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Hormone Replacement Therapy (HRT) in special conditions: Diabetic women with hysterectomy
MONDAY,
SEPTEMBER
4
12.5
Methods: Endometrial stromal cells from the secretory phase of the natural cycle, were cultured in charcoal stripped serum containing medium until confluence, then subcultured and exposed to vehicle control, 178 oestradiol (E2) 10~6M for 4 days, and then cultures were treated for 6 days with trimegestone (T) 10~6M, progesterone (P) 10~6M, E2+T, or E2+P. Polyadenylated mRNA was extracted from cell lysates using oligo-dt-linked paramagnetic beads. Quantitative PCR was performed for MMPl, MMP3 and the house keeping gene GAPDH using cDNA linked beads. Cycle limited amplification products were separated by agarose gel electrophoresis, analysed by videocapture, and quantified by using the Scion analysis scanning software (NIH). ANOVA for log of the gene ratios was used for statistical analysis. Results: Ten experiments were performed, where trimegestone was used in 6, and progesterone in 4. There was a statistically significant reduction in the expression of MMPl on the combined treatment of E2+P compared to E2 or P alone, similarly there was reduced expression of MMPl in cultures treated with E2+T compared to either E2 or T alone, but did not reach statistical significant. The expression of MMP3 was lower when the combinations of E2+P and E2+T were added, compared to when P, or T was added alone. However the reduction in expression of MMP3 was statistically significant only when combinations were compared to E2 alone. Conclusions: Combination treatment of E2+T, or E2+P is associated with a reduction in the gene expression of MMP 1 and 3 in endometrial stromal cell culture system. Trimegestone acted on MMPl and MMP3 gene expression in a similar manner to that of progesterone when combined with oestrogen.
P1.13.26 CYTOHORMONAL STUDY OF POST MENOPAUSAL USING FOODPRODUCTS AS NATURAL HRT G. Gannuli, G. Singhal, K. Mukherji, M. Dayal Department of Obstetrics and Gyaenecology M.L.N. Medical College, Allahabad, India
WOMEN
Menopause bears a major consequence on the health of most women, as with increasing life expectancy an average women has to pass one third of life through menopause. Prolonged HRT is still disagreeable to most of Indian women who have much faith in natural form. Aims of the study: 1. Evaluation of the effects of dietary phytoestrogen on symptomatic relief, vaginal cytology and oestrogen levels in post menopausal women. 2. Comparison of its efficacy with hormonal replacement therapy. Study method: On hundred and fifty post menopausal women were randomly assigned to study group (n=lOO) and control group (n=50) in the ratio of 2:l. Initial evaluation of patients by vaginal cytology and S. Estradiol was followed by instructions to consume diet containing 125 gm of dried soybean and rich in legumes, beans. Observations were repeated at three and six months interval. Results: In study group good clinical relief occurred in 70% of patients, while 22% had only partial relief. In control group good clinical relief was observed in 66% patients and 25% had minimal relief at the end of study. -Percentage of vaginal superficial cells increased by 18% by third month and 22% by sixth month of study which is statistically significant -Little changes occurred in S. estradiol concentration or body weight during study -Compliance rate in study group was found to be 70% while in control group it was only 50%. Conclusion: Natural estrogen (food supplement) has significant effect on clinical symptoms relief and reproductive tract epithelial cell proliferation.
P1.13.27 RISK FACTORS FOR THE ENDOMETRIAL THICKNESS IN MENOPAUSAL WOMEN Chnee. LH, Ueno, .I; Bagnoli, VR; Arie, WMY, Fonseca, AM; Junqueira, PAA & Pinotti, JA. Dept. OBIGYN, SBo Paula University Medical School, SBo Paula, Brazil Objective: The objective of this study was to evaluate the risk factors, as follows: arterial hypertension, hypercholesterolemia, smoking, parity and a previous hormonal replacement therapy in postmenopausal women to endometrial thickness. Methods: One hundred postmenopausal patients (one year or more) who presented at the Gynecologic and Endocrinology Ambulatory of SBo
Paula University Medical School with an endometrial echo of 6 mm or higher measured by Transvaginal Ultrasonography (TVUSG) were included in this retrospective study. All patients were submitted to medical history and physical examination. Possible risk factors for endometrial thickness (arterial hypertension, diabetes, hypercholesteremia, smoking, parity and a previous hormonal replacement therapy) were analyzed. Results: Of 100 (one hundred) postmenopausal patients with endometrial thickness, 79 were multiparas, 56 presented with hypercholesteremia, 39 underwent a previous hormonal replacement therapy, 35 presented with systemic arterial hypertension, and 7 with diabetes (who were smokers). Conclusion: Multiparity and hypercholesterolemia were predominant factors in postmenopausal women with endometrial thickness. On the other hand, the use of the previous hormonal replacement therapy, arterial hypertension, diabetes and smoking were found in less than 50% of cases.
P1.13.28 HORMONE REPLACEMENT THERAPY (HRT) IN SPECIAL CONDITIONS: DIABETIC WOMEN WITH HYSTERECTOMY Bannoli. VR; Cambraia, CPP, Massabki, JOP, Blanco, EBC, Fonseca, AM, Junqueira, LR & Pinotti, JA. Dept. OBIGYN, SBo Paula University Medical School, SBo Paula, Brazil. Objective: To compare the lipid screening, fasting glucose, Body Mass Index (BMI) and Kuppermann Menopausal Index (KMI) in diabetic patients with hysterectomy after the administration of oral or injectable HRT. Methods: Twenty diabetic women who underwent hysterectomy were included in this study. The age ranged from 45 to 72 years (mean age of 50 years). Patients were divided into 2 groups according to the HRT regimen recieved: Group A 5 mg of injectable estradiol hexahidrobenzoate given once a month, and Group B 0,625 mg of oral continuous conjugated equine estrogens. In all patients Body Mass Index O(BMI), Kuppermann Menopausal Index (KMI), lipid screening (total cholesterol, HDL, LDL, VLDL and triglycerides), and fasting glucose were evaluated before and after 1 year of therapy. Results:
Conclusions: No significant changes in fasting glucose were noted in both groups. There was a slight elevation of total cholesterol and LDL in both groups.
SEPTEMBER
4
12.5
Methods: Endometrial stromal cells from the secretory phase of the natural cycle, were cultured in charcoal stripped serum containing medium until confluence, then subcultured and exposed to vehicle control, 178 oestradiol (E2) 10~6M for 4 days, and then cultures were treated for 6 days with trimegestone (T) 10~6M, progesterone (P) 10~6M, E2+T, or E2+P. Polyadenylated mRNA was extracted from cell lysates using oligo-dt-linked paramagnetic beads. Quantitative PCR was performed for MMPl, MMP3 and the house keeping gene GAPDH using cDNA linked beads. Cycle limited amplification products were separated by agarose gel electrophoresis, analysed by videocapture, and quantified by using the Scion analysis scanning software (NIH). ANOVA for log of the gene ratios was used for statistical analysis. Results: Ten experiments were performed, where trimegestone was used in 6, and progesterone in 4. There was a statistically significant reduction in the expression of MMPl on the combined treatment of E2+P compared to E2 or P alone, similarly there was reduced expression of MMPl in cultures treated with E2+T compared to either E2 or T alone, but did not reach statistical significant. The expression of MMP3 was lower when the combinations of E2+P and E2+T were added, compared to when P, or T was added alone. However the reduction in expression of MMP3 was statistically significant only when combinations were compared to E2 alone. Conclusions: Combination treatment of E2+T, or E2+P is associated with a reduction in the gene expression of MMP 1 and 3 in endometrial stromal cell culture system. Trimegestone acted on MMPl and MMP3 gene expression in a similar manner to that of progesterone when combined with oestrogen.
P1.13.26 CYTOHORMONAL STUDY OF POST MENOPAUSAL USING FOODPRODUCTS AS NATURAL HRT G. Gannuli, G. Singhal, K. Mukherji, M. Dayal Department of Obstetrics and Gyaenecology M.L.N. Medical College, Allahabad, India
WOMEN
Menopause bears a major consequence on the health of most women, as with increasing life expectancy an average women has to pass one third of life through menopause. Prolonged HRT is still disagreeable to most of Indian women who have much faith in natural form. Aims of the study: 1. Evaluation of the effects of dietary phytoestrogen on symptomatic relief, vaginal cytology and oestrogen levels in post menopausal women. 2. Comparison of its efficacy with hormonal replacement therapy. Study method: On hundred and fifty post menopausal women were randomly assigned to study group (n=lOO) and control group (n=50) in the ratio of 2:l. Initial evaluation of patients by vaginal cytology and S. Estradiol was followed by instructions to consume diet containing 125 gm of dried soybean and rich in legumes, beans. Observations were repeated at three and six months interval. Results: In study group good clinical relief occurred in 70% of patients, while 22% had only partial relief. In control group good clinical relief was observed in 66% patients and 25% had minimal relief at the end of study. -Percentage of vaginal superficial cells increased by 18% by third month and 22% by sixth month of study which is statistically significant -Little changes occurred in S. estradiol concentration or body weight during study -Compliance rate in study group was found to be 70% while in control group it was only 50%. Conclusion: Natural estrogen (food supplement) has significant effect on clinical symptoms relief and reproductive tract epithelial cell proliferation.
P1.13.27 RISK FACTORS FOR THE ENDOMETRIAL THICKNESS IN MENOPAUSAL WOMEN Chnee. LH, Ueno, .I; Bagnoli, VR; Arie, WMY, Fonseca, AM; Junqueira, PAA & Pinotti, JA. Dept. OBIGYN, SBo Paula University Medical School, SBo Paula, Brazil Objective: The objective of this study was to evaluate the risk factors, as follows: arterial hypertension, hypercholesterolemia, smoking, parity and a previous hormonal replacement therapy in postmenopausal women to endometrial thickness. Methods: One hundred postmenopausal patients (one year or more) who presented at the Gynecologic and Endocrinology Ambulatory of SBo
Paula University Medical School with an endometrial echo of 6 mm or higher measured by Transvaginal Ultrasonography (TVUSG) were included in this retrospective study. All patients were submitted to medical history and physical examination. Possible risk factors for endometrial thickness (arterial hypertension, diabetes, hypercholesteremia, smoking, parity and a previous hormonal replacement therapy) were analyzed. Results: Of 100 (one hundred) postmenopausal patients with endometrial thickness, 79 were multiparas, 56 presented with hypercholesteremia, 39 underwent a previous hormonal replacement therapy, 35 presented with systemic arterial hypertension, and 7 with diabetes (who were smokers). Conclusion: Multiparity and hypercholesterolemia were predominant factors in postmenopausal women with endometrial thickness. On the other hand, the use of the previous hormonal replacement therapy, arterial hypertension, diabetes and smoking were found in less than 50% of cases.
P1.13.28 HORMONE REPLACEMENT THERAPY (HRT) IN SPECIAL CONDITIONS: DIABETIC WOMEN WITH HYSTERECTOMY Bannoli. VR; Cambraia, CPP, Massabki, JOP, Blanco, EBC, Fonseca, AM, Junqueira, LR & Pinotti, JA. Dept. OBIGYN, SBo Paula University Medical School, SBo Paula, Brazil. Objective: To compare the lipid screening, fasting glucose, Body Mass Index (BMI) and Kuppermann Menopausal Index (KMI) in diabetic patients with hysterectomy after the administration of oral or injectable HRT. Methods: Twenty diabetic women who underwent hysterectomy were included in this study. The age ranged from 45 to 72 years (mean age of 50 years). Patients were divided into 2 groups according to the HRT regimen recieved: Group A 5 mg of injectable estradiol hexahidrobenzoate given once a month, and Group B 0,625 mg of oral continuous conjugated equine estrogens. In all patients Body Mass Index O(BMI), Kuppermann Menopausal Index (KMI), lipid screening (total cholesterol, HDL, LDL, VLDL and triglycerides), and fasting glucose were evaluated before and after 1 year of therapy. Results:
Conclusions: No significant changes in fasting glucose were noted in both groups. There was a slight elevation of total cholesterol and LDL in both groups.