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A review of the literature concerning the relationship between menopausal estrogen treatment and endometrial carcinoma is presented. Results from animal studies indicate that estrogens may work in conjunction with carcinogenic substances to stimulate proliferation of cancerous growths. Since estrone is produced by fatty tissue, obesity and certain correlated diseases, such as hypertension or diabetes, may be predisposing factors to developing endometrial cancer. Other risk factors are a hereditary predisposition and age. Several American epidemiologica studies showed an increased risk of developing endometrial cancer among women who undergo hormone treatments during menopause. It must be remembered, however, that such studies cannot establish causal relationships. Also, in the American studies, several biases complicate evaluation of the data, e.g. a disregard for social factors, the uncertainty of the state of the endometrium before the beginning of the study, and the inclusion of the problematic "stage 0" into the study. Furthermore, in America there is a tendency to proscribe estrogens alone in high dosages for menopausal treatment over long periods of time. It is concluded that individually determined low-dosage cyclical estrogen therapy during menopause does not increase the risk of endometrial cancer.
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PMID:[Oestrogens during the menopause and the risk of endometrial carcinoma (author's transl)]. 21 69

1. Male rats were injected daily for 5 days with 0.15m-NaCl, corticotropin, cortisol or l-thyroxine and the rates of glycerolipid synthesis were measured in the livers after intraportal injection of [(14)C]palmitate and [(3)H]glycerol. 2. Injection of all three hormones decreased the rates of body-weight gain. 3. Cortisol treatment increased the weight of the liver relative to body weight. 4. Thyroxine treatment increased the relative rate of triacylglycerol synthesis from [(3)H]glycerol and decreased the relative accumulation of (3)H and (14)C in diacylglycerol. It did not significantly alter the accumulation of these isotopes in phosphatidate nor the activity of the soluble phosphatidate phosphohydrolase in the total liver. However, this activity increased by 1.5-fold when expressed relative to the soluble protein of the liver. The increased triacylglycerol synthesis appears to be related to a general increase in the turnover of fatty acids in the liver. 5. Treatment with cortisol and corticotropin increased the relative rate of triacylglycerol synthesis from [(3)H]glycerol, decreased the accumulation of (3)H in phosphatidate and increased the flux of both isotopes from phosphatidate to diacylglycerol. This appeared to be caused by the increased activity of the soluble phosphatidate phosphohydrolase that was observed in the livers of the cortisol-treated rats. 6. It is proposed that cortisol could be directly or indirectly involved in increasing the activity of hepatic phosphatidate phosphohydrolase in starvation, diabetes, laparotomy, subtotal hepatectomy, liver damage, ethanol feeding and in obesity. This enzyme adaptation could contribute to the potential of the liver to increase its synthesis and accumulation of triacylglycerols or to secrete very-low-density lipoproteins.
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PMID:The effects of cortisol, corticotropin and thyroxine on the synthesis of glycerolipids and on the phosphatidate phosphohydrolase activity in rat liver. 21 53

Type V hyperlipemia is not very common. The series of 54 cases descrubed here is the largest reported to date. Our observations were recorded when lipidograms showed the presence of chylomicrons and a large pre-beta-lipoprotein spot in the serum of fasting subjects. Type V hyperlipemia was often combined with other metabolic syndromes such as diabetes, hyperuricemia or gout, or obesity. Chronic alcoholism was also noted in half our subjects, in whom hyperlipemia quickly regressed after alcohol consumption ceased. Ischemic arterial complications, chiefly coronary, were found in one third of our cases, and the vascular risks accompanying this type of hyperlipemia rose considerably in patients with high blood pressure. Various type of treatment were administered, but all subjects were put on a special diet, comprising either the elimination of alcoholic drinks only, or, in addition to this, reduced carbohydrate or calorie intake. As a rule, these measures resulted in a distinct regression of lipid anomalies. Clofibrate or derivatives proved effective in cases where hyperlipemia failed to respond to dietary measures.
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PMID:[Type V hyperlipemia. 54 cases (author's transl)]. 22 80

Despite the advances in therapy, the high incidence, high mortality, and prematurity of coronary heart disease demonstrate the need for prevention. Measurement of a series of easily determined risk factors permits the early recognition of subjects at risk with remarkable reliability. However, reduction of risk factors affords protection against the illness only if they are causally connected with the disease mechanisms. The major evidence for linking atherosclerosis and its consequences with risk factors is reviewed. Particular attention is focused on serum lipids and the "lipid theory", smoking, elevated blood pressure, and physical inactivity, which are, on the basis of current knowledge, not only the most important factors but those most readily influenced by changes in daily living habits. Among the multiple risk factors mention is also made of obesity, diabetes, psychosocial stress, and hereditary predisposition. The probability of a causal relationship between risk factors and disease mechanisms justifies every effort to prevent the development of these precursors, or to treat them prophylactically if already present.
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PMID:[Prevention of arteriosclerosis. Current basis]. 22 49

An analysis was made of correlative factors which might be related to the angiographically measured extent of coronary artery disease in 140 patients. All patients presented with clinically important chest pain. Thirty-three had a normal coronary arteriogram. The extent of the atheromatous process was measured precisely at angiography by three different techniques. A coronary score, based on the percentage of luminal narrowing, was found to be best suited for the analysis. The most important contributory factors to the severity of atherosclerosis was duration of clinical history, number of previous myocardial infarctions, and male sex, but more specifically elevation of serum cholesterol and diabetes mellitus. Cigarette smoking, obesity, hypertension, a family history of atherosclerosis, and elevated serum triglycerides had a positive influence but this was not statistically significant.
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PMID:Relationship between extent of coronary artery disease and correlative risk factors. 22 61

Two-hundred-and-forty-eight full-blood tribal Aborigines from the West Kimberley region of Western Australia were surveyed for the prevalence of coronary heart disease, and compared with the known prevalence in whites in the country town of Busselton, WA. The prevalence was found to be greater among the Aborigines, with 7% of men, and 11% of women being found to have "probable" coronary heart disease. Seven per cent of the population had electrocardiographic changes characteristic of frank ischaemia. The major risk factors contributing to this high prevalence were hypertension, diabetes mellitus, and obesity. Thirty-seven per cent of the Aborigines were hypertensive, and 17% had diabetes mellitus.
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PMID:Coronary heart disease in tribal Aborigines--the West Kimberley survey. 28 96

A diabetes prevalence study in 1975 on an isolated urbanized Central Pacific island (Nauru) showed rates comparable to the American Pima Indians--the highest yet recorded in the world literature. This paper reports the results of a follow-up study and the high prevalence has been confirmed. In this survey of 417 people aged ten years and over, 9.8% were known diabetics. With a plasma glucose of 160 mg/100 ml or over at two hours after a 75 gram oral glucose load as the criterion of diagnosis, , diabetes was detected in a further 19.2%, making a total diabetic population of 29% in the population studied. The prevalence of diabetes was 44% in people aged 20 years and over. A further 7% had borderline diabetes on the basis of a two-hour plasma glucose of 140--159 mg/100 ml. Parity did not appear to be a causative factor in relation to the high diabetes prevalence. However, obesity is common in this community and is more marked than that seen in other Pacific or Caucasian communities. The high prevalence of diabetes in this population appears to be related to the inter-action of environmental factors, such as obesity, with a diabetic genotype. The results confirm the possible detrimental effects of westernization on native populations.
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PMID:The effect of westernization on native populations. Studies on a Micronesian community with a high diabetes prevalence. 30 51

An increasing incidence of endometrial cancer caused by a higher life expectancy and a number of other facters (i.e. obesity, diabetes, hypertension, lower pregnancy rate) as well as the unfavorable location for early detection when compared with cervical cancer has initiated this review in order to single out women with increased risk. Clinical characteristics of patients with endometrial cancer represented by age, menstrual disorders, reduced fertility, obesity, diabetes, hypertension, hirsutism, hyperplasia of the ovarian stroma or hilus cells in connection with an increased oestrogen effect in the vaginal smear and proliferative changes of the endometrium can be explained by extraglandular respectively peripheral aromatization of androgens to oestrogens, particular by the conversion of androstenedione to oestrone. This is supported by an increased plasma oestrone/oestradiol-ratio and increased conversion rate with age and overweight. In vivo- and in vitro-investigations have demonstrated the participation of adipose tissue in peripheral oestrogene production. The compiled data point towards the importance of the extraglandular oestrone production for the etiology of endometrial cancer by effecting the endometrium over a long period of time. The counter action of the normally cyclic changes of oestradiol and progesterone is lacking. Therefore, a dysoestrogenic effect of oestrone upon the endometrium can be fully effective, depending on the hormone receptor content of the respective endometrium. Based upon these data including recent publications, pre- and postmenopausal oestrogen therapy has to be critically reevaluated.
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PMID:[Endometrial cancer and extraglandular oestrogen biosynthesis (author's transl)]. 32 98

Within the last century the prevalence and mortality rates of diabetes and other degenerative diseases have increased considerably. Simultaneously, there have been marked alterations in the types and amounts of food consumed. One of the most conspicuous dietary changes has been the very considerable rise in sugar intake. Some regard this change specifically as the factor most responsible for the increase in diabetes. In this review, the relationship between rises in sugar intake and prevalences of diabetes and the bearing of sugar intake on obesity are discussed. There is not enough evidence that a high intake of sugar specifically promotes the development of diabetes, but this does not imply that sugar intake is unimportant. Because of the high prevalence of obesity in some populations, restriction of sugar intake is as important as other dietary restrictions.
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PMID:Sugar intake and diabetes mellitus. 32 90

Fat has been a menace to longevity since biblical times, but detailed studies of its deposition and function in the perinatal period only began comparatively recently. The function of brown fat in thermogenesis as distinct from that of white fat as a reserve of energy is now clear, but not why the guinea pig and the human baby should be two of the very few land mammals to lay down white fat in their bodies before birth. How much of this fat crosses the placenta and how much is synthesized by the fetus? There is evidence that the amounts and timing of the two events may not be the same in the two species but the reasons behind the differences are not at all clear. Genetic obesity in many forms is well known in rodents. None of them have contributed much to paediatrics as yet, but the Egyptian sand rat has promising similarities to persons who develop obesity and diabetes in adult life and a comparison of their metabolism in early life might be a profitable exercise.
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PMID:Fat. 33 59


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