Age at menopause in Latin America

OBJECTIVE: To assess the age at menopause (AM) in Latin America urban areas. DESIGN: A total of 17,150 healthy women, aged 40 to 59 years, accompanying patients to healthcare centers in 47 cities of 15 Latin American countries, were surveyed regarding their age, educational level, healthcare coverage, history of gynecological surgery, smoking habit, presence of menses, and the use of contraception or hormone therapy at menopause. The AM was calculated using logit analysis. RESULTS: The mean age of the entire sample was 49.4 ± 5.5 years. Mean educational level was 9.9 ± 4.5 years, and the use of hormone therapy and oral contraception was 22.1% and 7.9%, respectively. The median AM of women in all centers was 48.6 years, ranging from 43.8 years in Asuncion (Paraguay) to 53 years in Cartagena de Indias (Colombia). Logistic regression analysis determined that women aged 49 living in cities at 2,000 meters or more above sea level (OR = 2.0, 95% CI: 1.4-2.9, P less than 0.001) and those with lower educational level (OR = 1.9, 95% CI: 1.3-2.8, P less than 0.001) or living in countries with low gross national product (OR = 2.1, 95% CI: 1.5-2.9, P less than 0.001) were more prone to an earlier onset of menopause. CONCLUSIONS: The AM varies widely in Latin America. Lower income and related poverty conditions influence the onset of menopause. © 2006 by The North American Menopause Society

Efecto de la dieta rica en grasa (1%) sobre el perfil lipídico en conejas ovariectomizadas. I parte

Introduction: Cardiovascular disease is the main cause of morbility and mortality in developed and underveloped countries around the World. Instead of that ethiology is multifactorial, one of the most important factor is the use of saturated fats and its effect on lipoproteins and atherosclerosis. The aim of the authors was to assess the effect of the fat rich diet on the lipid profile of a rabbit experimental model. Methods: 20 female New Zealand rabbits with 2.500 t0 3 000 kg 0f weight were divided in two groups: Group I (n 10) : 5 controls (C) and 5 rich fat 1% diet (C+D) and group II (n 10) ovariectomized: 5 controls (O) and 5 rich fat 1% diet (O+D). At 3 and 6 months we avaluated the following parameters: weight, GLYCEMIA, total cholesterol TC, Triglycerides TG, HDL lipoproteins, low density lipoproteins LDL and estradiol E2. We use parametric and non parametric measures incluiding the Keuskall-Wallis tests to statistic evaluation. Results: The weight increase progressively in all the 4 groups but higher in the C+D (54%) (p <0.001) y O+D (61%) (p<0.001). Glycemia decrease at 3 and 6 months in controls (-56%) (p<0.002) with a higher decrease in O+D group (-64.67%)(p<0.043). HDL shown a decreased trend with not significant differences at 3 or 6 months. (p0.116 an p<0.609). LDL shown a non statistic significant decrease (p<0.754). TG shown an significant increase (p<0.011) at 3 months in the C+D group(p<0.012) and in ovariectomized (p<0.007). Estradiol had an increase in controls of 13% and 93% in the C+D group (p<0.001). Conclusion: This model is useful in assessing the lipid profile with a high-fat diet (1%) showing severe metabolic effects in ovariectomized rabbits.Introducción: la enfermedad cardiovascular (EC) es la principal causa de morbilidad y mortalidad en países desarrollados como en vía de desarrollo. Su etiología es multifactorial; uno de los factores es el consumo de grasas saturadas con efectos sobre las lipoproteínas y en la ateroesclerosis. Fue interés de los autores conocer el efecto de la dieta rica en grasa sobre el perfil lipídico en un modelo experimental como el conejo. Material y métodos: se tomaron 20 conejas New Zealand de 2.500 a 3.000 Kg. de peso, las cuales se dividieron en dos grupos: Grupo I (n=10) 5 control (C), 5 control + dieta rica en grasa 1% (C+D) y el grupo II (n=10) ovariectomizadas, 5 control (O) y 5 con dieta rica en grasa 1% (O + D). Se evaluaron los siguientes parámetros a los tres y seis meses: peso, glicemia, colesterol total (CT), triglicéridos (TG), lipoproteínas HDL, LDL, estradiol (E2). En la evaluación estadística se utilizaron medidas paramétricas y no paramétricas, incluyendo laprueba de Kruskall-Wallis. Resultados: el peso mostró un aumento progresivo en los cuatro grupos, siendo mayor enelgrupodelosC+D(54%)(p<0.001)ylasO+D(61%)(p<0.001).Laglicemiaproduce un descenso progresivo a los tres y seis meses en los controles (-56%) (p < 0.002), siendo mayor en las conejas (O + D) (-64.67%) (p < 0.041). El CT presenta una tendencia a la disminución que es significativa en el grupo (O + D) (p < 0.043). Las HDL muestran una tendencia a la disminución sin diferencias significativas ni a los tres ni seis meses (P < 0.116 y p < 0.609). Las LDL calculadas si bien muestran una disminución, esta no fue significativa (p < 0.754). Los TG muestran un aumento el cual fue significativo (p < 0.011), siendo evidente a los tres meses en los C + D (p < 0.012) y las ovariectomizadas (p < 0.007). El estradiol en los controles presenta un aumento del 13% y en los C + D de un 93% (p < 0.001). Conclusión: este modelo es útil en la evaluación del perfil lipídico con una dieta rica en grasa (1%), evidenciando severos efectos metabólicos en conejas ovariectomizadas.Incluye referencias bibliográfica

Efecto de la dieta rica en grasa (1%) sobre la aorta y el hígado en conejas ovariectomizadas. II parte

Cause more increased morbidity and mortality in the world. Atherosclerosis is a chronic inflammatory arterial injury exacerbated by an altered lipid metabolism and cardio-vascular risk factors. It was the interests of authors evaluate the effect of a high diet fat on specimen of aorta and liver in an animal model such as the rabbit. Material and Methods. 20 New Zealand rabbits were taken from 2500 to 3000 kg in weight which were divided into 2 groups: Group I (n = 10) 5 control (C), 5 control-fat diet + 1% (C+D) and group II (n = 10) ovariectomized, 5 control (O) and 5 high-fat diet with 1% (O+D). Was evaluated by ultrasonography the abdominal aorta. At the end of the 24 week was sacrificed a rabbit in each group to carried out histological studies of aorta and liver. Was used hematoxylin eosin staining and histological sections for high resolution and fat stain (Fast-Red) Results. In ultrasound the diameter of the aorta between the C and C+D grew by 18.40% in the O and O+D was 12.83%. The intima of the C and C+D grew by 33.33% and between O and O+D controls grew by 15.38%. 50% lower when comparing with controls. The evaluation of the intima between the C1 and O1 increased the diameter in a 14.72% and the thickness of the intima was 33.33%. In the case of C+O and O+D the diameter presented an increase of 0.33% and the adventitia was increased for 275.0%. Histology of the aorta and the hepatocyte shows that the C: had a little increase of fat granules in the intima and in the hepatocyte. C+D: the aorta were seen fat droplets in the intima with thickening of the intima (290 u-390 u). In the liver there was an inflammatory process with moderate hydropic changes and fat droplets inside. O: there was very little change in the intima, small lipid droplets and the diameter is slightly increased (180 u-240 u) compared with controls and inflammatory foci in the liver with hydropic degeneration and fat perilobulillar pericellular in relation to controls. O+D: the aorta showed a large accumulation of fat pericellular with increase in thickness (230 u-360 u) are little larger than the C+D, presents hepatocyte hydropic changes, severe vacuolization and fat perilobulillar strong reaction. Conclusion. The high-fat diet (1%) in a rabbit model produced severe injury to aortic endothelium and the hepatocyte, especially in rabbits with diet and to a lesser extent in the oophorectomised ones.Introducción. La enfermedad coronaria con la enfermedad cerebrovascular son las entidades que causan mayor morbilidad y mortalidad en el mundo. La ateroesclerosis es una lesión arterial inflamatoria crónica exacerbada por una alteración del metabolismo lipídico y factores de riesgo cardiovascular. Fue interés de los autores evaluar el efecto de una dieta rica en grasa sobre especímenes de aorta e hígado en un modelo animal como la coneja. Material y Métodos. Se tomaron 20 conejas New Zealand de 2.500 a 3.000 gr de peso,las cuales se dividieron en 4 grupos de 5 cada uno: grupo 1 n = 5 control (C1); grupo 2 n =5 control + dieta rica en grasa 1% (C+D); grupo 3 ovariectomizadas n = 5 control (O1) y grupo 4 n = 5 con dieta rica en grasa 1% (O+D). Se evaluó por estudio ecográfico la aorta abdominal y al final de las 24 semanas se sacrificó una coneja de cada uno de los 4 grupos, realizándose estudios histológicos de aorta y el hígado. Se utilizó la coloración de hematoxilina eosina, cortes histológicos para alta resolución y una coloración para grasa (Red Fast). Resultados. Ultrasonido de la aorta: el diámetro de la aorta se incrementó en un 18.40% en las conejas no ovariectomizadas y un 12.83% en las ovariectomizadas. La intima de los C y los C+D aumentó un 33.33% y entre las O controles y O+D aumentó un 15.38%, 50% menor al comprarla con los controles. La evaluación de la intima entre los C1 y O1 aumentó el diámetro en un 14.72% y el grosor de la intima fue del 33.33%. En los casos de C+O y O+D el diámetro presentó un aumento de 0.33% y la adventicia presentó un aumento de 275.0%. El estudio histológico de la aorta y el hepatocito muestra que las C: presentan un aumento escaso de gránulos de grasa en la intima y en el hepatocito; las C+D: en la aorta se aprecian pequeñas gotas de grasa en la intima con aumento del espesor de la intima (290 u-390 u). En el hígado se observa un proceso inflamatorio con alteraciones hidrópicas moderadas y gotas grasas en su interior; las O: se observan muy pocos cambios en la intima, escasas gotas de lípidos y el diámetro se encuentra ligeramente aumentado (180 u-240 u) en relación con los controles. En el hígado, focos inflamatorios con degeneración hidrópica perilobulillar y grasa pericelular; en las O+D: la aorta demuestra un gran acumulo de grasa pericelular con aumento en el espesor (230 u-360 u) un poco mayor que la C+D, el hepatocito presenta cambios hidrópicos, severa vasculización y marcada reacción grasa perilobulillar. Conclusión. La dieta rica en grasa (1%) en un modelo como el conejo produce lesiones severas a nivel del endotelio aórtico y el hepatocito, especialmente en las conejas con dieta y en menor proporción en las ooforectomizadas.Incluye referencias bibliográfica

Type II diabetes mellitus and menopause: A multinational study

Background Type II diabetes mellitus causes metabolic changes that may lead to early menopause and worsen climacteric symptoms. Objectives To determine the risk factors for type II diabetes mellitus and assess the impact of this disease on the age of menopause and on climacteric symptoms. Methods A total of 6079 women aged between 40 and 59 years from 11 Latin American countries were requested to answer the Menopause Rating Scale and Goldberg Anxiety-Depression Scale. Results The prevalence of diabetes was 6.7%. Diabetes mellitus was associated with arterial hypertension (odds ratio (OR) 4.49; 95% confidence interval (CI) 3.47-5.31), the use of psychotropic drugs (OR 1.54; 95% CI 1.22-1.94), hormonal therapy (OR 1.46; 95% CI 1.11-1.92), ? 50 years of age (OR 1.48; 95% CI 1.17-1.86), overweight or obese (OR 1.47; 95% CI 1.15-1.89), and waist circumference ? 88 cm (OR 1.32; 95% CI 1.06-1.65). Factors associated with lower risk of diabetes were the use of hormonal contraceptives (OR 0.55; 95% CI 0.35-0.87), alcohol (OR 0.73; 95% CI 0.54-0.98) and living in cities > 2500 meters above sea level (OR 0.70; 95% CI 0.53-0.91) or with high temperatures (OR 0.67; 95% CI 0.51-0.88). In turn, diabetes tripled the risk of menopause in women under 45 years of age. Diabetes did not increase the risk of deterioration of quality of life due to climacteric symptoms. Conclusion Menopause does not increase the risk of type II diabetes mellitus. Diabetes is associated with early menopause in women under 45 years of age. � 2013 International Menopause Society

Age at menopause in Latin America

OBJECTIVE: To assess the age at menopause (AM) in Latin America urban areas. DESIGN: A total of 17,150 healthy women, aged 40 to 59 years, accompanying patients to healthcare centers in 47 cities of 15 Latin American countries, were surveyed regarding their age, educational level, healthcare coverage, history of gynecological surgery, smoking habit, presence of menses, and the use of contraception or hormone therapy at menopause. The AM was calculated using logit analysis. RESULTS: The mean age of the entire sample was 49.4 ± 5.5 years. Mean educational level was 9.9 ± 4.5 years, and the use of hormone therapy and oral contraception was 22.1% and 7.9%, respectively. The median AM of women in all centers was 48.6 years, ranging from 43.8 years in Asuncion (Paraguay) to 53 years in Cartagena de Indias (Colombia). Logistic regression analysis determined that women aged 49 living in cities at 2,000 meters or more above sea level (OR = 2.0, 95% CI: 1.4-2.9, P less than 0.001) and those with lower educational level (OR = 1.9, 95% CI: 1.3-2.8, P less than 0.001) or living in countries with low gross national product (OR = 2.1, 95% CI: 1.5-2.9, P less than 0.001) were more prone to an earlier onset of menopause. CONCLUSIONS: The AM varies widely in Latin America. Lower income and related poverty conditions influence the onset of menopause. © 2006 by The North American Menopause Society

Epidemiology of menstrual disorders in developing countries: a systematic review

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74273/1/j.1471-0528.2004.00012.x.pd