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Oslei de Matos, Brenda Lenardt, Isabela C. de Lima, Gabriel A. Strapasson Furlan, Tsuani Yamaguishi, André Domingos Lass, Camil Castelo-Branco
Influence of the onset of menopause before and after age 50 on bone mineral density European Gynecology and Obstetrics. 2023; 5(1):15-19
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Abstract

Aim: To evaluate the effect of menopause on bone mineral density (BMD) considering the time of onset of this event in women participating in an exercise program for elders.
Methods: A total of 153 Brazilian postmenopausal women aged 65.6 ± 8.1years were included in this study. All participants were postmenopausal women as defined by the modified Reproductive Aging Workshop (STRAW) staging system. Dual-energy X-ray absorptiometry was used to determine BMD, fat and muscle percentage and distribution. For statistical analysis, the sample was divided into two groups, BA: menopause before age of 50 (inclusive) and AA: menopause after the age of 50.
Results: The correlation and regression analysis demonstrated that for the BA group total mass had a significant influence on BMI (78%), percentage of fat (52%) andandroid/gynoid relation (17%). BMI had influence on percentage of fat (57%) and android/gynoid relation (17%). Hip T-score influenced only with percentage of fat (4.5%). For the AA group, mass also showed an important influence, but only with age at menopause (9.5%) and BMI (87%). The OR for having lower BMD in group BA was 0.82 indicating a lower risk.
Conclusion: Despite similar results between the studied groups, the menopause group before 50 years of age showed the greatest associations between variables and influence on BMD, especially in hip area.
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Alessandro D Genazzani, Andrea R Genazzani
Polycystic Ovary Syndrome as Metabolic Disease: New Insights on Insulin Resistance touchREVIEWS in Endocrinology. 2023;19(1):71–7
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Polycystic ovary syndrome (PCOS) is a very frequent disease that affects reproductive ability and menstrual regularity. Other than the criteria established at the Rotterdam consensus, in these last few years a new issue, insulin resistance, has been found frequently, and at a very high grade, in patients with PCOS. Insulin resistance occurs for several factors, such as overweight and obesity, but it is now clear that it occurs in patients with PCOS with normal weight, thus supporting the hypothesis that insulin resistance is independent of body weight. Evidence shows that a complex pathophysiological situation occurs that impairs post-receptor insulin signalling, especially in patients with PCOS and familial diabetes. In addition, patients with PCOS have a high incidence of non-alcoholic fatty liver disease related to the hyperinsulinaemia. This narrative review focuses on the recent new insights about insulin resistance in patients with PCOS, to better understand the metabolic impairment accounting for most of the clinical signs/symptoms of PCOS.
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Christian Battipaglia, Tabatha Petrillo, Elisa Semprini, Francesco Ricciardiello, Maria Laura Rusce, Greta Prampolini, Fedora Ambrosetti, Alessandra Sponzilli and Alessandro D. Genazzani
Low-Dose Estrogens as Neuroendocrine Modulators in Functional Hypothalamic Amenorrhea (FHA): The Putative Triggering of the Positive Feedback Mechanism(s)Biomedicines 2023, 11, 1763.
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Functional hypothalamic amenorrhea (FHA) is a non-organic reversible chronic endocrine disorder characterized by an impaired pulsatile secretion of the gonadotropin-releasing hormone (GnRH) from the hypothalamus. This impaired secretion, triggered by psychosocial and metabolic stressors, leads to an abnormal pituitary production of gonadotropins. As LH and FSH release is defective, the ovarian function is steadily reduced, inducing a systemic hypoestrogenic condition characterized by amenorrhea, vaginal atrophy, mood changes and increased risk of osteoporosis and cardiovascular disease. Diagnosis of FHA is made excluding other possible causes for secondary amenorrhea, and it is based upon the findings of low serum gonadotropins and estradiol (E2) with evidence of precipitating factors (excessive exercise, low weight, stress).
Treatments of women with FHA include weight gain through an appropriate diet and physical activity reduction, psychological support, and integrative approach up to estrogen replacement therapy. If no spontaneous ovarian function is restored, assisted reproductive technologies may be used when pregnancy is desired. Because subjects with FHA are hypoestrogenic, the use of low-dose estrogens has been proposed as a putative treatment to positively modulate the spontaneous restart of gonadotropin secretion, counteracting the blockade of the reproductive axis triggered by stress acting through the neuroendocrine pathways at the basis of positive feedback of estrogens. The mechanism through which low-dose estrogens acts is still unknown, but kisspeptin-secreting neurons may be involved.
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Jieyu Zhang, Lei Jin, Lingnan Kong, Li Nie and Dongzhi Yuan
Physiological and pathological roles of locally expressed kisspeptin and KISS1R in the endometriumHuman Reproduction, 2023, 38(7), 1253–1260
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Kisspeptins, encoded by the KISS1 gene, are a family of polypeptides that bind the kisspeptin receptor (KISS1R) to perform biological functions. Produced mainly in the hypothalamus, these neuropeptides regulate the pulsatile secretion of GnRH and trigger the hypothalamus–pituitary–gonadal axis. Other peripheral organs also express kisspeptin, which inhibits metastasis. Kisspeptin and KISS1R are reportedly present in the endometrium and may play roles in limiting the migration and invasion of trophoblasts into the endometrium during pregnancy (decidua) to maintain endometrial homeostasis. A deficiency of kisspeptin and KISS1R in the endometrium can lead to pathological conditions such as endometriosis and endometrial carcinoma. Kisspeptin and KISS1R in the endometrium can also promote endometrial receptivity and decidualization. Overall, kisspeptin and KISS1R are important for maintaining the normal physiological functions of the endometrium. By summarizing the roles of kisspeptin and KISS1R in the endometrium, our review explores the regulatory roles in the peripheral reproductive system of this peptide family that plays broad and profound roles in many physiological processes.

n3/2023

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Sondaggio sulla PCOS

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