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On Aug 2018




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Aug 2018




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Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
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Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2011 | Month : August | Volume : 5 | Issue : 4 | Page : 795 - 797 Full Version

The Status of Trace Elements after Menopause: A Comparative Study


Published: August 1, 2011 | DOI: https://doi.org/10.7860/JCDR/2011/.1417
Naveenta Gupta, Khushdeep Singh Arora

Dr. Naveenta Gupta, M.B.B.S., M.D. Assistant Professor, Department of Physiology, Guru Gobind Singh Medical College, Faridkot, Punjab - 151203, India. Corresponding Author.

Correspondence Address :
Dr. Khushdeep Singh Arora, M.B.B.S., M.D.
Associate Professor, Department of Physiology,
Adesh Institute of Medical Sciences and Research,
Bathinda, Punjab - 151101
Email: khushdeep@gmail.com
Mobile no: 9780042132

Abstract

Aim: The aim of this study was to determine the status of trace elements in postmenopausal females as compared to that in premenopausal females.

Methods: 100 female subjects were studied, of which 50 were premenopausal (aged 30-40 years) and 50 were postmenopausal (aged 45-55 years, with a permanent cessation of menstruation for more than 1 year). The estimation of the serum levels of zinc (Zn), iron (Fe), copper (Cu), magnesium (Mg) and calcium (Ca) were done in both the groups.

Results: On comparative evaluation, the serum Fe (p <0.05) and the serum Ca (p <0.001) levels were found to be significantly increased,while the serum Cu (p <0.05) and the serum Mg (p <0.05) levels were found to be significantly decreased in the postmenopausal females as compared to the levels in the premenopausal females. However, there was no significant difference in the levels of serum Zn in both the groups (p >0.05).

Conclusion: Postmenopausal females are exposed to greater risk of serum biochemical changes as compared to the premenopausal females, thus leading to an increased risk of osteoporosis and cardiovascular diseases after menopause.

Keywords

Menopause, Trace elements

Menopause is the consequence of the exhaustion of the ovarian follicles, which results in a decreased production of estradiol and other hormones (1). The decrease in the levels of the sex steroid hormones during menopause in women causes a number of disturbances in the metabolisms of different organs. In this period of life, the risk of osteoporosis, cardiovascular diseases, arterial hypertension, impairment of glucose metabolism, breast cancer and degenerative cognition diseases rises. The impact of oestrogen deficiency after menopause on the trace minerals has not yet been widely studied but the expected menopause related alterations in the trace mineral status may have an impact on the above pathologies.

The risk of nutritional disturbances, particularly trace elements and vitamin deficiencies is high during menopause. Several trace elements are essential in bone metabolism (2). Magnesium enhances bone turnover through the stimulation of the osteoclastic function and its deficiency may play a role in postmenopausal osteoporosis. Mg acts as a surrogate for calcium in the transport and mineralization process (3). Its deficiency may lead to disturbances in the cardiac rhythm, necrotic changes, atheromatous plaques, a high value of total cholesterol and a low value of high density lipoprotein cholesterol (4). Zinc regulates the secretion of calcitonin from the thyroid gland and it has an influence on the bone turnover. Copper induces a low bone turnover by suppression of the osteoblastic and the osteoclastic functions (3). A deficiency of Cu, as well as its abundance may increase the cholesterol content of blood serum. In a condition of Cu deficiency, formation of the crosslinks of the elastin of blood vessels is disturbed (4). Calcium is important to prevent bone loss and to help restore the bone that might have been lost due to osteoporosis (5). Another importantfactor for menopausal changes is iron that is essential for oxygen transport, electron transfer reactions and for the regulation of cell growth and differentiation. Excess Fe can damage the tissues by catalysing the conversion of hydrogen peroxide to free radical ions that attack the cellular membrane, proteins and DNA. Elevated plasma Ferritin levels can lead to an increased risk of ischaemic heart disease (6).

The aim of the present study was to find out the status of trace metals in postmenopausal women.

Material and Methods

The present study was conducted on 100 females selected from the general population, out of which 50 were premenopausal and aged 30-40 years and 50 were post menopausal (with natural menopause, permanent cessation of the menstrual cycle for more than 1 year) and were aged 45-55 years. None of the females under study had taken any oral contraceptives, hormone replacement therapy (HRT), oestrogen therapy or any supportive treatment for the menopausal symptoms prior to the study. A detailed reproductive and menstrual history of all the females was taken and their general physical and systemic examination was done to exclude any disease which was known to affect the present study.

Venous blood samples were collected under aseptic conditions after overnight fasting in trace element free containers (Vacutainer –7 ml). After centrifugation, serum was rapidly separated from these samples and it was stored at –70°C. The serum zinc levels were estimated by Makino method (7) and the serum magnesium levels by Bohoun method (8). The serum calcium levels were determined by using the Ortho-Cresolphthalein complex, as described by Gitelman (9). The copper in the serum was estimated by usingBathocuproin disulphonate method (10) and serum iron by Zak method (11).

Statistical analysis was carried out by the Student’s paired ‘t’-test. The data was expressed as mean ± SD and p values < 0.05 were taken as significant.

Results

(Table/Fig 1) shows the Mean ± SD of various parameters which were studied in the premenopausal and the postmenopausal women. There was a significant increase in the serum Fe and Ca levels, with a significant decrease in the levels of Cu and Mg in the post menopausal women as compared to those in the premenopausal women whereas no significant difference was found in the serum levels of Zn in both the groups.

Discussion

Menopause is associated with numerous physiological and biochemical changes. The results from the present study show a significant increase in the Fe levels in the postmenopausal women as compared to those in the premenopausal women, which may be due to the increasing iron stores when the regular bleeding ceases. The accumulation of iron overload is related to a postmenopausal risk of coronary heart disease. This mechanism may involve the oxidant activity of the iron-dependent enzymes (12).

In our study, we observed a highly significant increase in the serum Ca levels after menopause, which may be explained by oestrogen deficiency, which induces synthesis of cytokines by the osteoblasts, monocytes and the T-cells. Thereby, the stimulation of bone resorption by the increasing cytoclastic activity. This results in modification of the reabsorption, excretion and the resorption of Ca, thus leading to increased circulating levels of Ca (13).

A decrease in the serum Cu levels was observed in the postmenopausal women as compared to that in the premenopausal women, which agrees with the previous reports that the concentration of Cu decreases with age in women. The administration of oestrogen during hormone replacement therapy has shown an improvement in the Cu levels in postmenopausal women (2). Serum Mg levels were also found to be reduced in postmenopausal women, which may be due to the uncoupling of bone formation as a result of loss of the bone mass. It may also be related to renal wasting andis exacerbated by dietary element deprivation and gastrointestinal losses with diarrhoea or vomiting (14).

The serum Zn concentration was not significantly different in the postmenopausal women from that of the premenopausal women. Menopause causes increased bone resorption, resulting in the mobilisation of bone Zn along with an increased urinary Zn excretion with normal serum Zn levels (15).

Conclusion

This study shows that there are changes in the serum biochemical profiles in postmenopausal women. Therefore, micronutrients in the form of trace elements, can be given to postmenopausal women as a substitute or an adjunct to HRT, (Hormone Replacement Therapy)in order to improve the symptoms and to minimise the side effects of HRT.

References

1.
Sachdeva A, Seth S, Khosla AH, Sachdeva S. Study of some common biochemical bone turnover markers in postmenopausal women. Indian Journal of Clinical Biochemistry 2005; 20(1):131-134.
2.
Bednarek-Tupikowska G, Jodkowska A, Antonowicz-Juchniewicz J. Zinc, copper, manganese, and selenium status in pre- and postmenopausal women during sex hormone therapy. Adv Clin Exp Med 2010; 19(3):337-345.
3.
Gur A, Colpan L, Nas K, Cevik R, Sarac J, Erdogan F, Duz MZ. The role of trace minerals in the pathogenesis of postmenopausal osteoporosis and a new effect of calcitonin. J Bone Miner Metab 2002; 20:39-43.
4.
Anke M. Role of trace elements in the dynamics of arteriosclerosis. Z Gesamte Inn Med 1986 Feb 15; 41(4):105-11.
5.
Masi L, Bilezikian JP. Osteoporosis: new hope for the future. Int J Fertil Womens Med. 1997 Jul-Aug; 42(4):245-54.
6.
Liu JM, Hankinson SE, Stampfer MJ, Rifai N, Willett WC, Ma J. Body iron stores and their determinants in healthy postmenopausal US women. American Journal of Clinical Nutrition December 2003; 78(6):1160-1167.
7.
Makino T, Satio M, Horiguchi D, Kina K. A highly sensitive colorimetric determination of serum zinc by using water-soluble pyridylazo dye. Clin Chim Acta 1982; 120(1):127-135.
8.
Bohuon C. Microdetermination of magnesium in various biological media. Clin Chim Acta 1962; 7:811-817.
9.
Gitelman HJ. An Improved automated procedure for the determination of Calcium in biological specimens. Anal Biochem 1967; 18:521-31.
10.
Zak B, Landers JW. Copper in serum. J Clin Pathol 1958; 29:590– 592.
11.
Zak B, Epstein E. Automated determination of serum iron. Clin Chem 1965;11:641-4.
12.
Berge LN, Bonaa KH, Nordoy A. Serum ferritin, sex hormones and cardiovascular risk factors in healthy women. Arteriosclerosis and Thrombosis 1994; 14(6):857-861.
13.
Usoro CAO, Onyeukwu CU, Nsonwu AC. Biochemical bone turnover markers in postmenopausal women in the Calabar Municipality. Asian J Biochem 2007; 2(2):130-135.
14.
Mutlu M, Argun M, Kilic E, Saraymen R, ,Yazar S. Magnesium, zinc and copper status in osteoporotic, osteopenic and normal postmenopausal women. The Journal of International Medical Research 2007; 35:692-695.
15.
Relea P, Revilla M, Ripoll E, Arribas I, Villa LF, Rico H. Zinc, biochemical markers of nutrition, and type 1 osteoporosis. Age and ageing 1995; 24:303-307.

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