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Dornisch SJ, Sievert LL, Sharmeen T, Begum K, Muttukrishna S, Chowdhury O, Bentley GR. Religious minority identity associates with stress and psychological health among Muslim and Hindu women in Bangladesh and London. Am J Hum Biol 2024:e24057. [PMID: 38415876 DOI: 10.1002/ajhb.24057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 02/29/2024] Open
Abstract
OBJECTIVES This study examined the association of minority religious identification (Hindu or Muslim) with self-reported stress and psychological symptoms among sedentee and immigrant Bangladeshi women. METHODS Women, aged 35-59 (n = 531) were drawn from Sylhet, Bangladesh and London, England. Muslim immigrants in London and Hindu sedentees in Sylhet represented minority religious identities. Muslim sedentees in Sylhet and Londoners of European descent represented majority religious identities. In bivariate analyses, minority religious identity was examined in relation to self-reported measures of stress, nervous tension, and depressed mood. Logistic regression was applied to examine the relationship between these variables while adjusting for marital status, parity, daily walking, and perceived financial comfort. RESULTS In bivariate analyses, religious minorities reported more stress than religious majorities in all group comparisons (p < .05), and minority Muslims reported more nervous tension and depressed mood than majority Muslims (p < .05). In logistic regression models, minority Muslims had greater odds of high stress than majority Muslims (OR 2.00, 95% CI 1.18-3.39). Minority Muslims had greater odds of stress (OR 3.05, 95% CI 1.51-6.17) and nervous tension (OR 3.37, 95% CI 1.66-6.87) than majority Londoners. Financial comfort reduced odds of stress and symptoms in all models. CONCLUSIONS Socioeconomic situation, immigration history, and minority ethnicity appear to influence the relationship between religious identity and psychosomatic symptoms in Bangladeshi women. Attention to personal and socioeconomic context is important for research examining the association between religion and mental health.
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Affiliation(s)
- S J Dornisch
- Department of Anthropology, UMass Amherst, Amherst, Massachusetts, USA
| | - L L Sievert
- Department of Anthropology, UMass Amherst, Amherst, Massachusetts, USA
| | - T Sharmeen
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - K Begum
- Department of Anthropology, Durham University, Durham, UK
| | - S Muttukrishna
- Department of Obstetrics and Gynecology, University College Cork, Cork, Ireland
| | - O Chowdhury
- Microbiology, Parkview Medical College, Sylhet, Bangladesh
| | - G R Bentley
- Department of Obstetrics and Gynecology, University College Cork, Cork, Ireland
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Stöger R, Choi M, Begum K, Leeman G, Emes RD, Melamed P, Bentley GR. Childhood environment influences epigenetic age and methylation concordance of a CpG clock locus in British-Bangladeshi migrants. Epigenetics 2023; 18:2153511. [PMID: 36495138 PMCID: PMC9980690 DOI: 10.1080/15592294.2022.2153511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Migration from one location to another often comes with a change in environmental conditions. Here, we analysed features of DNA methylation in young, adult British-Bangladeshi women who experienced different environments during their childhoods: a) migrants, who grew up in Bangladesh with exposure to comparatively higher pathogen loads and poorer health care, and b) second-generation British-Bangladeshis, born to Bangladeshi parents, who grew up in the UK. We used buccal DNA to estimate DNA methylation-based age (DNAm age) from 14 migrants and 11 second-generation migrants, aged 18-35 years. 'AgeAccel,' a measure of DNAm age, independent of chronological age, showed that the group of women who spent their childhood in Bangladesh had higher AgeAccel (P = 0.028), compared to their UK peers. Since epigenetic clocks have been proposed to be associated with maintenance processes of epigenetic systems, we evaluated the preference for concordant DNA methylation at the luteinizing hormone/choriogonadotropin receptor (LHCGR/LHR) locus, which harbours one of the CpGs contributing to Horvath's epigenetic clock. Measurements on both strands of individual, double-stranded DNA molecules indicate higher stability of DNA methylation states at this LHCGR/LHR locus in samples of women who grew up in Bangladesh. Together, our two independent analytical approaches imply that childhood environments may induce subtle changes that are detectable long after exposure occurred, which might reflect altered activity of the epigenetic maintenance system or a difference in the proportion of cell types in buccal tissue. This exploratory work supports our earlier findings that adverse childhood environments lead to phenotypic life history trade-offs.
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Affiliation(s)
- Reinhard Stöger
- School of Biosciences, University of Nottingham, Nottingham, UK
| | - Minseung Choi
- School of Medicine, Stanford University, Stanford, CA, USA
| | | | - Gregory Leeman
- School of Biosciences, University of Nottingham, Nottingham, UK
| | - Richard D Emes
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK.,Advanced Data Analysis Centre, University of Nottingham, Nottingham, UK
| | - Philippa Melamed
- Faculty of Biology, Technion-Israel Institute of Technology, Haifa, Israel
| | - Gillian R Bentley
- Department of Anthropology, Durham University, Durham, UK.,Wolfson Research Institute for Health and Wellbeing, Durham University, Durham, UK
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Bar-Sadeh B, Pnueli L, Keestra S, Bentley GR, Melamed P. Srd5a1 is Differentially Regulated and Methylated During Prepubertal Development in the Ovary and Hypothalamus. J Endocr Soc 2023; 7:bvad108. [PMID: 37646011 PMCID: PMC10461783 DOI: 10.1210/jendso/bvad108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Indexed: 09/01/2023] Open
Abstract
5α-reductase-1 catalyzes production of various steroids, including neurosteroids. We reported previously that expression of its encoding gene, Srd5a1, drops in murine ovaries and hypothalamic preoptic area (POA) after early-life immune stress, seemingly contributing to delayed puberty and ovarian follicle depletion, and in the ovaries the first intron was more methylated at two CpGs. Here, we hypothesized that this CpG-containing locus comprises a methylation-sensitive transcriptional enhancer for Srd5a1. We found that ovarian Srd5a1 mRNA increased 8-fold and methylation of the same two CpGs decreased up to 75% between postnatal days 10 and 30. Estradiol (E2) levels rise during this prepubertal stage, and exposure of ovarian cells to E2 increased Srd5a1 expression. Chromatin immunoprecipitation in an ovarian cell line confirmed ESR1 binding to this differentially methylated genomic region and enrichment of the enhancer modification, H3K4me1. Targeting dCas9-DNMT3 to this locus increased CpG2 methylation 2.5-fold and abolished the Srd5a1 response to E2. In the POA, Srd5a1 mRNA levels decreased 70% between postnatal days 7 and 10 and then remained constant without correlation to CpG methylation levels. Srd5a1 mRNA levels did not respond to E2 in hypothalamic GT1-7 cells, even after dCas9-TET1 reduced CpG1 methylation by 50%. The neonatal drop in POA Srd5a1 expression occurs at a time of increasing glucocorticoids, and treatment of GT1-7 cells with dexamethasone reduced Srd5a1 mRNA levels; chromatin immunoprecipitation confirmed glucocorticoid receptor binding at the enhancer. Our findings on the tissue-specific regulation of Srd5a1 and its methylation-sensitive control by E2 in the ovaries illuminate epigenetic mechanisms underlying reproductive phenotypic variation that impact life-long health.
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Affiliation(s)
- Ben Bar-Sadeh
- Faculty of Biology, Technion-Israel Institute of Technology, Haifa 32000, Israel
| | - Lilach Pnueli
- Faculty of Biology, Technion-Israel Institute of Technology, Haifa 32000, Israel
| | - Sarai Keestra
- Faculty of Biology, Technion-Israel Institute of Technology, Haifa 32000, Israel
- Department of Anthropology, Durham University, Durham, DH1 3LE, UK
| | | | - Philippa Melamed
- Faculty of Biology, Technion-Israel Institute of Technology, Haifa 32000, Israel
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Sievert LL, Sharmeen T, Begum K, Muttukrishna S, Chowdhury O, Bentley GR. Frequency of Phytoestrogen Consumption and Symptoms at Midlife among Bangladeshis in Bangladesh and London. Nutrients 2023; 15:3676. [PMID: 37686708 PMCID: PMC10490262 DOI: 10.3390/nu15173676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/15/2023] [Accepted: 08/19/2023] [Indexed: 09/10/2023] Open
Abstract
There is a longstanding interest in the relationship between diet and hot flash symptoms during midlife, especially in whether phytoestrogens ease menopausal symptoms. The purpose of this study was to examine hot flashes, night sweats, trouble sleeping, and vaginal dryness in relation to the intake of foods rich in phytoestrogens among Bangladeshi women aged 35 to 59 years who were living either in Sylhet, Bangladesh (n = 157) or as migrants in London (n = 174). Consumption ranges for phytoestrogens were constructed from food frequencies. We hypothesized that diets rich in isoflavones, lignans, and coumestrol would be associated with lower symptom frequencies. However, adjusted logistic regression results showed that with each incremental increase in general phytoestrogen consumption (scale of 0 to 10), the likelihood of hot flashes increased by 1.4%. Each incremental increase in lignan consumption raised the likelihood of hot flashes by 1.6%. In contrast, the odds of vaginal dryness decreased by 2%, with each incremental increase in phytoestrogen and lignan consumption, and by 4%, with each incremental increase in isoflavone consumption. Night sweats and trouble sleeping were not associated with phytoestrogen intake in logistic regressions. Our findings add to the conflicting data on relationships between phytoestrogens and symptoms associated with menopause.
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Affiliation(s)
| | - Taniya Sharmeen
- Nuffield Department of Medicine, University of Oxford, Oxford OX3 7BN, UK
| | - Khurshida Begum
- Department of Anthropology, Durham University, Durham DH1 3LE, UK
| | - Shanthi Muttukrishna
- Department of Obstetrics and Gynecology, University College Cork, T12 E7WX Cork, Ireland
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Straat ME, Martinez-Tellez B, van Eyk HJ, Bizino MB, van Veen S, Vianello E, Stienstra R, Ottenhoff THM, Lamb HJ, Smit JWA, Jazet IM, Rensen PCN, Boon MR. Differences in Inflammatory Pathways Between Dutch South Asians vs Dutch Europids With Type 2 Diabetes. J Clin Endocrinol Metab 2023; 108:931-940. [PMID: 36262060 PMCID: PMC9999357 DOI: 10.1210/clinem/dgac598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/06/2022] [Indexed: 11/19/2022]
Abstract
CONTEXT South Asian individuals are more prone to develop type 2 diabetes (T2D) coinciding with earlier complications than Europids. While inflammation plays a central role in the development and progression of T2D, this factor is still underexplored in South Asians. OBJECTIVE This work aimed to study whether circulating messenger RNA (mRNA) transcripts of immune genes are different between South Asian compared with Europid patients with T2D. METHODS A secondary analysis was conducted of 2 randomized controlled trials of Dutch South Asian (n = 45; age: 55 ± 10 years, body mass index [BMI]: 29 ± 4 kg/m2) and Dutch Europid (n = 44; age: 60 ± 7 years, BMI: 32 ± 4 kg/m2) patients with T2D. Main outcome measures included mRNA transcripts of 182 immune genes (microfluidic quantitative polymerase chain reaction; Fluidigm Inc) in fasted whole-blood, ingenuity pathway analyses (Qiagen). RESULTS South Asians, compared to Europids, had higher mRNA levels of B-cell markers (CD19, CD79A, CD79B, CR2, CXCR5, IGHD, MS4A1, PAX5; all fold change > 1.3, false discovery rate [FDR] < 0.008) and interferon (IFN)-signaling genes (CD274, GBP1, GBP2, GBP5, FCGR1A/B/CP, IFI16, IFIT3, IFITM1, IFITM3, TAP1; all FC > 1.2, FDR < 0.05). In South Asians, the IFN signaling pathway was the top canonical pathway (z score 2.6; P < .001) and this was accompanied by higher plasma IFN-γ levels (FC = 1.5, FDR = 0.01). Notably, the ethnic difference in gene expression was larger for women (20/182 [11%]) than men (2/182 [1%]). CONCLUSION South Asian patients with T2D show a more activated IFN-signaling pathway compared to Europid patients with T2D, which is more pronounced in women than men. We speculate that a more activated IFN-signaling pathway may contribute to the more rapid progression of T2D in South Asian compared with Europid individuals.
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Affiliation(s)
- Maaike E Straat
- Correspondence: Mariëtte R. Boon, MD PhD, Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands.
| | - Borja Martinez-Tellez
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
| | - Huub J van Eyk
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
| | - Maurice B Bizino
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
- Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
| | - Suzanne van Veen
- Department of Infectious Diseases, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
| | - Eleonora Vianello
- Department of Infectious Diseases, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
| | - Rinke Stienstra
- Nutrition, Metabolism and Genomics Group, Division of Human Nutrition and Health, Wageningen University, 6708 PB Wageningen, the Netherlands
- Department of Medicine, Radboud University Medical Center, 6525 XZ Nijmegen, the Netherlands
| | - Tom H M Ottenhoff
- Department of Infectious Diseases, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
| | - Johannes W A Smit
- Department of Medicine, Radboud University Medical Center, 6525 XZ Nijmegen, the Netherlands
| | - Ingrid M Jazet
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
| | - Patrick C N Rensen
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
| | - Mariëtte R Boon
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
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Relationship of Estradiol and Progesterone with Partnership and Parity Among Bangladeshi and British Women of European Origin. HUMAN NATURE (HAWTHORNE, N.Y.) 2023; 34:1-24. [PMID: 36882630 DOI: 10.1007/s12110-023-09442-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/03/2023] [Indexed: 03/09/2023]
Abstract
Recent studies in social endocrinology have explored the effects of social relationships on female reproductive steroid hormones-estradiol and progesterone-investigating whether they are suppressed in partnered and parous women. Results have been mixed for these hormones although evidence is more consistent that partnered women and women with young children have lower levels of testosterone. These studies were sequential to earlier research on men, based on Wingfield's Challenge Hypothesis, which showed that men in committed relationships, or with young children, have lower levels of testosterone than unpartnered men or men with older or no children. The study described here explored associations between estradiol and progesterone with partnership and parity among women from two different ethnicities: South Asian and white British. We hypothesized that both steroid hormones would be lower among partnered and/or parous women with children ≤3 years old, regardless of ethnicity. In this study we analyzed data from 320 Bangladeshi and British women of European origin aged 18 to 50 who participated in two previous studies of reproductive ecology and health. Levels of estradiol and progesterone were assayed using saliva and/or serum samples and the body mass index calculated from anthropometric data. Questionnaires provided other covariates. Multiple linear regressions were used to analyze the data. The hypotheses were not supported. We argue here that, unlike links between testosterone and male social relationships, theoretical foundations for such relationships with female reproductive steroid hormones are lacking, especially given the primary role of these steroids in regulating female reproductive function. Further longitudinal studies are needed to explore the bases of independent relationships between social factors and female reproductive steroid hormones.
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Batista MS, Tsitsiou Y, Dar S, Ancillotti G, Minhas S, Varshney N. Life course reproductive dynamics associated with menopause in Ugandan women aged 40-49. Am J Hum Biol 2022; 34:e23791. [PMID: 36193636 DOI: 10.1002/ajhb.23791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 06/26/2022] [Accepted: 07/17/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Early menopausal onset can increase adverse health outcomes in later life; meanwhile, reproductive experiences before menopause may affect its timing. Framed by life course methodology, the study tested for independent and interdependent associations between reproductive history (contraception, age at first birth, parity, terminated pregnancy) and socioeconomic factors (education, wealth, rural-urban residence, cigarette use, marital status, age at first cohabitation) with the occurrence of early menopause. METHODS The study population was ever-married women aged 40-49 from the 2016 Demographic & Health Survey (N = 2748). Analytical methods involved probability- and age-adjusted multivariate logistic regression models and predictive margins. RESULTS Connections between reproductive and socioeconomic characteristics were key dynamics associated with menopause in ages 40-49. Contraception, parity, and ages at first birth and marriage were found to be independently associated with menopause in this age group. Evidence of interactions was found where no contraceptive use was associated with higher probabilities of menopause for first-time mothers aged 12-15 and for women with no education. CONCLUSIONS Studying Ugandan women's reproductive histories highlighted the importance of regional knowledge about menopause. Though we hypothesized that risks would correlate in a chain, the results pointed to risks clustering around contraception, suggesting that improving contraceptive use and education for women could increase menopausal age. Furthermore, the positive association between low parity and early menopause supports the biological mechanism of faster oocyte depletion; however, high-parity populations like Uganda tend to have a younger menopausal age than low-parity populations. Declining mortality in the demographic transition could explain these inverse associations.
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Affiliation(s)
| | - Yvonne Tsitsiou
- Polygeia, London, UK
- Faculty of Medicine, Imperial College London, London, UK
| | - Sabeera Dar
- Polygeia, London, UK
- University College London Medical School, London, UK
| | - Giulia Ancillotti
- Polygeia, London, UK
- London School of Economics and Political Science, London, UK
| | - Sonica Minhas
- Polygeia, London, UK
- Barts and the London School of Medicine and Dentistry, Queen Mary University, London, UK
| | - Natania Varshney
- Polygeia, London, UK
- Faculty of Medicine, Imperial College London, London, UK
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Reilingh A, van den Meiracker T, Bolijn R, Galenkamp H, van Charante EM, van der Schouw Y, van Valkengoed I. Is early menopause a potential criterion for cardiovascular risk screening to detect high risk in a multi-ethnic population? The Helius study. Maturitas 2022; 162:1-7. [DOI: 10.1016/j.maturitas.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 03/03/2022] [Accepted: 03/06/2022] [Indexed: 10/18/2022]
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Zou P, Luo Y, Wyslobicky M, Shaikh H, Alam A, Wang W, Zhang H. Menopausal experiences of South Asian immigrant women: a scoping review. Menopause 2022; 29:360-371. [PMID: 35213522 DOI: 10.1097/gme.0000000000001919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
IMPORTANCE AND OBJECTIVE South Asians make up a significant portion of global immigration. Immigrants often face challenges when navigating the healthcare system, which can influence their experience during the menopausal transition. The purpose of this scoping review is to summarize the existing literature on South Asian immigrant women's menopausal experience. METHODS Various electronic databases were systematically searched to identify research articles. The menopausal experiences of South Asian immigrant women were examined. RESULTS A total of 11 studies were included in this scoping review. A variety of physical symptoms were reported, including vasomotor symptoms, musculoskeletal symptoms, somatic symptoms, and early onset of menopause. Psychosocial symptoms included anxiety, depression, and decreased memory/concentration. Cultural experiences were both positive and negative, depending on the connotations surrounding menopause. Individual facilitators for a healthy transition included education and employment. Familial barriers included a lack of knowledge and support. Community and societal factors were both positive and negative, depending on the level of acculturation. Self-management was the most widely used intervention. DISCUSSIONS AND CONCLUSION Findings of this scoping review can help guide the development and evaluation of menopause interventions for South Asian immigrant women. Culturally sensitive care, increased discussion on sexual health, support networks, and reduction of socioeconomic barriers are needed to address the health needs of South Asian immigrant women. Further research is needed to better understand South Asian immigrant women's menopausal needs and help guide intervention design.
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Affiliation(s)
- Ping Zou
- School of Nursing, Nipissing University, Toronto, ON, Canada
| | - Yan Luo
- Faculty of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China
| | | | - Haniah Shaikh
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Arzoo Alam
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Wei Wang
- Toronto Western Hospital Bariatric Surgical Program, University of Health Network, Toronto, ON, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Hui Zhang
- Department of Cardiology, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China
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Bar-Sadeh B, Amichai OE, Pnueli L, Begum K, Leeman G, Emes RD, Stöger R, Bentley GR, Melamed P. Epigenetic regulation of 5α reductase-1 underlies adaptive plasticity of reproductive function and pubertal timing. BMC Biol 2022; 20:11. [PMID: 34996447 PMCID: PMC8742331 DOI: 10.1186/s12915-021-01219-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 12/16/2021] [Indexed: 12/30/2022] Open
Abstract
Background Women facing increased energetic demands in childhood commonly have altered adult ovarian activity and shorter reproductive lifespan, possibly comprising a strategy to optimize reproductive success. Here, we sought to understand the mechanisms of early-life programming of reproductive function, by integrating analysis of reproductive tissues in an appropriate mouse model with methylation analysis of proxy tissue DNA in a well-characterized population of Bangladeshi migrants in the UK. Bangladeshi women whose childhood was in Bangladesh were found to have later pubertal onset and lower age-matched ovarian reserve than Bangladeshi women who grew-up in England. Subsequently, we aimed to explore the potential relevance to the altered reproductive phenotype of one of the genes that emerged from the screens. Results Of the genes associated with differential methylation in the Bangladeshi women whose childhood was in Bangladesh as compared to Bangladeshi women who grew up in the UK, 13 correlated with altered expression of the orthologous gene in the mouse model ovaries. These mice had delayed pubertal onset and a smaller ovarian reserve compared to controls. The most relevant of these genes for reproductive function appeared to be SRD5A1, which encodes the steroidogenic enzyme 5α reductase-1. SRD5A1 was more methylated at the same transcriptional enhancer in mice ovaries as in the women’s buccal DNA, and its expression was lower in the hypothalamus of the mice as well, suggesting a possible role in the central control of reproduction. The expression of Kiss1 and Gnrh was also lower in these mice compared to controls, and inhibition of 5α reductase-1 reduced Kiss1 and Gnrh mRNA levels and blocked GnRH release in GnRH neuronal cell cultures. Crucially, we show that inhibition of this enzyme in female mice in vivo delayed pubertal onset. Conclusions SRD5A1/5α reductase-1 responds epigenetically to the environment and its downregulation appears to alter the reproductive phenotype. These findings help to explain diversity in reproductive characteristics and how they are shaped by early-life environment and reveal novel pathways that might be targeted to mitigate health issues caused by life-history trade-offs. Supplementary Information The online version contains supplementary material available at 10.1186/s12915-021-01219-6.
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Affiliation(s)
- Ben Bar-Sadeh
- Faculty of Biology, Technion-Israel Institute of Technology, 32000, Haifa, Israel
| | - Or E Amichai
- Faculty of Biology, Technion-Israel Institute of Technology, 32000, Haifa, Israel
| | - Lilach Pnueli
- Faculty of Biology, Technion-Israel Institute of Technology, 32000, Haifa, Israel
| | - Khurshida Begum
- Department of Anthropology, Durham University, Durham, DH1 3LE, UK
| | - Gregory Leeman
- School of Biosciences, University of Nottingham, Nottingham, LE12 5RD, UK
| | - Richard D Emes
- School of Veterinary Medicine and Sciences, University of Nottingham, Nottingham, LE12 5RD, UK
| | - Reinhard Stöger
- School of Biosciences, University of Nottingham, Nottingham, LE12 5RD, UK
| | | | - Philippa Melamed
- Faculty of Biology, Technion-Israel Institute of Technology, 32000, Haifa, Israel.
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11
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Begum K, Cooper GD, Akhter N, Nahar P, Kasim A, Bentley GR. Early life, life course and gender influences on levels of C-reactive protein among migrant Bangladeshis in the UK. Evol Med Public Health 2022; 10:21-35. [PMID: 35035976 PMCID: PMC8754477 DOI: 10.1093/emph/eoab041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 11/18/2021] [Indexed: 11/14/2022] Open
Abstract
Background and objectives Humans co-evolved with pathogens, especially helminths, that educate the immune system during development and lower inflammatory responses. The absence of such stimuli in industrialized countries is associated with higher baseline levels of C-reactive protein (CRP) among adults who appear at greater risk for inflammatory disorders. This cross-sectional study examined effects of early life development on salivary CRP levels in 452 British-Bangladeshis who spent varying periods growing up in Bangladesh or UK. We also analyzed how gender and central obesity modulate effects on CRP. We hypothesized that: (i) first-generation Bangladeshis with higher childhood exposure to pathogens would have chronically lower CRP levels than second-generation British-Bangladeshis; (ii) effects would be greater with early childhoods in Bangladesh; (iii) effects by gender would differ; and (iv) increasing obesity would mitigate early life effects. Methodology Saliva samples were assayed for CRP using ELISAs, and anthropometric data collected. Participants completed questionnaires about demographic, socioeconomic, lifestyle and health histories. Data were analyzed using multiple linear regression. Results First-generation migrants who spent early childhoods in mostly rural, unhygienic areas, and moved to UK after age 8, had lower salivary CRP compared to the second-generation. Effects differed by gender, while waist circumference predicted higher CRP levels. CRP increased with years in UK, alongside growing obesity. Conclusions and implications Our study supports the hypothesis that pathogen exposure in early life lowers inflammatory responses in adults. However, protective effects differed by gender and can be eroded by growing obesity across the life course which elevates risks for other inflammatory disorders. Lay Summary: Migrants to the UK who spent early childhoods in less hygienic environments in Bangladesh that help to educate their immune systems had lower levels of the inflammatory marker, C-reactive protein (CRP) compared to migrants who grew up in UK. Both gender and increasing obesity were associated with increased levels of CRP.
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Affiliation(s)
- Khurshida Begum
- Department of Anthropology, Durham University, Dawson Building, South Road, Durham DH1 3LE, UK
| | - Gillian D Cooper
- Department of Anthropology, Durham University, Dawson Building, South Road, Durham DH1 3LE, UK
| | - Nasima Akhter
- Department of Anthropology, Durham University, Dawson Building, South Road, Durham DH1 3LE, UK
| | - Papreen Nahar
- Department of Anthropology, Durham University, Dawson Building, South Road, Durham DH1 3LE, UK
- Department of Global Health and Infection, University of Sussex, BSMS Teaching Building, Brighton BN1 9PX, East Sussex, UK
| | - Adetayo Kasim
- Department of Anthropology, Durham University, Dawson Building, South Road, Durham DH1 3LE, UK
- Durham Research Methods Centre, Faculty of Social Sciences & Health, Durham University, Arthur Holmes Building, Durham DH1 3LE, UK
- UCB Pharmaceuticals, 216 Bath Road, Slough SL1 3WE, UK
| | - Gillian R Bentley
- Department of Anthropology, Durham University, Dawson Building, South Road, Durham DH1 3LE, UK
- Corresponding author. Department of Anthropology, Durham University, Dawson Building, South Road, Durham DH1 3LE, UK. Tel: 011 44 191 334 1114; E-mail:
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Thakur J, Goswami M, Roy S. Do vasomotor and genitourinary symptoms of menopause vary between sedente and migrant groups? A study on the Oraon tribal populations of Eastern India. Am J Hum Biol 2021; 34:e23710. [PMID: 34883536 DOI: 10.1002/ajhb.23710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 10/25/2021] [Accepted: 11/24/2021] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES Human reproductive characteristics are embedded within local ecological contexts. A shift in the local ecology is likely to offer challenges in reproductive outcome. We aimed to investigate sedente-migrant variation in experiencing vasomotor and genitourinary symptoms at perimenopausal and postmenopausal stages and its concomitants. METHODS Four hundred Oraon tribal populations living in Eastern India (sedente [100 each from perimenopausal and postmenopausal groups] and migrants [100 each from perimenopausal and postmenopausal groups]) were studied. Data on vasomotor and genitourinary symptoms, socio-demographic and reproductive history, body compositions, lifestyle variables, and energy intake were compared between sedente and migrant independently for perimenopausal and postmenopausal groups. Principal component analysis (PCA) was used to identify the principal components (PCs) of menopausal symptoms. A two level multilevel linear regression was applied independently for perimenopausal and postmenopausal groups to identify the concomitants of menopausal symptoms and estimate sedente-migrant variance. RESULTS Bivariate analysis showed significant (p ≤ .05) sedente-migrant differences in socio-demographic, reproductive, body composition, energy intake, and lifestyle variables and in some of the vasomotor and genitourinary symptoms. In multilevel analyses, random effect did not show significant heterogeneity between sedente and migrant groups in experiencing menopausal symptoms; however, fixed effect showed that region from which participants were recruited (Gram Panchayat [GP]) and individual level characteristics were concomitants (p ≤ .05) for menopausal symptoms, irrespective of menopausal status. CONCLUSION Variability at GP levels and individual level characteristics of sedente and migrant groups predominantly determined menopausal symptoms of the study populations, but not the migration status.
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Affiliation(s)
- Joyeeta Thakur
- Department of Anthropology, University of Calcutta, Kolkata, West Bengal, India
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Sievert LL, Huicochea-Gómez L, Cahuich-Campos D, Whitcomb BW, Brown DE. Age at menopause among rural and urban women in the state of Campeche, Mexico. Menopause 2021; 28:1358-1368. [PMID: 34854837 DOI: 10.1097/gme.0000000000001886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The purpose of this study was to examine age at natural menopause among women of Maya and non-Maya ancestry living in urban and rural communities in the state of Campeche, Mexico. METHODS Women ages 40 to 60 (n = 543) participated in semi-structured interviews and anthropometric measures. The last names, languages spoken, and the birthplace of the woman, her parents, and her grandparents were used to determine Maya or non-Maya ethnicity. Recalled age at natural menopause was compared across four communities; analysis of variance was used to compare means and Kaplan-Meier analyses were used to compare medians. Probit analysis was also used to estimate median ages at menopause. Cox regression analyses were applied to identify variables associated with age at menopause. RESULTS Mean recalled age at natural menopause across all sites was 46.7 years, ranging from 47.8 years in the city of Campeche to 43.9 years in the rural Maya communities in the municipality of Hopelchén. Median ages at menopause across all sites were 50.55 years by probit analysis and 50.5 years by Kaplan-Meier. Variables associated with a later age at menopause included higher socioeconomic status, higher parity, and a later age at menarche. CONCLUSIONS The early mean recalled age at menopause in southern Hopelchén was consistent with previous studies in the Yucatán peninsula. As expected, probit and Kaplan-Meier analyses demonstrated later ages at menopause. Contrary to our expectations, Maya/non-Maya ethnicity was not associated with age at menopause. Demographic and reproductive factors were more important than ethnicity in explaining variation in age at menopause within the state of Campeche, Mexico.
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Affiliation(s)
| | - Laura Huicochea-Gómez
- Departamento de Sociedad y Cultura, El Colegio de la Frontera, ECOSUR, Campeche, México
| | - Diana Cahuich-Campos
- Departamento de Sociedad y Cultura, El Colegio de la Frontera, ECOSUR, Campeche, México
| | - Brian W Whitcomb
- Department of Biostatistics and Epidemiology, UMass Amherst, Amherst, MA
| | - Daniel E Brown
- Department of Anthropology, University of Hawai'i at Hilo, Hilo, HI
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Chaney C, Begum K, Núñez-de la Mora A, Sievert LL, Muttukrishna S, Harries V, Sharmeen T, Murphy L, Gunu R, Chowdhury O, Bentley GR. No impact of developmental conditions on serum estradiol levels among Bangladeshi women in the UK and Bangladesh. Am J Hum Biol 2021; 34:e23631. [PMID: 34174012 DOI: 10.1002/ajhb.23631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/09/2021] [Accepted: 06/14/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION While many aspects of female ovarian function respond to environmental stressors, estradiol (E2) appears less sensitive to stressors than progesterone, except under extreme ecological conditions. However, earlier studies relied on saliva samples, considered less sensitive than blood. Here, we investigated E2 variation among 177 Bangladeshi and UK white women, aged 35-59, using single serum samples. Bangladeshi women either grew up in Sylhet, Bangladesh (exposed to poor sanitation, limited health care, and higher pathogen loads but not poor energy availability), or in the UK. METHODS We collected samples on days 4-6 of the menstrual cycle in menstruating women and on any day for post-menopausal women. Participants included: (i) Bangladeshi sedentees (n = 36), (ii) Bangladeshis who migrated to the UK as adults (n = 52), (iii) Bangladeshis who migrated as children (n = 40), and (iv) UK white women matched for neighborhood residence to the migrants (n = 49). Serum was obtained by venipuncture and analyzed using electrochemiluminescence. We collected anthropometrics and supplementary sociodemographic and reproductive data through questionnaires. We analyzed the data using multivariate regression. RESULTS E2 levels did not differ between migrant groups after controlling for age, BMI, physical activity, psychosocial stress, parity, and time since last birth (parous women). Paralleling results from salivary E2, serum E2 did not differ among women who experienced varying developmental conditions. CONCLUSION Our results reinforce the hypothesis that E2 levels are stable under challenging environmental conditions. Interpopulation variation may only arise under chronic conditions of extreme nutritional scarcity, energy expenditure, and/or high disease burdens.
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Affiliation(s)
- Carlye Chaney
- Department of Anthropology, Yale University, New Haven, Connecticut, USA
| | | | | | - Lynnette L Sievert
- Department of Anthropology, University of Massachusetts, Amherst, Massachusetts, USA
| | - Shanthi Muttukrishna
- Anu Research Centre, Department of Obstetrics and Gynaecology, University College Cork, Cork, Republic of Ireland
| | - Victoria Harries
- Department of Anthropology, Yale University, New Haven, Connecticut, USA
| | - Taniya Sharmeen
- Reading School of Pharmacy, University of Reading, Reading, UK
| | - Lorna Murphy
- School of Public Health, University of Massachusetts, Amherst, Massachusetts, USA
| | - Richard Gunu
- Institute for Women's Health, University College London, London, UK
| | - Osul Chowdhury
- Department of Microbiology, Parkview Medical College, Sylhet, Bangladesh
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Racializing infertility: How South/Asian-ness has been constituted as an independent risk factor in infertility research and IVF practice. Soc Sci Med 2021; 280:114008. [PMID: 34051559 DOI: 10.1016/j.socscimed.2021.114008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 11/23/2022]
Abstract
Since the 1990s, scientific studies have explored possible correlations of "race/ethnicity" with ovarian aging and, by extension, the outcome of In Vitro Fertilization (IVF) procedures. Relying on a close reading of English-language scientific publications about "Asian" or "South Asian" women, corroborated by interviews with selected authors in 2018 and 2021 as well as ethnographic research in India conducted between 2010 and 2017, I analyze processes and practices of racializing infertility over time and across space. In a first step, I explore the socio-political configurations through which South/Asian race/ethnicity became a relevant variable in infertility research between the 1990s and 2010s. Further, I interrogate how South/Asian race/ethnicity has been scientifically mobilized and problematized by examining publications from the US, the UK, and India/Spain. I argue that South/Asian race/ethnicity has been constituted as an independent risk factor for ovarian aging and/or IVF outcome by invisibilizing possible alternative explanations for inequalities with regard to infertility and by establishing comparability and continuity between contexts. Inquiring why researchers actively try to make a seemingly universal notion of South/Asian race/ethnicity present in their work, I point to global scientific hierarchies and postcolonial power dynamics that characterize this body of literature. Finally, I explore the implications that the notion of South/Asian-ness as risk has in medical practice in India and illustrate how it contributes to bringing the (in)fertility of bodies racialized as "South Asian" into new realms of capital accumulation.
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Smith N, Sievert LL, Muttukrishna S, Begum K, Murphy L, Sharmeen T, Gunu R, Chowdhury O, Bentley GR. Mismatch: a comparative study of vitamin D status in British-Bangladeshi migrants. EVOLUTION MEDICINE AND PUBLIC HEALTH 2021; 9:164-173. [PMID: 33763230 PMCID: PMC7928960 DOI: 10.1093/emph/eoab001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 01/05/2021] [Indexed: 11/17/2022]
Abstract
Background and objectives Low levels of vitamin D among dark-skinned migrants to northern latitudes and increased risks for associated pathologies illustrate an evolutionary mismatch between an environment of high ultraviolet (UV) radiation to which such migrants are adapted and the low UV environment to which they migrate. Recently, low levels of vitamin D have also been associated with higher risks for contracting COVID-19. South Asians in the UK have higher risk for low vitamin D levels. In this study, we assessed vitamin D status of British-Bangladeshi migrants compared with white British residents and Bangladeshis still living in Bangladesh (‘sedentees’). Methodology The cross-sectional study compared serum vitamin D levels among 149 women aged 35–59, comprising British-Bangladeshi migrants (n = 50), white British neighbors (n = 54) and Bangladeshi sedentees (n = 45). Analyses comprised multivariate models to assess serum levels of 25-hydroxyvitamin D (25(OH)D), and associations with anthropometric, lifestyle, health and migration factors. Results Vitamin D levels in Bangladeshi migrants were very low: mean 25(OH)D = 32.2 nmol/L ± 13.0, with 29% of migrants classified as deficient (<25 nmol/L) and 94% deficient or insufficient (≤50 nmol/L). Mean levels of vitamin D were significantly lower among British-Bangladeshis compared with Bangladeshi sedentees (50.9 nmol/L ± 13.3, P < 0.001) and were also lower than in white British women (55.3 nmol/L ± 20.9). Lower levels of vitamin D were associated with increased body mass index and low iron status. Conclusions and implications We conclude that lower exposure to sunlight in the UK reduces vitamin D levels in Bangladeshi migrants. Recommending supplements could prevent potentially adverse health outcomes associated with vitamin D deficiency. Lay Summary Vitamin D deficiency is one example of mismatch between an evolved trait and novel environments. Here we compare vitamin D status of dark-skinned British-Bangladeshi migrants in the UK to Bangladeshis in Bangladesh and white British individuals. Migrants had lower levels of vitamin D and are at risk for associated pathologies.
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Affiliation(s)
- Nicholas Smith
- General Medicine, Gateshead Health NHS Foundation Trust, Gateshead, UK.,Department of Anthropology, Durham University, Durham, UK
| | | | - Shanthi Muttukrishna
- Department of Obstetrics and Gynaecology, ANU Research Centre, University of Cork, Cork, Ireland
| | | | - Lorna Murphy
- Department of Anthropology, UMass Amherst, Amherst, MA, USA
| | | | - Richard Gunu
- Institute for Women's Health, University College London, London, UK
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Bustami M, Matalka KZ, Elyyan Y, Hussein N, Hussein N, Abu Safieh N, Thekrallah F, Mallah E, Abu-Qatouseh L, Arafat T. Age of Natural Menopause Among Jordanian Women and Factors Related to Premature and Early Menopause. Risk Manag Healthc Policy 2021; 14:199-207. [PMID: 33500673 PMCID: PMC7826161 DOI: 10.2147/rmhp.s289851] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 01/05/2021] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE The aim of this study was to assess factors related to the onset of premature/early natural menopause among Jordanian women. METHODS A cross-sectional study was conducted in early 2016. Subjects were enrolled based on random drop-off technique to the Obstetrics and Gynecology clinics at the Jordan University Hospital. Women 18 years of age and above were initially eligible to enroll, and women who had surgically induced menopause or specific disease were excluded from the analysis. Relevant data were collected using a questionnaire that included 30 questions. The following variables were collected: socio-demographic, body mass index, chronic conditions, diseases, reproductive characteristics, and health status. Hormone indicators of menopause were tested by measuring estrogen (E2) and follicle-stimulating hormone (FSH) levels. Age at natural menopause (ANM) was self-reported retrospectively and considered an independent variable against BMI, smoking, hormone therapy, and concomitant diseases. Association analysis and multinomial logistic regression were used to examine the associated factors of ANM with adjusted odds ratios (ORs), and their 95% confidence intervals (CIs) were reported. RESULTS A total of 409 women were included in the analysis, aged between 20-75 years. The mean ANM in our sample was 48.5±5.0, with 2.7% of the women experienced premature menopause (ANM <40) and 7.8% early menopause (ANM 40-44). Within the menopause women (n=242), the percentage of women who had premature menopause was 4.5%, 13.6% with early menopause, and 21.1% with late menopause (ANM >52). Smoking was the major risk factor for premature/early menopausal age among Jordanian women with an OR of 2.46 (95% CI: 1.08-5.59, p<0.05). On the other hand, women with occasional arthritis symptoms and diseases such as hypertension, diabetes, dyslipidemia, and their combination were associated with average (45-52 years) or late menopause (>52 years). CONCLUSION Smoking is the main contributor of premature/early menopause in Jordanian women. Increased awareness and public health policy about the adverse effects of smoking on women's reproductive health are needed.
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Affiliation(s)
- Mona Bustami
- Department of Pharmacology and Biomedical Sciences, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman11196, Jordan
| | | | - Yousef Elyyan
- Department of Obstetrics and Gynecology, Jordan University Hospital, Amman, Jordan
| | | | - Nour Hussein
- School of Medicine, University of Jordan, Amman, Jordan
| | | | - Fida Thekrallah
- Department of Obstetrics and Gynecology, Jordan University Hospital, Amman, Jordan
| | - Eyad Mallah
- Department of Pharmaceutical Medicinal Chemistry and Pharmacognosy, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman11196, Jordan
| | - Luay Abu-Qatouseh
- Department of Pharmacology and Biomedical Sciences, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman11196, Jordan
| | - Tawfiq Arafat
- Jordan Center for Pharmaceutical Research, Amman, Jordan
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Bar-Sadeh B, Rudnizky S, Pnueli L, Bentley GR, Stöger R, Kaplan A, Melamed P. Unravelling the role of epigenetics in reproductive adaptations to early-life environment. Nat Rev Endocrinol 2020; 16:519-533. [PMID: 32620937 DOI: 10.1038/s41574-020-0370-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/11/2020] [Indexed: 11/08/2022]
Abstract
Reproductive function adjusts in response to environmental conditions in order to optimize success. In humans, this plasticity includes age of pubertal onset, hormone levels and age at menopause. These reproductive characteristics vary across populations with distinct lifestyles and following specific childhood events, and point to a role for the early-life environment in shaping adult reproductive trajectories. Epigenetic mechanisms respond to external signals, exert long-term effects on gene expression and have been shown in animal and cellular studies to regulate normal reproductive function, strongly implicating their role in these adaptations. Moreover, human cohort data have revealed differential DNA methylation signatures in proxy tissues that are associated with reproductive phenotypic variation, although the cause-effect relationships are difficult to discern, calling for additional complementary approaches to establish functionality. In this Review, we summarize how adult reproductive function can be shaped by childhood events. We discuss why the influence of the childhood environment on adult reproductive function is an important consideration in understanding how reproduction is regulated and necessitates consideration by clinicians treating women with diverse life histories. The resolution of the molecular mechanisms responsible for human reproductive plasticity could also lead to new approaches for intervention by targeting these epigenetic modifications.
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Affiliation(s)
- Ben Bar-Sadeh
- Faculty of Biology, Technion-Israel Institute of Technology, Haifa, Israel
| | - Sergei Rudnizky
- Faculty of Biology, Technion-Israel Institute of Technology, Haifa, Israel
| | - Lilach Pnueli
- Faculty of Biology, Technion-Israel Institute of Technology, Haifa, Israel
| | | | - Reinhard Stöger
- Department of Biological Sciences, University of Nottingham, Nottingham, UK
| | - Ariel Kaplan
- Faculty of Biology, Technion-Israel Institute of Technology, Haifa, Israel
| | - Philippa Melamed
- Faculty of Biology, Technion-Israel Institute of Technology, Haifa, Israel.
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Yazdkhasti M, Negarandeh R, Behboodi Moghadam Z. An empowerment model of Iranian women for the management of menopause: a grounded theory study. Int J Qual Stud Health Well-being 2020; 14:1665958. [PMID: 31589094 PMCID: PMC6792047 DOI: 10.1080/17482631.2019.1665958] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Background and Objectives: There is still no clear portrayal of women's empowerment in managing menopause. The present study was conducted to design a model for the empowerment of Iranian women in managing menopause. Materials and Methods: This qualitative study was conducted using the grounded theory on 40-60-year-old women who were first selected through purposive sampling and then by theoretical sampling from November 2013 to July 2016. Data were collected using 33 in-depth, semi-structured, individual interviews with 30 participants. Data were analyzed using the Strauss and Corbin(2008) approach and organized in MAXQDA-10. Results: The analysis of the data led to the emergence of "active coping with menopause" as the core variable with four themes. The two themes "threat to feminine identity" and "latent opportunity" explained the context of the study, and "redefining the feminine identity" and "self-retrieval" explained its process. Conclusion: In our social context, the phenomenon of menopause is a coin with two sides and its experience leans more on the threat to feminine identity and less on latent opportunity. The model of postmenopausal women's empowerment for managing menopause might offer health policy-makers a realistic and divergent understanding of the challenges of empowering women by explaining key concepts.
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Affiliation(s)
- Mansoureh Yazdkhasti
- Department of Midwifery, School of Medicine, Social Determinants of Health Research Center, Alborz University of Medical Sciences , Karaj , Iran
| | - Reza Negarandeh
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences , Tehran , Iran
| | - Zahra Behboodi Moghadam
- Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences , Tehran , Iran
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Langton CR, Whitcomb BW, Purdue-Smithe AC, Sievert LL, Hankinson SE, Manson JE, Rosner BA, Bertone-Johnson ER. Association of Parity and Breastfeeding With Risk of Early Natural Menopause. JAMA Netw Open 2020; 3:e1919615. [PMID: 31968114 PMCID: PMC6991272 DOI: 10.1001/jamanetworkopen.2019.19615] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
IMPORTANCE Pregnancy and breastfeeding prevent ovulation and may slow the depletion of the ovarian follicle pool. These factors may lower the risk of early menopause, a condition associated with increased risk of cardiovascular disease and other adverse health outcomes. OBJECTIVE To examine the association of parity and breastfeeding with the risk of early menopause. DESIGN, SETTING, AND PARTICIPANTS This population-based cohort study within the Nurses' Health Study II cohort (1989-2015) included premenopausal participants who were aged 25 to 42 years at baseline. Response rates were 85% to 90% for each cycle, and follow-up continued until menopause, age 45 years, hysterectomy, oophorectomy, death, cancer diagnosis, loss to follow-up, or end of follow-up in May 2015. Hypotheses were formulated after data collection. Data analysis took place from February to July 2019. EXPOSURES Parity (ie, number of pregnancies lasting ≥6 months) was measured at baseline and every 2 years. History and duration of total and exclusive breastfeeding were assessed 3 times during follow-up. Menopause status and age were assessed every 2 years. MAIN OUTCOMES AND MEASURES Risk of natural menopause before age 45 years. RESULTS At baseline, 108 887 premenopausal women aged 25 to 42 years (mean [SD] age, 34.1 [4.6] years; 102 246 [93.9%] non-Hispanic white) were included in the study. In multivariable models, higher parity was associated with lower risk of early menopause. Hazard ratios were attenuated with adjustment for breastfeeding but remained significant. Compared with nulliparous women, those reporting 1, 2, 3, and 4 or more pregnancies lasting at least 6 months had hazard ratios for early menopause of 0.92 (95% CI, 0.79-1.06), 0.84 (95% CI, 0.73-0.96), 0.78 (95% CI, 0.67-0.92), and 0.81 (95% CI, 0.66-1.01), respectively (P for trend = .006). In multivariable models also adjusted for parity, hazard ratios for duration of exclusive breastfeeding of 1 to 6, 7 to 12, 13 to 18, and 19 or more months were 0.95 (95% CI, 0.85-1.07), 0.72 (95% CI, 0.62-0.83), 0.80 (95% CI, 0.66-0.97), and 0.89 (95% CI, 0.69-1.16), respectively, compared with less than 1 month of exclusive breastfeeding (P for trend = .001). Despite the significant test for trend, estimates were not observed to be lower as duration of exclusive breastfeeding increased. In a stratified analysis of parous women, risk of early menopause was lowest among those reporting exclusive breastfeeding for 7 to 12 months in each level of parity (women with 2 pregnancies and 7-12 months of breastfeeding: HR, 0.79; 95% CI, 0.66-0.96; ≥3 pregnancies and 7-12 months of breastfeeding: HR, 0.68; 95% CI, 0.52-0.88; 2 pregnancies and ≥13 months of breastfeeding: HR, 0.87; 95% CI, 0.66-1.15; ≥3 pregnancies and 13-18 months of breastfeeding: HR, 0.86; 95% CI, 0.66-1.13; and ≥3 pregnancies and ≥19 months of breastfeeding: HR, 0.98; 95% CI, 0.72-1.32). CONCLUSIONS AND RELEVANCE In this study, an inverse association of parity with risk of early menopause was observed. Breastfeeding was associated with significantly lower risk, even after accounting for parity. Breastfeeding at levels consistent with current recommendations may confer an additional benefit of lower risk of early menopause.
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Affiliation(s)
- Christine R. Langton
- School of Public Health and Health Sciences, Department of Biostatistics and Epidemiology, University of Massachusetts, Amherst
| | - Brian W. Whitcomb
- School of Public Health and Health Sciences, Department of Biostatistics and Epidemiology, University of Massachusetts, Amherst
| | - Alexandra C. Purdue-Smithe
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | | | - Susan E. Hankinson
- School of Public Health and Health Sciences, Department of Biostatistics and Epidemiology, University of Massachusetts, Amherst
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - JoAnn E. Manson
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Division of Preventive Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Bernard A. Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Elizabeth R. Bertone-Johnson
- School of Public Health and Health Sciences, Department of Biostatistics and Epidemiology, University of Massachusetts, Amherst
- School of Public Health and Health Sciences, Department of Health Promotion and Policy, University of Massachusetts, Amherst
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Liu X, Fu X, Du R, Chen Z, Sun J, Ding Y. Epidemiology and Risk Factors of Menopause Syndrome Among Uyghur, Han, and Kazak Women in Xinjiang, China. MEDICAL SCIENCE MONITOR : INTERNATIONAL MEDICAL JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2018; 24:8950-8958. [PMID: 30531683 PMCID: PMC6298176 DOI: 10.12659/msm.909954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND This study analyzed the epidemiology and the risk factors of menopause syndrome (MPS) among Uyghur, Han, and Kazak women in Xinjiang. MATERIAL AND METHODS This was a cross-sectional study. The stratified-cluster random-sampling method was used. A total of 3382 women aged 40 to 60 years of age were included from Urumqi City, Kashgar City, Altay City, Ili Kazakh Autonomous Prefecture, Künes County, Mongolkure County, Tekes County,Talede town, Alemale Township, and Ulugchat County (Kashgar Prefecture) in Xinjiang Province. A questionnaire was used to survey the clinical characteristics of MPS. Logistic regression analysis was used to analyze the MPS risk factors among Uyghur, Han, and Kazak women. RESULTS Oral contraceptives, negative life events, and menopause stages can influence MPS in Han women. In addition, occupation, body weight, mental illness, drug or alcohol abuse, and income level also affect the MPS of Uyghur women. In contrast to Han and Uyghur participants, education, menopausal pattern (natural or artificial), reproductive factors, and smoking are risk factors of MPS in Kazakh women. CONCLUSIONS The menopausal stages and the risk factors for MPS are different among Uyghur, Han, and Kazak women.
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Affiliation(s)
- Xinlian Liu
- Department of Gynecology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China (mainland)
| | - Xi Fu
- Department of Gynecology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China (mainland)
| | - Rong Du
- Department of Gynecology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China (mainland)
| | - Zhifang Chen
- Department of Gynecology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China (mainland)
| | - Jialin Sun
- Department of Gynecology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China (mainland)
| | - Yan Ding
- Department of Gynecology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China (mainland)
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Kyweluk MA, Sievert LL, Huicochea-Gómez L, Cahuich-Campos D, McDade T, Brown DE. Variation in levels of AMH among Maya and non-Maya women in Campeche, Mexico. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2018; 167:282-290. [PMID: 30159886 DOI: 10.1002/ajpa.23627] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 05/09/2018] [Accepted: 05/19/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The purpose of this study was to examine anti-Müllerian hormone (AMH) levels among women of Maya and non-Maya ancestry in the city of Campeche, Mexico. Levels of AMH can potentially predict age at menopause. Previous studies have indicated an early mean age at menopause among the Maya. MATERIALS AND METHODS Women aged 40-60 (n = 97) participated in semistructured interviews, anthropometric measures, and blood samples. Maya/non-Maya ethnicity was determined by the last names, languages spoken, and birthplace of the woman, her parents, and her grandparents. AMH values were categorized as detectable (0.05-4.19 ng/mL) and undetectable (<0.05 ng/mL). Logistic regressions calculated odds ratios (OR) for undetectable AMH. RESULTS Women were categorized as Maya (n = 44), not Maya (n = 39), or not able to be clearly defined (n = 14). In bivariate comparisons, women with detectable levels of AMH were younger, more likely to be pre-menopausal, and not Maya. Age, menopausal status, and ethnicity remained significant in a logistic regression models after controlling for age at menarche. Maya women were more than five times as likely to have nondetectable AMH levels as non-Maya women. DISCUSSION Increasing age and progression through the menopausal transition were both associated with declining levels of AMH. The association between Maya ethnicity and a lower likelihood of detecting AMH is consistent with the early ages at menopause reported in previous studies. We considered a rapid life history model as an explanatory framework, and suggest, from an ecological perspective, that future research should consider measures of developmental stress that may compromise ovarian reserves.
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Affiliation(s)
- Moira A Kyweluk
- Department of Anthropology, Northwestern University, Evanston, Illinois, 60208
| | | | | | - Diana Cahuich-Campos
- Depto de Sociedad y Cultura, El Colegio de la Frontera, ECOSUR, Campeche, México
| | - Thomas McDade
- Department of Anthropology, Northwestern University, Evanston, Illinois, 60208.,Institute for Policy Research Northwestern University, Evanston, Illinois, 60208
| | - Daniel E Brown
- Department of Anthropology, University of Hawai'i at Hilo, Hawaii, 96720
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Childhood ecology influences salivary testosterone, pubertal age and stature of Bangladeshi UK migrant men. Nat Ecol Evol 2018; 2:1146-1154. [DOI: 10.1038/s41559-018-0567-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 05/01/2018] [Indexed: 02/07/2023]
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Golshiri P, Akbari M, Abdollahzadeh MR. Age at Natural Menopause and Related Factors in Isfahan, Iran. J Menopausal Med 2016; 22:87-93. [PMID: 27617243 PMCID: PMC5016509 DOI: 10.6118/jmm.2016.22.2.87] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 07/30/2016] [Accepted: 08/04/2016] [Indexed: 11/24/2022] Open
Abstract
Objective This study was aimed to evaluate the age at natural menopause and related factors among women in a population based study in 2015 in Isfahan, Islamic Republic of Iran. Methods In this cross-sectional study 960 menopausal women were selected by cluster sampling. Demographic, socioeconomic, lifestyle behavior and reproductive history aspects were collected using a structured questionnaire. Woman and her husband's educational level and occupation with family income were the variables to construct socioeconomic status using principal component analysis. Results Mean and median of natural menopause age were 48.66 and 48 years, respectively. Women body mass index (BMI) more than 30 kg/m2 had significantly higher menopausal age than women with lower BMI (P value = 0.022). The mean of menopausal age was not statistically significant in regard to marital status, physical activity, smoking status, menarche age, age at first pregnancy and history of abortion. Menopause age with pregnancy numbers and age at last pregnancy had a significant positive association. Women with better socioeconomic status had significantly higher natural menopause age. Multiple linear regression shows significant relationship between lower age at menopause with higher age at marriage, higher number of pregnancy and lower socioeconomic status. Conclusion Age at menopause in our studied sample is similar to previous estimates reported for other Iranian populations. Age at marriage, higher number of pregnancy and lower socioeconomic status were the significant factors in relations to age at menopause.
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Affiliation(s)
- Parastoo Golshiri
- Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mojtaba Akbari
- Department of Epidemiology, School of Health and Nutrition, Shiraz University of Medical Sciences, Shiraz, Iran
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Sievert LL, Begum K, Sharmeen T, Murphy L, Whitcomb BW, Chowdhury O, Muttukrishna S, Bentley GR. Hot flash report and measurement among Bangladeshi migrants, their London neighbors, and their community of origin. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2016; 161:620-633. [DOI: 10.1002/ajpa.23062] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 07/26/2016] [Indexed: 12/16/2022]
Affiliation(s)
- L. L. Sievert
- Department of AnthropologyUniversity of MassachusettsAmherst Massachusetts
| | - K. Begum
- Department of AnthropologyUniversity College LondonLondon United Kingdom
| | - T. Sharmeen
- Department of AnthropologyUniversity College LondonLondon United Kingdom
| | - L. Murphy
- Department of AnthropologyUniversity of MassachusettsAmherst Massachusetts
| | - B. W. Whitcomb
- School of Public HealthUniversity of MassachusettsAmherst Massachusetts
| | | | - S. Muttukrishna
- Department of Obstetrics and GynecologyUniversity College CorkCork Ireland
| | - G. R. Bentley
- Department of AnthropologyDurham UniversityDurham United Kingdom
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Dhanoya T, Sievert LL, Muttukrishna S, Begum K, Sharmeen T, Kasim A, Chowdhury O, Bentley GR. Hot flushes and reproductive hormone levels during the menopausal transition. Maturitas 2016; 89:43-51. [DOI: 10.1016/j.maturitas.2016.03.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 03/20/2016] [Accepted: 03/22/2016] [Indexed: 12/18/2022]
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Begum K, Muttukrishna S, Sievert LL, Sharmeen T, Murphy L, Chowdhury O, Kasim A, Gunu R, Bentley GR. Ethnicity or environment: effects of migration on ovarian reserve among Bangladeshi women in the United Kingdom. Fertil Steril 2015; 105:744-754.e1. [PMID: 26706133 DOI: 10.1016/j.fertnstert.2015.11.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 10/24/2015] [Accepted: 11/16/2015] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To assess whether the quality of early childhood environments among different groups of Bangladeshi women, including migrants to the United Kingdom (UK), contributes to variation in ovarian reserve and the rate of reproductive aging in later life. DESIGN Cross-sectional study. SETTING Not applicable. PATIENT(S) A total of 179 healthy women volunteers aged 35-59 years were divided into four groups: [1] 36 Bangladeshis living in Sylhet, Bangladesh; [2] 53 Bangladeshis who migrated to the UK as adults; [3] 40 Bangladeshis who migrated to the UK as children aged 0-16 years; and [4] a reference group of 50 women of European origin living in London. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Levels of serum antimüllerian hormone, inhibin B, FSH, and E2, and anthropometrics derived from biomarkers; reproductive, demographic, and health variables from structured questionnaires. RESULT(S) Bangladeshi migrants who moved to the UK as children and European women had a highly significantly larger, age-related ovarian reserve compared with migrant Bangladeshis who had moved to the UK as adults or Bangladeshi women still living in Bangladesh. There were no other significant covariates in the model aside from age and menopausal status. CONCLUSION(S) The study points to the importance of childhood development in considering variation in ovarian reserve across different ethnic groups. Clinical studies and research in assisted reproductive technology have emphasized the role of genes or race in determining inter-population variation in ovarian reserve. Early life developmental factors should be given due consideration when evaluating inter-group differences in response to assisted reproductive technology.
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Affiliation(s)
- Khurshida Begum
- Department of Anthropology, University College London, London, United Kingdom
| | - Shanthi Muttukrishna
- Anu Research Centre, Department of Obstetrics and Gynaecology, University College Cork, Cork, Republic of Ireland
| | | | - Taniya Sharmeen
- Department of Anthropology, University College London, London, United Kingdom
| | - Lorna Murphy
- School of Public Health, University of Massachusetts, Amherst, Massachusetts
| | | | - Adetayo Kasim
- Wolfson Research Institute for Health and Wellbeing, Durham University, Durham, United Kingdom
| | - Richard Gunu
- Institute for Women's Health, University College London, London, United Kingdom
| | - Gillian R Bentley
- Department of Anthropology and Wolfson Research Institute for Health and Wellbeing, Durham University, Durham, United Kingdom.
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Bogin B, Bragg J, Kuzawa C. Humans are not cooperative breeders but practice biocultural reproduction. Ann Hum Biol 2015; 41:368-80. [PMID: 24932750 DOI: 10.3109/03014460.2014.923938] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT Alloparental care and feeding of young is often called "cooperative breeding" and humans are increasingly described as being a cooperative breeding species. OBJECTIVE To critically evaluate whether the human offspring care system is best grouped with that of other cooperative breeders. METHODS (1) Review of the human system of offspring care in the light of definitions of cooperative, communal and social breeding; (2) re-analysis of human lifetime reproductive effort. RESULTS Human reproduction and offspring care are distinct from other species because alloparental behaviour is defined culturally rather than by genetic kinship alone. This system allows local flexibility in provisioning strategies and ensures that care and resources often flow between unrelated individuals. This review proposes the term "biocultural reproduction" to describe this unique human reproductive system. In a re-analysis of human life history data, it is estimated that the intense alloparenting typical of human societies lowers the lifetime reproductive effort of individual women by 14-29% compared to expectations based upon other mammals. CONCLUSION Humans are not cooperative breeders as classically defined; one effect of the unique strategy of human biocultural reproduction is a lowering of human lifetime reproductive effort, which could help explain lifespan extension.
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Affiliation(s)
- Barry Bogin
- School of Sport, Exercise & Health Sciences, Loughborough University , Loughborough , UK and
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Childhood environment influences adrenarcheal timing among first-generation Bangladeshi migrant girls to the UK. PLoS One 2014; 9:e109200. [PMID: 25309977 PMCID: PMC4195659 DOI: 10.1371/journal.pone.0109200] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 09/01/2014] [Indexed: 01/23/2023] Open
Abstract
Background Adrenarche is a key early life event that marks middle childhood at approximately 7 years of age. Earlier work with British-Bangladeshi migrant women suggested that environmental conditions experienced before adrenarche influence adult reproductive function. We therefore investigated whether Bangladeshi children who migrate to the United Kingdom (UK) reach adrenarche earlier than non-migrants in Bangladesh or the United Kingdom. Methods and Findings Healthy girls, aged 5–16 years, were recruited from schools in Sylhet, Bangladesh and London, England comprising four groups: Sylhetis (n = 165), first-generation migrants to the United Kingdom (n = 42), second-generation girls (n = 162), and British girls of European origin (n = 50). Anthropometric measurements were collected together with questionnaire data for migration and socioeconomic characteristics. Saliva samples were assayed for dehydroepiandrosterone (DHEAS) using enzyme-linked immunosorbent assays. Multiple linear regressions tested for group differences in anthropometric and socioeconomic variables and DHEAS levels. Median ages at adrenarche (DHEAS>400 pg/ml) were estimated using Weibull regression models for parametric survival analysis. Hazard ratios for reaching adrenarche earlier and 95% confidence intervals (CI), both unadjusted and adjusted for anthropometric variables, were estimated from the survival analyses. First-generation migrants had a median age at adrenarche (5.3 years) that was significantly earlier than Sylheti (7.2), second-generation (7.4), and European (7.1) girls. In univariate analyses, first-generation girls reached adrenarche significantly earlier than Sylhetis [HR (CI): 2.8 (1.4–5.5]. In multivariate models, first generation girls still reached adrenarche earlier than Sylhetis after adjusting for height [HR(CI): 1.9 (0.9–4.1)] and weight [HR(CI):1.7 (0.8–3.8)], but these results were attenuated. Conclusions We suggest that rapid catch-up growth experienced by first generation girls during early childhood may explain their advanced adrenarche. The environmental conditions leading to an earlier adrenarche, as well as the health implications of this early transition, merit further exploration.
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Abstract
A literature search was done using PubMed. The age at natural menopause (ANM) depends on various factors like genetic, environmental, socioeconomic, reproductive, dietary, and lifestyle of which some like nulliparity, vegetarian diet, smoking, high fat intake, cholesterol, and caffeine accelerates; while others like parity, prior use of oral contraceptive pills, and Japanese ethnicity delays the ANM. ANM is an important risk factor for long-term morbidity and mortality; and hence, the need to identify the modifiable risk factors like diet and lifestyle changes. Delayed menopause is associated with increased risk of endometrial and breast cancer, while early ANM enhances the risk for cardiovascular diseases and osteoporosis. The correlation between diet and ANM has not been extensively studied; however, whatever studies have been done till now point towards role of high intake of total calories, fruits, and proteins in delaying the ANM, while high polyunsaturated fat intake accelerates it. The role of dietary soy, total fat, saturated fat, red meat, and dietary fiber in determining the ANM has been controversial and needs further studies to substantiate it. The lifestyle factors like current smoking and vigorous exercise have been significantly associated with early menopause, while moderate alcohol consumption delays the ANM. Large prospective studies are needed to study the association of ANM and other modifiable factors like passive smoking fish consumption, soy, and various types of tea. The knowledge of modifiable determinants of ANM can help in setting up menopausal clinics and initiating health programs specially in developing countries.
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Affiliation(s)
- Shilpa Sapre
- Department of Obstetrics and Gynecology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Ratna Thakur
- Department of Obstetrics and Gynecology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
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Balić D, Rizvanović M, Cizek-Sajko M, Balić A. Age at natural menopause in refugee and domicile women who lived in Tuzla Canton in Bosnia and Herzegovina during and after the war. Menopause 2014; 21:721-5. [PMID: 24473533 DOI: 10.1097/gme.0000000000000173] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study aims to estimate age at onset of natural menopause in domicile and refugee women who lived in Tuzla Canton in Bosnia and Herzegovina during the war (1992-1995) and in the postwar period until the interview. METHODS A cross-sectional study was conducted on a sample of 331 postmenopausal women-264 (80%) domicile women and 67 (20%) refugee women-between June 2009 and February 2011. RESULTS The study encompassed 331 women with a mean age of 57.0 years (range, 39-75 y). The overall mean age at menopause was 49.1 years. The mean age at menopause was higher in domicile women (49.3 y) than in refugee women (48.0 y; unpaired t test, P = 0.023). After adjustment for age at menarche, education, marital status, living place, body mass index, number of abortions, use of contraceptives, and current smoking, only refugee status and parity remained as significant independent predictors of age at menopause (score test, P = 0.025). Refugee women had an increased probability of earlier onset of menopause compared with nonrefugee women (adjusted hazard ratio, 1.33; 95% CI, 1.02-1.75; P = 0.039), whereas there was a decreased probability of experiencing menopause with increasing number of births (adjusted hazard ratio, 0.92; 95% CI, 0.84-0.996; P = 0.04). CONCLUSIONS The age at onset of menopause in refugee women is lower than that in domicile women, indicating that war, independently of other factors, could influence the age when menopause occurs. On average, women who lived in Bosnia and Herzegovina during the war and postwar period entered menopause earlier than did women from Europe.
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Affiliation(s)
- Devleta Balić
- From the 1Center for Human Reproduction "Dr Balić," Tuzla, Bosnia and Herzegovina; 2Ob/Gyn Clinic, University Clinical Center, Tuzla, Bosnia and Herzegovina; and 3Institute for Biostatistics and Medical Informatics, University of Ljubljana, Ljubljana, Slovenia
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Sievert LL, Murphy L, Morrison L, Reza A, Brown DE. Age at menopause and determinants of hysterectomy and menopause in a multi-ethnic community: the Hilo Women's Health Study. Maturitas 2013; 76:334-41. [PMID: 24054435 PMCID: PMC3840033 DOI: 10.1016/j.maturitas.2013.08.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 08/13/2013] [Accepted: 08/16/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVES A lifespan approach was used to evaluate age at menopause, and determinants of surgical and natural menopause, in the multi-ethnic community of Hilo, Hawaii. STUDY DESIGN Participants aged 40-60 years (n=898) were drawn from a larger, randomly generated sample recruited by postal questionnaires. Median age at natural menopause was computed by probit analysis. Logistic regression analysis was applied to examine determinants of hysterectomy, and Cox regression analysis was used to examine risk factors for an earlier age at menopause. MAIN OUTCOME MEASURES History of hysterectomy, age at menopause. RESULTS Frequency of hysterectomy was 19.2% at a mean age of 40.5 years. The likelihood of hysterectomy increased with older ages, lower education, mixed ancestry, having been overweight at age 30, and married 20 years prior to survey. Median age at natural menopause was 53.0 years. Smoking and not being married 10 years before survey were associated with an earlier age at menopause. CONCLUSIONS Median age at menopause was later than the national average. Ethnicity and education were determinants of hysterectomy, but not associated with age at natural menopause. Events later in the lifespan (e.g., smoking and not being married 10 years prior to the survey) were more important than earlier events (e.g., childhood residence) in relation to age at menopause. The timing of weight gain and marital status appear to be important in relation to surgical menopause, and the timing of marital status appears to be important in relation to the timing of natural menopause.
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Affiliation(s)
| | - Lorna Murphy
- Department of Epidemiology and Biostatistics, School of Public Health, UMass Amherst, Amherst, MA 01003 USA
| | - Lynn Morrison
- Department of Anthropology, University of Hawaii, Hilo, HI 96720
| | - Angela Reza
- Department of Anthropology, UMass Amherst, Amherst, MA 01003 USA
| | - Daniel E. Brown
- Department of Anthropology, University of Hawaii, Hilo, HI 96720
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Shaw LJ, Tandon S, Rosen S, Mieres JH. Evaluation of suspected ischemic heart disease in symptomatic women. Can J Cardiol 2013; 30:729-37. [PMID: 24582723 DOI: 10.1016/j.cjca.2013.09.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Revised: 09/20/2013] [Accepted: 09/22/2013] [Indexed: 01/22/2023] Open
Abstract
There is a wealth of evidence about the role of a variety of diagnostic testing modalities to define coronary artery disease (CAD) risk in women presenting for evaluation of suspected myocardial ischemia. The exercise electrocardiogram (ECG) is the core index procedure, which can define risk in women capable of performing maximal exercise. Stress imaging, using echocardiography or myocardial perfusion single-photon emission computed tomography/positron emission tomography, is useful for symptomatic women with an abnormal resting ECG or for those who are functionally disabled. For women with low-risk stress imaging findings, there is a very low risk of CAD events, usually < 1%. There is a gradient relationship between the extent and severity of inducible abnormalities and CAD event risk. Women at high risk are those defined as having moderate to severely abnormal wall motion or abnormal perfusion imaging findings. In addition to stress imaging, the evidence of the relationship between CAD extent and severity and prognosis has been clearly defined with coronary computed tomographic angiography. In women, prognosis for those with mild but nonobstructive CAD is higher when compared with those without any CAD. The current evidence base clearly supports that women presenting with chest pain can benefit from one of the commonly applied diagnostic testing modalities.
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Affiliation(s)
- Leslee J Shaw
- Emory University School of Medicine, Atlanta, Georgia, USA.
| | | | - Stacey Rosen
- North Shore Long Island Jewish Hospital, Manhasset, New York, USA
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Pérez-Alcalá I, Sievert LL, Obermeyer CM, Reher DS. Cross cultural analysis of factors associated with age at natural menopause among latin-american immigrants to madrid and their spanish neighbors. Am J Hum Biol 2013; 25:780-8. [DOI: 10.1002/ajhb.22447] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 07/01/2013] [Accepted: 08/06/2013] [Indexed: 11/06/2022] Open
Affiliation(s)
- Irene Pérez-Alcalá
- Department of Sociology II (Human Ecology and Population Studies); Universidad Complutense de Madrid; Madrid Spain
| | | | | | - David Sven Reher
- Department of Sociology II (Human Ecology and Population Studies); Universidad Complutense de Madrid; Madrid Spain
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Sievert LL. Subjective and objective measures of hot flashes. Am J Hum Biol 2013; 25:573-80. [DOI: 10.1002/ajhb.22415] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 04/30/2013] [Accepted: 05/07/2013] [Indexed: 12/11/2022] Open
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