IntroductionAdiponectin may be a biomarker of cognitive impairment stage, and its clinical progression. In this study we aimed to evaluate the relationship between serum adiponectin levels and cognitive performances in menopausal women, and whether serum adiponectin levels may be differently associated with cognitive performances as compared to overweight/obese subjects.MethodsWe enrolled 188 post-menopausal women, divided into two groups: obese/overweight group (n = 96) and normal weight group (n = 92). After a clinical examination, and laboratory measurements, we assessed cognitive functions by Montreal Cognitive Assessment test (MoCA).ResultsA significant and greater decrease in executive/visuo-spatial and in attention functions occurred in obese/overweight group as compared to normal weight group (p< 0.001). A significant positive relationship between serum adiponectin levels, and MoCA Global cognitive function was found. MoCA executive, and MoCA attention functions significantly and positively correlated with serum adiponectin levels. BMI, WHR, and serum adiponectin levels were independently associated with MoCA Global cognitive function, but only serum adiponectin levels were independently associated with MoCA attention.ConclusionA significant positive association may exist between serum adiponectin levels, and better cognitive function in postmenopausal status. The major determinant of attentional capacity was just serum adiponectin levels, and dosage of serum adiponectin levels may be early serum marker of cognitive decline. Therefore, serum adiponectin level has to be used, as early biomarker, to detect cognitive decline, and to support an early prevention.

This study aims to compare the effects of low-dose emidrate estradiol/drospirenone (E2/DRSP) vs low-dose emidrate estradiol/dydrogesterone (E2/DG) combination on the mean amplitude of glycemic excursions (MAGE) value in postmenopausal women affected by metabolic syndrome (MS). One hundred sixty postmenopausal women were recruited to receive a treatment with oral doses of E2/1 mg plus drospirenone/2 mg (E2/DRSP group) or oral dose of E2/1 mg plus dydrogesterone/5 mg (E2/DG group) for 6 months. At enrollment and after 6 months, anthropometric, metabolic, and inflammatory parameters have been assessed. MAGE, evaluated during 48-h continuous subcutaneous glucose monitoring (CSGM), allowed us to assess daily glucose fluctuations at baseline and after 6 months. After hormone therapy, both groups showed a significant decline in fasting plasma glucose levels (p<0.05), while only E2/DRSP group showed a statistically significant decline in waist circumferences, post-prandial glycemia, LDL, plasma triglycerides, MAGE, HOMA index, and plasma IL-6 (p<0.05) levels. In the whole population (n=160), after 6 months of indicated therapy, changes in fasting plasma glucose and PAI-1 levels correlated with the changes in MAGE values, while only in E2/DRSP group that MAGE reduction was positively associated with a stronger decrease in waist circumferences, triglycerides, and TNF-α plasma levels. The independent effect of hormone therapy (HT) on reduction in MAGE value has been tested in three different multiple linear regression models. HT resulted to be associated with MAGE, independent of other confounding variables. Although both groups had a decline in fasting plasma glucose, only drospirenone treatment revealed positive effects on glycemic excursions and insulin sensitivity, induced favorable changes in lipid profile, and showed an improvement of inflammatory indices in postmenopausal women with MS.