations were observed for WC across all outcomes, excluding PM breast cancer for which HC was strongest. WC had greater discrimination compared to BMI for overall and colorectal cancer in men and women with c-statistics ranging from 0.70 to 0.71. We show all anthropometric measures are associated with the overall, colorectal, PM breast and obesity-related cancer in men and women, but not prostate cancer. WC discriminated marginally better than BMI. However, all anthropometric measures were similarly moderately predictive of cancer risk. We do not recommend one anthropometric marker over another for assessing an individuals' risk of cancer.

Terapia de reposição hormonal não altera a variabilidade da frequência cardíaca em mulheres pós-menopáusicas

INTRODUÇÃO. Mulheres pós-menopáusicas apresentam maior risco de desenvolvimento de doença arterial coronariana. Estudos observacionais demonstraram que a terapia de reposição hormonal produz efeitos benéficos no perfil lipídico e na modulação autonômica cardíaca. O aumento da variabilidade da freqüência cardíaca (VFC), até então atribuído à reposição hormonal, não foi testado em estudos randomizados, placebo-controlados, delineados para permitir a comparação entre as duas formas mais utilizadas de reposição hormonal. A VFC de 24 horas calculada pelo método não linear Mapa de Retorno Tridimensional permite avaliar tanto a modulação vagal como a simpática. OBJETIVOS Avaliar a modulação autonômica cardíaca de mulheres pósmenopáusicas através da análise da VFC no domínio do tempo e dos índices do Mapa de Retorno Tridimensional no ECG de 24 horas. Testar a hipótese de que a reposição hormonal contínua, seja com estradiol isolado (TRE), seja com estradiol associado à noretisterona (TRH), por um período de três meses, aumenta a VFC nessas mulheres. MÉTODOS Quarenta mulheres pós-menopáusicas (46 a 63 anos; média = 54,6 ± 4,2) foram randomizadas para um dos três tratamentos, de forma contínua: TRH, estrogenioterapia (TRE) ou placebo, por três meses consecutivos. Previamente, todas as mulheres foram submetidas a exames clínico, ginecológico e laboratorial (glicose, estradiol, HDL, LDL, triglicerídios; mamografia e ultrassonografia transvaginal). O ECG de 24 horas foi gravado em cada paciente, antes e após o tratamento, para calcular os índices da VFC. RESULTADOS Não houve diferença estatisticamente significativa entre os três grupos, após 3 meses de tratamento, nos índices da VFC e do Mapa de Retorno Tridimensional. A TRH diferiu da TRE apenas quanto ao perfil lipídico. A associação com a noretisterona provocou uma redução de 12,4 % no HDL (p = 0,008). CONCLUSÃO Em mulheres pós-menopáusicas, a terapia de reposição hormonal contínua com estradiol, ou com estradiol associado à noretisterona, por um período de 3 meses, não altera a modulação autonômica cardíaca avaliada pela VFC.

Caracterização térmica (TG/DTG, DTA, DSC, DSC-fotovisual) de Hormônios bioidênticos (estriol estradiol)

Bioidentical hormones are defined as compounds that have exactly the same chemical and molecular structure as hormones that are produced in the human body. It is believed that the use of hormones may be safer and more effective than the non-bioidentical hormones, because binding to receptors in the organism would be similar to the endogenous hormone. Bioidentical estrogens have been used in menopausal women, as an alternative to traditional hormone replacement therapy. Thermal data of these hormones are scarce in literature. Thermal analysis comprises a group of techniques that allows evaluating the physical-chemistry properties of a drug, while the drug is subjected to a controlled temperature programming. The thermal techniques are used in pharmaceutical studies for characterization of drugs, purity determination, polymorphism identification, compatibility and evaluation of stability. This study aims to characterize the bioidentical hormones estradiol and estriol through thermal techniques TG/DTG, DTA, DSC, DSC-photovisual. By the TG curves analysis was possible to calculated kinetic parameters for the samples. The kinetic data showed that there is good correlation in the different models used. For both estradiol and estriol, was found zero order reaction, which enabled the construction of the vapor pressure curves. Data from DTA and DSC curves of melting point and purity are the same of literature, showed relation with DSC-photovisual results. The analysis DTA curves showed the fusion event had the best linearity for both hormones. In the evaluation of possible degradation products, the analysis of the infrared shows no degradation products in the solid state

Fatores de risco para osteoporose em mulheres na pós-menopausa do sudeste brasileiro

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Efeitos da isoflavona sobre os sintomas climatéricos e o perfil lipídico na mulher em menopausa

OBJETIVO: avaliar os efeitos da isoflavona, do gérmen da soja, sobre os sintomas climatéricos e o perfil lipídico na mulher em menopausa. MÉTODOS: foi conduzido estudo prospectivo, com 50 mulheres em menopausa, divididas em: G1, usuárias de isoflavona (60 mg/dia) (n=25), e G2, placebo (n=25). Os critérios de inclusão foram FSH >40 mUI/mL e presença de fogachos. Foram excluídas as vegetarianas, fumantes, asiáticas, portadoras de doenças gastrointestinais e usuárias de terapia de reposição hormonal. No seguimento, de seis meses, foram obtidos o índice menopausal de Kupperman (IMK), o perfil hormonal e o lipídico. Na análise estatística, empregaram-se ANOVA, o teste t pareado e as provas não paramétricas de Wilcoxon e Mann-Whitney. RESULTADOS: os valores medianos do IMK, inicialmente iguais entre os grupos (IMK = 20), reduziram-se nas usuárias de isoflavona aos 2 e 4 meses (IMK = 14 e 9, respectivamente) e no grupo controle, apenas aos 2 meses (IMK = 15) (p<0,01). Ao final do estudo, a isoflavona foi superior ao placebo na redução dos fogachos (44% versus 12%, respectivamente). Aos seis meses, verificou-se que os valores médios de estradiol foram superiores no G1 quando comparados ao G2 (18,0 ± 6,7 versus 12,3 ± 3,8 ng/dL) (p<0,05), sem alterações no FSH e LH. Entre as usuárias de isoflavona, houve redução de 11,8% no LDL (de 151,5 ± 39,2 para 133,6 ± 26,4 mg/dL) e elevação de 27,3% no HDL (de 44,0 ± 11,3 para 56,0 ± 11,9 mg/dL) (p<0,05). CONCLUSÕES: a isoflavona, do gérmen da soja, induziu efeitos favoráveis sobre os sintomas climatéricos e o perfil lipídico, revelando-se opção interessante como terapêutica alternativa para mulheres em menopausa.

Implants of polyanionic collagen matrix in bone defects of ovariectomized rats

In recent years, there has been a great interest in the development of biomaterials that could be used in the repair of bone defects. Collagen matrix (CM) has the advantage that it can be modified chemically to improve its mechanical properties. The aim of the present study was to evaluate the effect of three-dimensional membranes of native or anionic (submitted to alkaline treatment for 48 or 96 h) collagen matrix on the consolidation of osteoporosis bone fractures resulting from the gonadal hormone alterations caused by ovariectomy in rats subjected to hormone replacement therapy. The animals received the implants 4 months after ovariectomy and were sacrificed 8 weeks after implantation of the membranes into 4-mm wide bone defects created in the distal third of the femur with a surgical bur. Macroscopic analysis revealed the absence of pathological alterations in the implanted areas, suggesting that the material was biocompatible. Microscopic analysis showed a lower amount of bone ingrowth in the areas receiving the native membrane compared to the bone defects filled with the anionic membranes. In ovariectomized animals receiving anionic membranes, a delay in bone regeneration was observed mainly in animals not subjected to hormone replacement therapy. We conclude that anionic membranes treated with alkaline solution for 48 and 96 h presented better results in terms of bone ingrowth.

La última palabra en dosis mínima

In this article we rewiewed the indications of the low-dose hormone replacement therapy in post menopausal women. We evaluate the effects of this therapy on menopausal symptoms bone metabolism, cardiovascular risk and endometrial cancer. The low-dose hormone replacement therapy is satisfactory to relief menopausal symptoms and improves lipid profile preventing atherosclerosis. It does not increase the risk of hyperplasia or endometrial cancer when is associate with progestagens. The low dose hormone replacement therapy is also associate to improve bone mineral density but to have better comprehension about the effective action of the low dose hormone replacement therapy on bone, more studies evaluating the risk of fractures are necessary.

Síndrome do climatério

The climateric is characterized by progressive hipoestrogenism and by tissue and functional alterations that leads the women to aging. The diagnosis approach needs to consider the symptoms originated by estrogenic deficiency and by the more prevalent chronic diseases in this lifetime, for instance, among others, the cardiovascular and osteoporosis diseases, witch need a systematic screening. The therapeutic management must consider the proposition of healthy life habits and, when indicated, pharmacological treatment for estrogenic deficiency or for anothers comorbidities existent. The estroprogestative hormonal therapeutic is a valuable tool to provide health and better quality of life, once obeyed the individualized criterion of the cases, doses, hormonal composition and mainly of the opportunity of intervention. There are nonhormonal alternatives to treat the menopausal symptoms, as the antidepressives and phytoestrogens. It's also advised to combine with regular physical activities and adequate calcium intake. © Copyright Moreira Jr. Editora. Todos os direitos reservados.

Estrogenic and mutagenic activities of crotalaria pallida measured by recombinant yeast assay and ames test

Background: Crotalaria pallida Ailton is a plant belonging to the Fabaceae family, popularly known as rattle or rattlesnake and used in traditional medicine to treat swelling of the joints and as a vermifuge. Previous pharmacological studies have also reported anti-inflammatory, antimicrobial and antifungal activities. Nevertheless, scientific information regarding this species is scarce, and there are no reports related to its possible estrogenic and mutagenic effects. Thus, the purpose of the present study was to investigate the estrogenic potential of C. pallida leaves by means of the Recombinant Yeast Assay (RYA), seeking an alternative for estrogen replacement therapy during menopause; and to reflect on the safe use of natural products to assess the mutagenic activity of the crude extract from C. pallida leaves, the dichloromethane fraction and stigmasterol by means of the Ames test.Methods: The recombinant yeast assay with the strain BY4741 of Saccharomyces cerevisiae, was performed with the ethanolic extract, dichloromethane fraction and stigmasterol isolated from the leaves of C. pallida. Mutagenic activity was evaluated by the Salmonella/microsome assay (Ames test), using the Salmonella typhimurium tester strains TA100, TA98, TA97 and TA102, with (+S9) and without (-S9) metabolization, by the preincubation method.Results: All samples showed estrogenic activity, mainly stigmasterol. The ethanolic extract from C. pallida leaves showed mutagenic activity in the TA98 strain (-S9), whereas dichloromethane fraction and stigmasterol were found devoid of activity.Conclusion: Considering the excellent estrogenic activity performed by stigmasterol in the RYA associated with the absence of mutagenic activity when evaluated by the Ames test, stigmasterol becomes a strong candidate to be used in hormone replacement therapy during menopause. © 2013 Boldrin et al.; licensee BioMed Central Ltd.

Evaluation of Estrogenic Potential of Flavonoids Using a Recombinant Yeast Strain and MCF7/BUS Cell Proliferation Assay

Phytoestrogens are of interest because of their reported beneficial effects on many human maladies including cancer, neurodegeneration, cardiovascular disease and diabetes. Furthermore, there is a search for compounds with estrogenic activity that can replace estrogen in hormone replacement therapy during menopause, without the undesirable effects of estrogen, such as the elevation of breast cancer occurrence. Thus, the principal objective of this study was to assess the estrogenic activity of flavonoids with different hydroxylation patterns: quercetin, kaempferol, luteolin, fisetin, chrysin, galangin, flavone, 3-hydroxyflavone, 5-hydroxyflavone and 7-hydroxyflavone via two different in vitro assays, the recombinant yeast assay (RYA) and the MCF-7 proliferation assay (E-screen), since the most potent phytoestrogens are members of the flavonoid family. In these assays, kaempferol was the only compound that showed ERα-dependent transcriptional activation activity by RYA, showing 6.74±1.7 nM EEQ, besides acting as a full agonist for the stimulation of proliferation of MCF-7/BUS cells. The other compounds did not show detectable levels of interaction with ER under the conditions used in the RYA. However, in the E-screen assay, compounds such as galangin, luteolin and fisetin also stimulated the proliferation of MCF-7/BUS cells, acting as partial agonists. In the evaluation of antiestrogenicity, the compounds quercetin, chrysin and 3-hydroxyflavone significantly inhibited the cell proliferation induced by 17-β-estradiol in the E-screen assay, indicating that these compounds may act as estrogen receptor antagonists. Overall, it became clear in the assay results that the estrogenic activity of flavonoids was affected by small structural differences such as the number of hydroxyl groups, especially those on the B ring of the flavonoid. © 2013 Resende et al.

Estilo de vida e efeito da ingestão de bebida de laranja e acerola contendo Echinacea na saúde de um grupo de idosos

Pós-graduação em Alimentos e Nutrição - FCFAR

Influência da reposição hormonal na densidade óssea avaliada em radiografias panorâmicas digitais por meio da análise fractal em mulheres na menopausa

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação comparativa da eficácia da terapia de reposição hormonal de baixa dose isolada ou associada à sinvastatina no perfil lipídico e lipoprotéico em mulheres sintomáticas e dislipidêmicas na pós-menopausa

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Qualidade de vida em mulheres no climatério atendidas na atenção básica de Promissão-SP

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Análise fitoquímica de Solanum lycocarpum A. St.-Hil. e efeito do tratamento crônico sobre o peso corporal e sobre o comportamento de ratas ovariectomizadas

Pós-graduação em Biociências - FCLAS