Menopause and diabetes: EMAS clinical guide

Słopień, Radosław; Wender-Ożegowska, Ewa; Rogowicz-Frontczak, Anita; Męczekalski, Błażej; Zozulińska−Ziółkiewicz, Dorota; Jaremek, J.D.; Cano, Antonio; Chedraui, Peter; Goulis, Dimitrios G.; Lopès, P.; Mishra, Gita D.; Mueck, Alfred O.; Rees, Margaret; Şentürk, Levent M.; Simoncini, Tommaso; Stevenson, John C.; Stute, Petra; Tuomikoski, Pauliina; Paschou, Stavroula Α.; Anagnostis, Panagiotis; Lambrinoudaki, Ιrene

doi:10.1016/j.maturitas.2018.08.009

Cited by 113 publications

(67 citation statements)

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“…This leads to serious pathophysiological changes such as depression, anxiety, sleep disorders, hot flashes, night sweats, and menstrual disorders [2]. In addition, the risk of metabolic abnormalities in menopausal women increases significantly [3][4][5][6]. For example, a cross-sectional and longitudinal analysis has shown that plasma intermediate-density lipoprotein (IDL) and LDL levels are higher in menopausal women than in women of childbearing age [3].…”

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confidence: 99%

“…Another prospective population study has shown that menopause and aging are independently correlated with body mass index (BMI) increase [4]. Insulin resistance in menopausal women is found to increase the incidence of type II diabetes (T2DM) [5], and significantly increase the risk of metabolic syndromes (MetS) [6]. Thus, the decline in estrogen level in menopause is closely related to metabolic abnormalities.…”

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confidence: 99%

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NRF2 deficiency increases obesity susceptibility in a mouse menopausal model

Huang

Cong

et al. 2020

PLoS ONE

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The risk of metabolic abnormalities in menopausal women increases significantly due to the decline in estrogen level. Nuclear factor E2-related factor 2 (NRF2) is an important oxidative stress sensor that plays regulatory role in energy metabolism. Therefore, an ovariectomized menopausal model in Nrf2-knockout (KO) mice was applied to evaluate the effect of Nrf2 deficiency on metabolism in menopausal females. The mice were divided into four groups according to their genotypes and treatments. Blood samples and bodyweights were obtained preoperatively and in the first to ninth postoperative weeks after overnight fasting. Serum levels of triglycerides (TG), total cholesterol (T-CHO), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and glucose (GLU) were measured at postoperative weeks 0, 1, 3, 5, 7, and 9. Neurotransmitter dopamine (DA) and serotonin (5-HT) was analyzed in brain tissues after sacrifice at postoperative week 9. The results demonstrated that, compared with the corresponding wild-type (WT) mice, KO ovariectomized mice had a greater bodyweight gain (P<0.01). Serum analysis showed that the serum GLU, T-CHO, and TG were significantly lower (P<0.05) but LDL was significantly higher (P<0.05) in the KO control mice than that in WT control mice. However, different from the WT counterparts, an increase in blood GLU level (P<0.05), unchanged T-CHO, TG, and HDL levels, and a significant reduction in LDL (P<0.01) was found in the KO ovariectomized mice. In addition, the level of 5-HT was significantly reduced (P<0.05) in the KO mice after ovariectomy. In conclusion, the combination of Nrf2 deletion and a decline in estrogen level induced a significant increase in bodyweight, which may be associated with their altered glucose and LDL metabolism and decreased 5-HT levels. From a clinical perspective, women with antioxidant defense deficiency may have an increased risk of metabolic abnormalities after menopause. Competing interests:The authors have declared that no competing interests exist.serum MDA levels increased in the WT-OVX and KO-CON groups, but decreased in the KO-OVX group, though no statistical significance was reached yet (Fig 2). Body weight changes in different groups of miceBody weight curves prepared by weighing each group of mice weekly showed that weight gain occurred in the WT-OVX and KO-OVX groups relative to the WT-CON and KO-CON groups (Fig 3b). No significant difference of the weight gain rate was found between the WT-CON and KO-CON groups, but OVX groups had increased weight compared to the counterpart CON groups (Fig 3b and 3a, P < 0.05 and P < 0.01). By calculating the rate of weight gain from the preoperative time to postoperative week 9 in different groups, we found that the weight gain rates of the KO-OVX was significantly higher than that in the corresponding KO-CON and WT-CON groups after postoperative week 4 (Fig 3b), and the weight gain rate of KO-OVX was the greatest and was significantly different from the WT-CON and KO-CON group (WT-CON 6.02% ± 2.95%, WT-OVX 18.55% ...

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confidence: 99%

NRF2 deficiency increases obesity susceptibility in a mouse menopausal model

Huang

Cong

et al. 2020

PLoS ONE

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“…5 However, this increased risk is of a similar magnitude to the risk of breast cancer for women who are overweight, or drinking one or two units of alcohol each night. 1 Frustratingly, despite this evidence, only around 10% of women in the UK are currently taking HRT. 10 Although some women choose not to take HRT or cannot take it for medical reasons, a large proportion of women are declined a prescription for HRT for no valid medical reason.…”

Section: The Risks Of Hrtmentioning

confidence: 99%

“…However, the effects of the menopause often have a negative impact on women's wellbeing and quality of life, and are frequently underestimated by noth women and their doctors. Furthermore, the low estrogen levels and other biological changes that occur in menopausal women are also associated with an increased risk of cardiovascular disease, osteoporosis, type 2 diabetes, 1 and dementia. 2 Around 75% of menopausal women experience symptoms, with around onethird of these experiencing severe symptoms which are having a negative effect on their lives, both at home and at work.…”

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confidence: 99%

“…2 Around 75% of menopausal women experience symptoms, with around onethird of these experiencing severe symptoms which are having a negative effect on their lives, both at home and at work. 1 Over the past two decades, there has been a huge amount of confusion regarding hormone replacement therapy (HRT). We now have clear, evidence-based guidelines available to ensure women have individualised care and treatment for their perimenopause and menopause.…”

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