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      Relación entre la obesidad central y el estrés oxidativo en mujeres premenopáusicas versus posmenopáusicas Translated title: Relationship between central obesity and oxidative stress in premenopausal versus postmenopausal women

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          Abstract

          Resumen Introducción: los cambios endocrinológicos de la menopausia producen un incremento en la adiposidad central y el estrés oxidativo, por lo que podría inferirse que las mujeres posmenopáusicas obesas mostrarían un estrés oxidativo significativamente mayor que las mujeres premenopáusicas. Objetivo: evaluar la relación entre la obesidad central y el estrés oxidativo en mujeres premenopáusicas en comparación con posmenopáusicas utilizando diferentes índices. Métodos: estudio transversal con 237 mujeres premenopáusicas y 255 posmenopáusicas (40-60 años). Como marcadores de estrés oxidativo se midieron los niveles de malondialdehído plasmático y ácido úrico sérico, las enzimas antioxidantes superóxido-dismutasa y glutatión-peroxidasa eritrocitarias, y la capacidad plasmática antioxidante total. También se obtuvieron el peso, la estatura y la circunferencia de cintura y cadera, con lo que se calcularon los índices de masa corporal (IMC), cintura-cadera (ICC) y cintura-talla (ICT). Resultados: se observaron más de un 30 % de obesidad y un 50 % de sobrepeso en ambos grupos. Los niveles de malondialdehído y de ácido úrico son más altos en las mujeres con sobrepeso/obesidad en ambos grupos. El ICT tuvo una correlación positiva con el nivel de malondialdehído (r = 0,298, p < 0,0001) y ácido úrico (r = 0,263, p < 0,0001), y una negativa con la actividad de GPx (r = -0,148, p < 0,01). Con un valor de corte de ICT > 0,6, aumentan el malondiahldehído y el ácido úrico, sin importar el estado menopáusico. Los demás índices no mostraron ninguna relación. Conclusión: nuestros hallazgos sugieren una asociación entre la obesidad central medida por el ICT y el aumento del estrés oxidativo, independientemente del estado menopáusico.

          Translated abstract

          Abstract Background: endocrine changes in midlife women produce an increase in central obesity and oxidative stress, thus it is possible that obese postmenopausal women exhibit a higher oxidative stress than premenopausal women. Objective: to evaluate the relationship between central obesity and oxidative stress in premenopausal compared with postmenopausal women using different indices. Methods: this is a cross-sectional study that included 237 pre- and 255 post-menopausal women (40-60 years old). As oxidative stress markers we measured plasma malondialdehyde and serum uric acid levels, erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (GPx), and total plasma antioxidant status. We also measured height, weight, and waist and hip circumferences, and we calculated body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR). Results: we found over 30 % of women within the obesity range, whereas 50 % were placed in the overweight category in both groups. Plasma malondialdehyde and serum uric acid levels were higher in women with overweight or obesity than in women with normal weight regardless of menopausal status. We found a positive correlation between WHtR and malondialdehyde level (r = 0.298, p < 0.0001) and serum uric acid level (r = 0.263, p < 0.0001), and a negative correlation with erythrocyte GPx activity (r = -0.148, p < 0.01). If we use a WHtR > 0.6, malondialdehyde and uric acid levels increase regardless of menopausal status. The other indices measured did not show any relationship. Conclusion: our findings suggest that there is an association between central obesity, as measured with WHtR, and increased oxidative stress regardless of menopausal status.

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          Most cited references31

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          2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society.

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            Ovarian aging: mechanisms and clinical consequences.

            Menopause is the final step in the process referred to as ovarian ageing. The age related decrease in follicle numbers dictates the onset of cycle irregularity and the final cessation of menses. The parallel decay in oocyte quality contributes to the gradual decline in fertility and the final occurrence of natural sterility. Endocrine changes mainly relate to the decline in the negative feedback from ovarian factors at the hypothalamo-pituitary unit. The declining cohort of antral follicles with age first results in gradually elevated FSH levels, followed by subsequent stages of overt cycle irregularity. The gradual decline in the size of the antral follicle cohort is best represented by decreasing levels of anti-Mullerian hormone. The variability of ovarian ageing among women is evident from the large variation in age at menopause. The identification of women who have severely decreased ovarian reserve for their age is clinically relevant. Ovarian reserve tests have appeared to be fairly accurate in predicting response to ovarian stimulation in the assisted reproductive technology (ART) setting. The capacity to predict the chances for spontaneous pregnancy or pregnancy after ART appears very limited. As menopause and the preceding decline in oocyte quality seem to have a fixed time interval, tests that predict the age at menopause may be useful to assess individual reproductive lifespan. Especially genetic studies, both addressing candidate gene and genome wide association, have identified several interesting loci of small genetic variation that may determine fetal follicle pool development and subsequent wastage of his pool over time. Improved knowledge of the ovarian ageing mechanisms may ultimately provide tools for prediction of menopause and manipulation of the early steps of folliculogenesis for the purpose of contraception and fertility lifespan extension.
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              The diagnostic validity of the Athens Insomnia Scale.

              To provide documentation for the diagnostic validity of the Athens Insomnia Scale (AIS), a self-assessment psychometric tool which has previously shown high consistency, reliability and external validity for the evaluation of the intensity of sleep difficulty. The AIS was administered to a total of 299 subjects (105 primary insomniacs, 100 psychiatric outpatients, 44 psychiatric inpatients and 50 nonpatient controls) who were also assessed for the ICD-10 diagnosis of "nonorganic insomnia" blindly in terms of the AIS scores. 176 subjects were identified as insomniacs and 123 as noninsomniacs. Logistic regression of AIS total score against the ICD-10 diagnosis of insomnia demonstrated that a score of 6 is the optimum cutoff based on the balance between sensitivity and specificity. When diagnosing individuals with a score of 6 or higher as insomniacs, the scale presents with 93% sensitivity and 85% specificity (90% overall correct case identification). For this cutoff score, in the general population, the scale has a positive predictive value (PPV) of 41% and a negative predictive value (NPV) of 99%. For the same cutoff score, among unselected psychiatric patients, the PPV was found to be 86% and the NPV 92%. Other cutoff scores can be also considered, however, depending on the importance of avoiding false positive or false negative results; for example, for a cutoff score of 10, the PPV in the general population reaches about 90% without the NPV becoming lower than 94%. The AIS can be utilized in clinical practice and research, not only as an instrument to measure the intensity of sleep-related problems, but also as a screening tool in reliably establishing the diagnosis of insomnia.
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                Author and article information

                Journal
                nh
                Nutrición Hospitalaria
                Nutr. Hosp.
                Grupo Arán (Madrid, Madrid, Spain )
                0212-1611
                1699-5198
                April 2020
                : 37
                : 2
                : 267-274
                Affiliations
                [2] orgnameInstituto de Salud del Estado de México orgdiv1Hospital Gustavo Baz Prada orgdiv2División de Ginecología y Obstetricia México
                [1] orgnameUniversidad Nacional Autónoma de México orgdiv1Facultad de Estudios Superiores Zaragoza orgdiv2Unidad de Investigación en Gerontología Mexico
                Article
                S0212-16112020000300007 S0212-1611(20)03700200007
                10.20960/nh.02552
                4de848bd-4199-47bb-9f23-c25ac50d4116

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 22 December 2019
                : 20 February 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 35, Pages: 8
                Product

                SciELO Spain

                Categories
                Trabajos Originales

                Malondialdehyde,Malondialdehído,Menopausia,Índice cintura-talla,Obesidad central,Estrés oxidativo,Menopause,Waist-to-height ratio,Central obesity,Oxidative stress

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