Female ; Humans ; Male ; Diabetes Mellitus, Type 2/genetics* ; Genetic Predisposition to Disease/genetics* ; Postmenopause ; Risk Factors ; Sex Hormone-Binding Globulin/genetics* ; Testosterone

Postmenopausal osteoporosis is a kind of degenerative disease, also described as "invisible killer." Estrogen is generally considered as the key hormone for women to maintain bone mineral content during their lives. Iron accumulation refers to a state of human serum ferritin that is higher than the normal value but less than 1000 μg/L. It has been found that iron accumulation and osteoporosis could occur simultaneously with the decrease in estrogen level after menopause. In recent years, many studies indicated that iron accumulation plays a vital role in postmenopausal osteoporosis, and a significant correlation has been found between iron accumulation and fragility fractures. In this review, we summarize and analyze the relevant literature including randomized controlled trials, systematic reviews, and meta-analyses between January 1996 and July 2022. We investigate the mechanism of the effect of iron accumulation on bone metabolism and discuss the relationship of iron accumulation, osteoporosis, and postmenopausal fragility fractures, as well as the main clinical treatment strategies. We conclude that it is necessary to pay attention to the phenomenon of iron accumulation in postmenopausal women with osteoporosis and explore the in-depth mechanism of abnormal bone metabolism caused by iron accumulation, in order to facilitate the discovery of effective therapeutic targets for postmenopausal osteoporosis.
Humans ; Female ; Osteoporotic Fractures ; Osteoporosis, Postmenopausal/drug therapy* ; Postmenopause ; Osteoporosis ; Bone Density ; Estrogens ; Iron/therapeutic use*

To explore the relationship between the early or delayed age at natural menopause and metabolic syndrome (MS) in women. A total of 4 734 natural menopausal women who completed the baseline survey from November 2017 to January 2020 in the Guangzhou Middle-aged and Elderly Chronic Disease Prospective Cohort Study were selected in this cross-sectional study. Data on general demographic characteristics, disease history and female physiological health indicators were collected. Logistic regression model and restricted cubic spline curve were used to analyze the relationship between the age at natural menopause and MS. The results showed that the mean age of the subjects was (60±6) years old. The median (Q₁,Q₃) age at natural menopause was 50 (49, 52) years old, and the prevalence of MS was 14.8%(699/4 734). After adjusting for confounders, the age at natural menopause was closely related to MS in an approximate"U"shape. Compared with the group of normal age at natural menopause, the early age at menopause (OR=1.52, 95%CI: 1.12-2.06) and delayed age at menopause (OR=1.77, 95%CI: 1.36-2.30) had a higher risk of MS. In the group with time since menopause ≤6 years and 7-9 years, the risk of MS in the group with delayed age at menopause was 2.40 times (95%CI: 1.54-3.75) and 2.19 times (95%CI: 1.11-4.31) higher than that in the group with normal menopausal age, respectively. In conclusion, the early and delayed age at natural menopause increased the risk of MS. The increased risk of MS in delayed age at natural menopause mainly occurred within 10 years since menopause.
Middle Aged ; Aged ; Female ; Humans ; Child ; Postmenopause ; Metabolic Syndrome/epidemiology* ; Prospective Studies ; Cross-Sectional Studies ; Menopause/physiology* ; Risk Factors

OBJECTIVE: To evaluate the effect of denosumab on bone mineral density around proximal femoral prosthesis after total hip arthroplasty(THA) in the postmenopausal osteoporotic patients. METHODS: Fifty-four consecutive patients underwent unilateral primary THA were included in this retrospective study. Twenty-five patients received denosumab for osteoporosis as the treatment group, and the twenty-nine without denosumab were the control group. At 1 week, 3month, 6 months, and 12 months after THA, bone turnover markers and proximal femoral periprosthetic bone mineral density (BMD) were measured. RESULTS: At 3, 6 and 12 months after operation, the level of TRACP-5b in the control group was significantly higher than that in the treatment group (P<0.05);the level of bone-specific alkaline phosphatase (BALP) between two groups showed significant difference in 12 months after operation (control group was higher than treatment group, P<0.05). The BMD of Gruen 1 and Gruen 7 decreased at 3, 6 and 12 months after operation compared with 1 week after operation. Comparing the treatment group and the control group, the differences of the the decrease of BMD in Gruen 1 and Gruen 7 were no significant at 3 months after surgery. In Gruen 1, Gruen 7 at 6 months after operation and Gruen 1, Gruen 7 at 12 months after operation, the decrease of BMD in the control group was significantly higher than that in the treatment group(P<0.05). It is suggested that desudumab could inhibit the loss of BMD after 6 months, and continuously show a protective effect on bone mass at 12 months after operation. CONCLUSION After THA in postmenopausal patients with osteoporotic femoral neck fracture, Desuzumab can reduce the loss of BMD around the proximal femoral prosthesis and effectively inhibit bone resorption.
Humans ; Arthroplasty, Replacement, Hip ; Bone Density ; Denosumab/therapeutic use* ; Retrospective Studies ; Postmenopause ; Absorptiometry, Photon ; Bone Remodeling ; Follow-Up Studies ; Hip Prosthesis

Objective: To understand the prevalence of osteoporosis and related factors in postmenopausal women aged ≥40 years in China and provide scientific evidence for osteoporosis prevention and control. Methods: Data of this study were from the 2018 China Osteoporosis Epidemiological Survey, covering 44 counties (districts) in 11 provinces in China. Related variables were collected by questionnaire survey and physical measurement, and the BMD of lumbar spine and proximal femur was measured by dual-energy X-ray absorption method. The prevalence of osteoporosis and its 95%CI in postmenopausal women aged ≥40 years were estimated with complex sampling weights. Results: A total of 5 728 postmenopausal women aged ≥40 years were included in the analysis and the prevalence of osteoporosis was 32.5% (95%CI: 30.3%-34.7%). The prevalence of osteoporosis in postmenopausal women aged 40-49 years, 50-59 years, 60-69 years, 70-79 years, and ≥80 years were 16.0% (95%CI:4.5%-27.5%), 18.4% (95%CI:15.9%-20.8%), 37.5% (95%CI:34.5%-40.4%), 52.9% (95%CI: 47.5%-58.3%), and 68.0% (95%CI:55.9%-80.1%) respectively. The prevalence of osteoporosis was higher (P<0.001) in those with education level of primary school or below (47.2%, 95%CI: 43.0%-51.3%) and in those with individual annual income less than 10 000 Yuan, (40.3%, 95%CI: 36.9%-43.7%). The prevalence of osteoporosis was 35.1% in rural areas (95%CI: 32.0%-38.1%), which was higher than that in urban areas (P<0.001). The prevalence of osteoporosis in low weight, normal weight, overweight and obese groups were 69.9% (95%CI: 59.0%-80.8%), 42.2% (95%CI: 38.7%-45.7%), 24.2% (95%CI: 21.3%-27.1%) and 14.6% (95%CI: 11.1%-18.0%), respectively. The prevalence of osteoporosis in those with menstrual maintenance years ≤30 years and in those with menopause years ≥11 years were 46.1% (95%CI:40.8%-51.3%) and 48.2% (95%CI:45.0%-51.3%), respectively. Multivariate logistic analysis showed that age ≥60 years, education level of primary school or below, annual household income per capita less than 10 000 Yuan, low body weight, menstrual maintenance years ≤30 years, menopause years ≥11 years were risk factors of osteoporosis in postmenopausal women in China. Conclusions: The prevalence of osteoporosis was high in postmenopausal women aged ≥40 years in China, and there were differences in osteoporosis prevalence among different socioeconomic groups. Effective interventions should be taken for the prevention and control of osteoporosis in key groups in the future.
Absorptiometry, Photon ; Bone Density ; China/epidemiology* ; Female ; Humans ; Lumbar Vertebrae ; Osteoporosis/epidemiology* ; Osteoporosis, Postmenopausal/etiology* ; Postmenopause ; Prevalence ; Risk Factors

The present study explored the correlation of coronary heart disease(CHD) with blood stasis syndrome in postmenopausal women with artery elasticity and endothelial function indexes and evaluated the diagnostic efficacy of the prediction model via logistic regression and receiver operating characteristic(ROC) curve model. A retrospective comparison was made between 366 postmenopausal CHD patients from August 1, 2020, to September 30, 2021, in the Department of Cardiology of Integrated Traditional Chinese and Western Medicine of China-Japan Friendship Hospital, who were divided into the blood stasis syndrome group(n=196) and the non-blood stasis syndrome group(n=170). General clinical characteristics of the two groups were compared. Multivariate logistic regression analysis was used to probe the correlation of CHD with blood stasis syndrome in postmenopausal women with brachial-ankle pulse wave velocity(baPWV), ankle-brachial index(ABI), and flow-mediated dilatation(FMD), and the ROC curve was drawn to evaluate the diagnostic efficiency of the prediction model. Multivariate logistic regression analysis showed that the correlation coefficients of CHD with blood stasis syndrome in postmenopausal women with baPWV, ABI, and FMD were 1.123, 0.109, and 0.719, respectively(P=0.004, P=0.005, P<0.001),and the regression equation for predicting probability P was P=1/[1+e~(-(3.131+0.116×baPWV-2.217×ABI-0.330×FMD))]. ROC curve analysis suggested that in the context of baPWV≥19.19 m·s~(-1) or ABI≤1.22 or FMD≤9.7%, it was of great significance to predict the diagnosis of CHD with blood stasis syndrome in postmenopausal women. The AUC of baPWV, ABI, FMD, and prediction probability P was 0.763, 0.607, 0.705, and 0.836, respectively. The AUC of prediction probability P was higher than that of each index alone(P<0.001), and the sensitivity and specificity were 0.888 and 0.647, respectively. The results demonstrate that baPWV, ABI, and FMD are independently correlated with CHD with blood stasis syndrome in postmenopausal women, and show certain independent predictive abilities(P<0.05). The combined evaluation of the three possesses the best diagnostic efficiency.
Ankle Brachial Index ; Brachial Artery ; Coronary Disease/diagnosis* ; Elasticity ; Female ; Humans ; Logistic Models ; Postmenopause ; Pulse Wave Analysis ; ROC Curve ; Retrospective Studies

Background: Post-menopausal women experiences changes in estrogen levels affecting body metabolism, which may lead to weight gain and obesity. Moreover, one of the most prevalent diseases among this group is osteoporosis. However, the relationship between fat mass and its protective property remains unclear. This study assesses the correlation of fat mass with bone mineral density (BM) and 10-year FRAX based fracture probability among Filipino women. Methods: A cross-sectional review of records of post-menopausal Filipino women who underwent whole body bone mineral densitometry scans via dual-energy X-ray absorptiometry (DXA) between January 1, 2015, and December 31, 2018 in the Radioisotope Laboratory of the Philippine General Hospital was done. Pearson correlation and simple linear regression analyses were done to determine the correlation between the two outcomes – BMD and 10-year FRAX based fracture probability. Results: A total of 258 postmenopausal women were included in the analysis. There was a weak positive correlation of fat mass with BMD of L1-L4 vertebrae (R-score of 0.318), BMD of femoral neck (R-score of 0.3937) and hips (R - score of 0.3031). The 10-year FRAX based fracture probability for both hip and osteoporotic had very weak and weak negative correlation, respectively (R-score of - 0.06752 and - 0.29017). Conclusion Despite having varying available, data on the protective effects of fat mass on fracture protection, this study showed that fat mass has a poor correlation with BMD and reduction in FRAX probability.
Postmenopause ; Bone Density ; Fractures, Bone

Objective: This study evaluated the knowledge, attitude and practice of Filipino gynecologists towards hormonal therapy for menopausal symptoms. Methods: This was a cross-sectional study carried out among practicing Filipino gynecologists in different regions of the Philippines from April to October 2018. A self-administered questionnaire was used to identify the current knowledge, attitude and practice of gynecologists regarding the use of hormonal replacement therapy. Results: There were 369 respondents included in the study. Our findings indicate that the most common indication for MHT are vasomotor symptoms and vaginal dryness. Almost all Filipino gynecologists participating in this study were aware that MHT will improve vasomotor and urogenital symptoms, sexual dysfunction and mood. Majority of them correctly agreed that MHT will decrease the risk of osteoporosis and coronary artery disease. On the other hand, at least half of the respondents falsely believed that MHT can decrease the risk for cognitive dysfunction, cerebrovascular disease, Parkinson’s disease and vascular thrombosis. Only 68% of the respondents agreed that they have adequate knowledge about the treatment options for postmenopausal symptoms and as much as 32% of them are still not confident with their knowledge. Majority (65%) of Filipino gynecologists do not routinely recommend or offer the use of MHT to every postmenopausal woman. Conclusion The knowledge and attitude of gynecologists on hormonal therapy play an important role in the decision making of a woman during her climacteric period. Basic knowledge on menopausal symptoms and indications for hormonal therapy are known to the respondents but these knowledge do not translate to practice.
Hormone Replacement Therapy ; Menopause ; Postmenopause

OBJECTIVE: This study will evaluate the knowledge, attitude and practice of gynecologists towards hormonal therapy for menopausal symptoms. METHODS: A descriptive study design was carried out across the different regions of the Philippines from April to October 2018. A self-administered questionnaire was used to identify current knowledge, attitude and practice of gynecologists regarding the use of hormonal replacement therapy. RESULTS: A total of 369 respondents were able to complete the questionnaire. Our findings indicate that the most common indication for giving MHT are vasomotor symptoms such as hot flushes, night sweats, diaphoresis, vaginal dryness and its associated discomfort and pain during intercourse. Almost all Filipino gynecologists participating in this study are aware that MHT will improve vasomotor, urogenital symptoms, sexual dysfunction and mood. Majority of Filipino gynecologists who participated in this study agreed correctly that MHT will decrease the risk of osteoporosis and coronary artery disease. However, still majority of Filipino gynecologists do not routinely recommend/offer the use of MHT to every postmenopausal woman. On the other hand, at least half of the respondents falsely believe that MHT can decrease the risk for cognitive dysfunction, cerebrovascular disease, Parkinson's disease and vascular thrombosis. CONCLUSION The overall knowledge of Filipino gynecologist who participated in this study is lacking. Only 68% of them agreed that they have adequate knowledge about the treatment options for postmenopausal symptoms and as much as 32% of them are still not confident. Basic knowledge on menopausal symptoms and indications for hormonal therapy are known to the respondents but these knowledge does not translate to practice.
Postmenopause

OBJECTIVE: To explore the relationships of periodontal parameters, cortical width on mental foramen and osteoporotic condition in postmenopausal women. METHODS: Ninetyeight postmenopausal women between 50 to 65 years old were recruited. General conditions, such as age, menopausal age, duration of menopause, and body mass index (BMI) were recorded. Periodontal parameters were examined, including oral hygiene index simplified (OHI-S), probing depth (PD), clinical attachment loss (CAL), gingival recession (GR) and bleeding on probing (BOP). Panoramic radiograph was taken and the cortical width (CW) of mental foramen was measured on images. The examiner was celebrated. Bone mass density (BMD) of left hip and lumbar spine was assessed using standardized dual energy X-ray absorptiometry. According to World Health Organization, based on the T-score of BMD (difference of the measured BMD and the mean value of young white women in terms of standard deviations), the subjects were divided into osteoporotic group (T-score<-2.5) and non-osteoporotic group (T-score≥-2.5). These parameters were compared between the groups. RESULTS: The number of osteoporotic group was 47 (47.96%). Ages and duration of menopause were significantly different between the groups. Osteoporotic group presented older ages [(59.64±4.58) years vs. (56.94 ± 4.26) years, P<0.05], and longer duration of menopause [(10.17± 5.37) years vs. (6.02 ±4.48) years, P<0.05]. There was no significant difference in menopausal age and BMI between the groups. BOP% was statistically significantly higher in osteoporotic group (29.43±21.12) than in non-osteoporotic group (21.43±17.09), with a P-value of 0.046. The other periodontal parameters, including OHI-S, PD, CAL, and GR were not statistically significantly different in the groups. The CWs were statistically significantly lower in osteoporotic group compared with non-osteoporotic group, with a P-value of 0.001. The mean values of CWs were (3.61±1.04) mm (osteoporotic group) and (4.25±0.77) mm (non-osteoporotic group), respectively. CONCLUSION The study demonstrated absence of a significant association between periodontal parameters and BMD. However, the CWs were found to be related with the BMD, which may be used to detect BMD abnormal in maxillofacial imaging. The dentists should pay attention not only to the oral health, but also to the general bone mass density, which may be detected on panoramic images.
Absorptiometry, Photon ; Aged ; Bone Density ; Female ; Humans ; Middle Aged ; Osteoporosis, Postmenopausal ; Periodontitis ; Postmenopause