Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(1):45-52
DOI 10.1590/S0100-72032004000100007
PURPOSE: to evaluate the relationship between epidemiologic, anthropometric, reproductive and hormonal factors and mammographic density in postmenopausal women. METHODS: this is a retrospective, cross-sectional study, including 144 women aged 45 years or more, with at least 12 months of amenorrhea and who were non users of hormone replacement therapy during the last six months. Medical charts were reviewed to evaluate age, weight, body mass index (BMI), parity, age at menarche, age at menopause and levels of estradiol, follicle stimulating (FSH) and luteinizing hormones. Mammograms were analyzed by two blinded investigators. The films were taken in the craniocaudal and mediolateral views and mammography was classified as dense and nondense, according to the Wolfe criteria. For statistical analysis, the frequency, median, minimum and maximum values, the Wilcoxon test and the odds ratio were used. Multiple logistic regression was performed, using the stepwise selection, with a 5% significance level. RESULTS: the frequency of dense breasts was 45%. Women with dense breasts were of lower weight (60.5 vs. 71.9 kg - p<0.01), had a lower BMI (25.9 vs 31.0 kg/m² - p<0.01), a shorter time since onset of menopause (6.0 vs 10 years - p<0.01) and higher levels of FSH (75.2 vs 60.3 mU/mL - p<0.01). The probability of having dense breasts decreased in women whose weight was 67 kg or more (OR = 4.0, CI 95% = 1.50-10.66), BMI was higher than 30 kg/m² (OR = 6.69, CI 95% = 1.67-36.81), time since onset of menopause was superior or equal to seven years (OR = 2.05, CI 95% = 1.05-3.99) and FSH levels were lower than 134.8 mU/mL. CONCLUSION: weight, BMI, parity, time since menopause and FSH levels were significantly associated with mammographic density patterns.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(5):283-287
DOI 10.1590/S0100-72032001000500003
Purpose: to study in primigravid adolescents the behavior of serum leptin levels during the evolution of normal pregnancy, comparing the results with those obtained from preeclamptics. Methods: prospective, longitudinal study conducted in 15 normotensive pregnant adolescents and 5 preeclamptic adolescents. Serum leptin levels (ng/mL) were determined by radioimmunoassay. Blood pressure was measured by the oscilometric method by using DINAMAP 1846. Patients were evaluated in two different gestational periods: between the 21st and 30th week and between the 31st and 40th week. The ratio leptin/body mass index (BMI) was used to correct changes observed in BMI throughout gestation. Preeclamptic pregnant patients were diagnosed when the blood pressure was > or = 140/90 mmHg, proteinuria >300 mg/24 h and when arteriolar spasm was present in the optic fundi. Results: there was a trend towards an elevation of serum leptin at the end of pregnancy in both groups although more pronounced in preeclamptic patients. In pregnant normotensive patients serum leptin increased from 11.9±1.20 (21stto 30th week) to 13.9±2.23 ng/mL (31st to 40th week), and in preeclamptic from 11.9±1.20 to 17.6±4.565 ng/mL. In preeclamptic patients the BMI increased significantly in the period from the 21st to 30th week when compared to the period between the 31st and 40thweek: 21.5±0.8 vs 27.4±1.7 kg/m², p<0.05.In normotensive these values were maintained stable: 24.9±1.5 vs 25.1±1.00 kg/m². At the end of gestation the ratio leptin/BMI was significantly higher in preeclamptics: 0.56±0.06 (21stto 30thweek) vs 0.70±0.15, p<0.05. The values of the ratio leptin/BMI in normotensive pregnants varied from 0.44±0.02 between the 21st and 30th week to 0.41±0.04 between the 31st to 40thweek. In normal pregnants there was a direct and significant correlation between the levels of leptin and BMI in both periods of pregnancy: r = 0.7, p<0.004 (31st to 40th ) vs r = 0.94, p<0.0001 (31st to 40th week). These correlations were lost in preeclamptic patients in both gestational periods. Conclusion: the higher concentrations of leptin and leptin/BMI ratio observed when preeclamptics were compared with normotensive patients, in both gestational periods, suggest a leptin resistance pattern in preeclampsia.