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Objectives: Although carotid artery intima media thickness (CIMT) is a widely used determinant of subclinical atherosclerosis, gray‐scale median of the intima‐media complex (IM‐GSM) of the common carotid artery is a relatively novel measure of echogenicity reflecting composition of the arterial wall. It is important to compare cardiovascular disease (CVD) risk factor correlates across CIMT and IM‐GSM to determine whether these measures reflect distinct aspects of atherosclerosis. Methods: Baseline information from a completed randomized clinical trial of 643 healthy postmenopausal women without clinically apparent CVD was included in this cross‐sectional study. The women were on average ± SD 61 ± 7 years old, and predominantly non‐Hispanic White. CIMT and IM‐GSM were measured by high‐resolution B‐mode ultrasonogram in the far wall of the right common carotid artery. CVD risk factors including age, race, body mass index (BMI), smoking, weekly hours of physical activity, systolic (SBP) and diastolic blood pressure (DBP), lipids, glucose, and inflammatory markers were measured at baseline. Linear regression models were used to assess associations of CVD risk factors with CIMT and IM‐GSM. Multivariable models included groups of risk factors added one at a time with and withoutbasic demographic factors (age, race, BMI, physical activity) with model R2 values compared between CIMT and IM‐GSM. Results: In multivariable analysis, age, Black race, BMI, SBP, and DBP were associated with CIMT (all P <.05), whereas age, Hispanic race, BMI, SBP, physical activity, LDL‐cholesterol, and leptin were correlates of IM‐GSM (all P <.05). Adjusted for age, race, BMI, and physical activity, the R2 value for SBP was greater for CIMT association, whereas R2 values for lipids, glucose, inflammatory markers, and adipokines were greater for IM‐GSM associations. Conclusions: CIMT and IM‐GSM assess different attributes of subclinical atherosclerosis. Integrating both measures may provide improved assessment of atherosclerosis in asymptomatic individuals. [ABSTRACT FROM AUTHOR]

Objectives To determine effect of change in urine excretion of isoflavonoids on cognitive change. Design Post hoc analysis of isoflavonoid exposure (mean 2.7 years) during the randomized, placebo-controlled, double-blind Women's Isoflavone Soy Health trial. Setting General community. Participants Healthy postmenopausal women (N = 350). Intervention Twenty-five grams of isoflavone-rich soy protein (91 mg of aglycone weight isoflavones: 52 mg genistein, 36 mg daidzein, 3 mg glycitein) or milk protein-matched placebo provided daily. Measurements Overnight urine excretion, fasting plasma levels of isoflavonoids, and cognitive function measured at baseline and endpoint. Results Three hundred women (age: mean 61, range 45-92) completed both cognitive assessments and did not use hormone replacement therapy during the trial. Mean on-trial change from baseline in urine excretion of isoflavonoids was not significantly associated with change in a composite score of global cognition ( P = .39). Secondary analyses indicated that change in urine excretion of isoflavonoids was inversely associated with change in a factor score representing general intelligence ( P = .02) but not with factor scores representing verbal or visual episodic memory. Mean differences in this general intelligence factor score between women in the lowest and highest quartiles of isoflavonoid change were equivalent to an approximate 4.4-year age-associated decline. Analyses based on plasma isoflavonoid levels yielded similar but attenuated results. Conclusion In healthy postmenopausal women, long-term changes in isoflavonoids are not associated with global cognition, supporting clinical trial results, although greater isoflavonoid exposure from dietary supplements is associated with decrements in general intelligence but not memory; this finding requires confirmation in future studies. [ABSTRACT FROM AUTHOR]

Objective: To determine the effect of prior oophorectomy in healthy postmenopausal women on the rate of loss of bone mineral density (BMD) and rate of increase in carotid artery intima-media thickness (CIMT). Design: Secondary analysis from a randomized controlled trial. Setting: University-based research clinic. Patient(s): Two hundred twenty-two healthy postmenopausal women in the Greater Los Angeles area. Intervention(s): Baseline and annual screening of BMD and assessment of CIMT every 6 months for a total of 3 years. Main Outcome Measure(s): Changes in BMD and CIMT during postmenopausal years. Result(s): Among women who were menopausal for more than 10 years, the rate of CIMT progression was statistically significantly less in women with intact ovaries compared with those in women with prior oophorectomy. In women 5–10 years postmenopause, there was a trend toward a slower loss of BMD in those who retained their ovaries, and in women more than 10 years postmenopause there was significantly less BMD loss in those who retained their ovaries. Conclusion(s): As time from menopausal transition increases, retained ovaries are associated with a slower rate of bone loss and a slower rate of thickening of the carotid artery wall compared with rates in menopausal women with oophorectomy. [ABSTRACT FROM AUTHOR]