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Ahlawat P, Singh MM, Garg S, Mala YM. Prevalence of Depression and its Association with Sociodemographic Factors in Postmenopausal Women in an Urban Resettlement Colony of Delhi. J Midlife Health 2019; 10:33-36. [PMID: 31001054 PMCID: PMC6459070 DOI: 10.4103/jmh.jmh_66_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Menopause is defined as the time of cessation of ovarian function resulting in permanent amenorrhea. Menopause is associated with various symptoms such as physical, vasomotor, sexual, and psychological symptoms. Depression is a common symptom in postmenopausal women as menopause is associated with the end of the fertile period of a women's life. Menopause is an important subject to study as due to increase in life expectancy and improved health care delivery number of postmenopausal women is significantly increasing. Objectives: The objective of the study is to determine the prevalence of depression and its association with sociodemographic factors in postmenopausal women in an urban resettlement colony of Delhi. Materials and Methods: A community-based cross-sectional study was conducted among 580 postmenopausal women who were resident of Gokulpuri in North-East Delhi, using a predesigned, pretested, and semi-structured interview schedule. Hamilton Depression (HAM-D) scale was used to find out the prevalence of depression. The collected data were analyzed using SPSS-22 version. Results: In our study, 58.4% postmenopausal women were normal with no depression, 38.3% were in a mild depression, and 3.3% women were having moderate depression. Depression was more prevalent in women belonging to the younger age group, lower socioeconomic status, and illiterate women. Furthermore, the prevalence of depression was more in women who were divorced or widow. Conclusions: Study revealed prevalence of depression in significant number of postmenopausal women. To improve the quality of life of women in postmenopausal period, diagnosis of depression and relevant influencing factors is important.
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Affiliation(s)
- Pooja Ahlawat
- Department of Community Medicine, Maulana Azad Medical College, Delhi, India
| | | | - Suneela Garg
- Department of Community Medicine, Maulana Azad Medical College, Delhi, India
| | - Y M Mala
- Department of Obstetrics and Gynaecology, Maulana Azad Medical College, Delhi, India
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Khan AA, Farhad A, Siddiqui PQR, Ansari B. Effects of osteoanabolic exercises on bone mineral density of osteoporotic females: A randomized controlled trial. Int J Health Sci (Qassim) 2019; 13:9-13. [PMID: 30842712 PMCID: PMC6392486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES With the increase in the life expectancy of older adults, the scoring diagnosis of osteoporosis has been highly reported hence rising the incidence of fragility fractures due to decrease in bone mineral density (BMD), thereby significantly impacting the quality of life and health status of elderly population. The aim of this study is to identify the impact of different exercise regimes in improving the BMD among osteoporotic females. METHODOLOGY A trial was conducted on 93 diagnosed postmenopausal osteoporotic females aged 50-75 years screened on the basis of physical activity readiness-questionnaire and YOU form randomly divided equally into three groups', that is, aerobic, anaerobic, and osteoanabolic exercises using an envelope method. The intervention was given on the basis of American College of Sports Medicine (ACSM), frequency, intensity, time, and type protocol for the period of 12 weeks. The pre- and post-BMD was determined to find out the improvements on the t-value of the participants. The outcome measure was calculated using a peripheral dual X-ray absorptiometry scan (bone densitometer). RESULTS At 95% of confidence interval, the pre- and post-median difference observed within the osteoanabolic group was 0.4 followed by 0.3 and 0.1 in the aerobic and anaerobic groups, respectively. The level of significance was determined by applying the Friedman test revealing a statistically significant difference P < 0.001 between the groups. Further, post hoc analysis shows that osteoanabolic exercises were more significant in comparison with aerobic and anaerobic exercises. CONCLUSION Structured physical exercises based on ACSM protocol show improvement among the osteoporotic females; however, the impact of osteoanabolic exercises significantly increased the BMD, thus reducing the t-value. However, larger scale studies in different clinical settings are recommended for more accurate results.
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Affiliation(s)
- Amna Aamir Khan
- Department of Physical Therapy, Ziauddin College of Rehabilitation Sciences, Ziauddin University, Karachi, Pakistan,Address for correspondence: Amna Aamir Khan, Ziauddin College of Rehabilitation Sciences, Ziauddin University, Institute, Plot # E - 40/1, Wahid Colony Block - B North Nazimabad Karachi, Pakistan. Phone: 021-36629250-51/0342-2497814.
| | - Ali Farhad
- Department of Physical Therapy, Ziauddin College of Rehabilitation Sciences, Ziauddin University, Karachi, Pakistan
| | - Pirzada Qasim Raza Siddiqui
- Professor of Physiology, Vice Chancellor Ziauddin university and a Co-PI, Ziauddin University, Karachi, Pakistan
| | - Basit Ansari
- Department of Health, Physical Education and Sports Sciences, University of Karachi, Karachi, Pakistan
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Ustundag Y, Aykurt KL, Sambel M, Ozturk M, Satır A, Yolgosteren E, Neselioglu S, Erel O. Vitamin D and thiol-disulfide homeostasis levels in postmenopausal women with overactive bladder syndrome. J Med Biochem 2020; 39:1-6. [PMID: 32549770 DOI: 10.2478/jomb-2019-0003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 01/29/2019] [Indexed: 01/13/2023] Open
Abstract
Background This study aimed to find a relationship between vitamin D concentration and thiol-disulfide homeostasis in the pathophysiology of overactive bladder (OAB) syndrome in postmenopausal women. Methods A total of 76 postmenopausal women, referred for routine controls, were recruited between January and March 2018 to participate in this study. Participants with an overactive bladder questionnaire (OAB-q) score of >11 (n = 34) were included in the OAB syndrome group, while those with a score of <5 (n = 42) were included in the control group. Serum total antioxidant capacity, ischemia-modified albumin, C-reactive protein, 25-hydroxy vitamin D levels, and thiol-disulfide homeostasis were measured. Results Patients with OAB syndrome had waist circumferences of 106 ± 11 cm, and their body mass indexes (BMIs) were 30.8 ± 4.8 kg/m2. The control groups' waist circumferences were 102 ± 11 cm and their BMIs were 28.9 ± 4.3 kg/m2 (p = 0.069 and p = 0.098, respectively). The level of vitamin D in the control group was 33.7 (IQR: 30.7) nmol/L and 27.0 (IQR: 27.5) nmol/L (p = 0.081) in the OAB syndrome group. Conclusions We were not able to demonstrate with certainty any significant relationships between serum 25-hydroxy vitamin D levels and thiol-disulfide homeostasis parameters and OAB syndrome.
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Garcia-Yu IA, Garcia-Ortiz L, Gómez-Marcos MA, Alonso-Dominguez R, Gonzalez-Sanchez J, Mora-Simon S, González-Manzano S, Rodriguez-Sanchez E, Maderuelo-Fernandez JA, Recio-Rodriguez JI. Vascular and cognitive effects of cocoa-rich chocolate in postmenopausal women: a study protocol for a randomised clinical trial. BMJ Open 2018; 8:e024095. [PMID: 30552275 PMCID: PMC6303642 DOI: 10.1136/bmjopen-2018-024095] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 10/03/2018] [Accepted: 11/02/2018] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION The intake of polyphenols has certain health benefits. This study will aim to assess the effect of adding a daily amount of chocolate high in cocoa content and polyphenols to the normal diet on blood pressure, vascular function, cognitive performance, quality of life and body composition in postmenopausal women. METHODS AND ANALYSIS Here we plan a randomised clinical trial with two parallel groups involving a total of 140 women between 50 and 64 years in the postmenopausal period, defined by amenorrhoea of at least 12 consecutive months. The main variable will be the change in blood pressure. Secondary variables will be changes in vascular function, quality of life, cognitive performance and body composition. The intervention group will be given chocolate containing 99% cocoa, with instructions to add 10 g daily to their normal diet for 6 months. The daily nutritional contribution of this amount of chocolate is 59 kcal and 65.4 mg of polyphenols. There will be no intervention in the control group. All variables will be measured at the baseline visit and 3 and 6 months after randomisation, except cognitive performance and quality of life, which will only be assessed at baseline and at 6 months. Recruitment is scheduled to begin on 1 June 2018, and the study will continue until 31 May 2019. ETHICS AND DISSEMINATION This study was approved by the Clinical Research Ethics Committee of the Health Area of Salamanca, Spain ('CREC of Health Area of Salamanca'), in February 2018. A SPIRIT checklist is available for this protocol. The clinical trial has been registered at ClinicalTrials.gov provided by the US National Library of Medicine, number NCT03492983. The results will be disseminated through open access peer-reviewed journals, conference presentations, broadcast media and a presentation to stakeholders.
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Affiliation(s)
- Irene A Garcia-Yu
- Primary Health Care Research Unit, La Alamedilla Health Center, Institute of Biomedical Research of Salamanca (IBSAL), Health Service of Castilla y León (SACyL), Salamanca, Spain
- Gerencia de Atención Primaria de Burgos, SACYL, Burgos
| | - Luis Garcia-Ortiz
- Primary Health Care Research Unit, La Alamedilla Health Center, Institute of Biomedical Research of Salamanca (IBSAL), Health Service of Castilla y León (SACyL), Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - Manuel A Gómez-Marcos
- Primary Health Care Research Unit, La Alamedilla Health Center, Institute of Biomedical Research of Salamanca (IBSAL), Health Service of Castilla y León (SACyL), Salamanca, Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Rosario Alonso-Dominguez
- Primary Health Care Research Unit, La Alamedilla Health Center, Institute of Biomedical Research of Salamanca (IBSAL), Health Service of Castilla y León (SACyL), Salamanca, Spain
| | - Jesus Gonzalez-Sanchez
- Primary Health Care Research Unit, La Alamedilla Health Center, Institute of Biomedical Research of Salamanca (IBSAL), Health Service of Castilla y León (SACyL), Salamanca, Spain
- Department of Nursing, University of Extremadura, Plasencia, Spain
| | - Sara Mora-Simon
- Primary Health Care Research Unit, La Alamedilla Health Center, Institute of Biomedical Research of Salamanca (IBSAL), Health Service of Castilla y León (SACyL), Salamanca, Spain
- Department of Basic Psychology, Psychobiology and Behavioral Sciences Methodology, University of Salamanca, Salamanca, Spain
| | | | - Emiliano Rodriguez-Sanchez
- Primary Health Care Research Unit, La Alamedilla Health Center, Institute of Biomedical Research of Salamanca (IBSAL), Health Service of Castilla y León (SACyL), Salamanca, Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Jose A Maderuelo-Fernandez
- Primary Health Care Research Unit, La Alamedilla Health Center, Institute of Biomedical Research of Salamanca (IBSAL), Health Service of Castilla y León (SACyL), Salamanca, Spain
| | - Jose I Recio-Rodriguez
- Primary Health Care Research Unit, La Alamedilla Health Center, Institute of Biomedical Research of Salamanca (IBSAL), Health Service of Castilla y León (SACyL), Salamanca, Spain
- Faculty of Health Sciences, University of Burgos, Burgos, Spain
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Abstract
OBJECTIVE The study aimed to identify the factors associated with the sexual lives of perimenopausal and postmenopausal women in China. METHODS A total of 426 participants were approached about this study from May 2012 to August 2013. In total, 252 cases were included in this study. One hundred and ninety-seven women who filled out the Quality of Sexual Life Questionnaire for Women (QSLQW) and the modified Kupperman Menopausal Index (KMI) had an active sexual life. Pearson's coefficient index was used to determine the correlation between the KMI and different domains of the QSLQW. Multivariable statistical analysis was performed to determine the correlation between different factors and the sexual life of perimenopausal and postmenopausal women. RESULTS When the participants reported a higher KMI, they suffered lower sexual satisfaction (r = -0.16, p = 0.035), more severe sexual anxiety (r = -0.367, p = 4.9 × 10-7), and less sexual response (r = -0.21, p = 0.004). No correlation was found between the KMI and sexual communication, sexual attitude, and self-image. Multivariable statistical analysis showed that menopause status and higher KMI scores are associated with a decrease in sexual satisfaction among Chinese women (β = -9.76, 95% CI -16.89 to -2.64 and β = -0.41, 95% CI -0.68 to -0.15, respectively), and that the better the spousal relationship, the fewer deliveries and the higher the scores of sexual life quality (β = 8.86, 95% CI -0.91 to 18.63 and β = -6.65, 95% CI -11.83 to -1.48, respectively). CONCLUSION Factors including parity, spousal relationship, menopausal status, and menopausal symptoms are associated with the quality of sexual life of perimenopausal and postmenopausal women in China.
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Affiliation(s)
- Y Zhao
- a Department of Gynecology and Obstetrics , Peking University People's Hospital , Beijing , P. R. China
| | - W Dong
- b Department of Gynecology and Obstetrics , The First People's Hospital of Yunnan Province , Kumming City, P. R. China
| | - L Sun
- c Department of Gynecology and Obstetrics , Tianjin Medical University Cancer Institute and Hospital , Tianjin , P. R. China
| | - Q Su
- a Department of Gynecology and Obstetrics , Peking University People's Hospital , Beijing , P. R. China
| | - Y Zhu
- a Department of Gynecology and Obstetrics , Peking University People's Hospital , Beijing , P. R. China
| | - M Lu
- a Department of Gynecology and Obstetrics , Peking University People's Hospital , Beijing , P. R. China
| | - C Tan
- a Department of Gynecology and Obstetrics , Peking University People's Hospital , Beijing , P. R. China
| | - X Yang
- a Department of Gynecology and Obstetrics , Peking University People's Hospital , Beijing , P. R. China
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206
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Freeman M, Waller J, Sasieni P, Lim AWW, Marlow LAV. Acceptability of non-speculum clinician sampling for cervical screening in older women: A qualitative study. J Med Screen 2018; 25:205-210. [PMID: 29439604 PMCID: PMC6262594 DOI: 10.1177/0969141318756452] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 01/10/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVES One reason that women over age 50 report avoiding cervical screening is increased discomfort postmenopause. This study aimed to explore the acceptability of human papillomavirus testing on clinician-collected vaginal samples without a speculum ('non-speculum') for cervical screening among older women. METHODS Thirty-eight women in England aged 50-64 with a range of cervical screening experience ('up-to-date' n = 17, 'overdue screening' n = 18, 'never screened' n = 3) were identified via a recruitment agency. Women participated in focus groups or interviews about the potential for using clinician-collected samples without a speculum. Discussions were analysed using Framework Analysis. RESULTS The two main themes identified were women's perceptions of the speculum and attitudes towards non-speculum screening. Many women reported negative experiences with the speculum, including increased pain after the menopause. Women generally had positive attitudes towards non-speculum clinician sampling and felt it would be a less intrusive option, but expressed concern that it could be less accurate than screening with a speculum. Women who were 'up-to-date' preferred conventional screening, while overdue and never screened women welcomed the option to be screened without a speculum. CONCLUSIONS Human papillomavirus testing on non-speculum clinician-collected vaginal samples could be an acceptable alternative cervical screening method for older women. Offering this approach could increase screening uptake in older women who find conventional cervical screening to be less acceptable with ageing or the menopause.
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Affiliation(s)
- Madeleine Freeman
- Research Department of Behavioural Science and Health,
University College London, London, UK
| | - Jo Waller
- Research Department of Behavioural Science and Health,
University College London, London, UK
| | - Peter Sasieni
- Barts & The London School of Medicine and Dentistry, Queen
Mary University of London, London, UK
| | - Anita WW Lim
- Barts & The London School of Medicine and Dentistry, Queen
Mary University of London, London, UK
| | - Laura AV Marlow
- Research Department of Behavioural Science and Health,
University College London, London, UK
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207
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Rukmini JN, Sachan R, Sibi N, Meghana A, Malar CI. Effect of Menopause on Saliva and Dental Health. J Int Soc Prev Community Dent 2018; 8:529-533. [PMID: 30596044 PMCID: PMC6280573 DOI: 10.4103/jispcd.jispcd_68_18] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 03/19/2018] [Indexed: 11/12/2022] Open
Abstract
Aims and Objectives: This research is intended to observe the influence of menopause on saliva and dental health. Salivary flow rate, pH of stimulated whole saliva, oral hygiene status, dental caries status, and periodontal status were evaluated in frequently menstruating and postmenopausal womankind. Materials and Methods: A cross-sectional study was conducted on forty healthy postmenopausal women (case group) and forty regularly menstruating healthy women (control group), who were selected from the Outpatient Department of Dr. Syamala Reddy Dental College and Hospital, Bengaluru. None of them had any systemic disease and not under any medication. Participants were asked to chew on an elastic band of standardized size. The flow rate was measured as ml/min. Salivary pH was measured using pH strips. Oral Hygiene Index-simplified (OHI-S), Decayed Missing and Filled Teeth (DMFT index), Community Periodontal Index (CPI), and Loss of Attachment (LOA) were assessed clinically. The results were analyzed with the Chi-square test and Student's t-test (P < 0.05). Results: Salivary pH and flow rate in the case cluster were considerably lesser when related to the control group (P < 0.001). OHI-S, DMFT, CPI, and LOA were found to be greater in postmenopausal women when related to the control group (P < 0.001). Conclusion: Here exists a noticeable diminution in the salivary pH and flow rate in postmenopausal womanhood which in turn leads to increased OHI-S, DMFT, CPI, and LOA. The study has presented that the significance of preventive dentistry upsurges with aging in females.
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Affiliation(s)
- J N Rukmini
- Department of Public Health Dentistry, M.R. Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India
| | - Ritu Sachan
- Department of Public Health Dentistry, Dr. Syamala Reddy Dental College and Hospital, Bengaluru, Karnataka, India
| | - Nilima Sibi
- Department of Public Health, Western University, Canada, North America
| | - A Meghana
- Department of Public Health Dentistry, M.R. Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India
| | - C Indu Malar
- Department of Public Health Dentistry, Dr. Syamala Reddy Dental College and Hospital, Bengaluru, Karnataka, India
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Alcázar JL, Bonilla L, Marucco J, Padilla AI, Chacón E, Manzour N, Salas A. Risk of endometrial cancer and endometrial hyperplasia with atypia in asymptomatic postmenopausal women with endometrial thickness ≥11 mm: A systematic review and meta-analysis. J Clin Ultrasound 2018; 46:565-570. [PMID: 30113073 DOI: 10.1002/jcu.22631] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 06/22/2018] [Accepted: 07/09/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE To evaluate the risk of endometrial cancer and/or endometrial hyperplasia with atypia in asymptomatic postmenopausal women with endometrial thickness ≥ 11 mm. METHODS Systematic review of literature using database search (PubMed and Web of Science) of articles published between January 1990 and December 2016 evaluating the correlation between endometrial thickness as measured by transvaginal ultrasound (double layer) and histopathological findings in asymptomatic postmenopausal women, using the following terms: "endometrial thickness," "postmenopausal," "postmenopause," and "asymptomatic." Inclusion criteria were prospective or retrospective studies of more than 150 cases that provided information on endometrial thickness and its correlation with histopathological data. Studies that included patients with hormone replacement therapy, tamoxifen, or aromatase inhibitors were excluded. The overall relative risk (RR) for EC/EHA was calculated, stratifying the patients into two groups according to endometrial thickness (<11 mm and ≥11 mm). Heterogeneity was assessed by calculating I2 . RESULTS The search identified 289 studies. After exclusions, nine articles that met all the inclusion criteria were included, comprising data from 4751 women. The prevalence of endometrial cancer and/or endometrial hyperplasia with atypia was 2.4%. The relative risk of endometrial cancer and/or endometrial hyperplasia with atypia in the ≥11 mm group was 2.59 (95% CI: 1.66-4.05). High heterogeneity was observed between studies (I2 : 57.3%, P = .016). CONCLUSIONS Overall the risk for EC/EHA was 2.6 times greater in women with ET ≥11 mm vs women with ET 5-10 mm, although there was significant heterogeneity in estimates across studies.
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Affiliation(s)
- Juan Luis Alcázar
- Department of Obstetrics and Gynecology, Clínica Universidad de Navarra, School of Medicine, University of Navarra, Pamplona, Spain
| | - Laura Bonilla
- Department of Obstetrics and Gynecology, University Hospital Virgen de las Nieves, Granada, Spain
| | | | - Ana Isabel Padilla
- Department of Obstetrics and Gynecology, Canaty Islands University Hospital, Tenerife, Spain
| | - Enrique Chacón
- Department of Obstetrics and Gynecology, Clínica Universidad de Navarra, School of Medicine, University of Navarra, Pamplona, Spain
| | - Nabil Manzour
- Department of Obstetrics and Gynecology, Clínica Universidad de Navarra, School of Medicine, University of Navarra, Pamplona, Spain
| | - Aina Salas
- Department of Obstetrics and Gynecology, Clínica Universidad de Navarra, School of Medicine, University of Navarra, Pamplona, Spain
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Tatlock S, Abraham L, Bushmakin A, Moffatt M, Williamson N, Coon C, Arbuckle R. Psychometric evaluation of electronic diaries assessing side-effects of hormone therapy. Climacteric 2018; 21:594-600. [PMID: 30372631 DOI: 10.1080/13697137.2018.1517738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Postmenopausal women (PMW) can experience side-effects (breast pain/tenderness and vaginal spotting/bleeding) associated with estrogen plus progestin therapies (EPTs). To assess these outcomes, the Breast Pain and Tenderness Daily Diary (BPT-DD) and the Vaginal Bleeding and Spotting Daily Diary (VBS-DD) were developed for electronic completion (eDiaries). This study evaluated the psychometric properties of the eDiaries. METHODS The eDiaries were completed daily for 28 days by 202 PMW experiencing breast pain/tenderness and/or vaginal spotting/bleeding while on EPTs. Confirmatory factor analysis (CFA) investigated the BPT-DD structure. Response distributions, test-retest reliability (intraclass correlation coefficient [ICC]), internal consistency (BPT-DD only), and construct validity (via known groups and convergent validity analyses) were assessed. RESULTS Completion rates were high: over 90% of women missed <3 daily entries. CFA supported the BPT-DD unidimensional structure (Bentler's Comparative Fit Index >0.98). BPT-DD inter-item correlations (r = 0.77-0.89) and internal consistency (Cronbach's alpha = 0.95-0.97) were high and good test-retest reliability was demonstrated (ICC ≥ 0.70). The eDiaries correlated moderately (>0.40), in a logical pattern with other instruments, supporting convergent validity. Known-groups analyses indicated both measures demonstrated significant differences between patients of differing severity (p < 0.001). CONCLUSION The study provides evidence of strong psychometric properties for the BPT-DD and VBS-DD to assess breast pain/tenderness and spotting/bleeding in PMW.
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Affiliation(s)
- S Tatlock
- a Adelphi Mill , Adelphi Values , Bollington , Cheshire , UK
| | - L Abraham
- b Pfizer Ltd , Tadworth , Surrey , UK
| | | | - M Moffatt
- b Pfizer Ltd , Tadworth , Surrey , UK
| | - N Williamson
- a Adelphi Mill , Adelphi Values , Bollington , Cheshire , UK
| | - C Coon
- d Outcometrix , Essex , MA , USA
| | - R Arbuckle
- a Adelphi Mill , Adelphi Values , Bollington , Cheshire , UK
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210
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Kagan R, Abreu P, Andrews E. Vaginal bleeding/spotting with conjugated estrogens/bazedoxifene, conjugated estrogens/medroxyprogesterone acetate, and placebo. Postgrad Med 2018; 130:687-693. [PMID: 30280946 DOI: 10.1080/00325481.2018.1520046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE In the 1-year phase 3 Selective estrogens, Menopause, And Response to Therapy-5 trial, cumulative amenorrhea rates with conjugated estrogens/bazedoxifene (CE/BZA) were similar to placebo and higher than with conjugated estrogens/medroxyprogesterone acetate (CE/MPA). This post hoc analysis reports bleeding/spotting rates in 4-week intervals (cycles) and 3-month intervals (quarters) with these therapies and the percentage of cases attributable to spotting only. METHODS Generally healthy postmenopausal women with menopausal symptoms recorded vaginal bleeding/spotting in daily diaries while receiving CE 0.45 mg/BZA 20 mg, CE 0.625 mg/BZA 20 mg, CE 0.45 mg/MPA 1.5 mg, or placebo. RESULTS A total of 1596 women in the modified intent-to-treat population contributed data. Incidence of bleeding/spotting was significantly (p < 0.001) lower with CE 0.45 mg/BZA 20 mg (0.54‒4.44%), CE 0.625 mg/BZA 20 mg (1.26‒5.02%), and placebo (1.55‒4.82%) compared with CE 0.45 mg/MPA 1.5 mg (8.81‒25.63%) in all 4-week cycles. Each quarter, <10% of women taking CE/BZA doses or placebo had bleeding/spotting, significantly (p < 0.001) less than the 21-36% with CE 0.45 mg/MPA 1.5 mg. Odds ratio for bleeding/spotting with CE 0.45 mg/BZA 20 mg vs CE 0.45 mg/MPA 1.5 mg was 0.1 in each quarter (95% CI, Q1-Q3: 0.1-0.2; Q4: 0.1-0.3). Across all treatments, most (88-100%) bleeding/spotting cases were spotting only. Mean days of bleeding/spotting were <1 per quarter with CE/BZA doses and placebo, which was significantly (p < 0.01) less than the 3-5 days per quarter with CE/MPA. CONCLUSIONS Bleeding/spotting with CE/BZA treatment was similar to placebo and significantly less frequent than with CE/MPA treatment. Most cases were spotting only across all treatments.
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Affiliation(s)
- Risa Kagan
- a Department of Obstetrics, Gynecology, and Reproductive Sciences , University of California , San Francisco , CA , USA.,b Sutter East Bay Medical Foundation , Berkeley , CA , USA
| | - Paula Abreu
- c Department of Clinical Affairs , Pfizer Inc , New York , NY , USA
| | - Emma Andrews
- d US/Global Medical Affairs , Pfizer Inc , New York , NY , USA
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Park SJ, Jung JH, Kim MS, Lee HJ. High dairy products intake reduces osteoporosis risk in Korean postmenopausal women: A 4 year follow-up study. Nutr Res Pract 2018; 12:436-442. [PMID: 30323911 PMCID: PMC6172171 DOI: 10.4162/nrp.2018.12.5.436] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 06/18/2018] [Accepted: 09/03/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND/OBJECTIVES The aim of this study was to identify the effect of dairy products, milk and yogurt on osteoporosis incidence among Korean postmenopausal women using prospective cohort data. MATERIALS/METHODS Between 2001 and 2003, 10,038 participants were recruited in rural and urban areas for a baseline examination of a community-based cohort study. Of those, 1,573 postmenopausal women (aged 40–69 years at baseline) were eligible for the present study. Intakes of dairy products, milk, and yogurt were assessed using a validated semi-quantitative food frequency questionnaire. The speed of sound at the radius and tibia were measured using a quantitative ultrasound device and osteoporosis was defined based on the WHO criteria (T-score ≤ −2.5). RESULTS During the 4-years follow-up study, the cumulative incidence of osteoporosis was 18.4% (273 cases) in the radius and 33.6% (407 cases) in the tibia. The subjects with higher frequency of dairy product consumption showed a decreased risk of radius osteoporosis after adjusting for potential confounders [hazard ratio (HR) = 0.51, 95% confidence interval (CI): 0.33–0.80 for >1 time/day vs. non consumer; P for trend = 0.0027]. Similarly, high frequency of milk and yogurt consumption had a protective effect on radius osteoporosis risk [milk: HR = 0.60, 95% CI: 0.42–0.87 for > 5–6 times/week vs. non consumer (P for trend = 0.0130), yogurt: HR = 0.51, 95% CI: 0.30–0.85 for > 5–6 times/week vs. non consumer (P for trend = 0.0167)]. However, high dairy products consumption was not related with tibia osteoporosis. CONCLUSIONS This study suggests that daily intake of dairy products could potentially reduce radius osteoporosis incidence among Korean postmenopausal women.
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Affiliation(s)
- Seon-Joo Park
- Department of Food and Nutrition, College of BioNano Technology, Gachon University, 1342 Seongnam-daero, Sujeong-gu, Seongnam-si, Gyeonggi 13120, Korea
| | - Ji Hye Jung
- Institute for Clinical Nutrition, Inje University, Seoul 04551, Korea
| | - Myung-Sunny Kim
- Research Division of Food Functionality, Korea Food Research Institute, Wanju 55365, Korea
| | - Hae-Jeung Lee
- Department of Food and Nutrition, College of BioNano Technology, Gachon University, 1342 Seongnam-daero, Sujeong-gu, Seongnam-si, Gyeonggi 13120, Korea
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212
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Techapatiphandee M, Tammachote N, Tammachote R, Wongkularb A, Yanatatsaneejit P. VDR and TNFSF11 polymorphisms are associated with osteoporosis in Thai patients. Biomed Rep 2018; 9:350-356. [PMID: 30233789 DOI: 10.3892/br.2018.1137] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 07/31/2018] [Indexed: 12/13/2022] Open
Abstract
Determining molecular markers for osteoporosis may be valuable for improving the quality of life of affected elderly patients by aiding in early detection and disease management. In the present study, the association between single nucleotide polymorphisms (SNPs) of the vitamin D receptor (VDR) and tumour necrosis factor superfamily number 11 (TNFSF11) genes and the susceptibility of developing osteoporosis was investigated in a Thai female cohort. The study group consisted of 105 Thai postmenopausal patients diagnosed with osteoporosis and 132 healthy Thai postmenopausal female volunteers. DNA extracted from blood samples was used to genotype the VDR and TNFSF11 genes using polymerase chain reaction-restriction fragment length polymorphism and sequencing analysis. For VDR, the frequencies of the genotypes TT, CT and CC for the TaqI SNP (rs731236) were 87.88, 11.36 and 0.76%, respectively, in the control group, while in the osteoporosis cohort were 92.38, 5.71 and 1.91%, respectively. For the FokI SNP (rs2228570), the frequencies of the genotypes CC, CT and TT were 31.06, 55.30 and 13.64%, respectively, in the control group, and in the osteoporosis group were 29.52, 43.81 and 26.67%, respectively. For BsmI SNP (rs1544410), the frequencies of the genotypes GG, GA and AA were 78.03, 18.94 and 3.03%, respectively, in control group, and in the osteoporosis group were 80.95, 18.10 and 0.95%, respectively. The significant risk of osteoporosis associated with the FokI SNP was determined. The odds ratio (95% confidence interval) was 2.30 (1.14-4.69; P=0.01) among patients with osteoporosis with TT as the susceptibility genotype. For TNFSF11, the frequencies of the genotypes TT, CT and CC for the -290C>T SNP (rs9525641) in the control group were 36.36, 50.76 and 12.88%, respectively, while in the osteoporosis group were 31.43, 56.19 and 12.38%, respectively. For the -643C>T SNP (rs9533156), the frequencies of the genotypes TT, CT and CC in the control group were 35.61, 48.48 and 15.91%, respectively, while in the osteoporosis group were 32.38, 55.24 and 12.38%, respectively. For the -693G>C SNP (rs9533155), the frequencies of the genotypes CC, CG, and GG in the control group were 39.39, 46.97 and 13.64%, respectively, and in the osteoporosis group were 36.19, 53.33 and 10.48%, respectively. No significant associations of the TNFSF11 SNPs with osteoporosis were determined; however, it was notable that the GCT haplotype of TNFSF11 may be a protective haplotype for osteoporosis. Therefore, it was concluded that the SNP FokI of VDR may be a potential molecular biomarker for the development of osteoporosis in Thai females.
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Affiliation(s)
- Mananya Techapatiphandee
- Human Genetics Research Group, Department of Botany, Faculty of Science, Chulalongkorn University, Bangkok 10330, Thailand
| | - Nattapol Tammachote
- Department of Orthopaedics, Faculty of Medicine, Thammasat University Hospital, Khlong Nueng, Pathumthani 12120, Thailand
| | - Rachaneekorn Tammachote
- Human Genetics Research Group, Department of Botany, Faculty of Science, Chulalongkorn University, Bangkok 10330, Thailand
| | - Anna Wongkularb
- Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Pattamawadee Yanatatsaneejit
- Human Genetics Research Group, Department of Botany, Faculty of Science, Chulalongkorn University, Bangkok 10330, Thailand
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213
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Abstract
Menopause is defined as permanent cessation of menstrual periods, determined retrospectively after a woman has experienced 12 months of amenorrhea without any other obvious cause. Over the years, the discourse surrounding the Climacteric was mainly elicited as a "disease of the castrates", as opposed to the feminist views. There has been a large feminist contribution to both the debate of contraception and menopause in the last few years. Over the years, menopause has been treated in a uniform fashion, as a disease, excluding the different circumstances and lived experiences that patients go through during this sensitive period. Every primary care provider should be familiar with the menopausal process and be able to provide adequate care for these women, respecting patient's autonomy and decision making. A brief historical of menopause and hormone replacement therapy (HRT) will be reviewed in this paper. We will also discuss the different views of the menopausal discourse as well as the benefits and risks, compliance rates and reasons for discontinuation of HRT.
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Affiliation(s)
- Salam Chalouhi
- Department of OBGYN, 1104 University of New Mexico Hospital, Albuquerque, USA
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214
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Gordon JH, LaMonte MJ, Genco RJ, Zhao J, Cimato TR, Hovey KM, Wactawski-Wende J. Association of clinical measures of periodontal disease with blood pressure and hypertension among postmenopausal women. J Periodontol 2018; 89:1193-1202. [PMID: 29802640 DOI: 10.1002/jper.17-0562] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 12/08/2017] [Accepted: 12/29/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Hypertension and periodontal disease are common conditions among postmenopausal women. Periodontal disease has been found associated with hypertension in previous studies, but data in postmenopausal women is limited. METHODS We assessed the cross-sectional associations of clinically measured periodontal disease with prevalent hypertension and measured systolic blood pressure (SBP) among 1341 postmenopausal women enrolled in the Buffalo Osteoporosis and Periodontal Disease (OsteoPerio) study, an ancillary study of the Women's Health Initiative-Observational Study. RESULTS Clinical attachment level (CAL) and number of teeth missing were positively associated with SBP among those not taking antihypertensive medication in crude and multivariable adjusted linear regression models (both P < 0.05). Alveolar crestal height (ACH) and gingival bleeding on probing were associated with higher SBP in crude but not multivariable adjusted models. Neither probing pocket depth (PPD) nor severity categories of periodontitis were associated with SBP. Number of teeth missing was significantly associated with prevalent hypertension in crude and multivariable adjusted models (OR = 1.14, per 5 teeth; P = 0.04). ACH was associated with prevalent hypertension in crude but not adjusted models. CAL, PPD, gingival bleeding, and severity of periodontitis were not significantly associated with prevalent hypertension. CONCLUSIONS These results suggest that measures of oral health including CAL and number of teeth missing are associated with blood pressure in postmenopausal women. Prospective studies are needed to further investigate these associations and the potential underlying mechanisms for these relationships.
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Affiliation(s)
- Joshua H Gordon
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY
| | - Michael J LaMonte
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY
| | - Robert J Genco
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, State University of New York, Buffalo, NY.,Department of Microbiology and Immunology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
| | - Jiwei Zhao
- Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY
| | - Thomas R Cimato
- Department of Medicine/Division of Cardiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
| | - Kathleen M Hovey
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY
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215
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Zhu D, Li X, Macrae VE, Simoncini T, Fu X. Extragonadal Effects of Follicle-Stimulating Hormone on Osteoporosis and Cardiovascular Disease in Women during Menopausal Transition. Trends Endocrinol Metab 2018; 29:571-580. [PMID: 29983231 DOI: 10.1016/j.tem.2018.06.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 06/03/2018] [Accepted: 06/05/2018] [Indexed: 01/16/2023]
Abstract
The risk of osteoporosis and cardiovascular disease increases significantly in postmenopausal women. Until recently, the underlying mechanisms have been primarily attributed to estrogen decline following menopause. However, follicle-stimulating hormone (FSH) levels rise sharply during menopausal transition and are maintained at elevated levels for many years. FSH receptor has been detected in various extragonadal sites, including osteoclasts and endothelial cells. Recent advances suggest FSH may contribute to postmenopausal osteoporosis and cardiovascular disease. Here, we review the key actions through which FSH contributes to the risk of osteoporosis and cardiovascular disease in women as they transition through menopause. Advancing our understanding of the precise mechanisms through which FSH promotes osteoporosis and cardiovascular disease may provide new opportunities for improving health-span for postmenopausal women.
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Affiliation(s)
- Dongxing Zhu
- Guangzhou Institute of Cardiovascular Diseases, The Second Affiliated Hospital; Key Laboratory of Cardiovascular Diseases, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou 511436, China
| | - Xiaosa Li
- Guangzhou Institute of Cardiovascular Diseases, The Second Affiliated Hospital; Key Laboratory of Cardiovascular Diseases, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou 511436, China
| | - Vicky E Macrae
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian EH25 9RG, UK.
| | - Tommaso Simoncini
- Molecular and Cellular Gynecological Endocrinology Laboratory (MCGEL), Department of Reproductive Medicine and Child Development, University of Pisa, Pisa 56100, Italy.
| | - Xiaodong Fu
- Guangzhou Institute of Cardiovascular Diseases, The Second Affiliated Hospital; Key Laboratory of Cardiovascular Diseases, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou 511436, China.
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216
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Park EJ, Lee HS, Lee SH, Shim KW, Cho C, Yoo BW. The level of vitamin D using the LC-MS/MS method and related factors in healthy Korean postmenopausal women. J Obstet Gynaecol Res 2018; 44:1977-1984. [PMID: 30015370 DOI: 10.1111/jog.13745] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 06/17/2018] [Indexed: 12/30/2022]
Abstract
AIM The main purposes of the study were (i) to evaluate serum vitamin D concentration in the forms of 25(OH)D2 , 25(OH)D3 and total 25(OH)D in Korean postmenopausal women using the LC-MS/MS method, which offers increased sensitivity and selectivity; (ii) to determine the relationship between the bone turnover marker, parathyroid hormone (PTH) and 25(OH)D3 , total 25(OH)D separately; and (iii) to determine the factors that may be associated with vitamin D deficiency using body composition analysis and laboratory blood tests. METHOD A total of 200 postmenopausal women were recruited from November 2012 to March 2014. To control for seasonal ultraviolet exposure time differences in serum 25(OH)D, laboratory tests were performed only from November to March when vitamin D is not synthesized. Independent relationships between 25(OH)D3 , total 25(OH)D and other variables were assessed by multiple regression analysis. RESULTS The mean serum 25(OH)D2 , 25(OH)D3 and total 25(OH)D levels were 0.51 (±0.44) ng/mL, 14.23 (±7.05) ng/mL and 14.69 (±7.13) ng/mL, respectively. Both 25(OH)D3 and total 25(OH)D were positively correlated with erythrocyte sedimentation rate (ESR), Apo A-I and C-terminal cross-linked telopeptides of type I collagen in Korean postmenopausal women. Both serum 25(OH)D3 and total 25(OH)D were negatively correlated with alkaline phosphatase , PTH and percent body fat. However, osteocalcin showed a negative correlation (r = -0.451; P = 0.041) with only 25(OH)D3 and not with total 25(OH)D (r = -0.417; P = 0.064). CONCLUSION Both 25(OH)D3 and total 25(OH)D were negatively correlated with PTH, a bone formation marker (alkaline phosphatase) and percent body fat. Both 25(OH)D3 and total 25(OH)D were positively correlated with a bone resorption marker (C-terminal cross-linked telopeptides of type I collagen), ESR and Apo A-I after multiple regression analysis.
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Affiliation(s)
- Eun Jung Park
- Department of Family Medicine, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, South Korea
| | - Hong Soo Lee
- Department of Family Medicine, Ewha Womans University College of Medicine, Mokdong Hospital, Seoul, South Korea
| | - Sang Hwa Lee
- Department of Family Medicine, Ewha Womans University College of Medicine, Mokdong Hospital, Seoul, South Korea
| | - Kyung Won Shim
- Department of Family Medicine, Ewha Womans University College of Medicine, Mokdong Hospital, Seoul, South Korea
| | - Chooyon Cho
- Department of Family Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, South Korea
| | - Byung-Wook Yoo
- Department of Family Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, South Korea
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217
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Yang L, Lin L, Kartsonaki C, Guo Y, Chen Y, Bian Z, Xie K, Jin D, Li L, Lv J, Chen Z. Menopause Characteristics, Total Reproductive Years, and Risk of Cardiovascular Disease Among Chinese Women. Circ Cardiovasc Qual Outcomes 2018; 10:CIRCOUTCOMES.117.004235. [PMID: 29117982 PMCID: PMC5704734 DOI: 10.1161/circoutcomes.117.004235] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Accepted: 10/17/2017] [Indexed: 12/26/2022]
Abstract
Supplemental Digital Content is available in the text. Background— Previous studies, mostly of Western women, have reported inconsistent findings on the association of menopause characteristics (status, age, and time since menopause) and total reproductive years with risk of cardiovascular disease (CVD). Methods and Results— The China Kadoorie Biobank recruited 302 632 women in 2004 to 2008 from 10 regions across China. During 9-year follow-up, 19 393 incident cases of stroke, 18 611 of ischemic heart disease, and 4978 CVD deaths occurred. Cox regression yielded adjusted hazard ratios relating each menopause characteristic and total reproductive years to CVD risk. Among 274 233 women with no prior CVD at baseline, 134 010 were naturally postmenopausal women (mean [SD] age at menopause of 48.6 [4.0] years and total reproductive years 32.7 [4.4]). Compared with premenopausal women, naturally peri- or postmenopausal women were at a higher risk of either fatal or nonfatal CVD. Among women who had had menopause, inverse associations were observed between age at menopause and risks of CVD mortality, incident ischemic heart disease, stroke, and subtypes of stroke, with 1.5% higher risk of CVD death (P<0.001), 0.7% for incident ischemic heart disease (P=0.002), and 0.5% for incident stroke (P=0.02) for every 1 year lower age at menopause. Compared with women who had menopause at age 48 to 50 years, lower age at menopause (ie, <43 years) was associated with 14% higher risk of CVD death and 6% higher risks of both incident ischemic heart disease and stroke. Higher risks of both fatal and nonfatal CVD were also found in women with 5 to 10, 10 to 15, 15 to 20, or >20 years since menopause compared with <5 years since menopause. Total reproductive years were inversely associated with risks of both fatal and nonfatal CVD, with 1.4% lower risk of CVD death per additional reproductive year (P<0.001). Conclusions— Women with younger age at menopause, longer time since menopause, or fewer total reproductive years had a higher risk of CVD.
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Affiliation(s)
- Ling Yang
- From the Medical Research Council Population Health Research Unit (L.Y., C.K., Y.C.) and Clinical Trial Service Unit and Epidemiological Studies Unit (L.Y., C.K., Y.C., Z.C.), University of Oxford, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China (L. Lin, L. Li, J.L.); Chinese Academy of Medical Sciences, Beijing (Y.G., Z.B.); NCDs Prevention and Control Department, Tongxiang CDC, China (K.X.); and NCDs Prevention and Control Department, Hunan CDC, Changsha, China (D.J.).
| | - Liling Lin
- From the Medical Research Council Population Health Research Unit (L.Y., C.K., Y.C.) and Clinical Trial Service Unit and Epidemiological Studies Unit (L.Y., C.K., Y.C., Z.C.), University of Oxford, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China (L. Lin, L. Li, J.L.); Chinese Academy of Medical Sciences, Beijing (Y.G., Z.B.); NCDs Prevention and Control Department, Tongxiang CDC, China (K.X.); and NCDs Prevention and Control Department, Hunan CDC, Changsha, China (D.J.)
| | - Christiana Kartsonaki
- From the Medical Research Council Population Health Research Unit (L.Y., C.K., Y.C.) and Clinical Trial Service Unit and Epidemiological Studies Unit (L.Y., C.K., Y.C., Z.C.), University of Oxford, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China (L. Lin, L. Li, J.L.); Chinese Academy of Medical Sciences, Beijing (Y.G., Z.B.); NCDs Prevention and Control Department, Tongxiang CDC, China (K.X.); and NCDs Prevention and Control Department, Hunan CDC, Changsha, China (D.J.)
| | - Yu Guo
- From the Medical Research Council Population Health Research Unit (L.Y., C.K., Y.C.) and Clinical Trial Service Unit and Epidemiological Studies Unit (L.Y., C.K., Y.C., Z.C.), University of Oxford, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China (L. Lin, L. Li, J.L.); Chinese Academy of Medical Sciences, Beijing (Y.G., Z.B.); NCDs Prevention and Control Department, Tongxiang CDC, China (K.X.); and NCDs Prevention and Control Department, Hunan CDC, Changsha, China (D.J.)
| | - Yiping Chen
- From the Medical Research Council Population Health Research Unit (L.Y., C.K., Y.C.) and Clinical Trial Service Unit and Epidemiological Studies Unit (L.Y., C.K., Y.C., Z.C.), University of Oxford, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China (L. Lin, L. Li, J.L.); Chinese Academy of Medical Sciences, Beijing (Y.G., Z.B.); NCDs Prevention and Control Department, Tongxiang CDC, China (K.X.); and NCDs Prevention and Control Department, Hunan CDC, Changsha, China (D.J.)
| | - Zheng Bian
- From the Medical Research Council Population Health Research Unit (L.Y., C.K., Y.C.) and Clinical Trial Service Unit and Epidemiological Studies Unit (L.Y., C.K., Y.C., Z.C.), University of Oxford, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China (L. Lin, L. Li, J.L.); Chinese Academy of Medical Sciences, Beijing (Y.G., Z.B.); NCDs Prevention and Control Department, Tongxiang CDC, China (K.X.); and NCDs Prevention and Control Department, Hunan CDC, Changsha, China (D.J.)
| | - Kaixu Xie
- From the Medical Research Council Population Health Research Unit (L.Y., C.K., Y.C.) and Clinical Trial Service Unit and Epidemiological Studies Unit (L.Y., C.K., Y.C., Z.C.), University of Oxford, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China (L. Lin, L. Li, J.L.); Chinese Academy of Medical Sciences, Beijing (Y.G., Z.B.); NCDs Prevention and Control Department, Tongxiang CDC, China (K.X.); and NCDs Prevention and Control Department, Hunan CDC, Changsha, China (D.J.)
| | - Donghui Jin
- From the Medical Research Council Population Health Research Unit (L.Y., C.K., Y.C.) and Clinical Trial Service Unit and Epidemiological Studies Unit (L.Y., C.K., Y.C., Z.C.), University of Oxford, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China (L. Lin, L. Li, J.L.); Chinese Academy of Medical Sciences, Beijing (Y.G., Z.B.); NCDs Prevention and Control Department, Tongxiang CDC, China (K.X.); and NCDs Prevention and Control Department, Hunan CDC, Changsha, China (D.J.)
| | - Liming Li
- From the Medical Research Council Population Health Research Unit (L.Y., C.K., Y.C.) and Clinical Trial Service Unit and Epidemiological Studies Unit (L.Y., C.K., Y.C., Z.C.), University of Oxford, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China (L. Lin, L. Li, J.L.); Chinese Academy of Medical Sciences, Beijing (Y.G., Z.B.); NCDs Prevention and Control Department, Tongxiang CDC, China (K.X.); and NCDs Prevention and Control Department, Hunan CDC, Changsha, China (D.J.)
| | - Jun Lv
- From the Medical Research Council Population Health Research Unit (L.Y., C.K., Y.C.) and Clinical Trial Service Unit and Epidemiological Studies Unit (L.Y., C.K., Y.C., Z.C.), University of Oxford, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China (L. Lin, L. Li, J.L.); Chinese Academy of Medical Sciences, Beijing (Y.G., Z.B.); NCDs Prevention and Control Department, Tongxiang CDC, China (K.X.); and NCDs Prevention and Control Department, Hunan CDC, Changsha, China (D.J.)
| | - Zhengming Chen
- From the Medical Research Council Population Health Research Unit (L.Y., C.K., Y.C.) and Clinical Trial Service Unit and Epidemiological Studies Unit (L.Y., C.K., Y.C., Z.C.), University of Oxford, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China (L. Lin, L. Li, J.L.); Chinese Academy of Medical Sciences, Beijing (Y.G., Z.B.); NCDs Prevention and Control Department, Tongxiang CDC, China (K.X.); and NCDs Prevention and Control Department, Hunan CDC, Changsha, China (D.J.)
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Hwu CM, Liou HH, Lee CJ, Hsu BG. A positive association between interleukin-1 receptor antagonist and insulin resistance in postmenopausal women. Gynecol Endocrinol 2018; 34:574-578. [PMID: 29345164 DOI: 10.1080/09513590.2018.1427225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE The purpose of this study was to determine whether higher circulating interleukin-1 receptor antagonist (IL-1Ra), an anti-inflammatory cytokine, was associated with insulin resistance in postmenopausal women. METHODS We measured IL-1Ra concentrations in 160 naturally postmenopausal women without a history of diabetes mellitus. A Pearson coefficient was computed to assess the relationship between plasma IL-1Ra and homeostasis model assessment of insulin resistance (HOMA-IR). The association between HOMA-IR and IL-1Ra plasma level above the median was assessed by logistic regression. Linear regression was used to explore the determinants of IL-1Ra plasma levels. RESULTS A significant positive correlation existed between IL-1Ra and HOMA-IR (r = 0.42, p < .0001). The upper-tertile group of HOMA-IR was associated with approximately 4.5-fold increased risk of plasma IL-1Ra level above the median compared with the low-tertile group after adjustments. When multiple correlates were entered into the regression model simultaneously, only Log HOMA-IR remained significantly related to Log IL-1Ra (p = .007). CONCLUSIONS Our results demonstrated a positive association between plasma IL-1Ra and insulin resistance in postmenopausal women. This analysis suggested that insulin resistance was an important determinant of circulating IL-1Ra for these women.
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Affiliation(s)
- Chii-Min Hwu
- a Department of Medicine, Section of Endocrinology and Metabolism , Taipei Veterans General Hospital , Taipei , Taiwan
- b Faculty of Medicine , National Yang-Ming University School of Medicine , Taipei , Taiwan
| | - Hung-Hsiang Liou
- c Department of Internal Medicine, Division of Nephrology , Hsin-Jen Hospital , New Taipei City , Taiwan
| | - Chung-Jen Lee
- d Department of Nursing , Tzu-Chi University of Science and Technology , Hualien , Taiwan
| | - Bang-Gee Hsu
- e Department of Medicine, Division of Nephrology , Buddhist Tzu Chi General Hospital , Hualien , Taiwan
- f Faculty of Medicine, School of Medicine , Tzu Chi University , Hualien , Taiwan
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Sato N, Masuda N, Morimoto T, Ueno T, Kanbayashi C, Kaneko K, Yasojima H, Saji S, Sasano H, Morita S, Ohno S, Toi M. Neoadjuvant endocrine therapy with exemestane followed by response-guided combination therapy with low-dose cyclophosphamide in postmenopausal patients with estrogen receptor-positive breast cancer: A multicenter, open-label, phase II study. Cancer Med 2018; 7:3044-3056. [PMID: 29905023 PMCID: PMC6051169 DOI: 10.1002/cam4.1600] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 05/08/2018] [Accepted: 05/12/2018] [Indexed: 01/28/2023] Open
Abstract
Patients with estrogen receptor (ER)‐positive breast cancer are less likely to achieve a pathological complete response (pCR) with neoadjuvant chemotherapy. Neoadjuvant endocrine therapy may be more appropriate than neoadjuvant chemotherapy in these hormone‐sensitive patients. Most patients with ER‐positive breast cancer are postmenopausal, and therefore, generally older and less able to tolerate chemotherapy. We aimed to investigate the efficacy and safety of tailored neoadjuvant endocrine and chemoendocrine therapy for postmenopausal breast cancer patients. Untreated patients with primary invasive ER‐positive, HER2‐negative, stage I‐IIIA breast cancer, and Ki67 index ≤30% were enrolled. Patients received exemestane 25 mg/d for 12 weeks. Based on clinical response and change in Ki67 index, assessed at 8‐12 weeks, patients with complete response (CR), partial response (PR) with Ki67 index ≤5% after treatment, or stable disease (SD) with Ki67 index ≤5% before and after treatment were defined as responders. For the subsequent 24 weeks, responders continued exemestane monotherapy (group A), and nonresponders received exemestane 25 mg/d plus cyclophosphamide 50 mg/d (group B). The primary endpoint was clinical response at weeks 24 and 36. A total of 59 patients (median age, 69 years) started initial exemestane monotherapy. After exclusion of three patients who discontinued during this period, 56 remained enrolled to receive subsequent treatment. Clinical response rates (CR and PR) and 95% CI at weeks 24 and 36 were 85% (12/14; 57.2%‐98.2%) and 71% (10/14; 41.9%‐91.6%), respectively, in group A; and 54% (23/42; 38.7%‐70.2%) and 71% (30/42; 55.4%‐84.3%), respectively, in group B. At week 36, no significant difference was found in median Ki67 index between the groups (3.5% and 4.0%). There were no treatment‐related deaths. We found that clinical response comparable to that of responders was achieved in nonresponders after addition of cyclophosphamide to the initial endocrine therapy.
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Affiliation(s)
- Nobuaki Sato
- Department of Breast Oncology, Niigata Cancer Center Hospital, Niigata, Japan
| | - Norikazu Masuda
- Department of Surgery, Breast Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Takashi Morimoto
- Department of Breast Surgery, Yao Municipal Hospital, Osaka, Japan
| | - Takayuki Ueno
- Breast Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital, Tokyo, Japan
| | - Chizuko Kanbayashi
- Department of Breast Oncology, Niigata Cancer Center Hospital, Niigata, Japan
| | - Koji Kaneko
- Department of Breast Oncology, Niigata Cancer Center Hospital, Niigata, Japan
| | - Hiroyuki Yasojima
- Department of Surgery, Breast Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Shigehira Saji
- Department of Medical Oncology, Fukushima Medical University, Fukushima, Japan
| | | | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shinji Ohno
- Breast Oncology Center, Cancer Institute Hospital, Tokyo, Japan
| | - Masakazu Toi
- Department of Surgery (Breast Surgery), Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Gittens P, Mullen G. The effects of fractional microablative CO 2 laser therapy on sexual function in postmenopausal women and women with a history of breast cancer treated with endocrine therapy. J COSMET LASER THER 2018; 21:127-131. [PMID: 29883233 DOI: 10.1080/14764172.2018.1481510] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE To examine the outcomes of sexual function in postmenopausal women and women with a history of breast cancer treated with endocrine therapy who were experiencing the symptoms of GSM for which they were treated with fractional microablative CO2 laser. MATERIALS AND METHODS From July 2015 to October 2016, a retrospective chart review of women who underwent fractional microablative CO2 laser therapy (MonaLisa Touch, DEKA) for GSM was conducted. Several validated questionnaires were used to assess changes in symptoms and sexual function including the Female Sexual Function Index (FSFI), the Wong-Baker Faces Scale (WBFS), and the Female Sexual Distress Scale-Revised (FSDSR). Comparisons of mean symptom scores were described at baseline and six weeks after each treatment. RESULTS There was a statistically significant improvement in every domain of FSFI, WBFS, and FSDS-R when comparing baseline symptom scores to after treatment three symptom scores for all patients. The secondary outcome was to evaluate the differences, if any, in outcomes of sexual function between postmenopausal women and women with a history of breast cancer treated with endocrine therapy. Both groups had statistically significant improvements in many domains studied. CONCLUSIONS Fractional microablative CO2 laser therapy (MonaLisa Touch, DEKA) is an effective modality in treating the symptoms of GSM in postmenopausal women and women with a history of breast cancer treated with endocrine therapy.
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Affiliation(s)
- Paul Gittens
- a Philadelphia Center for Sexual Medicine , Philadelphia, PA , USA
| | - Gregory Mullen
- b Drexel University College of Medicine , Philadelphia, PA , USA
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Abstract
Progesterone is a neurosteroid and a neuroactive steroid, produced primarily by the corpus luteum and the placenta. In some animal models, progesterone affects cognitive performance, and its potential role in human cognition is especially germane to women. This role can be investigated through associations between peripheral concentrations of progesterone in blood or saliva and neuropsychological test results, through differences in cognitive profiles between women using menopausal hormone therapy with and without a progestogen, and through clinical trials. In naturally cycling reproductive-age women and pregnant women, there is no consistent relation between progesterone levels and cognition. In postmenopausal women within 6 years of menopause and not using hormone therapy, progesterone levels are positively associated with verbal memory and global cognition, but reported associations in older postmenopausal women are null. Some observational studies of postmenopausal women using hormone therapy raise concern of a small deleterious cognitive effect of progestogen (medroxyprogesterone acetate was most often reported in these studies), but this association may due to confounding factors. Small, short-term clinical trials of progesterone show no meaningful effect on cognition. The quality of evidence is low, but overall findings do not reveal consistent, clinically important effects of progesterone on cognitive function in women.
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Affiliation(s)
- V W Henderson
- a Departments of Health Research & Policy (Epidemiology) and of Neurology & Neurological Sciences , Stanford University , Stanford , CA , USA
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Carranza-Lira S, Núñez FDC. Sexual dysfunction prevalence in a group of pre- and postmenopausal Mexican women. Prz Menopauzalny 2018; 17:39-42. [PMID: 29725284 DOI: 10.5114/pm.2018.74901] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 01/24/2018] [Indexed: 12/04/2022]
Abstract
Introduction To determine the prevalence of sexual dysfunction in pre and postmenopausal women. Material and methods A cross-sectional, descriptive, comparative study was done in climacteric women from 40 to 59 years of age. Female sexual function was evaluated with the female sexual function index (FSFI) on the day of consultation. The comparison between pre and postmenopausal women and between those with or without sexual dysfunction was done with Mann Whitney U test, χ2, and Spearman’s correlation analysis was done. Results One hundred and ten women were studied, 55 were premenopausal (group 1) and 55 postmenopausal (group 2). The median of age in group 1 was 46 (40-58) years and in group 2 it was 53 (45-60) years. Premenopausal women had higher education level than postmenopausal women (p < 0.023). From those sexually active, 62.1% had sexual dysfunction. No statistically significant difference was found in education level, religion and marital status between women with or without sexual dysfunction. No difference in sexual dysfunction was found between premenopausal (62.1%) and postmenopausal (62.5%) women, but greater sexual dysfunction was found starting from 50 years age. Age negatively correlated with FSFI score (ρ = –0.324, p < 0.001). Conclusion In postmenopausal women, those older had a greater impairment in sexual function.
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Abstract
PURPOSE Metabolic changes due to menopause may alter urine composition and kidney stone risk but results of prior work on this association have been mixed. We examined menopause and the risk of incident kidney stones, and changes in 24-hour urine composition in the NHS (Nurses' Health Study) II. MATERIALS AND METHODS Using multivariate adjusted Cox proportional hazards models we prospectively analyzed 108,639 NHS II participants who provided information on menopause and kidney stones. We also analyzed 24-hour urine collections from 658 participants who performed a collection while premenopausal and a repeat collection after menopause. RESULTS During 22 years of followup there were 3,456 incident kidney stones. The multivariate adjusted relative risk of an incident kidney stone in postmenopausal participants compared with premenopause was 1.27 (95% CI 1.08-1.46). On stratified analysis compared with premenopause the multivariate adjusted relative risk of natural and surgically induced menopause was 1.27 (95% CI 1.09-1.48) and 1.43 (95% CI 1.19-1.73), respectively. Among the 74,505 postmenopausal participants there was a total of 1,041 incident stone events. Compared with no hormone therapy neither current nor past use was significantly associated with kidney stone risk. Compared with premenopause the postmenopausal urine collections had lower mean calcium, citrate, phosphorus and uric acid, and higher mean volume. CONCLUSIONS Postmenopausal status is associated with a higher risk of incident kidney stones. Natural menopause and surgical menopause are independently associated with higher risk. There are small but significant differences in urine composition between premenopausal and postmenopausal urine collections.
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224
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Harrington LB, Blondon M, Cushman M, Kaunitz AM, Allison MA, Wang L, Sullivan S, Woods NF, LaCroix AZ, Heckbert SR, McKnight B, Rossouw J, Smith NL. Vasomotor symptoms and the risk of incident venous thrombosis in postmenopausal women. J Thromb Haemost 2018; 16:886-892. [PMID: 29504242 PMCID: PMC5932241 DOI: 10.1111/jth.13993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Indexed: 11/30/2022]
Abstract
Essentials Vasomotor symptoms have been proposed as markers of changing cardiovascular risk. In this cohort study, we evaluated these symptoms as markers of venous thrombosis (VT) risk. We found no evidence that vasomotor symptom presence or severity were associated with VT risk. Among these postmenopausal women, vasomotor symptoms are not a useful marker of VT risk. SUMMARY Background Vasomotor symptoms may be markers of changes in cardiovascular risk, but it is unknown whether these symptoms are associated with the risk of venous thrombosis (VT). Objective To evaluate the association of vasomotor symptom presence and severity with incident VT risk among postmenopausal women, independent of potential explanatory variables. Methods This cohort study included participants of the Women's Health Initiative (WHI) Hormone Therapy Trials (n = 24 508) and Observational Study (n = 87 783), analyzed separately. At baseline, women reported whether hot flashes or night sweats were present and, if so, their severity. Using Cox proportional hazards models, we estimated the VT risk associated with vasomotor symptom presence and severity, adjusted for potential explanatory variables: age, body mass index, smoking status, race/ethnicity, and time-varying current hormone therapy use. Results At baseline, WHI Hormone Therapy Trial participants were aged 64 years and WHI Observational Study participants were aged 63 years, on average. In the WHI Hormone Therapy Trials over a median of 8.2 years of follow-up, 522 women experienced a VT event. In the WHI Observational Study, over 7.9 years of follow-up, 1103 women experienced a VT event. In adjusted analyses, we found no evidence of an association between vasomotor symptom presence (hazard ratio [HR]adj 0.91, 95% confidence interval [CI] 0.75-1.1 in the WHI Hormone Therapy Trials; HRadj 1.1, 95% CI 0.99-1.3 in the WHI Observational Study) or severity (HRadj for severe versus mild 0.99, 95% CI 0.53-1.9 in the WHI Hormone Therapy Trials; HRadj 1.3, 95% CI 0.89-2.0) in the WHI Observational Study) and the risk of incident VT. Conclusions Although vasomotor symptoms have been associated with the risk of other cardiovascular events in published studies, our findings do not suggest that vasomotor symptoms constitute a marker of VT risk.
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Affiliation(s)
- L B Harrington
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - M Blondon
- Division of Angiology and Hemostasis, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - M Cushman
- Department of Medicine, University of Vermont, Burlington, VT, USA
| | - A M Kaunitz
- Department of Obstetrics and Gynecology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, USA
| | - M A Allison
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
| | - L Wang
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - S Sullivan
- Department of Endocrinology, Medstar Georgetown University Hospital and Medstar Washington Hospital Center, Washington, DC, USA
| | - N F Woods
- School of Nursing, University of Washington, Seattle, WA, USA
| | - A Z LaCroix
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
| | - S R Heckbert
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - B McKnight
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - J Rossouw
- National Heart Lung and Blood Institute, Bethesda, MD, USA
| | - N L Smith
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Group Health Research Institute, Group Health Cooperative, Seattle, WA, USA
- Department of Veterans Affairs Office of Research and Development, Seattle Epidemiologic Research and Information Center, Seattle, WA, USA
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225
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Yang L, Yang M. Early initiation of zoledronic acid does not impact bone healing or clinical outcomes of hallux valgus orthomorphia. J Int Med Res 2018; 46:3251-3261. [PMID: 29658353 PMCID: PMC6134676 DOI: 10.1177/0300060518760128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective This prospective randomized controlled study was performed to determine whether early drug use for osteoporosis impacts bone healing after orthomorphic surgery for hallux valgus (HV) in menopausal patients with osteoporosis. Methods This study included 113 consecutive patients with osteoporosis who underwent a combination of Lapidus arthrodesis and Akin osteotomy for treatment of HV. The patients were randomly divided into a zoledronic acid (ZOL) group (5-mg intravenous injection of ZOL, n = 56) and a placebo group (n = 57); both ZOL and placebo were administered 1 week postoperatively. Radiographs were taken preoperatively and at 1, 6, 8, 10, and 12 weeks postoperatively to record the time of the first tarsometatarsal joint (FTJ) fusion and Akin osteotomy site healing. Clinical outcomes were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) scoring system 24 weeks after surgery. Results There were no statistically significant differences in the FTJ fusion time after Lapidus arthrodesis, healing time after Akin osteotomy, or postoperative AOFAS scores between the two groups. Conclusion Early initiation of ZOL does not impact the bone healing or clinical outcomes of orthomorphic surgery for HV in postmenopausal women diagnosed with osteoporosis after a combination of Lapidus arthrodesis and Akin osteotomy.
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Affiliation(s)
- Lei Yang
- 1 Department of Orthopedics, the First Hospital of China Medical University, Liaoning, China.,2 Department of Orthopedics, Shenjing Hospital of China Medical University, Shenyang, China
| | - Maowei Yang
- 1 Department of Orthopedics, the First Hospital of China Medical University, Liaoning, China
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Al-Ahmad BEM, Kashmoola MA, Mustafa NS, Hassan H, Arzmi MH. The relationship between tooth loss, body mass index, and hypertension in postmenopausal female. Eur J Dent 2018; 12:120-122. [PMID: 29657536 PMCID: PMC5883463 DOI: 10.4103/ejd.ejd_322_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective This study aimed to investigate the relationship between tooth loss and the level of blood pressure with the hypothesis that tooth loss is associated with the increase of hypertension in postmenopausal women. Materials and Methods Sixty postmenopausal female patients aged 51-68 years were included in the study to assess the relationship between tooth loss and the level of blood pressure. The information including sociodemographics, last menstruation period, hypertension history, and the duration of having tooth loss was recorded. Blood pressure was measured using sphygmomanometer and the number of tooth loss was determined. Results The results showed a more significant tooth loss in hypertension (median: 23 + 4; interquartile range [IQR]: 6) compared to the normotension postmenopausal women (median: 18 + 6; IQR: 12; P < 0.05). Furthermore, obese patients had more tooth loss (median: 23 + 5; IQR: 8) than the overweight patients (median: 19 + 8; IQR: 8). Conclusion Tooth loss is associated with the increase of hypertension in postmenopausal women which may have a role in the development of vascular diseases.
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Affiliation(s)
- Basma Ezzat Mustafa Al-Ahmad
- Department of Fundamental Basic Dental Sciences, Kulliyyah of Dentistry, International Islamic University Malaysia, Selangor, Malaysia
| | - Muhannad Ali Kashmoola
- Department of Oral Maxillofacial Surgery and Oral Diagnosis, Kulliyyah of Dentistry, International Islamic University Malaysia, Selangor, Malaysia
| | - Nazih Shaaban Mustafa
- Department of Oral Maxillofacial Surgery and Oral Diagnosis, Kulliyyah of Dentistry, International Islamic University Malaysia, Selangor, Malaysia
| | - Haszelini Hassan
- Department of Oral Maxillofacial Surgery and Oral Diagnosis, Kulliyyah of Dentistry, International Islamic University Malaysia, Selangor, Malaysia
| | - Mohd Hafiz Arzmi
- Department of Fundamental Basic Dental Sciences, Kulliyyah of Dentistry, International Islamic University Malaysia, Selangor, Malaysia
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Grochans E, Szkup M, Kotwas A, Kopeć J, Karakiewicz B, Jurczak A. Analysis of Sociodemographic, Psychological, and Genetic Factors Contributing to Depressive symptoms in Pre-, Peri- and Postmenopausal Women. Int J Environ Res Public Health 2018; 15:ijerph15040712. [PMID: 29642625 PMCID: PMC5923754 DOI: 10.3390/ijerph15040712] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 04/05/2018] [Accepted: 04/07/2018] [Indexed: 12/13/2022]
Abstract
Depressive symptoms that are faced by women in the pre-, peri-, and postmenopausal periods are determined by a wide array of sociodemographic, psychological, and biological variables. The aim of our study was to identify factors that contribute to depressive problems at this stage of life. The study included 815 healthy Polish women aged 45–60 years. The survey part was conducted using the Beck Depression Inventory (BDI), the State–Trait Anxiety Inventory (STAI), the Neuroticism–Extroversion–Openness Five Factor Inventory (NEO-FFI), and a self-developed questionnaire. Genetic analysis was also performed. Depressive symptoms were observed in 25.5% of participants. 70% of the women were postmenopausal. No statistically significant differences in the severity of depressive symptoms were demonstrated with regard to genetic variables (p > 0.05). Reproductive capacity (p < 0.001), employment (p < 0.001), and being married (p < 0.018) were found to reduce the incidence of depressive symptoms. The contribution of personality and anxiety as a trait to depressive symptoms varied. Conclusions: The factors predisposing pre-, peri-, and postmenopausal women to depressive symptoms include lower education, lack of a life partner, unemployment, high anxiety, and neurotic personality. No evidence was found for the contribution of genetic factors to depressive symptoms in the examined women.
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Affiliation(s)
- Elżbieta Grochans
- Department of Nursing, Pomeranian Medical University in Szczecin, ul. Żołnierska 48, 71-210 Szczecin, Poland.
| | - Małgorzata Szkup
- Department of Nursing, Pomeranian Medical University in Szczecin, ul. Żołnierska 48, 71-210 Szczecin, Poland.
| | - Artur Kotwas
- Department of Public Health, Pomeranian Medical University in Szczecin, ul. Żołnierska 48, 71-210 Szczecin, Poland.
| | - Jacek Kopeć
- Faculty of Medicine, School of Population and Public Health, The University of British Columbia, 2206 East Mall Vancouver, BC V6T 1Z3, Canada.
| | - Beata Karakiewicz
- Department of Public Health, Pomeranian Medical University in Szczecin, ul. Żołnierska 48, 71-210 Szczecin, Poland.
| | - Anna Jurczak
- Department of Clinical Nursing, Pomeranian Medical University in Szczecin, ul. Żołnierska 48, 71-210 Szczecin, Poland.
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Carranza-Lira S, Cruz-Ramírez ME, Sulvarán-Victoria D. Changes in microscopic analysis of the urinary sediment in postmenopausal women who receive vaginal conjugated oestrogens. Prz Menopauzalny 2017; 16:96-8. [PMID: 29507575 DOI: 10.5114/pm.2017.70585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 07/11/2017] [Indexed: 11/29/2022]
Abstract
Introduction Microscopic haematuria is common in adults and it has been reported in 13% of postmenopausal women. Objective To evaluate the changes in urinary sediment after the use of vaginal conjugated oestrogens. Material and methods Postmenopausal women with vaginal dryness were studied. In all them a urinalysis was done, looking for density, pH, and the presence of leukocytes and erythrocytes. In order to be included in the study, all of the women had to have microscopic haematuria, considered as the presence of 3 or more erythrocytes in the urinary sediment. All received vaginally 1 g of conjugated equine oestrogens cream 3 times per week for one month, moment in which a new urinalysis was carried out and the same parameters were evaluated. Results Twenty-four women were studied. The median age was 62 years (40-83), and the time since menopause was 144 months (24-336). When comparing the values between baseline and end of treatment urinalyses, no significant differences in pH and urinary density were found. The number of leukocytes significantly decreased after treatment (3.0 [1-6] vs. 1.0 [1-6], p < 0.026), and the erythrocytes number decreased (4.5 [3-12] vs. 0.0 [0-2], p < 0.001). Conclusion In postmenopausal women with microscopic haematuria and vaginal dryness, it is worth considering administration of local oestrogen for one month, and after repeat the urine exam, before deciding to begin the microscopic haematuria study protocol.
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Affiliation(s)
- Stacie L Demel
- From the Department of Neurology and Ophthalmology and Department of Pharmacology and Toxicology, Michigan State University, East Lansing (S.L.D.); Baltimore Veterans Administration Medical Center and Department of Neurology, University of Maryland School of Medicine (S.K.); Channing Division of Network Medicine and Division of Women's Health (K.M.R.), Department of Medicine, Brigham and Women's Hospital, Boston, MA (S.H.L.); Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA (S.H.L.); and University of Michigan Stroke Program, Ann Arbor (M.M.)
| | - Steven Kittner
- From the Department of Neurology and Ophthalmology and Department of Pharmacology and Toxicology, Michigan State University, East Lansing (S.L.D.); Baltimore Veterans Administration Medical Center and Department of Neurology, University of Maryland School of Medicine (S.K.); Channing Division of Network Medicine and Division of Women's Health (K.M.R.), Department of Medicine, Brigham and Women's Hospital, Boston, MA (S.H.L.); Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA (S.H.L.); and University of Michigan Stroke Program, Ann Arbor (M.M.)
| | - Sylvia H Ley
- From the Department of Neurology and Ophthalmology and Department of Pharmacology and Toxicology, Michigan State University, East Lansing (S.L.D.); Baltimore Veterans Administration Medical Center and Department of Neurology, University of Maryland School of Medicine (S.K.); Channing Division of Network Medicine and Division of Women's Health (K.M.R.), Department of Medicine, Brigham and Women's Hospital, Boston, MA (S.H.L.); Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA (S.H.L.); and University of Michigan Stroke Program, Ann Arbor (M.M.)
| | - Mollie McDermott
- From the Department of Neurology and Ophthalmology and Department of Pharmacology and Toxicology, Michigan State University, East Lansing (S.L.D.); Baltimore Veterans Administration Medical Center and Department of Neurology, University of Maryland School of Medicine (S.K.); Channing Division of Network Medicine and Division of Women's Health (K.M.R.), Department of Medicine, Brigham and Women's Hospital, Boston, MA (S.H.L.); Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA (S.H.L.); and University of Michigan Stroke Program, Ann Arbor (M.M.)
| | - Kathryn M Rexrode
- From the Department of Neurology and Ophthalmology and Department of Pharmacology and Toxicology, Michigan State University, East Lansing (S.L.D.); Baltimore Veterans Administration Medical Center and Department of Neurology, University of Maryland School of Medicine (S.K.); Channing Division of Network Medicine and Division of Women's Health (K.M.R.), Department of Medicine, Brigham and Women's Hospital, Boston, MA (S.H.L.); Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA (S.H.L.); and University of Michigan Stroke Program, Ann Arbor (M.M.).
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Abstract
RATIONALE The incidence of severe hyperandrogenism associated with masculinity in women is very low. While rare and difficult to diagnose, androgen secreting tumors should be suspected in women with hyperandrogenism and hirsutism, especially in the postmenopausal population. Herein we present one case of ovarian Leydig cell tumor (LCT) with markedly elevated serum testosterone levels and frank hirsutism. PATIENT CONCERNS A 60-year-old woman, presented with increased hair growth and androgenic alopecia and the hormonal laboratory examination showed that she had elevated serum testosterone level and normal dehydroepiandrosterone sulfate (DHEAS), androstenedione, 17- hydroxyprogesterone, cortisol and thyroid stimulating hormone (TSH). DIAGNOSES The diagnosis of possible testosterone secreting tumor was performed when pelvic computed tomography (CT) and magnetic resonance image (MRI) showed a right adnexal mass of 15mm×16mm indicative of sex cord- stromal tumors. INTERVENTIONS The patient received laparoscopic total abdominal hysterectomy and bilateral salpingo-oophorectomy. OUTCOMES After operation, testosterone got back to the normal level and clinical symptoms subsided. LESSONS It is common that postmenopausal androgen excess is a state of relative or absolute androgen excess originating from the adrenal gland and/or ovaries. In either case, doctors need to assess such patients and exclude relatively rare potential causes of tumors. Any woman who has hirsutism or frank evidence of markedly increased testosterone should exclude this kind of possibility of androgen producing tumors. It is possible to determine the origin of androgen hypersecretion with the severity of symptoms, the extent of androgen excess, and the relevant imaging studies. Since LCT are rare ovarian sex-cord stromal tumors, it can be beneficial for diagnosis with careful research of patient history of the defeminization followed by virilization, and a CT and MRI image.
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Affiliation(s)
- Min Chen
- Department of Endocrinology, the First Affiliated Hospital, College of Medicine, Zhejiang University
| | - Weibin Zhou
- Department of Endocrinology, the First Affiliated Hospital, College of Medicine, Zhejiang University
| | - Zhe Zhang
- Department of Endocrinology, the First Affiliated Hospital, College of Medicine, Zhejiang University
| | - Yuting Zou
- Department of Endocrinology, the Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Chengjiang Li
- Department of Endocrinology, the First Affiliated Hospital, College of Medicine, Zhejiang University
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Jakobsen PR, Hermann AP, Søndergaard J, Wiil UK, Dixon RF, Clemensen J. Left in limbo - Experiences and needs among postmenopausal women newly diagnosed with osteoporosis without preceding osteoporotic fractures: A qualitative study. Post Reprod Health 2018; 24:26-33. [PMID: 29392982 DOI: 10.1177/2053369118755189] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Introduction Despite the fact that the first osteoporotic fracture is preventable, osteoporosis is still a major health challenge. The disease is highly prevalent among postmenopausal women. However little is known about how to meet and support women, when they are diagnosed with osteoporosis without preceding fractures. Therefore this study aims at gaining a deeper understanding of how women experience being diagnosed. Furthermore to describe and identify their needs, which should be met in future healthcare services. Methods We conducted a phenomenological qualitative study. We included 17 women aged 52-65 and collected data through semi-structured interviews. We analysed data following Giorgi's methodology. Findings Needs among the women were classified into three main themes: (1) needs of targeted and tailored information about osteoporosis, (2) needs of being prepared for GP visit to participate in treatment decision-making and (3) needs of being able to take care of bone health. Conclusion and implications In general the women experienced as been left 'in limbo', and they requested targeted and tailored information about osteoporosis. In particular, they want information about dual-energy X-ray absorptiometry (DXA) scan results and treatment options in advance of the GP visit. This will help them in being prepared and able to participate in treatment decisions. They ask for support in self-management of the disease with less focus on disease and risk of fracture. Instead, they demand more attention on the benefits of detecting early stage osteoporosis. The study highlights the call for new approaches to postmenopausal women newly diagnosed with osteoporosis without preceding fractures.
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Affiliation(s)
- Pernille Ravn Jakobsen
- 1 Centre for Innovative Medical Technology, 11286 Odense University Hospital , Odense, Denmark
- 2 Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | | | - Jens Søndergaard
- 4 Institute of Public Health, Research Unit of General Practice, University of Southern Denmark, Odense, Denmark
| | - Uffe Kock Wiil
- 1 Centre for Innovative Medical Technology, 11286 Odense University Hospital , Odense, Denmark
- 5 Health Informatics and Technology, The Maersk Mc-Kinney Moller Institute, University of Southern Denmark, Odense, Denmark
| | - Ronald F Dixon
- 6 Centre for the Integration of Medicine and Innovative Technology, Boston, MA, USA
- 7 Division of General Medicine, 2348 Massachusetts General Hospital , Boston, MA, USA
| | - Jane Clemensen
- 1 Centre for Innovative Medical Technology, 11286 Odense University Hospital , Odense, Denmark
- 2 Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- 8 HC Andersen Children's Hospital, 11286 Odense University Hospital , Odense, Denmark
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232
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Frota IPR, Rocha ABO, Neto JAV, Vasconcelos CTM, De Magalhaes TF, Karbage SAL, Augusto KL, Nascimento SLD, Haddad JM, Bezerra LRPS. Pelvic floor muscle function and quality of life in postmenopausal women with and without pelvic floor dysfunction. Acta Obstet Gynecol Scand 2018; 97:552-559. [PMID: 29352460 DOI: 10.1111/aogs.13305] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 12/27/2017] [Indexed: 12/20/2022]
Abstract
INTRODUCTION This study aims to compare pelvic floor muscle (PFM) function in postmenopausal women with and without pelvic floor dysfunction (PFD) and the relation between PFM function and quality of life. MATERIAL AND METHODS A case-control study with 216 postmenopausal women with (n = 126) and without (n = 90) PFD. PFM function was assessed by digital vaginal palpation using the PERFECT scale. Specific quality of life was evaluated using the King's Health Questionnaire for women with urinary incontinence and the Prolapse Quality-of-Life Questionnaire for women with pelvic organ prolapse. We analyzed women with PFD into two categories: Oxford's grade ≤2 or ≥3 using a chi-squared test. RESULTS Out of 126 womem with PFD 44 (34.9%) presented stress urinary incontinence, 21 (16.6%) had pelvic organ prolapse and 61 (48.4%) had urinary incontinence + pelvic organ prolapse. Strength had a median value 2 (0-5) in all women studied and most of them had insufficient strength, reduced endurance and repetition without statistical difference between groups. Incontinent women with strength ≤2 had worse perception of general health domain of King's Health Questionnaire (p = 0.007). No association was found between PFM function and Prolapse Quality-of-Life Questionnaire. CONCLUSIONS PFM function assessed by bidigital palpation in postmenopausal women was not sufficiently sensitive to differentiate between women with vs. women without PFM dysfunction and was not related with specific quality of life in women with urinary incontinence and pelvic organ prolapse, respectively. These data should be used to reinforce the widespread recommendation that PFM training is essencial in PFD treatment.
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Affiliation(s)
- Isabella Parente Ribeiro Frota
- Department of Surgery, Maternidade Escola Assis Chateaubriand and Department of Maternal-Child Health, Federal University of Ceará, Fortaleza, CE, Brazil
| | | | - José Ananias Vasconcelos Neto
- Department of Surgery, Maternidade Escola Assis Chateaubriand and Department of Maternal-Child Health, Federal University of Ceará, Fortaleza, CE, Brazil
| | | | - Thais Fontes De Magalhaes
- Department of Surgery, Maternidade Escola Assis Chateaubriand and Department of Maternal-Child Health, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Sara Arcanjo Lino Karbage
- Department of Surgery, Maternidade Escola Assis Chateaubriand and Department of Maternal-Child Health, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Kathiane Lustosa Augusto
- Department of Surgery, Maternidade Escola Assis Chateaubriand and Department of Maternal-Child Health, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Simony Lira Do Nascimento
- Department of Physical Therapy, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Jorge Millem Haddad
- Department of Gynecology, Faculty of Medicine, University of Sao Paulo, São Paulo, SP, Brazil
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233
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Jin G, Aobulikasimu A, Piao J, Aibibula Z, Koga D, Sato S, Ochi H, Tsuji K, Nakabayashi T, Miyata T, Okawa A, Asou Y. A small-molecule PAI-1 inhibitor prevents bone loss by stimulating bone formation in a murine estrogen deficiency-induced osteoporosis model. FEBS Open Bio 2018; 8:523-532. [PMID: 29632806 PMCID: PMC5881535 DOI: 10.1002/2211-5463.12390] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 12/20/2017] [Accepted: 01/04/2018] [Indexed: 11/06/2022] Open
Abstract
Osteoporosis is a progressive bone disease caused by an imbalance between bone resorption and formation. Recently, plasminogen activator inhibitor-1 (PAI-1) was shown to play an important role in bone metabolism using PAI-1-deficient mice. In this study, we evaluated the therapeutic benefits of novel, orally available small-molecule PAI-1 inhibitor (iPAI-1) in an estrogen deficiency-induced osteoporosis model. Eight-week-old C57BL/6J female mice were divided into three groups: a sham + vehicle (Sham), ovariectomy + vehicle (OVX + v), and OVX + iPAI-1 (OVX + i) group. iPAI-1 was administered orally each day for 6 weeks starting the day after the operation. Six weeks of iPAI-1 treatment prevented OVX-induced trabecular bone loss in both the femoral bone and lumbar spine. Bone formation activity was significantly higher in the OVX + i group than in the OVX + v and Sham groups. Unexpectedly, OVX-induced osteoclastogenesis was partially, but significantly reduced. Fluorescence-activated cell sorting analyses indicated that the number of bone marrow stromal cells was higher in the OVX + i group than that in the OVX + v group. A colony-forming unit-osteoblast assay indicated enhanced mineralized nodule formation activity in bone marrow cells isolated from iPAI-1-treated animals. Bone marrow ablation analysis indicated that the remodeled trabecular bone volume was significantly higher in the iPAI-1-treated group than that in the control group. In conclusion, our results suggest PAI-1 blockade via a small-molecule inhibitor is a new therapeutic approach for the anabolic treatment of postmenopausal osteoporosis.
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Affiliation(s)
- Guangwen Jin
- Department of Orthopedics Surgery Tokyo Medical and Dental University Japan.,Department of Orthopaedic Surgery Yanbian University Hospital Yanji City Jilin Province China
| | | | - Jinying Piao
- Department of Orthopedics Surgery Tokyo Medical and Dental University Japan
| | - Zulipiya Aibibula
- Department of Orthopedics Surgery Tokyo Medical and Dental University Japan
| | - Daisuke Koga
- Department of Orthopedics Surgery Tokyo Medical and Dental University Japan
| | - Shingo Sato
- Department of Physiology and Cell Biology Tokyo Medical and Dental University Japan
| | - Hiroki Ochi
- Department of Physiology and Cell Biology Tokyo Medical and Dental University Japan
| | - Kunikazu Tsuji
- Department of Cartilage Regeneration Tokyo Medical and Dental University Japan
| | - Tetsuo Nakabayashi
- Department of Molecular Medicine and Therapy United Centers for Advanced Research and Translational Medicine Tohoku University Graduate School of Medicine Miyagi Japan
| | - Toshio Miyata
- Department of Molecular Medicine and Therapy United Centers for Advanced Research and Translational Medicine Tohoku University Graduate School of Medicine Miyagi Japan
| | - Atsushi Okawa
- Department of Orthopedics Surgery Tokyo Medical and Dental University Japan
| | - Yoshinori Asou
- Department of Orthopedics Surgery Tokyo Medical and Dental University Japan
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234
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Hwu CM, Lin YC, Lin KH. β-Cell function in postmenopausal women with isolated post-challenge hyperglycemia. J Diabetes 2018; 10:158-165. [PMID: 28544644 DOI: 10.1111/1753-0407.12571] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 04/12/2017] [Accepted: 05/02/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Isolated post-challenge hyperglycemia (IPH) is an early stage of type 2 diabetes mellitus (T2DM), with fasting glucose <126 mg/dL and 2-h glucose ≥200 mg/dL. Observations of insulin secretion profile in subjects with IPH may provide an insight into the pathogenesis of T2DM in older women. METHODS We recruited 555 naturally postmenopausal women without a history of T2DM to the present study. All participants received a 75-g oral glucose tolerance test to determine whether they had IPH. General linear models were used to compare differences in glucose metabolism among subjects. RESULTS Early phase insulin responses to oral glucose were significantly decreased in women with IPH versus those with impaired glucose tolerance (IGT) and normal glucose tolerance (geometric mean [95% confidence interval] insulinogenic index 61 [54-79] vs 90 [83-97] and 105 [96-116], respectively; P < 0.0001). In addition, there were significant decreases in late-phase insulin release as metabolic status shifted from normal glucose tolerance to IGT to IPH. In the present cohort, the relative contribution of early insulin secretion to 2-h glucose was no longer significant ( P = 0.15) after multiple factors, including indicators of insulin resistance and late-phase insulin release, were entered into the regression model simultaneously. CONCLUSIONS The results demonstrate that postmenopausal women with IPH are characterized by impaired β-cell function. There were significant decreases in early and late-phase insulin release as glucose intolerance escalated. Disturbance in β-cell function seems to be an important factor associated with early T2DM in postmenopausal women.
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Affiliation(s)
- Chii-Min Hwu
- Section of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Yi-Chun Lin
- Section of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Kuan-Hung Lin
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
- Department of Medicine, National Yang-Ming University Hospital, Yi-Lan, Taiwan
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235
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Villa JKD, Diaz MAN, Pizziolo VR, Martino HSD. Effect of vitamin K in bone metabolism and vascular calcification: A review of mechanisms of action and evidences. Crit Rev Food Sci Nutr 2018; 57:3959-3970. [PMID: 27437760 DOI: 10.1080/10408398.2016.1211616] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Osteoporosis is a public health concern associated with an increased risk of bone fractures and vascular calcification. Vitamin K presents unique benefits on these issues, although understudied. The two main forms of vitamin K are phylloquinone (vitamin K1) and menaquinone (vitamin K2). In this study, it was especially investigated the action of vitamin K2 in bones and vessels. Vitamin K2 has shown to stimulate bone formation by promoting osteoblast differentiation and carboxylation of osteocalcin, and increasing alkaline phosphatase, insulin-like growth factor-1, growth differentiation factor-15, and stanniocalcin 2 levels. Furthermore, vitamin K2 reduces the pro-apoptotic proteins Fas and Bax in osteoblasts, and decreases osteoclast differentiation by increasing osteoprotegerin and reducing the receptor activator of nuclear factor kappa-B ligand. In blood vessels, vitamin K2 reduces the formation of hydroxyapatite, through the carboxylation of matrix Gla protein and Gla rich protein, inhibits the apoptosis of vascular smooth muscle cells, by increasing growth arrest-specific gene 6, and reduces the transdifferentiation of vascular smooth muscle cells to osteoblasts. The commonly used dosage of vitamin K2 in human studies is 45 mg/day and its application can be an interesting strategy in benefitting bone and vascular health, especially to osteoporotic post-menopausal women.
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Affiliation(s)
- Julia Khéde Dourado Villa
- a Departamento de Bioquímica e Biologia Molecular , Universidade Federal de Viçosa , Minas Gerais , Brazil
| | - Marisa Alves Nogueira Diaz
- a Departamento de Bioquímica e Biologia Molecular , Universidade Federal de Viçosa , Minas Gerais , Brazil
| | - Virgínia Ramos Pizziolo
- a Departamento de Bioquímica e Biologia Molecular , Universidade Federal de Viçosa , Minas Gerais , Brazil
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Kipriyanova KE, Tipisova EV, Gorenko IN, Elfimova AE, Popkova VA. [Pituitary-gonadal and pituitary-thyroid axis hormone serum levels in postmenopausal women of the European North of the Russian Federation, depending on the age.]. Adv Gerontol 2018; 31:75-81. [PMID: 29860733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Using the methods of radioimmunoassay and enzyme immunoassay there were studied the levels of hormones of the pituitary-thyroid and pituitary-gonadal systems in the postmenopausal women of the European North of the Russian Federation in the second period of mature age, elderly and senile ages. The lower concentrations of total and free fractions of triiodothyronine and total thyroxin, testosterone, dehydroepiandrosterone sulfate, and estradiol were noted in the blood of investigated women in the senile age. Excess levels of thyroid-stimulating hormone were shown in 12,1% of people in the II period of mature age and 17,4% of people in the elderly age. The examined women showed signs of androgenization, manifested by elevated values of luteinizing hormone, testosterone and dehydroepiandrosterone sulfate. The levels of luteinizing hormone exceed the norm in 50% of persons of the second period of mature age, 18,2% of the elderly and 26,1% of the persons of senile age. The concentrations of testosterone and dehydroepiandrosterone sulfate exceed the norms established for the postmenopausal period in 15,4 and 91,7% of persons in the second period of mature age and in 11,4 of 84,2% of the elderly age. The greatest number of correlation interrelations of the studied hormones levels was noted in senile age.
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Affiliation(s)
- K E Kipriyanova
- Federal Center for Integrated Arctic Research RAS, 23, nab. Severnoj Dviny, 163000, Arkhangelsk, Russian Federation;
| | - E V Tipisova
- Federal Center for Integrated Arctic Research RAS, 23, nab. Severnoj Dviny, 163000, Arkhangelsk, Russian Federation;
| | - I N Gorenko
- Federal Center for Integrated Arctic Research RAS, 23, nab. Severnoj Dviny, 163000, Arkhangelsk, Russian Federation;
| | - A E Elfimova
- Federal Center for Integrated Arctic Research RAS, 23, nab. Severnoj Dviny, 163000, Arkhangelsk, Russian Federation;
| | - V A Popkova
- Federal Center for Integrated Arctic Research RAS, 23, nab. Severnoj Dviny, 163000, Arkhangelsk, Russian Federation;
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237
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Ganderton C, Pizzari T, Cook J, Semciw A. Gluteus Minimus and Gluteus Medius Muscle Activity During Common Rehabilitation Exercises in Healthy Postmenopausal Women. J Orthop Sports Phys Ther 2017; 47:914-22. [PMID: 29034801 DOI: 10.2519/jospt.2017.7229] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Study Design Controlled laboratory study, cross-sectional. Background The gluteus medius (GMed) and gluteus minimus (GMin) provide dynamic stability of the hip joint and pelvis. These muscles are susceptible to atrophy and injury in individuals during menopause, aging, and disease. Numerous studies have reported on the ability of exercises to elicit high levels of GMed activity; however, few studies have differentiated between the portions of the GMed, and none have examined the GMin. Objectives To quantify and rank the level of muscle activity of the 2 segments of the GMin (anterior and posterior fibers) and 3 segments of the GMed (anterior, middle, and posterior fibers) during 4 isometric and 3 dynamic exercises in a group of healthy, postmenopausal women. Methods Intramuscular electrodes were inserted into each segment of the GMed and GMin in 10 healthy, postmenopausal women. Participants completed 7 gluteal rehabilitation exercises, and average normalized muscle activity was used to rank the exercises from highest to lowest. Results The isometric standing hip hitch with contralateral hip swing was the highest-ranked exercise for all muscle segments except the anterior GMin, where it was ranked second. The highest-ranked dynamic exercise for all muscle segments was the dip test. Conclusion The hip hitch and its variations maximally activate the GMed and GMin muscle segments, and may be useful in hip muscle rehabilitation in postmenopausal women. J Orthop Sports Phys Ther 2017;47(12):914-922. Epub 15 Oct 2017. doi:10.2519/jospt.2017.7229.
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238
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Caufriez A, Leproult R, Copinschi G. Circadian profiles of progesterone, gonadotropins, cortisol and corticotropin in cycling and postmenopausal women. Chronobiol Int 2017; 35:72-79. [PMID: 29111782 DOI: 10.1080/07420528.2017.1381971] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Little is known about the regulation of temporal variations of progesterone over the 24-hr span in young cycling women as well as in postmenopausal women. The purpose of the present study was to investigate the relationships between diurnal variations of progesterone and diurnal variations of hormones of the gonadotropic and corticotropic axes, and to provide further information on the source of progesterone secretion under physiological conditions. Twenty-four-hour hormonal profiles were explored under well-controlled laboratory conditions in 10 healthy women (21-36 yr old) with normal ovulatory cycles during early-mid follicular and late luteal phases, and in 8 healthy postmenopausal women (48-74 yr old). In young cycling women, significant positive relationships were found between progesterone and follicle-stimulating hormone (FSH) - but not luteinizing hormone (LH) - profiles during late luteal phase. Conversely, during follicular phase, significant positive relationships were evidenced between progesterone and cortisol profiles, but not between progesterone and FSH or LH. In postmenopausal women, strong positive correlations were found between progesterone and corticotropin (ACTH) or cortisol profiles. The present results indicate that during late luteal phase, temporal progesterone profiles are associated with FSH rather than with LH profiles. They also provide evidence that adrenal cortex is a major - or possibly the only - source of progesterone production during the follicular phase of the normal ovulatory cycle, and probably the only source after menopause.
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Affiliation(s)
- Anne Caufriez
- a Laboratoire de Physiologie et Pharmacologie , Université libre de Bruxelles , Brussels , Belgium
| | - Rachel Leproult
- a Laboratoire de Physiologie et Pharmacologie , Université libre de Bruxelles , Brussels , Belgium
| | - Georges Copinschi
- a Laboratoire de Physiologie et Pharmacologie , Université libre de Bruxelles , Brussels , Belgium
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Czyzyk A, Latacz J, Filipowicz D, Podfigurna A, Moszynski R, Jasinski P, Sajdak S, Gaca M, Genazzani AR, Meczekalski B. Severe hyperandrogenemia in postmenopausal woman as a presentation of ovarian hyperthecosis. Case report and mini review of the literature. Gynecol Endocrinol 2017; 33:836-839. [PMID: 28604129 DOI: 10.1080/09513590.2017.1337094] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Ovarian hyperthecosis (OH) is characterized by the presence of abundant luteinized theca cells in ovaries that secret androgen. It typically presents as severe hyperandrogenism and/or virilization in postmenopausal woman. Here we describe a 66-year old woman with presentation of severe hirsutism, alopecia, clitoromegaly and laboratory finding of significantly elevated serum total testosterone concentration and hyperinsulinemia. Performed imaging studies revealed normal sized, homogeneous ovaries, signs of endometrial hypertrophy and normal adrenal glands. Due to severe hyperandrogenemia and signs of endometrial hypertrophy, the total abdominal hysterectomy with bilateral salpingo-oophorectomy has been performed. Pathological examination revealed OH and endometrial hyperplasia. Androgenic activity of ovarian stromal cells has been confirmed using alpha-inhibin histochemical staining. Postmenopausal hyperandrogenemia is a diagnostic and therapeutic challenge and the imaging studies often may be misleading and require careful and critical consideration.
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Affiliation(s)
- Adam Czyzyk
- a Department of Gynecological Endocrinology , Poznan University of Medical Sciences , Poznan , Poland
| | - Justyna Latacz
- b Students Scientific Association of the Department of Gynecological Endocrinology , Poznan University of Medical Sciences , Poznan , Poland
| | - Dorota Filipowicz
- b Students Scientific Association of the Department of Gynecological Endocrinology , Poznan University of Medical Sciences , Poznan , Poland
| | - Agnieszka Podfigurna
- a Department of Gynecological Endocrinology , Poznan University of Medical Sciences , Poznan , Poland
| | - Rafal Moszynski
- c Division of Gynecological Surgery , Poznan University of Medical Sciences , Poznan , Poland
| | - Piotr Jasinski
- d Gynecological and Obstetric Clinical Hospital in Poznan , Poznan , Poland
| | - Stefan Sajdak
- c Division of Gynecological Surgery , Poznan University of Medical Sciences , Poznan , Poland
| | - Michal Gaca
- e Department of Anesthesiology in Obstetrics and Gynecology , Poznan University of Medical Sciences , Poznan , Poland
| | - Andrea R Genazzani
- f Department of Reproductive Medicine and Child Development, Division of Gynecology and Obstetrics , University of Pisa , Pisa , Italy
| | - Blazej Meczekalski
- a Department of Gynecological Endocrinology , Poznan University of Medical Sciences , Poznan , Poland
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Pardhe BD, Pathak S, Bhetwal A, Ghimire S, Shakya S, Khanal PR, Marahatta SB. Effect of age and estrogen on biochemical markers of bone turnover in postmenopausal women: a population-based study from Nepal. Int J Womens Health 2017; 9:781-788. [PMID: 29123427 PMCID: PMC5661842 DOI: 10.2147/ijwh.s145191] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Osteoporosis, a common disease worldwide, is characterized by low bone mass and architectural deterioration of bone tissue, leading to enhanced bone fragility and increase in fracture risks. Both menopause and aging are related factors leading to greater risk of bone disease, particularly among postmenopausal women. Hence, the main purpose of this study was to investigate the differences in biochemical markers of bone turnover and to evaluate the association of hormones and age-related factors with biochemical markers between pre- and postmenopausal women. METHODS A descriptive cross-sectional study was conducted over a period of 6 months among the female population of Dholahity community, Lalitpur, Nepal. A total of 496 healthy women were selected based on the questionnaire strategy. Among them, 244 were premenopausal and 252 were postmenopausal women. Different bone markers were evaluated as per the guideline provided by the reagent manufacturer, and hormonal assay, particularly estradiol level assessment, was performed by chemiluminescence immunoassay-based technique. RESULTS A significant decrease in serum calcium level and estradiol level was observed in postmenopausal women as compared to premenopausal women, whereas a significant increase in serum phosphorus and alkaline phosphatase (ALP) levels was seen among postmenopausal (p<0.001). Age was significantly correlated with bone markers (ALP and calcium) in postmenopausal group (p<0.005), while there was no significant correlation in premenopausal group. In addition, there was significant positive correlation between calcium and estradiol in postmenopausal women, while ALP was negatively correlated with estradiol in that group. Further, no significant correlation was demonstrated between estradiol and bone markers in postmenopausal women in body mass index and age-adjusted partial correlation analysis. CONCLUSION Timely diagnosis of osteoporosis in women would be of significant benefit for effective care for required populations and help to minimize mortality rate and financial burden of our country.
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Affiliation(s)
- Bashu Dev Pardhe
- Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
| | - Sabala Pathak
- Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
| | - Anjeela Bhetwal
- Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
| | - Sumitra Ghimire
- Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
| | - Shreena Shakya
- Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
| | - Puspa Raj Khanal
- Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
| | - Sujan Babu Marahatta
- Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
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241
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Yan Y, Cheng L, Chen X, Wang Q, Duan M, Ma J, Zhao L, Jiang X, Ai J. Estrogen deficiency is associated with hippocampal morphological remodeling of early postmenopausal mice. Oncotarget 2017; 8:21892-21902. [PMID: 28423534 PMCID: PMC5400632 DOI: 10.18632/oncotarget.15702] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 01/24/2017] [Indexed: 01/10/2023] Open
Abstract
Estrogen (E2) deficiency is reported to involve in the impairment of cognition in postmenopausal women. However, the morphological basis is still unclear. In the present study, using transmission electron microscopy (TEM), we observed the ultrastructure of hippocampus in female C57BL/6 mice at the age of 18 months (18 M) which is considered as the early stage of postmenopause (n = 8). Compared with control mice aged 6 M (n = 8), we identified that the morphological changes in the hippocampus of these menopausal mice were mitochondrial damage, lipofuscin deposition and microtubule degradation. Notably, after E2 was subcutaneously injected into mice aged 16 M with a dosage of 3.5 μg/kg every three days for two months in the 18 M + E2 group (n = 8), mitochondrial damage and lipofuscin deposition in the DG region of hippocampus were prevented, but the degraded microtubules in the hippocampus of postmenopausal mice were failed to restore. These data suggest that hippocampal ultrastructure remodeling in mice can be initiated at the early stage of postmenopause, E2 supplementation could only have an effect on mitochondrial damage and lipofuscin increase.
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Affiliation(s)
- Yan Yan
- Department of Pharmacology, Harbin Medical University, The State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Heilongjiang Province, Harbin 150081, China
| | - Liang Cheng
- College of Bioinformatics Science and Technology, Harbin Medical University, Heilongjiang Province, Harbin 150081, China
| | - Xin Chen
- Department of Pharmacology, Harbin Medical University, The State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Heilongjiang Province, Harbin 150081, China
| | - Qin Wang
- Department of Pharmacology, Harbin Medical University, The State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Heilongjiang Province, Harbin 150081, China
| | - Mingjing Duan
- Department of Pharmacology, Harbin Medical University, The State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Heilongjiang Province, Harbin 150081, China
| | - Jichao Ma
- Department of Pharmacology, Harbin Medical University, The State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Heilongjiang Province, Harbin 150081, China
| | - Linjing Zhao
- Department of Pharmacology, Harbin Medical University, The State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Heilongjiang Province, Harbin 150081, China
| | - Xuemei Jiang
- Department of Pharmacology, Harbin Medical University, The State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Heilongjiang Province, Harbin 150081, China
| | - Jing Ai
- Department of Pharmacology, Harbin Medical University, The State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Heilongjiang Province, Harbin 150081, China
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Tácito LHB, Yamada LN, de Souza Pinhel MA, Yugar-Toledo JC, Souza DRS. Influence of Apolipoprotein E on the Lipid Profile and Postprandial Triglyceride Levels in Brazilian Postmenopausal Women With Artery Disease. Clin Med Insights Cardiol 2017; 11:1179546817731110. [PMID: 28974920 PMCID: PMC5613840 DOI: 10.1177/1179546817731110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 08/22/2017] [Indexed: 11/16/2022]
Abstract
This study confirms the association of risk factors for coronary artery disease (CAD) and the apoE polymorphisms, specifically related to the APOE*4 allele, with coronary disease in postmenopausal women. Significantly altered values of the lipid profile were found in patients when compared with controls, independent of the presence of the APOE*4 allele. However, the controls showed higher high-density lipoprotein cholesterol (HDL-C) levels and reduced triglyceride (TG) levels, differing significantly from patients. In this case, the study of subgroups, considering the APOE*3/3 and APOE*3/4 genotypes, suggests that the APOE*4 allele is not implicated in the variations of the lipid profile of patients and determined an increase in the production levels of HDL-C and a reduction in TG highly benefiting the control group compared with APOE*3/3 genotype. The metabolic kinetics of TG, although with the same pattern between groups, and the presence of the APOE*4 allele are suggested to be associated with accelerated clearance compared with APOE*3 allele in non-CAD group.
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Affiliation(s)
- Lúcia Helena Bonalume Tácito
- Endocrinology Division, Internal Medicine Department, State Medical School of São José Rio Preto (FAMERP), São José do Rio Preto, Brazil
| | - Lilian Nakachima Yamada
- Molecular Biology and Biochemistry Department, State Medical School of São José Rio Preto (FAMERP), São José do Rio Preto, Brazil
| | - Marcela Augusta de Souza Pinhel
- Molecular Biology and Biochemistry Department, State Medical School of São José Rio Preto (FAMERP), São José do Rio Preto, Brazil
| | - Juan Carlos Yugar-Toledo
- Internal Medicine Department, State Medical School of São José Rio Preto (FAMERP), São José do Rio Preto, Brazil
| | - Dorotéia Rossi Silva Souza
- Molecular Biology and Biochemistry Department, State Medical School of São José Rio Preto (FAMERP), São José do Rio Preto, Brazil
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Yu J, Yin B. Postmenopausal hormone and the risk of nephrolithiasis: A meta-analysis. EXCLI J 2017; 16:986-994. [PMID: 28900379 PMCID: PMC5579406 DOI: 10.17179/excli2017-304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 06/10/2017] [Indexed: 11/16/2022]
Abstract
Menopause is reported to be associated with increased urinary calcium excretion, which may enhance the risk for the development of calcium kidney stones. However, it remains controversial about whether high level of postmenopausal hormone (PMH) is a risk factor for formation of nephrolithiasis. Several observational studies have shown that PMH is protective based on 24-hour urinary parameters. Recent clinical trials provided evidence to conclude that estrogen therapy increases the risk of nephrolithiasis in healthy postmenopausal women. Our study aimed to comprehensively assess clinical evidence on the relationship between postmenopausal hormone level and risk of nephrolithiasis. To conduct systematic review, we pooled total 98 potentially related articles in Cochrane library, Medline, and Embase. Three studies with a total of 71101 study participants that included two clinical trials, 4 stratified and potentially usable results by the status of menopause and type of PMH use derived from one prospective cohort study, and one case-control studies were selected to pool relative risk using random-effect model. How the difference in menopause status, whether naturally menopausal or surgically menopausal, influenced the pooled relative risk was included in the subgroup analysis. The study population aged from 45 to 70 years old. The follow-up year and adjusted confounders differed across different studies. The pooled relative risk for the 7 stratified studies was 0.91 (95 % confidence interval (CI): [0.72, 1.14]). In the menopausal status-specific analysis, the pooled relative risk for naturally menopausal women was 0.92 (95 % CI, [0.64, 1.27]; I2 = 82.74 %) whereas the pooled relative risk for surgically postmenopausal women is 0.90 (95 % CI, [0.63, 1.29]; I2 = 78.47 %). The above results suggested that there was no significant association between PMH and the risk of nephrolithiasis. The difference in menopausal status did not influence the relationship between PMH and the risk of kidney stone formation.
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Affiliation(s)
- Juan Yu
- Eastern Operation room, Yantai Yuhuangding Hospital, Medical College of Qingdao University, Yantai 264000, Shandong, P.R. China
| | - Binyan Yin
- Operation room, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, P.R. China
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Abstract
INTRODUCTION The climacteric symptoms during peri- and postmenopause have not been extensively studied in China. To further understanding of the characteristics of Chinese women during their menopausal transition, the aim of the study was to compare the prevalence and severity of climacteric symptoms of peri- and postmenopausal Chinese women. METHODS The retrospective descriptive study was carried out in perimenopausal and postmenopausal women from 20 provinces of China who visited Beijing Obstetrics & Gynecology hospital during 2008-2015. A total of 1225 women aged 34-76 years without hormone replacement therapy were analyzed. Menopausal status was defined by the "2011 Stages of Reproductive Aging Workshop criteria". The following climacteric symptoms were assessed: fatigue, insomnia, irritability, depression, palpitations, muscle and joint pain, dizziness, vaginal dryness, headache, urinary incontinence, hot flash, sweat, pain during intercourse, and formication. RESULTS The most frequent five symptoms were fatigue (75.84%), insomnia (69.39%), irritability (67.02%), palpitations (62.78%), and depression (61.88%). The prevalence of 14 symptoms was significantly higher in the postmenopause compared with the perimenopause status group (all p < .05).The severity of fatigue, insomnia, irritability, palpitation, vaginal dryness, muscle, and joint pain and pain during intercourse was significantly different between the perimenopausal and postmenopausal groups. CONCLUSIONS The most frequent five symptoms among the investigated 1225 Chinese women were fatigue, insomnia, irritability, palpitations, depression, nearly the same in perimenopausal and postmenopausal women. The prevalence and the severity of most of the symptoms were significantly different between the two groups.
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Affiliation(s)
- Xiangyan Ruan
- a Department of Gynecological Endocrinology , Beijing Obstetrics & Gynecology Hospital, Capital Medical University , Chaoyang District , Beijing , China.,b Section of Endocrinology and Menopause , University Women's Hospital of Tuebingen, Department of Women's Health, University of Tueiben , Germany
| | - Yamei Cui
- a Department of Gynecological Endocrinology , Beijing Obstetrics & Gynecology Hospital, Capital Medical University , Chaoyang District , Beijing , China
| | - Juan Du
- a Department of Gynecological Endocrinology , Beijing Obstetrics & Gynecology Hospital, Capital Medical University , Chaoyang District , Beijing , China
| | - Fengyu Jin
- a Department of Gynecological Endocrinology , Beijing Obstetrics & Gynecology Hospital, Capital Medical University , Chaoyang District , Beijing , China
| | - Alfred Otto Mueck
- a Department of Gynecological Endocrinology , Beijing Obstetrics & Gynecology Hospital, Capital Medical University , Chaoyang District , Beijing , China.,b Section of Endocrinology and Menopause , University Women's Hospital of Tuebingen, Department of Women's Health, University of Tueiben , Germany
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Lambert MNT, Thybo CB, Lykkeboe S, Rasmussen LM, Frette X, Christensen LP, Jeppesen PB. Combined bioavailable isoflavones and probiotics improve bone status and estrogen metabolism in postmenopausal osteopenic women: a randomized controlled trial. Am J Clin Nutr 2017; 106:909-920. [PMID: 28768651 DOI: 10.3945/ajcn.117.153353] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 06/28/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Female age-related estrogen deficiency increases the risk of osteoporosis, which can be effectively treated with the use of hormone replacement therapy. However, hormone replacement therapy is demonstrated to increase cancer risk. Bioavailable isoflavones with selective estrogen receptor affinity show potential to prevent and treat osteoporosis while minimizing or eliminating carcinogenic side effects.Objective: In this study, we sought to determine the beneficial effects of a bioavailable isoflavone and probiotic treatment against postmenopausal osteopenia.Design: We used a novel red clover extract (RCE) rich in isoflavone aglycones and probiotics to concomitantly promote uptake and a favorable intestinal bacterial profile to enhance isoflavone bioavailability. This was a 12-mo, double-blind, parallel design, placebo-controlled, randomized controlled trial of 78 postmenopausal osteopenic women supplemented with calcium (1200 mg/d), magnesium (550 mg/d), and calcitriol (25 μg/d) given either RCE (60 mg isoflavone aglycones/d and probiotics) or a masked placebo [control (CON)].Results: RCE significantly attenuated bone mineral density (BMD) loss at the L2-L4 lumbar spine vertebra (P < 0.05), femoral neck (P < 0.01), and trochanter (P < 0.01) compared with CON (-0.99% and -2.2%; -1.04% and -3.05%; and -0.67% and -2.79, respectively). Plasma concentrations of collagen type 1 cross-linked C-telopeptide was significantly decreased in the RCE group (P < 0.05) compared with CON (-9.40% and -6.76%, respectively). RCE significantly elevated the plasma isoflavone concentration (P < 0.05), the urinary 2-hydroxyestrone (2-OH) to 16α-hydroxyestrone (16α-OH) ratio (P < 0.05), and equol-producer status (P < 0.05) compared with CON. RCE had no significant effect on other bone turnover biomarkers. Self-reported diet and physical activity were consistent and differences were nonsignificant between groups throughout the study. RCE was well tolerated with no adverse events.Conclusions: Twice daily RCE intake over 1 y potently attenuated BMD loss caused by estrogen deficiency, improved bone turnover, promoted a favorable estrogen metabolite profile (2-OH:16α-OH), and stimulated equol production in postmenopausal women with osteopenia. RCE intake combined with supplementation (calcium, magnesium, and calcitriol) was more effective than supplementation alone. This trial was registered at clinicaltrials.gov as NCT02174666.
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Affiliation(s)
| | | | - Simon Lykkeboe
- Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
| | - Lars Melholt Rasmussen
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark; and
| | - Xavier Frette
- Department of Chemical Engineering, Biotechnology and Environmental Technology, University of Southern Denmark, Odense, Denmark
| | - Lars Porskjær Christensen
- Department of Chemical Engineering, Biotechnology and Environmental Technology, University of Southern Denmark, Odense, Denmark
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Vaikkakara S, Raj MN, Sachan A, Mohan A, Vengamma B, Rao PVLNS, Mukka A, Sravani C, Reddy AP. Impact of Severity of Illness on the Function of the Hypothalamo-pituitary-gonadal Axis in Postmenopausal Women with Acute Severe Illness: Implications for Predicting Disease Outcome. Indian J Endocrinol Metab 2017; 21:738-744. [PMID: 28989885 PMCID: PMC5628547 DOI: 10.4103/ijem.ijem_398_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND While elevated levels of estradiol were predictive of mortality in critically ill surgical and trauma patients, their ability to predict outcome in nonsurgical patients has not been studied. We aimed to study the determinants of gonadotropin levels in acutely ill postmenopausal women with nonsurgical disease and the impact of changes in the gonadal axis on the outcome of these patients. METHODS Thirty-five postmenopausal women admitted to medical intensive care with acute severe illness and having a Simplified Acute Physiology Score (SAPS II score) ≥30 (in-hospital mortality rate ≥ 10%) were recruited. On the 5th day of hospitalization, fasting samples were collected at 8.00 am and tested for luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, free triiodothyronine, free thyroxine, thyrotropin, cortisol, prolactin, dehydroepiandrosterone, androstenedione, and sex hormone-binding globulin. Multiple linear regression analysis was performed to identify independent determinants if any of LH and FSH. Receiver operating characteristic (ROC) curves were drawn for different cutoffs of LH, FSH, and estradiol to diagnose mortality and prolonged hospitalization. RESULTS There was an independent negative association between the FSH and the SAPS II score (beta = -0.435; P = 0.014), but not with any of the other tested parameters (estradiol, prolactin, or cortisol). Among components of the SAPS II score, the total leukocyte count (TLC) was negatively associated with serum FSH (beta coefficient = -0.635, P = 0.013). None of these parameters were determinants of LH. On ROC analysis, neither estradiol nor gonadotropins were diagnostic for in-hospital mortality. However, among survivors, low estradiol was diagnostic for prolonged hospital stay (area under the curve = 0.785; P = 0.015). CONCLUSION FSH, but not LH, is negatively associated with the severity of illness, particularly to its inflammatory component (TLC). Low estradiol in survivors was a predictor of prolonged hospital stay.
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Affiliation(s)
- Suresh Vaikkakara
- Department of Endocrinology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Marella Neelima Raj
- Department of Pharmacy Practice, Sri Venkateswara College of Pharmacy, Chittoor, Nellore, Andhra Pradesh, India
| | - Alok Sachan
- Department of Endocrinology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Alladi Mohan
- Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Bhuma Vengamma
- Department of Neurology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - P. V. L. N. Srinivas Rao
- Department of Biochemistry, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Arun Mukka
- Department of Endocrinology, Yashoda Hospitals, Hyderabad, Telangana, India
| | - Chiruvella Sravani
- Department of Endocrinology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Amaresh P. Reddy
- Department of Endocrinology, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India
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Chandra RV, Sailaja S, Reddy AA. Estimation of tissue and crevicular fluid oxidative stress marker in premenopausal, perimenopausal and postmenopausal women with chronic periodontitis. Gerodontology 2017; 34:382-389. [PMID: 28568604 DOI: 10.1111/ger.12279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2017] [Indexed: 01/27/2023]
Abstract
OBJECTIVES The aim of this study was to estimate tissue and gingival crevicular fluid (GCF) levels of the oxidative stress marker 8-hydroxy-2'-deoxyguanosine (8-OHdG) in premenopausal, perimenopausal and postmenopausal women with chronic periodontitis. BACKGROUND Oxidative stress has been implicated in the etiopathogenesis of periodontitis and menopause induces oxidative stress. MATERIALS AND METHODS According to Stages of Reproductive Aging Workshop (STRAW) criteria, women diagnosed with periodontitis were subdivided into three groups of 31 participants each 1. Premenopausal 2. Perimenopausal and 3. Postmenopausal. GCF and gingival tissue samples were collected from sites with maximum probing depth. Tissue DNA was extracted from the gingival sample and 8-OHdG in the extracted DNA, and GCF samples were measured using ELISA. RESULTS There was a highly significant difference in the overall GCF 8-OHdG levels among the three groups with the pairwise difference being highly significant between the premenopausal-postmenopausal groups and perimenopausal-postmenopausal groups. However, no overall significant differences in tissue 8-OHdG levels were found among the three groups. Pairwise, highly significant differences were found between the premenopausal-postmenopausal groups and perimenopausal-postmenopausal groups for tissue 8-OHdG levels. No significant correlations were found between various measure of periodontal disease and GCF/tissue 8-OHdG levels among all the groups. CONCLUSION Premenopausal-postmenopausal and perimenopausal-postmenopausal transition resulted in significant increase in tissue and GCF 8-OHdG levels. However, no association was found between stages of reproductive ageing and tissue levels of 8-OHdG.
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Affiliation(s)
- Rampalli Viswa Chandra
- Department of Periodontics, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
| | - Sistla Sailaja
- Department of Periodontics, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
| | - Aileni Amarender Reddy
- Department of Periodontics, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
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Abstract
OBJECTIVE To compare leukocyte telomere length (LTL) by race and describe demographic, health, and psychosocial factors associated with LTL in postmenopausal women. DESIGN Descriptive study with comparative analyses and correlations. SETTING Data were collected at the University of California-San Francisco, San Francisco Clinical and Translational Science Institute. PARTICIPANTS Thirty-nine African American and White postmenopausal women between 58 and 65 years of age (mean age = 61.3 ± 1.83 years). METHODS Measures included demographics, blood pressure, anthropometrics, scores on the Perceived Stress Scale and the Center for Epidemiologic Studies-Depression, and blood samples for LTL. RESULTS African American women (n = 14) had greater PSS-10 and CES-D scores, greater blood pressure, and greater body mass index than White women (n = 25; p < .05), but LTL did not significantly differ between the two groups. Age was inversely related to LTL (r = -.355, p < .05). After age and race were controlled, fewer children (p = .005) and greater perceived stress (p = .036) were related to shorter LTL. CONCLUSION Findings from this small sample support the association between age and LTL. The association between perceived stress, number of children, and shorter LTL in postmenopausal women requires further research and replication of findings in a larger, more diverse sample.
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Iwahashi N, Deguchi Y, Horiuchi Y, Ino K, Furukawa K. Omental synovial sarcoma mimicking an ovarian malignancy: A case report. Mol Clin Oncol 2017; 6:688-690. [PMID: 28529743 PMCID: PMC5431683 DOI: 10.3892/mco.2017.1213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 03/17/2017] [Indexed: 11/17/2022] Open
Abstract
Synovial sarcoma is clinically rare, and cases of synovial sarcoma arising in the omentum are particularly rare. Only 3 cases have been reported in the literature to dtae, and they were associated with a poor prognosis. We herein report a rare case of aggressive primary omental synovial sarcoma presenting as an ovarian malignancy. A 53-year-old multigravida woman was referred to our hospital due to progressive abdominal distension. Magnetic resonance imaging revealed a large heterogeneous mass with an irregular component occupying the lower abdominal cavity, with an intact uterus. Intraoperative examination revealed a solid mass arising from the lower omentum. The diagnosis of omental synovial sarcoma was established based on postoperative pathological and immunohistochemical examination of the tumor. The patient underwent multiple surgical resection procedures due to the development of metastases in the liver, lungs and abdominal cavity and received adjuvant chemotherapy including doxorubicin-ifosfamide, pazopanib and trabectedin. Such rare neoplasms may be difficult to diagnose preoperatively based on radiological examinations alone. Thus, gynecologists should be aware of the possibility of omental synovial sarcoma, and combined surgical and chemotherapeutic interventions are required to control such aggressive tumors.
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Affiliation(s)
- Naoyuki Iwahashi
- Department of Obstetrics and Gynecology, Hashimoto Municipal Hospital, Hashimoto, Wakayama 648-0005, Japan.,Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan
| | - Yoko Deguchi
- Department of Obstetrics and Gynecology, Hashimoto Municipal Hospital, Hashimoto, Wakayama 648-0005, Japan.,Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan
| | - Yuko Horiuchi
- Department of Obstetrics and Gynecology, Hashimoto Municipal Hospital, Hashimoto, Wakayama 648-0005, Japan.,Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan
| | - Kazuhiko Ino
- Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan
| | - Kenichi Furukawa
- Department of Obstetrics and Gynecology, Hashimoto Municipal Hospital, Hashimoto, Wakayama 648-0005, Japan
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