Quality of life as an indicator of connective tissue condition in women with metabolic syndrome without estrogen support
https://doi.org/10.18699/SSMJ20240115
Abstract
In modern medicine, the relevance of the problem associated with the aging of the female body is undeniable. Due to the decrease in the intensity of secretion of sex steroids, the addition of metabolic syndrome is accompanied by processes which can worsen women quality of life. Under conditions of hypoestrogenemia, their physical condition suffers, which directly depends on the structure of the connective tissue that forms the basis of the skin, blood vessels, kidneys, bones, joints and ligaments. This literature review presents current data on reversible and irreversible clinical manifestations of climacteric syndrome. Reversible processes are based on changes that can be corrected: vasomotor, psycho-emotional, urogenital, sexual and musculoskeletal. Late manifestations of menopause on the part of metabolic disorders in the connective tissue determine the greatest severity of the course, and therefore represent a serious public health and health problem. The literature review shows in detail the features of the immune regulation of collagen metabolism, the characteristics of changes in bone modeling markers under conditions of estrogen deficiency. Clinically proven efficacy of phytoestrogens in menopausal disorders and metabolic disorders in women. This review shows the mechanism for reducing vasomotor symptoms, slowing down the process of bone tissue destruction in patients under the influence of this group of drugs. In addition, phytoestrogens provide the correction of lipid metabolism, thereby depressing atherogenesis and promoting prevention of cardiovascular complications. It is necessary to develop a strategy to normalize the vital functions of perimenopausal patients with symptoms of menopause with the introduction into clinical practice of measures to maintain the quality of life of women.
About the Authors
E. S. KrutikovRussian Federation
Evgeniy S. Krutikov, doctor of medical sciences, professor
295051, Simferopol, Lenina blvd., 5/7
Z. S. Rumyantseva
Russian Federation
Zoya S. Rumyantseva, candidate of medical sciences
295051, Simferopol, Lenina blvd., 5/7
N. S. Tribrat
Russian Federation
Natalya S. Tribrat, candidate of biological sciences
295051, Simferopol, Lenina blvd., 5/7
E. Yu. Zyablitskaya
Russian Federation
Evgenia Yu. Zyablitskaya, doctor of medical sciences
295051, Simferopol, Lenina blvd., 5/7
V. B. Demyanova
Russian Federation
Viktoria B. Demyanova
295051, Simferopol, Lenina blvd., 5/7
G. A. Puchkina
Russian Federation
Galina A. Puchkina, candidate of medical sciences
295051, Simferopol, Lenina blvd., 5/7
N. V. Efremova
Russian Federation
Nataliya V. Efremova
295051, Simferopol, Lenina blvd., 5/7
A. A. Gorbunov
Russian Federation
Alexandr A. Gorbunov
295051, Simferopol, Lenina blvd., 5/7
References
1. Kaysinova A.S., Lepshokova A.B., Men’shikova T.B., Akhkubekova N.K., Cherevashchenko L.A., Mallaeva R.M. Investigation of calcium-phosphoric exchange in women with the menopause state suffering from osteoarthrosis and concomitant osteopenic syndrome. Vestnik Avitsenny = Bulletin of Avicenna. 2017;19(4):520–523. [In Russian]. doi: 10.25005/2074-0581-2017-19-4-520-523
2. Silaeva E.A., Timoshkova Yu.L., Atayants K.M., Kurmanbaev T.E., Gayvoronskikh D.I. Epidemiology and risk factors for pelvic organ prolapse. Izvestiya Rossiyskoy voyenno-meditsinskoy akademii = Russian Military Medical Academy Reports. 2020;39(S3-1):161–163. [In Russian].
3. Selikhova M.S., Ershov G.V., Ershov A.G. Pelvic organ prolapsed, a hidden epidemic of the 21st century. Uspekhi gerontologii = Advances in Gerontology. 2021;34(3):431–437. [In Russian]. doi: 10.34922/AE.2021.34.3.013
4. Musin I.I., Minasov T.B., Naftulovich R.A., Popova E.M., Mingareeva K.N., Berg E.A. The state of bone mineral density in prolapse of the pelvic organs. Ginekologiya = Gynecology. 2021;23(2):173–176. [In Russian]. doi: 10.26442/20795696.2021.2.200747
5. Weintraub A., Glinter H., Marcus-Braun N. Narrative review of the epidemiology, diagnosis and pathophysiology of pelvic organ prolapse. Int. Braz. J. Urol. 2020;46(1):5–14. doi: 10.1590/S1677-5538.IBJU.2018.0581
6. Hansen M. Female hormones: do they influence muscle and tendon protein metabolism? Proc. Nutr. Soc. 2018;77(1):32–41. doi: 10.1017/S0029665117001951
7. Traish A., Vignozzi L., Simon J., Goldstein I., Kim N. Role of androgens in female genitourinary tissue structure and function: implications in the genitourinary syndrome of menopause. Sex. Med. Rev. 2018;6(4):558–571. doi: 10.1016/j.sxmr.2018.03.005
8. Sharma D., Anderson P., Morris H., Clifton P. Acute C-terminal crosslinking telopeptide of type i collagen (CTX-1) suppression with milk calcium or calcium carbonate is independent of visceral fat in a randomized crossover study in lean and overweight postmenopausal women. J. Nutr. 2022;152(4):1006–1014. doi: 10.1093/jn/nxab384
9. Shien A., Ishii S., Greendale G., Caulye J., Karvonen-Guutierrez C., Karlamangla A. A bone resorption marker as predictor of rate of change in femoral neck size and strength during the menopause transition. Osteoporos Int. 2019;30(12):2449–2457. doi: 10.1007/s00198-019-05099-z
10. Kehlet S., Willumset N., Armbrecht G., Dietzel R., Brix S., Henriksen K., Karsdal M. Age-related collagen turnover of the interstitial matrix and basement membrane: Implications of age- and sex-dependent remodeling of the extracellular matrix. PloS One. 2018;13(3):e0194458. doi: 10.1371/journal.pone.0194458
11. Toledano M., Toledano-Osorio M., Guerado E., Caso E., Osorio E., Osorio R. Assessing bone quality through mechanical properties in postmenopausal trabecular bone. Injury. 2018;49(2):S3–S10. doi: 10.1016/j.injury.2018.07.035
12. Zhao S., Mo X., Wen Z., Liu M., Chen Z., Lin W., Huang Z., Chen B. Declining serum bone turnover markers are associated with the short-term positive change of lumbar spine bone mineral density in postmenopausal women. Menopause. 2022;29(3):335–343. doi: 10.1097/GME.0000000000001920
13. Bønløkke S., Rand M., Haddock B., Arup S., Smith C., Jensen J., Schwarz P., Hovind P., Oturai P.S., Jensen L.T., … Jørgensen N.R. Baseline bone turnover marker levels can predict change in bone mineral density during antiresorptive treatment in osteoporotic patients: the Copenhagen bone turnover marker study. Osteoporos. Int. 2022;33(10):2155–2164. doi: 10.1007/s00198-022-06457-0
14. Alhazidou E., Pergialiotis V., Panagopoulos P., Chrelias C., Hatziagelaki E., Papantoniou N., Trakakis E. The impact of the metabolic syndrome on bone mass density: a prospective case control study. Horm. Mol. Biol. Clin. Investig. 2017;33(3):1–6. doi: 10.1515/hmbci-2017-0053
15. Mao M., Li Y., Zhang Y., Kang J., Zhu L. Tissue composition and biomechanical property changes in the vaginal wall of ovariectomized young rats. Biomed. Res. Int. 2019;2019:8921284. doi: 10.1155/2019/8921284
16. Ko S., Jung Y. Energy metabolism changes and dysregulated lipid metabolism in postmenopausal women. Nutrients. 2021;13(12):4556. doi: 10.3390/nu13124556
17. Cui J., Shibata Y., Zhu T., Zhou J., Zhang J. Osteocytes in bone aging: Advances, challenges, and future perspectives. Ageing Res. Rev. 2022;77:101608. doi: 10.1016/j.arr.2022.101608
18. Reus T.L., Brohem C.A., Schuck D.C., Lorencini M. Revisiting the effects of menopause on the skin: Functional changes, clinical studies, in vitro models and therapeutic alternatives. Mech. Ageing Dev. 2020;185:111193. doi: 10.1016/j.mad.2019.111193
19. Jeong С., Kim J., Lim Y., Ha J., Kim M.K., Kwon H., Song K., Kang M., Baek K. Roles of follicle-stimulating hormone on bone metabolism in late postmenopausal women. J. Bone Metab. 2022;29(3):175–183. doi: 10.11005/jbm.2022.29.3.175
20. Islamoglu A.H., Garipagaoglu M., Bicer H.S., Kurtulus D., Ozturk M., Gunes F.E. The effects of dietary changes on bone markers in postmenopausal vertebral osteopenia. Clin. Nutr. 2020;39(12):3744–3749. doi: 10.1016/j.clnu.2020.04.001
21. Abildgaard J., Ploug T., Pedersen A.T., Eiken P., Pedersen B.K., Holst J.J., Hartmann B., Lindegaard B. Preserved postprandial suppression of bone turnover markers, despite increased fasting levels, in postmenopausal women. Bone. 2021;143:115612. doi: 10.1016/j.bone.2020.115612
22. Thompson D.M., Lee H.M., Stoner J.A., Golub L.M., Nummikoski P.V., Payne J.B. Loss of alveolar bone density in postmenopausal, osteopenic women is associated with circulating levels of gelatinases. J. Periodontal. Res. 2019;54(5):525–532. doi: 10.1111/jre.12656
23. Dumitru N., Carsote M., Cocolos A., Petrova E., Olaru M., Caragheorgheopol A., Dumitrache K., Ghemigian A. Metabolic and bone profile in postmenopausal women with and without type 2 diabetes: a crosssectional study. Rom. J. Intern. Med. 2019;57(1):61–67. doi: 10.2478/rjim-2018-0036
24. McClung M.R., Kagan R., Graham S., Bernick B., Mirkin S., Constantine G. Effects of E2/P4 oral capsules on bone turnover in women with vasomotor symptoms. Menopause. 2022;29(3):304–308. doi: 10.1097/GME.0000000000001915
25. Zha K.X., An Z.M., Ge S.H., Cai J., Zhou Y., Ying R., Zhou J., Gu T., Guo H., Zhao Y., Wang N.J., Lu Y.L. FSH may mediate the association between HbA1c and bone turnover markers in postmenopausal women with type 2 diabetes. J. Bone Miner. Metab. 2022;40(3):468–477. doi: 10.1007/s00774-021-01301-7
26. O‘Donnell E., Scheid J.L., West S.L., de Souza M.J. Impaired vascular function in exercising anovulatory premenopausal women is associated with low bone mineral density. Scand. J. Med. Sci. Sports. 2019;29(4):544–553. doi: 10.1111/sms.13354
27. Wochna K., Nowak A., Huta-Osiecka A., Sobczak K., Kasprzak Z., Leszczyński P. Bone mineral density and bone turnover markers in postmenopausal women subjected to an aqua fitness training program. Int. J. Environ. Res. Public. Health. 2019;16(14):2505. doi: 10.3390/ijerph16142505
28. Park S.G., Jeong S.U., Lee J.H., Ryu S.H., Jeong H.J., Sim Y.J., Kim D.K., Kim G.C. The changes of CTX, DPD, osteocalcin, and bone mineral density during the postmenopausal period. Ann. Rehabil. Med. 2018;42(3):441–448. doi: 10.5535/arm.2018.42.3.441
29. Costa-Paiva L., Wender M.C.O., Machado R.B., Pompei L.M., Nahas E.A., Nahas-Neto J., Del Debbio S.Y., Badalotti M., Cruz A.M. Effects of ultra-low dose hormone therapy on biochemical bone turnover markers in postmenopausal women: A randomized, placebo-controlled, double-blind trial. Post. Reprod. Health. 2022;28(3):149–157. doi: 10.1177/20533691221116769
30. Xu W., Zhu X., Chen C., Hu R., Li Y., Xu R., Li Z. Beneficial effect of pristimerin against the development of osteoporosis in ovariectomy-induced osteoporosis rats by the RANKL/TRAF6/NF-κB pathway. Arch. Med. Sci. 2019;18(6):1650–1658. doi: 10.5114/aoms.2019.86816
31. Abdi F., Rahnemaei F.A., Roozbeh N., Pakzad R. Impact of phytoestrogens on treatment of urogenital menopause symptoms: A systematic review of randomized clinical trials. Eur. J. Obstet. Gynecol. Reprod. Biol. 2021;261:222–235. doi: 10.1016/j.ejogrb.2021.03.039
32. Dominguez-Lopez I., Yago-Aragon M., Salas-Huetos A., Tresserra-Rimbau A., Hurtado-Barroso S. Effects of dietary phytoestrogens on hormones throughout a human lifespan: a review. Nutrients. 2020;12(8):2456. doi: 10.3390/nu12082456
33. Klimontov V.V., Fazullina O.N., Lykov A.P., Konenkov V.I. The relationships between bone turnover markers and bone mineral density in postmenopausal type 2 diabetic women. Sakharnyy diabet = Diabetes Mellitus. 2016;19(5):375–382. doi: 10.14341/DM8008
34. Terzi R., Dindar S., Terzi H., Demirtas O. Relationships among the metabolic syndrome, bone mineral density, bone turnover markers, and hyperglycemia. Metab. Syndr. Relat. Disord. 2015;13(2):78–83. doi: 10.1089/met.2014.0074
35. Vdovichenko V.P., Borisenok O.A., Bronskaya G.M., Korshak T.A., Yakoltsevich V.M., Vasilyuk A.A. Efficacy and safety of the use of phytoestrogens in women with menopausal symptoms. Meditsinskiye novosti = Medical News. 2020;7(310):18–21.
36. Ceccarelli I., Bioletti L., Peparini S., Solomita E., Ricci C., Casini I., Miceli E., Aloisi A.M. Estrogens and phytoestrogens in body functions. Neurosci. Biobehav. Rev. 2022;132:648–663. doi: 10.1016/j.neubiorev.2021.12.007
37. Canivenc-Lavier M.C., Bennetau-Pelissero C. Phytoestrogens and health effects. Nutrients. 2023;15(2):317. doi: 10.3390/nu15020317
38. Pandozzi C., Giannetta E., Tarsitano M.G. Phytotherapic approach in menopause: light and darkness. Minerva Endocrinol. (Torino). 2022;47(4):421–436. doi: 10.23736/S2724-6507.22.03712-5
39. Mukund V. Genistein: its role in breast cancer growth and metastasis. Curr. Drug Metab. 2020;21(1):6–10. doi: 10.2174/1389200221666200120121919
40. Gomez-Zorita S., Gonzalez-Arceo M., Fernandez-Quintela A., Eseberri I., Trepiana J., Portillo M.P. Scientific evidence supporting the beneficial effects of isoflavones on human health. Nutrients. 2020;12(12):3853. doi: 10.3390/nu12123853