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IMPACT OF A WALKING PROGRAM ON THE METABOLIC RISK PROFILE OF OBESE POSTMENOPAUSAL WOMEN
8th European Congress on Menopause (EMAS) / Maturitas 63, Supplement 1 (2009) S1–S136
5.96±4.92 years. Anthropometric characteristics and blood pressure were measured. Blood was taken at 8 am for: fasting glucose, triglycerides, cholesterol, HDL, LDL, apolipoprotein A (ApoA), apolipoprotein B (ApoB), lipoprotein(a) (Lp(a)), C-reactive protein (CRP), fibrinogen, FSH, LH, prolactin (PRL), estradiol (E2 ), progesterone (P), testosterone (T) and sex hormone binding globulin (SHBG). Results: Significant differences between groups were found for: weight, BMI, waist, hips circumference, waist/hip ratio, diastolic blood pressure, Lp(a), FSH, LH, PRL (all p<0.01) and fasting glucose (p<0.05). In obese women significant negative correlations were found for: FSH and fasting glucose, SHBG and LDL, SHBG and TC, SHBG and fasting glucose, BMI and HDL, WC and HDL. In controls positive correlation was detected between LH and HDL. Conclusion: Hypoestrogenism in the menopause induce gaining weight leading to metabolic syndrome with all complications. Appropriate estroprogestogen therapy initiating on time in the menopause and special dietary regimen can prevent metabolic syndrome. Keywords: Menopause, obesity, lipids, fasting glucose.
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3 sessions/week of 45 min-walking at 60% of their heart rate reserve. Body composition, resting blood pressure (BP), fasting lipid-lipoprotein profile and cardiorespiratory fitness (CRF) were measured before and after exercise. Results: In the whole sample of 153 women, CRF estimated by O2 max increased in response to walking (p<0.0001). Endurance-training promoted body weight and fat mass losses, reduced waist girth and BP, while it decreased plasma triglyceride, cholesterol and LDL-cholesterol levels, and increased HDL-cholesterol concentrations (p<0.0001). Improvements in lipid-lipoprotein levels were not associated with increases in CRF but seemed to be dependent on reduced body fatness. However, the greatest ameliorations in metabolic risk profile were found in women characterized by 2 or more determinants of MS at baseline (0.05
98 96 THE INFLUENCE OF ADIPOSITY, THE MUSCULAR CONDITION AND THE CHARACTERISTICS OF MENOPAUSE, IN THE MAXIMUM OXYGEN INTAKE OF POSTMENOPAUSAL WOMEN M. Moreira, F. Aragão, V. Almeida, M. Monteiro, P. Mota, J. Soares. University of Trás-os-Montes and Alto Douro, Department of Sport Science, Vila Real, Portugal Objectives: To analyse the variation of maximum oxygen intake (VO2max ) in postmenopausal women, considering: fat mass (%FM), skeletal muscle mass index (SMI), hormone replacement therapy (HRT) and the time of menopause (TM). Methods: Thirty two women aged 60 to 73 performed a reproductive history and VO2max was assessed by a modified Bruce treadmill protocol. Skeletal muscle mass, basal metabolic rate (BMR) and %FM were evaluated by tetrapolar bioimpedance being the first expressed as SMI. The cut-off points to obesity and sarcopenia were: FM≥35% and SMI≤28%. Student’s t test for independent samples and ANOVA with Bonferroni correction were used to compare groups. Results: The averages of VO2max and BMR were, respectively, 33.36 ml/kg/min, and 1275.27 kcal/day. In the absence of HRT, the women with TM>10 years revealed (p<0.05) a lower VO2max (-8.38 ml/kg/min), noting that the HRT has a beneficial effect in this variable in the presence of TM>10 years (+10.28 ml/kg/min). The obese/sarcopenic women presented average levels of VO2max inferior (p<0.01) to those registered to non-sarcopenic with obesity (-7.88 ml/kg/min) and without obesity (-15.27 ml/kg/min). In the presence of a normal muscular condition, the obesity negatively influenced the VO2max . Conclusions: Obesity and its overall combination with sarcopenia create a lower VO2max in postmenopausal women, therefore benefiting the use of HRT, in the presence of an amenorrhea period superior to 10 years. In the absence of HRT, the TM worsens the aerobic capacity. Keywords: Maximum oxygen intake, obesity, sarcopenia, hormone replacement therapy and time of menopause.
97 IMPACT OF A WALKING PROGRAM ON THE METABOLIC RISK PROFILE OF OBESE POSTMENOPAUSAL WOMEN P. Mauriège 1 , M. Roussel 1 , S. Garnier 1 , S. Lemoine 1 , I. Gaubert 2 , L. Charbonnier 1 , G. Auneau 1 . 1 Université P. Sabatier, UFR S.T.A.P.S., Toulouse, France; 2 Fédération Française d’Éducation Physique et de Gymnastique Volontaire, Paris, France Objectives: Menopause transition is associated with an increased prevalence of metabolic syndrome (MS) which may partly explain the higher coronary heart disease (CHD) risk. The aim of this study was to examine the impact of a 16-week walking program on the metabolic risk profile of women 50-65 years-old, whose body mass index ranged from 29 to 35 kg/m2 . Methods: 153 postmenopausal women among whom 46 vs. 84 of them were characterized by 1 vs. 2 or more determinants of MS, whereas 23 of them did not show this condition, at baseline, were subjected to
CORONARY HEART DISEASES AND HRT IN FRANCE: MISSION STUDY PROSPECTIVE PHASE RESULTS T. Chevallier 1 , P. De Reilhac 2 , P. Mares 3 , M.C. Micheletti 4 , D. Postrunick 4 . 1 IURC - Montpellier, Biostatistique Epidémiologie Recherche Clinique, Montpellier, France; 2 3 Place Ladmirault, Nantes, France; 3 Hopital Carémeau, Nimes, France; 4 Theramex, Monaco, Monaco Objectives: The MISSION study is a national prospective study with random patient selection carried out in France by the National Federation of Medical Gynaecology Colleges (F.N.C.G.M.). Its aim is to determine morbidity incidence in postmenopausal women, under a gynaecologist’s care, depending on whether or not they are treated with HRTs commonly prescribed in France. Here we present the results concerning the incidence of Coronary Heart Disease (CHD). Methods: MISSION study started on 5 January 2004 and the cut-off date for data collection was December 2007 (Follow-up No. 2). “Exposed group” (exp): postmenopausal women currently on HRTs commonly prescribed in France or stopped ≤5 years previously; “Unexposed group” (Uexp): never received HRT or stopped >5 years previously. Results: Data were available for 5462 patients: 2940 Exposed group and 2522 Unexposed group. The incidence of postmenopausal CHD was not significantly different in the Exposed group compared to the Unexposed group (0.20% and 0.19% respectively – RR(exp/Uexp) = 1,0247). Conclusions: At the end of the second prospective follow-up of the MISSION cohort, no increased risk of CHD was found in the Exposed group compared with the Unexposed group. Keywords: HRT, Cardiovascular disease, Epidemiology.
99 MICROCIRCULATORY FUNCTION IN POSTMENOPAUSAL WOMEN: ROLE OF AGING, HORMONAL THERAPY, PREVIOUS CONTRACEPTIVE USE AND METABOLIC SYNDROME DIAGNOSIS R. Clapauch 1 , E. Bouskela 2 . 1 State University of Rio de Janeiro, Laboratório de Pesquisas em Microcirculação & Hospital da Lagoa, Health Ministry, Rio de Janeiro, Brazil; 2 State University of Rio de Janeiro, Laboratório de Pesquisas em Microcirculação, Rio de Janeiro, Brazil Objectives: To evaluate the microcirculatory function in postmenopausal women using functional parameters in relation to age, time since menopause (TSM), hormonal therapy (HT), previous contraceptive use and metabolic profile. Methods: 68 nonsmokers, normotensive and non-diabetic postmenopausal women were evaluated. HT was withheld in current users (n=27) one month before microvascular assessment, performed non-invasively by nailfold videocapillaroscopy. Basal (RBCV) and maximum (RBCVmax ) red blood cell velocity before and after 1 min arterial occlusion and time (T) to reach RBCVmax during the reactive hyperemia response were measured. Results: Selected women had 53.5±8.0 (34-70) years and BMI 25.8±4 kg/m2 . TSM, postmenopausal years with and without HT were 7±6 (0.524); 2.5±3.0 (0-12) and 4±5 (0-21) years, respectively. Age and TSM were inversely correlated with RBCV and RBCVmax (p=0.02 for age; p=0.01 and p=0.03 for TSM). Longer time without HT was associated to lower
5.96±4.92 years. Anthropometric characteristics and blood pressure were measured. Blood was taken at 8 am for: fasting glucose, triglycerides, cholesterol, HDL, LDL, apolipoprotein A (ApoA), apolipoprotein B (ApoB), lipoprotein(a) (Lp(a)), C-reactive protein (CRP), fibrinogen, FSH, LH, prolactin (PRL), estradiol (E2 ), progesterone (P), testosterone (T) and sex hormone binding globulin (SHBG). Results: Significant differences between groups were found for: weight, BMI, waist, hips circumference, waist/hip ratio, diastolic blood pressure, Lp(a), FSH, LH, PRL (all p<0.01) and fasting glucose (p<0.05). In obese women significant negative correlations were found for: FSH and fasting glucose, SHBG and LDL, SHBG and TC, SHBG and fasting glucose, BMI and HDL, WC and HDL. In controls positive correlation was detected between LH and HDL. Conclusion: Hypoestrogenism in the menopause induce gaining weight leading to metabolic syndrome with all complications. Appropriate estroprogestogen therapy initiating on time in the menopause and special dietary regimen can prevent metabolic syndrome. Keywords: Menopause, obesity, lipids, fasting glucose.
S27
3 sessions/week of 45 min-walking at 60% of their heart rate reserve. Body composition, resting blood pressure (BP), fasting lipid-lipoprotein profile and cardiorespiratory fitness (CRF) were measured before and after exercise. Results: In the whole sample of 153 women, CRF estimated by O2 max increased in response to walking (p<0.0001). Endurance-training promoted body weight and fat mass losses, reduced waist girth and BP, while it decreased plasma triglyceride, cholesterol and LDL-cholesterol levels, and increased HDL-cholesterol concentrations (p<0.0001). Improvements in lipid-lipoprotein levels were not associated with increases in CRF but seemed to be dependent on reduced body fatness. However, the greatest ameliorations in metabolic risk profile were found in women characterized by 2 or more determinants of MS at baseline (0.05
98 96 THE INFLUENCE OF ADIPOSITY, THE MUSCULAR CONDITION AND THE CHARACTERISTICS OF MENOPAUSE, IN THE MAXIMUM OXYGEN INTAKE OF POSTMENOPAUSAL WOMEN M. Moreira, F. Aragão, V. Almeida, M. Monteiro, P. Mota, J. Soares. University of Trás-os-Montes and Alto Douro, Department of Sport Science, Vila Real, Portugal Objectives: To analyse the variation of maximum oxygen intake (VO2max ) in postmenopausal women, considering: fat mass (%FM), skeletal muscle mass index (SMI), hormone replacement therapy (HRT) and the time of menopause (TM). Methods: Thirty two women aged 60 to 73 performed a reproductive history and VO2max was assessed by a modified Bruce treadmill protocol. Skeletal muscle mass, basal metabolic rate (BMR) and %FM were evaluated by tetrapolar bioimpedance being the first expressed as SMI. The cut-off points to obesity and sarcopenia were: FM≥35% and SMI≤28%. Student’s t test for independent samples and ANOVA with Bonferroni correction were used to compare groups. Results: The averages of VO2max and BMR were, respectively, 33.36 ml/kg/min, and 1275.27 kcal/day. In the absence of HRT, the women with TM>10 years revealed (p<0.05) a lower VO2max (-8.38 ml/kg/min), noting that the HRT has a beneficial effect in this variable in the presence of TM>10 years (+10.28 ml/kg/min). The obese/sarcopenic women presented average levels of VO2max inferior (p<0.01) to those registered to non-sarcopenic with obesity (-7.88 ml/kg/min) and without obesity (-15.27 ml/kg/min). In the presence of a normal muscular condition, the obesity negatively influenced the VO2max . Conclusions: Obesity and its overall combination with sarcopenia create a lower VO2max in postmenopausal women, therefore benefiting the use of HRT, in the presence of an amenorrhea period superior to 10 years. In the absence of HRT, the TM worsens the aerobic capacity. Keywords: Maximum oxygen intake, obesity, sarcopenia, hormone replacement therapy and time of menopause.
97 IMPACT OF A WALKING PROGRAM ON THE METABOLIC RISK PROFILE OF OBESE POSTMENOPAUSAL WOMEN P. Mauriège 1 , M. Roussel 1 , S. Garnier 1 , S. Lemoine 1 , I. Gaubert 2 , L. Charbonnier 1 , G. Auneau 1 . 1 Université P. Sabatier, UFR S.T.A.P.S., Toulouse, France; 2 Fédération Française d’Éducation Physique et de Gymnastique Volontaire, Paris, France Objectives: Menopause transition is associated with an increased prevalence of metabolic syndrome (MS) which may partly explain the higher coronary heart disease (CHD) risk. The aim of this study was to examine the impact of a 16-week walking program on the metabolic risk profile of women 50-65 years-old, whose body mass index ranged from 29 to 35 kg/m2 . Methods: 153 postmenopausal women among whom 46 vs. 84 of them were characterized by 1 vs. 2 or more determinants of MS, whereas 23 of them did not show this condition, at baseline, were subjected to
CORONARY HEART DISEASES AND HRT IN FRANCE: MISSION STUDY PROSPECTIVE PHASE RESULTS T. Chevallier 1 , P. De Reilhac 2 , P. Mares 3 , M.C. Micheletti 4 , D. Postrunick 4 . 1 IURC - Montpellier, Biostatistique Epidémiologie Recherche Clinique, Montpellier, France; 2 3 Place Ladmirault, Nantes, France; 3 Hopital Carémeau, Nimes, France; 4 Theramex, Monaco, Monaco Objectives: The MISSION study is a national prospective study with random patient selection carried out in France by the National Federation of Medical Gynaecology Colleges (F.N.C.G.M.). Its aim is to determine morbidity incidence in postmenopausal women, under a gynaecologist’s care, depending on whether or not they are treated with HRTs commonly prescribed in France. Here we present the results concerning the incidence of Coronary Heart Disease (CHD). Methods: MISSION study started on 5 January 2004 and the cut-off date for data collection was December 2007 (Follow-up No. 2). “Exposed group” (exp): postmenopausal women currently on HRTs commonly prescribed in France or stopped ≤5 years previously; “Unexposed group” (Uexp): never received HRT or stopped >5 years previously. Results: Data were available for 5462 patients: 2940 Exposed group and 2522 Unexposed group. The incidence of postmenopausal CHD was not significantly different in the Exposed group compared to the Unexposed group (0.20% and 0.19% respectively – RR(exp/Uexp) = 1,0247). Conclusions: At the end of the second prospective follow-up of the MISSION cohort, no increased risk of CHD was found in the Exposed group compared with the Unexposed group. Keywords: HRT, Cardiovascular disease, Epidemiology.
99 MICROCIRCULATORY FUNCTION IN POSTMENOPAUSAL WOMEN: ROLE OF AGING, HORMONAL THERAPY, PREVIOUS CONTRACEPTIVE USE AND METABOLIC SYNDROME DIAGNOSIS R. Clapauch 1 , E. Bouskela 2 . 1 State University of Rio de Janeiro, Laboratório de Pesquisas em Microcirculação & Hospital da Lagoa, Health Ministry, Rio de Janeiro, Brazil; 2 State University of Rio de Janeiro, Laboratório de Pesquisas em Microcirculação, Rio de Janeiro, Brazil Objectives: To evaluate the microcirculatory function in postmenopausal women using functional parameters in relation to age, time since menopause (TSM), hormonal therapy (HT), previous contraceptive use and metabolic profile. Methods: 68 nonsmokers, normotensive and non-diabetic postmenopausal women were evaluated. HT was withheld in current users (n=27) one month before microvascular assessment, performed non-invasively by nailfold videocapillaroscopy. Basal (RBCV) and maximum (RBCVmax ) red blood cell velocity before and after 1 min arterial occlusion and time (T) to reach RBCVmax during the reactive hyperemia response were measured. Results: Selected women had 53.5±8.0 (34-70) years and BMI 25.8±4 kg/m2 . TSM, postmenopausal years with and without HT were 7±6 (0.524); 2.5±3.0 (0-12) and 4±5 (0-21) years, respectively. Age and TSM were inversely correlated with RBCV and RBCVmax (p=0.02 for age; p=0.01 and p=0.03 for TSM). Longer time without HT was associated to lower