Ana Maria Fernandez Alonso

Importance: Low handgrip strength (HGS) is a highly prevalent condition in postmenopausal women, although there is no clear evidence about the convenience and benefit of enhanced protein intake (EPI). Objective: This systematic review and meta-analysis evaluate the association between EPI and HGS in postmenopausal women. Evidence review: The meta-analysis protocol was registered in the PROSPERO database (CRD420261299335). We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive literature search was conducted up to February 2026 across four databases (PubMed, Web of Science, Scopus, and LILACS) for studies comparing the effect of EPI with mild protein intake on the HGS in postmenopausal women. The quality of the included studies was assessed using the Newcastle–Ottawa Scale. Statistical analyses were performed with the RevMan 5.4 software. Results are reported as standardized mean difference (SMD) and the 95% CI. Findings: Seven studies with low or moderate risk of bias, including 8,922 postmenopausal women, showed that EPI was significantly associated with HGS (SMD: 0.15, 95% CI: 0.10 to 0.20; Z = 5.54, P < 0.0001; I ² = 6%, τ ² = 0.00) compared with the control group under low protein intake. There was a lower body mass index in women under EPI compared with the control group (SMD: −0.43, 95% CI: −0.68 to −0.18; Z = 3.35, P < 0.0001; I ² = 90%, τ ² = 0.04), and there was no significant age difference (SMD: −0.17, 95% CI: −0.36 to 0.02; I ² = 83%, τ ² = 0.08). The HGS sensitivity analysis for protein intake and HGS indicates that the statistical heterogeneity was low, ranging I ² from 0% to 22%. Conclusion and Relevance: Postmenopausal women with EPI have significantly higher HGS and lower body mass index compared with those with lower protein intakes.

Introduction Bariatric surgery is the most effective treatment for severe obesity. We evaluated whether a 16-week supervised exercise program initiated immediately post-surgery improves weight loss, body composition, cardiometabolic health, inflammation, and physical fitness compared with usual care. Methods In this randomized clinical trial, 80 participants undergoing bariatric surgery were assessed before surgery, 4- and 12-month post-surgery. The intervention consisted of 16 weeks of individually supervised concurrent exercise training initiated ~ 10 days post-surgery, with three 60-min sessions/week including progressive resistance training (50–75% of one-repetition maximum) and aerobic training (65–85% heart rate reserve). Adherence was monitored throughout the intervention. The main outcome was percent of total weight loss (%TWL). Results No significant differences between groups were observed for the primary outcome. At 4 months, %TWL was 24.9% in the exercise group and 23.4% in the control group; corresponding values at 12 months were 37.0% and 37.2%, respectively. Compared with usual care, the exercise group showed greater reductions in systolic blood pressure (− 6.5 mmHg; 95% CI, − 12.7 to − 0.2; p = 0.040) and glycated hemoglobin (− 0.3%; 95% CI, − 0.5 to − 0.1; p = 0.018) at 4 months. These differences were not maintained at 12 months. No significant between-group differences were observed in body composition, inflammatory markers, or physical fitness outcomes at any timepoint. Conclusion A 16-week supervised concurrent exercise program initiated ~ 10 days after bariatric surgery did not improve weight loss compared with usual care. Although short-term improvements in systolic blood pressure and glycated hemoglobin were observed, these were not sustained at 12 months.

This systematic review synthesizes current evidence on metabolomics-based biomarkers for the early prediction or diagnosis of preeclampsia and highlights promising candidates with potential clinical application. Following PRISMA guidelines, a comprehensive search was performed in PubMed, Cochrane Library, Web of Science, and ClinicalTrials.gov up to September 2024, using predefined terms related to preeclampsia, metabolomics, and pregnancy. Study selection and risk of bias assessment were conducted with CADIMA, applying PICO-based inclusion criteria and predefined quality appraisal standards. Of 112 records identified, 16 were duplicates, 57 were excluded after title and abstract screening, and 31 after full-text review, leaving 12 studies for inclusion. These comprised cohort, case–cohort, case–control, validation, prospective control, and translational designs. Data extraction captured study characteristics, populations, methodologies, biological matrices, and main findings. Considerable heterogeneity was observed across studies, with limited overlap in identified metabolites. Nonetheless, alanine was reported in serum, lactate was observed in both serum and urine, and glutamate and glutamine were detected across serum, plasma, and placental tissue. These metabolites, interconnected through the Cori and glucose–alanine cycles, have been linked to hepatic dysfunction, immune regulation, and excitotoxicity. Overall, metabolomics shows strong potential as a sensitive tool for biomarker discovery in preeclampsia, though further research is required to confirm findings, improve reproducibility, and integrate metabolomic data with clinical parameters to support personalized medicine approaches. Systematic review registration: PROSPERO, CRD42024540619.

The purpose of this systematic review and meta-analysis is to assess the association of handgrip strength (HGS) in subjects with high-normal or mildly elevated and low-normal serum uric acid (SUA) reported by quartiles. The research protocol was registered at PROSPERO (CRD420251050351). We searched four databases to obtain relevant articles reporting HGS by SUA quartiles in subjects without gout. Outcomes were compared by combining the third and fourth SUA (higher) quartiles versus the first and second (low) quartiles. The risk of bias was assessed using the Newcastle‒Ottawa Scale, and heterogeneity with the I² test. The results are reported as the mean difference (MD), standardized MD (SMD), or odds ratio (OR). Seven cross-sectional studies, including 18,765 adult subjects with higher SUA quartiles showed significant higher HGS (SMD: 0.21, 95% confidence interval [CI]: 0.03, 0.39), body mass index (MD: 1.02 kg/m², 95% CI: 0.48, 1.55), total cholesterol (SMD: 0.14, 95% CI: 0.05, 0.24), LDL-cholesterol SMD: 0.13, 95% CI: 0.09, 0.17), and triglycerides (SMD: 0.26, 95% CI: 0.11, 0.41) than those with lower SUA quartiles. HDL-cholesterol was significantly reduced in subjects with higher SUA (SMD: -0.13, 95% CI: -0.20, -0.07). High SUA levels were associated with a drinking history (OR: 1.21, 95% CI: 1.10, 1.34) and hypertension (OR: 1.51, 95% CI: 1.15, 1.99). Subjects with higher normal SUA levels showed higher HGS compared to those with lower normal levels.

Aim: We evaluated the prevalence of low genital tract symptoms in postmenopausal women using the Vulvovaginal Symptoms Questionnaire (VSQ). Methods: Systematic review and meta‐analysis of studies reporting results obtained using the VSQ. The study was registered at PROSPERO‐University of York (CRD 2024570513). Electronic database searches were conducted following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines for studies evaluating postmenopausal women using the VSQ as reported by the authors. The pooled proportions of vulvovaginal symptoms were calculated as the prevalence of symptoms with their 95% confidence interval (CI), using random effects and inverse variance methods. Results: We meta‐analyzed seven cross‐sectional studies with a low to moderate risk of bias, including 1455 postmenopausal women based on the VSQ. Prevalences of vulvovaginal symptoms were dryness at 46.75% (95% CI, 28.61%–65.34%); burning at 26.08% (95% CI, 13.98%–40.36%); discharge at 19.96% (95% CI, 11.04%–30.69%); hurting at 21.26% (95% CI, 10.53%–34.47%); irritation at 31.76% (95% CI, 21.34%–43.18%); itching at 33.30% (95% CI, 22.35%–45.23%); and odor at 23.14% (95% CI, 11.27%–37.67%). The sensitivity analyses showed that the prevalence trends were maintained. The prevalence of women without vulvovaginal symptoms was 29.81% (95% CI, 17.42%–43.91%). Conclusion: The VSQ provides detailed prevalences of vulvovaginal symptoms, ranging from vulvovaginal discharge in 19.96% to dryness in 46.75% of postmenopausal women. The VSQ allows for measuring subjective vulvovaginal symptoms in postmenopausal women and determining their prevalence.

Article: Age and phytoestrogen use, but not resilience, influence urinary incontinence in postmenopausal women - Minerva Obstetrics and Gynecology 2024 Oct 08 - Minerva Medica - Journals

A systematic review and meta-analysis were performed to determine the association of metabolic syndrome (METS) in women with and without overactive bladder (OAB). PRISMA guidelines were followed and the protocol was registered at PROSPERO (CRD42024606398). We searched PubMed, Embase, Cochrane Library, and LILACS databases to obtain relevant articles for studies reporting METS outcomes related to OAB published through October 2024. A meta-analysis was performed of available studies using random effect models. Results are reported as mean difference (MD), standardized MD (SMD), or odds ratio (OR) and their 95% confidence interval (CI). Heterogeneity was described with the I² statistic. The quality of studies was assessed using the Newcastle-Ottawa Scale. Of the 108 non-duplicated retrieved citations, after successive selection, four case-control studies with low or moderate risk of bias reported information about the association of METS in women assessed with the 8-item OAB Symptom Bother Scale. OAB patients displayed higher body mass index (BMI, MD: 3.27, 95% CI: 2.12, 4.43), waist circumference (MD: 7.96, 95% CI: 4.41, 11.52), fasting blood glucose (SMD: 1.26, 95% CI: 0.18, 2.34), triglycerides (SMD: 0.24, 95% CI: 0.01, 0.47), and LDL-cholesterol (SMD: 0.30, 95%CI: 0.06, 0.54) levels. In addition to low HDL-cholesterol levels (SMD: -0.40, 95% CI: -0.74, -0.06) compared to the control group. There were no significant differences in circulating total cholesterol levels and rates of hypertension, hysterectomy, postmenopausal status, and constipation in women with and without OAB. Women with OAB display associations with age, BMI, waist circumference, and METS factors.

Purpose We performed a systematic review and meta-analysis to examine the associations between telomere length and telomerase activity in subjects with and without metabolic syndrome (MetS). Methods The meta-analysis protocol was registered in the PROSPERO database. The PubMed, Embase, Cochrane Library, and LILACS databases were searched for studies reporting telomere length or telomerase activity in adult men and non-pregnant women with and without MetS. The risk of bias was assessed with the Newcastle-Ottawa Scale. Random effects and inverse variance methods were used to meta-analyze associations. We conducted a bootstrapped analysis to test the accuracy of clinical results. Results Five studies reported telomere length and two studies telomerase activity. There was no significant difference in telomere length (standardized mean difference [SMD]: 0.10, 95% confidence interval [CI]: -0.07, 0.28, I²: 54%), between subjects of similar age (mean difference: 2.68, 95%CI: -0.04, 5.40 years) with and without the MetS. Subjects with MetS displayed significantly higher body mass index, triglycerides, and blood pressure, and lower HDL-cholesterol values than subjects without the syndrome. A bootstrapping mediation analysis of telomere length confirmed the clinical results. There was no significant difference in telomerase activity (SMD: 1.19, 95% CI -0.17, 2.55, I²: 93%) between subjects with and without the MetS. Conclusion There were no significant differences of telomere length and telomerase activity in patients with MetS and subjects of similar age without the syndrome.