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Baldacci S, Santoro M, Mezzasalma L, Pierini A, Coi A. Medication use during pregnancy and the risk of gastroschisis: a systematic review and meta-analysis of observational studies. Orphanet J Rare Dis 2024; 19:31. [PMID: 38287353 PMCID: PMC10826191 DOI: 10.1186/s13023-023-02992-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/12/2023] [Indexed: 01/31/2024] Open
Abstract
OBJECTIVES The aetiology of gastroschisis is considered multifactorial. We conducted a systematic review and meta-analysis to assess whether the use of medications during pregnancy, is associated with the risk of gastroschisis in offspring. METHODS PubMed, EMBASE, and Scopus were searched from 1st January 1990 to 31st December 2020 to identify observational studies examining the association between medication use during pregnancy and the risk of gastroschisis. The Newcastle-Ottawa Scale was used for the quality assessment of the individual studies. We pooled adjusted measures using a random-effect model to estimate relative risk [RR] and the 95% confidence interval [CI]. I2 statistic for heterogeneity and publication bias was calculated. RESULTS Eighteen studies providing data on 751,954 pregnancies were included in the meta-analysis. Pooled RRs showed significant associations between aspirin (RR 1.66, 95% CI 1.16-2.38; I2 = 58.3%), oral contraceptives (RR 1.52, 95% CI 1.21-1.92; I2 = 22.0%), pseudoephedrine and phenylpropanolamine (RR 1.51, 95% CI 1.16-1.97; I2 = 33.2%), ibuprofen (RR 1.42, 95% CI 1.26-1.60; I2 = 0.0%), and gastroschisis. No association was observed between paracetamol and gastroschisis (RR 1.16, 95% CI 0.96-1.41; I2 = 39.4%). CONCLUSIONS These results suggest that the exposure in the first trimester of pregnancy to over the counter medications (OTC) such as aspirin, ibuprofen, pseudoephedrine and phenylpropanolamine as well as to oral contraceptives, was associated with an increased risk of gastroschisis. However, these associations are significant only in particular subgroups defined by geographic location, adjustment variables and type of control. Therefore, further research is needed to investigate them as potential risk factors for gastroschisis, to assess their safety in pregnancy and to develop treatment strategies to reduce the risk of gastroschisis in offspring. PROSPERO registration number: CRD42021287529.
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Affiliation(s)
- Silvia Baldacci
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Via G. Moruzzi 1, 56124, Pisa, Italy.
| | - Michele Santoro
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Via G. Moruzzi 1, 56124, Pisa, Italy
| | - Lorena Mezzasalma
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Via G. Moruzzi 1, 56124, Pisa, Italy
| | - Anna Pierini
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Via G. Moruzzi 1, 56124, Pisa, Italy
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Alessio Coi
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Via G. Moruzzi 1, 56124, Pisa, Italy
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Özcan Ö, den Elzen WPJ, Hillebrand JJ, den Heijer M, van Loendersloot LL, Fischer J, Hamer H, de Jonge R, Heijboer AC. The effect of hormonal contraceptive therapy on clinical laboratory parameters: a literature review. Clin Chem Lab Med 2024; 62:18-40. [PMID: 37419659 DOI: 10.1515/cclm-2023-0384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 06/14/2023] [Indexed: 07/09/2023]
Abstract
Hormonal contraceptives (HC) are widely used among women in reproductive ages. In this review, the effects of HCs on 91 routine chemistry tests, metabolic tests, and tests for liver function, hemostatic system, renal function, hormones, vitamins and minerals were evaluated. Test parameters were differently affected by the dosage, duration, composition of HCs and route of administration. Most studies concerned the effects of combined oral contraceptives (COC) on the metabolic, hemostatic and (sex) steroids test results. Although the majority of the effects were minor, a major increase was seen in angiotensinogen levels (90-375 %) and the concentrations of the binding proteins (SHBG [∼200 %], CBG [∼100 %], TBG [∼90 %], VDBP [∼30 %], and IGFBPs [∼40 %]). Also, there were significant changes in levels of their bound molecules (testosterone, T3, T4, cortisol, vitamin D, IGF1 and GH). Data about the effects of all kinds of HCs on all test results are limited and sometimes inconclusive due to the large variety in HC, administration routes and dosages. Still, it can be concluded that HC use in women mainly stimulates the liver production of binding proteins. All biochemical test results of women using HC should be assessed carefully and unexpected test results should be further evaluated for both methodological and pre-analytical reasons. As HCs change over time, future studies are needed to learn more about the effects of other types, routes and combinations of HCs on clinical chemistry tests.
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Affiliation(s)
- Ömer Özcan
- Department of Laboratory Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
| | - Wendy P J den Elzen
- Department of Laboratory Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Jacquelien J Hillebrand
- Department of Laboratory Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
| | - Martin den Heijer
- Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
- Department of Endocrinology and Metabolism, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Laura L van Loendersloot
- Department of Reproductive Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Johan Fischer
- Department of Laboratory Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Henrike Hamer
- Department of Laboratory Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Robert de Jonge
- Department of Laboratory Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Department of Laboratory Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Annemieke C Heijboer
- Department of Laboratory Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
- Department of Laboratory Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands
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3
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Schreuder A, Mokadem I, Smeets NJL, Spaanderman MEA, Roeleveld N, Lupattelli A, van Gelder MMHJ. Associations of periconceptional oral contraceptive use with pregnancy complications and adverse birth outcomes. Int J Epidemiol 2023; 52:1388-1399. [PMID: 37040615 PMCID: PMC10555752 DOI: 10.1093/ije/dyad045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/23/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Periconceptional use of oral contraceptives (OCs) has been reported to increase risks of pregnancy complications and adverse birth outcomes, but risks are suggested to differ depending on the timing of discontinuation, amount of oestrogen and progestin content. METHODS Prospective cohort study among 6470 pregnancies included in the PRegnancy and Infant DEvelopment (PRIDE) Study in 2012-19. Exposure was defined as any reported use of OCs within 12 months pre-pregnancy or after conception. Outcomes of interest were gestational diabetes, gestational hypertension, pre-eclampsia, pre-term birth, low birthweight and small for gestational age (SGA). Multivariable Poisson regression using stabilized inverse probability weighting estimated relative risks (RRs) with 95% CIs. RESULTS Any periconceptional OC use was associated with increased risks of pre-eclampsia (RR 1.38, 95% CI 0.99-1.93), pre-term birth (RR 1.38, 95% CI 1.09-1.75) and low birthweight (RR 1.45, 95% CI 1.10-1.92), but not with gestational hypertension (RR 1.09, 95% CI 0.91-1.31), gestational diabetes (RR 1.02, 95% CI 0.77-1.36) and SGA (RR 0.96, 95% CI 0.75-1.21). Associations with pre-eclampsia were strongest for discontinuation 0-3 months pre-pregnancy, for OCs containing ≥30 µg oestrogen and for first- or second-generation OCs. Pre-term birth and low birthweight were more likely to occur when OCs were discontinued 0-3 months pre-pregnancy, when using OCs containing <30 µg oestrogen and when using third-generation OCs. Associations with SGA were observed for OCs containing <30 µg oestrogen and for third- or fourth-generation OCs. CONCLUSIONS Periconceptional OC use, particularly those containing oestrogen, was associated with increased risks of pre-eclampsia, pre-term birth, low birthweight and SGA.
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Affiliation(s)
- Anton Schreuder
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ibtissam Mokadem
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nori J L Smeets
- Department of Pharmacology and Toxicology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marc E A Spaanderman
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Obstetrics and Gynaecology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Nel Roeleveld
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Angela Lupattelli
- PharmacoEpidemiology and Drug Safety Research Group, School of Pharmacy, and PharmaTox Strategic Research Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
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Hathaway CA, Townsend MK, Sklar EM, Thomas-Purcell KB, Terry KL, Trabert B, Tworoger SS. The Association of Kidney Function and Inflammatory Biomarkers with Epithelial Ovarian Cancer Risk. Cancer Epidemiol Biomarkers Prev 2023; 32:1451-1457. [PMID: 37540498 PMCID: PMC10592177 DOI: 10.1158/1055-9965.epi-23-0543] [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: 05/11/2023] [Revised: 06/30/2023] [Accepted: 08/01/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND One of the mechanisms of ovarian tumorigenesis is through inflammation. Kidney dysfunction is associated with increased inflammation; thus, we assessed its relationship with ovarian cancer risk. METHODS In prospectively collected samples, we evaluated the association of kidney function markers and C-reactive protein (CRP) with ovarian cancer risk in the UK Biobank. We used multivariable-adjusted Cox proportional hazards models to evaluate quartiles of serum and urine markers with ovarian cancer risk overall and by histology. We assessed effect modification by CRP (≤3.0, >3.0 mg/L). RESULTS Among 232,908 women (1,110 ovarian cancer cases diagnosed from 2006-2020), we observed no association between estimated glomerular filtration rate and ovarian cancer risk (Q4 vs. Q1: HR, 1.00; 95% confidence intervals, 0.83-1.22). Potassium was associated with endometrioid (Q4 vs. Q1: 0.33, 0.11-0.98) and clear cell (4.74, 1.39-16.16) tumors. Poor kidney function was associated with a nonsignificant increase in ovarian cancer risk among women with CRP>3.0 mg/L (e.g., uric acid Q4 vs. Q1; 1.23, 0.81-1.86), but not CRP≤3.0 mg/L (0.83, 0.66-1.05). Other associations did not vary across CRP categories. CONCLUSIONS Kidney function was not clearly associated with ovarian cancer risk. Larger studies are needed to evaluate possible histology specific associations. Given the suggestive trend for increased ovarian cancer risk in women with poor kidney function and high CRP, future work is needed, particularly in populations with a high prevalence of inflammatory conditions. IMPACT This study provided the first evaluation of markers of kidney function in relation to ovarian cancer risk.
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Affiliation(s)
- Cassandra A. Hathaway
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA
- Dr. Pallavi Patel College of Health Care Science, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Mary K. Townsend
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Elliot M. Sklar
- Dr. Pallavi Patel College of Health Care Science, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Kamilah B. Thomas-Purcell
- Dr. Pallavi Patel College of Health Care Science, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Kathryn L. Terry
- Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women’s Hospital and Harvard Medical School; Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Britton Trabert
- Department of Obstetrics and Gynecology, University of Utah and Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, USA
| | - Shelley S. Tworoger
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA
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Andersen CJ, Huang L, Zhai F, Esposito CP, Greco JM, Zhang R, Woodruff R, Sloan A, Van Dyke AR. Consumption of Different Egg-Based Diets Alters Clinical Metabolic and Hematological Parameters in Young, Healthy Men and Women. Nutrients 2023; 15:3747. [PMID: 37686779 PMCID: PMC10490185 DOI: 10.3390/nu15173747] [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: 07/03/2023] [Revised: 08/17/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
Eggs-particularly egg yolks-are a rich source of bioactive nutrients and dietary compounds that influence metabolic health, lipid metabolism, immune function, and hematopoiesis. We investigated the effects of consuming an egg-free diet, three egg whites per day, and three whole eggs per day for 4 weeks on comprehensive clinical metabolic, immune, and hematologic profiles in young, healthy adults (18-35 y, BMI < 30 kg/m2 or <30% body fat for men and <40% body fat for women, n = 26) in a 16-week randomized, crossover intervention trial. We observed that average daily macro- and micronutrient intake significantly differed across egg diet periods, including greater intake of choline during the whole egg diet period, which corresponded to increased serum choline and betaine without altering trimethylamine N-oxide. Egg white and whole egg intake increased serum isoleucine while whole egg intake reduced serum glycine-markers of increased and decreased risk of insulin resistance, respectively-without altering other markers of glucose sensitivity or inflammation. Whole egg intake increased a subset of large HDL particles (H6P, 10.8 nm) and decreased the total cholesterol:HDL-cholesterol ratio and % monocytes in female participants using combined oral contraceptive (COC) medication (n = 11) as compared to female non-users (n = 10). Whole egg intake further increased blood hematocrit whereas egg white and whole egg intake reduced blood platelet counts. Changes in clinical immune cell counts between egg white and whole egg diet periods were negatively correlated with several HDL parameters yet positively correlated with measures of triglyceride-rich lipoproteins and insulin sensitivity. Overall, the intake of whole eggs led to greater overall improvements in micronutrient diet quality, choline status, and HDL and hematologic profiles while minimally-yet potentially less adversely-affecting markers of insulin resistance as compared to egg whites.
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Affiliation(s)
- Catherine J. Andersen
- Department of Biology, Fairfield University, Fairfield, CT 06824, USA; (J.M.G.); (A.S.)
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA; (L.H.); (F.Z.); (R.Z.); (R.W.)
| | - Lindsey Huang
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA; (L.H.); (F.Z.); (R.Z.); (R.W.)
| | - Fangyi Zhai
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA; (L.H.); (F.Z.); (R.Z.); (R.W.)
| | - Christa Palancia Esposito
- Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT 06824, USA;
| | - Julia M. Greco
- Department of Biology, Fairfield University, Fairfield, CT 06824, USA; (J.M.G.); (A.S.)
| | - Ruijie Zhang
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA; (L.H.); (F.Z.); (R.Z.); (R.W.)
| | - Rachael Woodruff
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA; (L.H.); (F.Z.); (R.Z.); (R.W.)
| | - Allison Sloan
- Department of Biology, Fairfield University, Fairfield, CT 06824, USA; (J.M.G.); (A.S.)
| | - Aaron R. Van Dyke
- Department of Chemistry and Biochemistry, Fairfield University, Fairfield, CT 06824, USA;
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Badenhorst CE, Govus AD, Mündel T. Does chronic oral contraceptive use detrimentally affect C-reactive protein or iron status for endurance-trained women? Physiol Rep 2023; 11:e15777. [PMID: 37487629 PMCID: PMC10365947 DOI: 10.14814/phy2.15777] [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: 05/30/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 07/26/2023] Open
Abstract
PURPOSE Chronic use of the oral contraceptive pill (OCP) is reported to increase C-reactive protein (CRP) levels and increase the risk of cardiovascular disease in premenopausal females. METHODS A secondary analysis of data from two research studies in eumenorrheic (n = 8) and OCP (n = 8) female athletes. Basal CRP and iron parameters were included in the analysis. Sample collection occurred following a standardized exercise and nutritional control for 24 h. Eumenorrheic females were tested in the early-follicular and mid-luteal phases, and the OCP users were tested in quasi-follicular and quasi-luteal phases (both active pill periods). RESULTS A main effect for group (p < 0.01) indicated that average CRP concentration was higher in OCP users compared with eumenorrheic females, regardless of the day of measurement within the cycle. Results demonstrate a degree of iron parameters moderation throughout the menstrual cycle that is influenced by basal CRP levels; however, no linear relationship with CRP, serum iron, and ferritin was observed. CONCLUSIONS Basal CRP values were consistently higher in the OCP group despite participants being in a rested state. These results may indicate a potential risk of cardiovascular disease in prolonged users of the OCP when compared to eumenorrheic female athletes.
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Affiliation(s)
- C. E. Badenhorst
- School of Sport, Exercise and NutritionMassey UniversityPalmerston NorthNew Zealand
| | - A. D. Govus
- Discipline of Sport and Exercise ScienceLa Trobe UniversityMelbourneVictoriaAustralia
| | - T. Mündel
- School of Sport, Exercise and NutritionMassey UniversityPalmerston NorthNew Zealand
- Department of KinesiologyBrock UniversitySt. CatharinesCanada
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7
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Mosorin ME, Piltonen T, Rantala AS, Kangasniemi M, Korhonen E, Bloigu R, Tapanainen JS, Morin-Papunen L. Oral and Vaginal Hormonal Contraceptives Induce Similar Unfavorable Metabolic Effects in Women with PCOS: A Randomized Controlled Trial. J Clin Med 2023; 12:jcm12082827. [PMID: 37109164 PMCID: PMC10143750 DOI: 10.3390/jcm12082827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/31/2023] [Accepted: 04/08/2023] [Indexed: 04/29/2023] Open
Abstract
This clinical trial aims to compare hormonal and metabolic changes after a 9-week continuous use of oral or vaginal combined hormonal contraceptives (CHCs) in women with polycystic ovary syndrome (PCOS). We recruited 24 women with PCOS and randomized them to use either combined oral (COC, n = 13) or vaginal (CVC, n = 11) contraception. At baseline and 9 weeks, blood samples were collected and a 2 h glucose tolerance test (OGTT) was performed to evaluate hormonal and metabolic outcomes. After treatment, serum sex hormone binding globulin (SHBG) levels increased (p < 0.001 for both groups) and the free androgen index (FAI) decreased in both study groups (COC p < 0.001; CVC p = 0.007). OGTT glucose levels at 60 min (p = 0.011) and AUCglucose (p = 0.018) increased in the CVC group. Fasting insulin levels (p = 0.037) increased in the COC group, and insulin levels at 120 min increased in both groups (COC p = 0.004; CVC p = 0.042). There was a significant increase in triglyceride (p < 0.001) and hs-CRP (p = 0.032) levels in the CVC group. Both oral and vaginal CHCs decreased androgenicity and tended to promote insulin resistance in PCOS women. Larger and longer studies are needed to compare the metabolic effects of different administration routes of CHCs on women with PCOS.
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Affiliation(s)
- Maria-Elina Mosorin
- Department of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90220 Oulu, Finland
- Research Unit of Clinical Medicine, University of Oulu, 90220 Oulu, Finland
- Medical Research Center, University of Oulu, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90220 Oulu, Finland
| | - Terhi Piltonen
- Department of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90220 Oulu, Finland
- Research Unit of Clinical Medicine, University of Oulu, 90220 Oulu, Finland
- Medical Research Center, University of Oulu, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90220 Oulu, Finland
| | - Anni S Rantala
- Department of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90220 Oulu, Finland
- Research Unit of Clinical Medicine, University of Oulu, 90220 Oulu, Finland
- Medical Research Center, University of Oulu, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90220 Oulu, Finland
| | - Marika Kangasniemi
- Department of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90220 Oulu, Finland
- Research Unit of Clinical Medicine, University of Oulu, 90220 Oulu, Finland
- Medical Research Center, University of Oulu, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90220 Oulu, Finland
| | - Elisa Korhonen
- Department of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90220 Oulu, Finland
- Research Unit of Clinical Medicine, University of Oulu, 90220 Oulu, Finland
- Medical Research Center, University of Oulu, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90220 Oulu, Finland
| | - Risto Bloigu
- Research Unit of Clinical Medicine, University of Oulu, 90220 Oulu, Finland
- Medical Research Center, University of Oulu, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90220 Oulu, Finland
| | - Juha S Tapanainen
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, 00290 Helsinki, Finland
| | - Laure Morin-Papunen
- Department of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90220 Oulu, Finland
- Research Unit of Clinical Medicine, University of Oulu, 90220 Oulu, Finland
- Medical Research Center, University of Oulu, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90220 Oulu, Finland
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Figueroa-Hall LK, Xu B, Kuplicki R, Ford BN, Burrows K, Teague TK, Sen S, Yeh HW, Irwin MR, Savitz J, Paulus MP. Psychiatric symptoms are not associated with circulating CRP concentrations after controlling for medical, social, and demographic factors. Transl Psychiatry 2022; 12:279. [PMID: 35821205 PMCID: PMC9276683 DOI: 10.1038/s41398-022-02049-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 06/26/2022] [Accepted: 06/30/2022] [Indexed: 01/08/2023] Open
Abstract
Elevated serum concentrations (>3 mg/L) of the acute-phase protein, C-reactive protein (CRP), is used as a clinical marker of inflammation and is reported to be a strong risk factor for cardiovascular disease. In psychiatric populations, CRP concentration is reported to be higher in depressed versus healthy individuals. Positive associations between CRP and depression have been established in both clinical and community samples, but effect sizes are attenuated after controlling for confounding variables. Similarly, emerging research has begun to draw a link between inflammation, symptoms of anxiety, and substance abuse. Given the high level of comorbid anxiety and substance use disorders in many depressed populations, this study examined whether depression (Patient Health Questionnaire 9 [PHQ-9]) and substance use-related (Drug Abuse Screening Test [DAST]) symptoms were associated with CRP concentrations in the blood after adjusting for relevant medical, social, and demographic covariates in a large sample undergoing screening for several transdiagnostic psychiatric research studies. A total of 1,724 participants were analyzed for association of CRP with variables using multivariate linear regression. An unadjusted model with no covariates showed that PHQ-9 was significantly associated with CRP in All (β = 0.125), Female (β = 0.091), and Male (β = 0.154) participants, but DAST was significantly associated with CRP in males only (β = 0.120). For the adjusted model, in both males and females, mood-stabilizer treatment (β = 0.630), opioid medication (β = 0.360), body mass index (β = 0.244), percent body fat (β = 0.289), nicotine use (β = 0.063), and self-reported sleep disturbance (β = 0.061) were significantly associated with increased CRP concentrations. In females, oral contraceptive use (β = 0.576), and waist-to-hip ratio (β = 0.086), and in males, non-steroidal anti-inflammatory drug use (β = 0.367) were also associated with increased CRP concentrations. There was no significant association between CRP and individual depressive, anxiety, or substance use-related symptoms when covariates were included in the regression models. These results suggest that associations between circulating CRP and the severity of psychiatric symptoms are dependent on the type of covariates controlled for in statistical analyses.
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Affiliation(s)
| | - Bohan Xu
- Laureate Institute for Brain Research, Tulsa, OK, 74136, USA
- Department of Computer Science, Tandy School of Computer Science, The University of Tulsa, Tulsa, OK, 74104, USA
| | - Rayus Kuplicki
- Laureate Institute for Brain Research, Tulsa, OK, 74136, USA
| | - Bart N Ford
- Department of Pharmacology & Physiology, Oklahoma State University, Center for Health Sciences, Tulsa, OK, 74107, USA
| | - Kaiping Burrows
- Laureate Institute for Brain Research, Tulsa, OK, 74136, USA
| | - T Kent Teague
- Department of Surgery and Department of Psychiatry, University of Oklahoma-School of Community Medicine, Tulsa, OK, 74135, USA
| | - Sandip Sen
- Department of Computer Science, Tandy School of Computer Science, The University of Tulsa, Tulsa, OK, 74104, USA
| | - Hung-Wen Yeh
- Division of Health Services & Outcomes Research, Children's Mercy Kansas City, Kansas City, MO, 64108, USA
| | - Michael R Irwin
- Department of Psychiatry and Behavioral Sciences, UCLA Geffen School of Medicine, Los Angeles, CA, 90095, USA
| | - Jonathan Savitz
- Laureate Institute for Brain Research, Tulsa, OK, 74136, USA
- Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK, 74199, USA
| | - Martin P Paulus
- Laureate Institute for Brain Research, Tulsa, OK, 74136, USA
- Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK, 74199, USA
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Gomes VA, Sacramento MDSD, Cecilia LMS, Jesus DSD, Barbosa JS, Almeida FOBD, Oliveira ECD, Petto J. Effects of Physical Exercise on Lipid and Inflammatory Profile of Women Using Combined Oral Contraceptive: A Cross-Over Study. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2022. [DOI: 10.36660/ijcs.20200399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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10
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Association between Oral Contraceptive Use and the High-Sensitivity C-Reactive Protein Level in Premenopausal Korean Women. Healthcare (Basel) 2022; 10:healthcare10020361. [PMID: 35206975 PMCID: PMC8872382 DOI: 10.3390/healthcare10020361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/04/2022] [Accepted: 02/10/2022] [Indexed: 12/04/2022] Open
Abstract
Although oral contraceptives (OCs) are widely used, few national epidemiological studies have evaluated the association between OC use and serum high-sensitivity C-reactive protein (hs-CRP) levels in Korean women. This population-based cross-sectional study was conducted with data from the 2015–2018 National Health and Nutrition Examination Survey. In the sample of 5332 premenopausal women aged ≥19 years, hs-CRP concentrations were 1.087 mg/L among OC users and 0.953 mg/L among OC non-users. After adjustment for confounders, OC users had an increased likelihood of having risky (>1.0 mg/L) hs-CRP levels (adjusted odds ratio (aOR) = 1.58; 95% confidence interval (CI), 1.25–1.98) compared with OC non-users. In addition, the aOR for high-risk (>3.0 mg/L) hs-CRP levels in OC users compared with non-users was 1.51 (95% CI, 1.06–2.16). These findings demonstrate that OC use alters the concentration of hs-CRP, a biomarker of chronic low-grade inflammation, and suggest that long-term OC use is a risk factor in the pathogenesis of inflammatory diseases, including cardiovascular diseases.
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11
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Al-Lami RA, Taha SA, Jalloul RJ, Taylor HS. High-sensitivity C-reactive protein is not independently associated with self-reported infertility in National Health and Nutrition Examination Survey 2015–2018 data. F S Rep 2021; 3:63-70. [PMID: 35386498 PMCID: PMC8978077 DOI: 10.1016/j.xfre.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/08/2021] [Accepted: 12/16/2021] [Indexed: 11/29/2022] Open
Abstract
Objective To study the association between high-sensitivity C-reactive protein (hs-CRP) and infertility among reproductive-age women while controlling for obesity and other metabolic markers. Previous studies found a link between infertility and cardiovascular diseases (CVDs). C-reactive protein is a sensitive marker of CVDs, and its levels are affected by obesity. Design/Setting We conducted a cross-sectional study using national data from 2015 through 2018. Patients A total of 940 women aged 20–45 years who self-reported infertility, had hs-CRP values measured, and did not have CRP >10 mg/L, asthma, arthritis, bronchitis, thyroid disease, bilateral oophorectomy, hysterectomy, and who were not breastfeeding or pregnant, premenarchal at the time of study or had menarche after the age of 20. Interventions N/A. Main outcome measure(s) Infertility status (ever reporting inability to conceive with 12 months of trying to become pregnant). Results In comparison to noninfertile women, self-reported infertile women had higher mean of hs-CRP (3.11 mg/L vs. 2.40 mg/L) and higher percentage of moderate/high hs-CRP values (77.0% vs 58.8%). However, after adjusting for metabolic markers, there was a nonsignificant association between moderate/high hs-CRP and self-reported infertility in the multivariable logistic regression analysis. Odds ratio estimates of the association between hs-CRP and infertility increased over 40% after removing obesity measures and/or high-density lipoprotein from regression models. Conclusion There was no association between hs-CRP and self-reported infertility after controlling for obesity measures and other risk factors for CVDs in a sample of U.S. women aged 20–45 years.
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12
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Oxidative Stress Is Increased in Combined Oral Contraceptives Users and Is Positively Associated with High-Sensitivity C-Reactive Protein. Molecules 2021; 26:molecules26041070. [PMID: 33670593 PMCID: PMC7921945 DOI: 10.3390/molecules26041070] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/10/2021] [Accepted: 02/16/2021] [Indexed: 12/23/2022] Open
Abstract
Information concerning the mechanisms underlying oxidative stress and low-grade inflammation in young healthy women predisposing eventually to future diseases is scarce. We investigated the relationship of oxidative stress and high-sensitivity C-reactive protein (hsCRP) in fertile-age women by oral combined contraceptive (OC) use. Caucasian Italian healthy non-obese women (n = 290; 100 OC-users; 190 non-OC-users; mean age 23.2 ± 4.7 years) were analyzed. Blood hydroperoxides, as oxidative stress biomarkers, were assessed by Free Oxygen Radical Test (FORT). Serum hsCRP was determined by an ultra-sensitive method (hsCRP). Markedly elevated oxidative stress (≥400 FORT Units) was found in 77.0% of OC-users and 1.6% of non-OC-users, odds ratio (OR) = 209, 95% CI = 60.9–715.4, p < 0.001. Elevated hsCRP levels ≥ 2.0 mg/L, considered risky for cardiovascular diseases (CVDs), were found in 41.0% of OC-users and 9.5% of non-OC-users, OR = 6.6, 95%CI 3.5–12.4, p < 0.001. Hydroperoxides were strongly positively correlated to hsCRP in all women (rs = 0.622, p < 0.001), in OC-users (rs = 0.442, p < 0.001), and in non-OC-users (rs = 0.426, p < 0.001). Women with hydroperoxides ≥ 400 FORT Units were eight times as likely to have hsCRP ≥ 2 mg/L. In non-OC-users only, hydroperoxides values were positively correlated with weight and body mass index, but negatively correlated with red meat, fish and chocolate consumption. Our research is the first finding a strong positive correlation of serum hydroperoxides with hsCRP, a marker of low-grade chronic inflammation, in young healthy women. Further research is needed to elucidate the potential role of these two biomarkers in OC-use associated side-effects, like thromboembolism and other CVDs.
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13
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Giovanelli N, Lazzer S, Cauci S. Muscle damage and inflammatory status biomarkers after a 3-stage trail running race. J Sports Med Phys Fitness 2020; 60:1486-1492. [PMID: 32586083 DOI: 10.23736/s0022-4707.20.10997-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Participants in ultramarathon and multi-stage races are continuously increasing. A detailed knowledge of the time-course of the restoration in muscular, cardiac, and inflammatory biomarkers after a multi-stage race may help the design of training schedules focused to avoid adverse outcomes of repetitive high-intensity endurance exercise and athlete exhaustion. Thus, the aim of the study was to evaluate blood parameters and serum biomarkers associated to muscle damage and inflammation in athletes participating in a 3-stage competition. METHODS Ten runners concluded the race "Magraid" consisting of 3 stages of 22, 48 and 20 km. Before (PRE), immediately after the end of the third stage (POST) and five days after the last stage (R5d), we collected blood samples. RESULTS Among others, at POST mean white blood cell (+57±42%; P=0.006), blood urea nitrogen (+68±39%; P<0.001), creatinine (+17±12%, P=0.005), alanine aminotransferase (ALT, +104±69%; P=0.002), lactate dehydrogenase (LDH, +116±64%; P<0.001), creatine kinase (CK, +2044±1433%; P=0.011), CK-MBm (+1544±1007%; P=0.004), cardiac troponin I (cTnI, +85±129%; P=0.015), C-reactive protein (hsCRP, +2137±1660%; P=0.015) were higher than PRE. At R5d, ALT (+72±53%; P=0.010), LDH (+32±25%; P=0.006) and hsCRP (+252±234%; P=0.021) were still different compared with PRE. CONCLUSIONS A 3-stage trail running race induces an inflammatory status and muscle damage and functional consequences on some physiological systems that may not be completely recovered within a short period.
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14
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Larsen B, Cox A, Colbey C, Drew M, McGuire H, Fazekas de St Groth B, Hughes D, Vlahovich N, Waddington G, Burke L, Lundy B, West N, Minahan C. Inflammation and Oral Contraceptive Use in Female Athletes Before the Rio Olympic Games. Front Physiol 2020; 11:497. [PMID: 32523546 PMCID: PMC7261912 DOI: 10.3389/fphys.2020.00497] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 04/23/2020] [Indexed: 12/19/2022] Open
Abstract
This study investigated the association between synthetic ovarian hormone use [i.e., the oral contraceptive (OC) pill] and basal C-reactive protein (CRP), peripheral blood immune cell subsets, and circulating pro- and anti-inflammatory cytokine concentrations in elite female athletes. Elite female athletes (n = 53) selected in Rio Summer Olympic squads participated in this study; 25 were taking an OC (AthletesOC) and 28 were naturally hormonally cycling (AthletesNC). Venous blood samples were collected at rest for the determination of sex hormones, cortisol, CRP, peripheral blood mononuclear memory and naïve CD4+ T-cells, CD8+ T-cells and natural killer cells, as well as pro- and anti-inflammatory cytokine concentrations. C-reactive protein concentrations were elevated (p < 0.001) in AthletesOC (median = 2.02, IQR = 3.15) compared to AthletesNC (median = 0.57, IQR = 1.07). No differences were reported for cortisol, cytokines, or PBMC immune cell subsets, although there was a trend (p = 0.062) for higher IL-6 concentrations in AthletesNC. Female Olympians had substantially higher CRP concentrations, a marker of inflammation and tissue damage, before the Rio Olympic Games if they used an OC. Future research should examine the potential consequences for athlete performance/recovery so that, if necessary, practitioners can implement prevention programs.
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Affiliation(s)
- Brianna Larsen
- Griffith Sports Physiology and Performance, School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.,Queensland Academy of Sport, Nathan, QLD, Australia
| | - Amanda Cox
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.,School of Medical Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Candice Colbey
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.,School of Medical Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Michael Drew
- Australian Institute of Sport, Canberra, ACT, Australia.,Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, VIC, Australia.,University of Canberra Research Institute for Sport and Exercise, Canberra, ACT, Australia
| | - Helen McGuire
- University of Sydney, Sydney, NSW, Australia.,Centenary Institute, Sydney, NSW, Australia
| | | | - David Hughes
- Australian Institute of Sport, Canberra, ACT, Australia
| | | | - Gordon Waddington
- University of Canberra Research Institute for Sport and Exercise, Canberra, ACT, Australia
| | - Louise Burke
- Australian Institute of Sport, Canberra, ACT, Australia
| | - Bronwen Lundy
- Australian Institute of Sport, Canberra, ACT, Australia
| | - Nicholas West
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.,School of Medical Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Clare Minahan
- Griffith Sports Physiology and Performance, School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
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15
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Peres LC, Mallen AR, Townsend MK, Poole EM, Trabert B, Allen NE, Arslan AA, Dossus L, Fortner RT, Gram IT, Hartge P, Idahl A, Kaaks R, Kvaskoff M, Magliocco AM, Merritt MA, Quirós JR, Tjonneland A, Trichopoulou A, Tumino R, van Gils CH, Visvanathan K, Wentzensen N, Zeleniuch-Jacquotte A, Tworoger SS. High Levels of C-Reactive Protein Are Associated with an Increased Risk of Ovarian Cancer: Results from the Ovarian Cancer Cohort Consortium. Cancer Res 2019; 79:5442-5451. [PMID: 31462430 PMCID: PMC6801098 DOI: 10.1158/0008-5472.can-19-1554] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 07/17/2019] [Accepted: 08/23/2019] [Indexed: 12/19/2022]
Abstract
Growing epidemiologic evidence supports chronic inflammation as a mechanism of ovarian carcinogenesis. An association between a circulating marker of inflammation, C-reactive protein (CRP), and ovarian cancer risk has been consistently observed, yet, potential heterogeneity of this association by tumor and patient characteristics has not been adequately explored. In this study, we pooled data from case-control studies nested within six cohorts in the Ovarian Cancer Cohort Consortium (OC3) to examine the association between CRP and epithelial ovarian cancer risk overall, by histologic subtype and by participant characteristics. CRP concentrations were measured from prediagnosis serum or plasma in 1,091 cases and 1,951 controls. Multivariable conditional logistic regression was used to estimate ORs and 95% confidence intervals (CI). When CRP was evaluated using tertiles, no associations with ovarian cancer risk were observed. A 67% increased ovarian cancer risk was found for women with CRP concentrations >10 mg/L compared with <1 mg/L (OR = 1.67; 95% CI = 1.12-2.48). A CRP concentration >10 mg/L was positively associated with risk of mucinous (OR = 9.67; 95% CI = 1.10-84.80) and endometrioid carcinoma (OR = 3.41; 95% CI = 1.07-10.92), and suggestively positive, although not statistically significant, for serous (OR = 1.43; 95% CI = 0.82-2.49) and clear cell carcinoma (OR = 2.05; 95% CI = 0.36-11.57; P heterogeneity = 0.20). Heterogeneity was observed with oral contraceptive use (P interaction = 0.03), where the increased risk was present only among ever users (OR = 3.24; 95% CI = 1.62-6.47). This study adds to the existing evidence that CRP plays a role in ovarian carcinogenesis and suggests that inflammation may be particularly implicated in the etiology of endometrioid and mucinous carcinoma. SIGNIFICANCE: C-reactive protein is involved in ovarian carcinogenesis, and chronic inflammation may be particularly implicated in the etiology of mucinous and endometrioid carcinomas.
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Affiliation(s)
- Lauren C Peres
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
| | - Adrianne R Mallen
- Department of Gynecologic Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
- Department of Gynecologic Oncology, University of South Florida, Tampa, Florida
| | - Mary K Townsend
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Elizabeth M Poole
- Channing Division of Network Medicine, Harvard Medical School, Boston, Massachusetts
| | - Britton Trabert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Naomi E Allen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Alan A Arslan
- Department of Obstetrics and Gynecology, New York University School of Medicine, New York, New York
- Department of Environmental Medicine, New York University School of Medicine, New York, New York
- Department of Population Health, New York University School of Medicine, New York, New York
- New York University Perlmutter Cancer Center, New York, New York
| | - Laure Dossus
- International Agency for Research on Cancer, Lyon, France
| | - Renée T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Inger T Gram
- Faculty of Health Sciences, Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - Patricia Hartge
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Annika Idahl
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Marina Kvaskoff
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
- Gustave Roussy, Villejuif, France
| | - Anthony M Magliocco
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Melissa A Merritt
- University of Hawaii Cancer Center, Honolulu, Hawaii
- School of Public Health, Imperial College London, London, United Kingdom
| | | | - Anne Tjonneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Rosario Tumino
- Cancer Registry and Histopathology Department, "M.P. Arezzo" Hospital, ASP Ragusa, Italy
| | - Carla H van Gils
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Kala Visvanathan
- Division of Cancer Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Nicolas Wentzensen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Anne Zeleniuch-Jacquotte
- Department of Environmental Medicine, New York University School of Medicine, New York, New York
- Department of Population Health, New York University School of Medicine, New York, New York
- New York University Perlmutter Cancer Center, New York, New York
| | - Shelley S Tworoger
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
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16
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Ihalainen JK, Hackney AC, Taipale RS. Changes in inflammation markers after a 10-week high-intensity combined strength and endurance training block in women: The effect of hormonal contraceptive use. J Sci Med Sport 2019; 22:1044-1048. [PMID: 31186194 DOI: 10.1016/j.jsams.2019.04.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/19/2019] [Accepted: 04/10/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVES The influence of hormonal contraceptives (HC) on inflammation and body composition after high-intensity combined strength and endurance training was investigated. DESIGN Active healthy women formed two training groups: HC users (HCU, n = 9) and those who had never used HC (NHC, n = 9). Training included two strength training sessions and two high-intensity interval training sessions per week for 10 weeks. METHODS Before (PRE) and after (POST) the training intervention, high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), and interleukin-1beta (IL-1β) concentrations were measured. Dual-energy X-ray absorptiometry was used to estimate fat mass (FM), abdominal fat mass (aFM), and lean mass (LM). RESULTS Circulating concentrations of hs-CRP decreased significantly in the NHC from pre to post with -0.46 mg l-1 (95% CI: -0.78, -0.14, p = 0.009, ES = 0.434), whereas a significant increase was observed in HCU from pre to post with 0.89 mg l-1 (95% CI: 1.66, 0.12, p = 0.048, ES = 1.988) with a significant between-group difference (p = 0.015). In addition, hs-CRP concentration was significantly higher in HCU than in NHC after training (p = 0.036) at post. Lean mass increased significantly more in NHC than in HCU (p = 0.049). CONCLUSIONS High-intensity combined strength and endurance training can modify inflammation and body composition of women. The present study showed that inflammation, in terms of hs-CRP was higher post training in HCU than NHC, which may be associated with smaller gains in lean mass in response to training.
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Affiliation(s)
- J K Ihalainen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland; Department of Health Sciences, Swedish Winter Sports Research Centre, Mid Sweden University, Sweden.
| | - A C Hackney
- University of North Carolina at Chapel Hill, USA
| | - R S Taipale
- Kajaani University of Applied Sciences, Finland
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17
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Mattina GF, Van Lieshout RJ, Steiner M. Inflammation, depression and cardiovascular disease in women: the role of the immune system across critical reproductive events. Ther Adv Cardiovasc Dis 2019; 13:1753944719851950. [PMID: 31144599 PMCID: PMC6545651 DOI: 10.1177/1753944719851950] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 04/29/2019] [Indexed: 12/18/2022] Open
Abstract
Women are at increased risk for developing depression and cardiovascular disease (CVD) across the lifespan and their comorbidity is associated with adverse outcomes that contribute significantly to rates of morbidity and mortality in women worldwide. Immune-system activity has been implicated in the etiology of both depression and CVD, but it is unclear how inflammation contributes to sex differences in this comorbidity. This narrative review provides an updated synthesis of research examining the association of inflammation with depression and CVD, and their comorbidity in women. Recent research provides evidence of pro-inflammatory states and sex differences associated with alterations in the hypothalamic-pituitary-adrenal axis, the renin-angiotensin-aldosterone system and the serotonin/kynurenine pathway, that likely contribute to the development of depression and CVD. Changes to inflammatory cytokines in relation to reproductive periods of hormonal fluctuation (i.e. the menstrual cycle, perinatal period and menopause) are highlighted and provide a greater understanding of the unique vulnerability women experience in developing both depressed mood and adverse cardiovascular events. Inflammatory biomarkers hold substantial promise when combined with a patient's reproductive and mental health history to aid in the prediction, identification and treatment of the women most at risk for CVD and depression. However, more research is needed to improve our understanding of the mechanisms underlying inflammation in relation to their comorbidity, and how these findings can be translated to improve women's health.
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Affiliation(s)
- Gabriella F. Mattina
- Neuroscience Graduate Program, McMaster University, 1280 Main Street West, ON L8S 4L8, Canada
| | - Ryan J. Van Lieshout
- Neuroscience Graduate Program, McMaster University, ON, Canada
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Meir Steiner
- Women’s Health Concerns Clinic, St. Joseph’s Healthcare, Hamilton, ON, Canada
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
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18
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Combined Oral Contraceptive Effects on Low-Grade Chronic Inflammatory Mediators in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis. Int J Inflam 2018; 2018:9591509. [PMID: 30595838 PMCID: PMC6286752 DOI: 10.1155/2018/9591509] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 10/04/2018] [Indexed: 02/03/2023] Open
Abstract
Polycystic ovary syndrome is associated with dyslipidemia, dysglycemia, metabolic syndrome, and low-grade chronic inflammation, which increase the risks for cardiovascular disease. Combined oral contraceptives may affect the mediators of low-grade chronic inflammation with potential additive risk in PCOS patients. This meta-analysis investigates the impact of oral contraceptive on markers of chronic inflammation in PCOS patients. Pubmed, Scopus, and Cochrane database were used to search studies reporting on this matter in the target population. Twenty seven studies were selected, including a total of 838 women. The data were expressed as the standardized mean difference. The random-effects model was used to summarize effect sizes. Heterogeneity was examined using Cochran's test (Q) and I2 statistics. Most of the preparations increased C-reactive protein (CRP) in PCOS patients (p >0.001). The increase in homocysteine levels was not significant (p >0.05). Follistatin significantly increased with pills containing cyproterone acetate (p= 0.008). Interleukin-6 changes were inconsistent and plasminogen activator inhibitor-1 decreased with pills containing desogestrel, norgestimate, and drospirenone. Collectively, the results of this review indicate that oral contraceptives modify most inflammatory markers of PCOS patients. However, the clinical implications are not clear yet and future studies must consider longer follow-up and the inclusion of objective clinical parameters.
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20
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Cauci S, Francescato MP, Curcio F. Combined Oral Contraceptives Increase High-Sensitivity C-Reactive Protein but Not Haptoglobin in Female Athletes. Sports Med 2018; 47:175-185. [PMID: 27084393 DOI: 10.1007/s40279-016-0534-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND No studies have examined the effects of oral hormonal contraception on chronic low-grade inflammation as assessed by stratified levels of high-sensitivity C-reactive protein (hsCRP) in athletes. We explored the impact of combined oral contraceptives (OCs) on serum hsCRP, haptoglobin, triglycerides and cholesterol in white female athletes. METHODS Italian sportswomen (n = 205; mean age 24 ± 5.3 years; body mass index 21 ± 2.2 kg m-2; sport activity 8.7 ± 3.65 h week-1) were analyzed according to OC use. RESULTS Progressive hsCRP levels were evaluated in OC users (n = 53) compared to non-OC users (n = 152). Levels of hsCRP from 3.0 to <10.0 mg L-1 (at high risk of future cardiovascular events) were found in 26.4 % (14/53) of OC users and only in 2.6 % (4/153) of non-OC users (OR = 13.3, 95 % CI 4.14-42.6, P < 0.001). Risky hsCRP levels ≥1.0 mg L-1 were found in 62.3 % of OC users versus 13.2 % non-OC users (OR = 10.9, 95 % CI 5.26-22.5, P < 0.001). Protective hsCRP levels (<0.5 mg L-1) were found in 17.0 % of OC users and in 64.5 % of non-OC users (OR = 0.11, 95 % CI 0.05-0.25, P < 0.001). OC use increased serum triglycerides (P < 0.001), total cholesterol (P = 0.027) and HDL cholesterol (P = 0.018), whereas haptoglobin was unaffected. Hours of exercise week-1 had a mild inverse association with hsCRP (P = 0.048) in non-OC users only. CONCLUSIONS OC use markedly elevated chronic low-grade inflammation in athletes, which could predispose to a higher inflammatory response to physical stress and elevate cardiovascular risk. Physical activity without OC use seemed to favor low hsCRP. Further research is needed to extend our results and to elucidate the potential effects on athletic performance of chronically elevated hsCRP. Our findings would be useful for sport physicians interpreting blood tests in athletes.
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Affiliation(s)
- Sabina Cauci
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Piazzale Kolbe 4, Udine, 33100, Italy.
| | - Maria Pia Francescato
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Piazzale Kolbe 4, Udine, 33100, Italy
| | - Francesco Curcio
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Piazzale Kolbe 4, Udine, 33100, Italy.,Clinical Analysis Laboratory, Department of Laboratory Medicine, Institute of Clinical Pathology, Santa Maria della Misericordia University-Hospital, Udine, 33100, Italy
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21
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The association between high-sensitivity C-reactive protein and metabolic risk factors in black and white South African women: a cross-sectional study. BMC OBESITY 2018; 5:14. [PMID: 29760934 PMCID: PMC5937032 DOI: 10.1186/s40608-018-0191-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 04/22/2018] [Indexed: 11/10/2022]
Abstract
Background High-sensitivity C-reactive protein (hsCRP) is associated with metabolic risk, however it is unclear whether the relationship is confounded by racial/ethnic differences in socioeconomic status (SES), lifestyle factors or central adiposity. The aims of the study was, (1) to investigate whether hsCRP levels differ by race/ethnicity; (2) to examine the race/ethnic-specific associations between hsCRP, HOMA-IR and serum lipids [total cholesterol (TC), triglycerides (TG), high-density lipoproteins (HDL-C) and low-density lipoproteins (LDL-C)]; and (3) to determine whether race/ethnic-specific associations are explained by SES, lifestyle factors or waist circumference (WC). Methods The convenience sample comprised 195 black and 153 white apparently health women, aged 18-45 years. SES (education, assets and housing density) and lifestyle factors (alcohol use, physical activity and contraceptive use) were collected by questionnaire. Weight, height and WC were measured, and fasting blood samples collected for hsCRP, glucose, insulin, and lipids. Results Black women had higher age- and BMI-adjusted hsCRP levels than white women (p = 0.047). hsCRP was associated with HOMA-IR (p < 0.001), TG (p < 0.001), TC (p < 0.05), HDL-C (p < 0.05), and LDL-C (p < 0.05), independent of age and race/ethnicity. The association between hsCRP and lipids differed by race/ethnicity, such that hsCRP was positively associated with TG and LDL-C in white women, and inversely associated with HDL-C in black women. Higher hsCRP was also associated with higher TC in white women and lower TC in black women. Furthermore, when adjusting for SES and lifestyle factors, the associations between hsCRP, and TC and TG, remained, however the associations between hsCRP, and HDL-C and LDL-C, were no longer significant. Conclusion Although circulating hsCRP may identify individuals at increased metabolic risk, the heterogeneity in these associations between racial/ethnic groups highlights the need for prospective studies investigating the role of hsCRP for risk prediction in different populations.
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Ghanei N, Rezaei N, Amiri GA, Zayeri F, Makki G, Nasseri E. The probiotic supplementation reduced inflammation in polycystic ovary syndrome: A randomized, double-blind, placebo-controlled trial. J Funct Foods 2018. [DOI: 10.1016/j.jff.2017.12.047] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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Ter Horst R, Jaeger M, Smeekens SP, Oosting M, Swertz MA, Li Y, Kumar V, Diavatopoulos DA, Jansen AFM, Lemmers H, Toenhake-Dijkstra H, van Herwaarden AE, Janssen M, van der Molen RG, Joosten I, Sweep FCGJ, Smit JW, Netea-Maier RT, Koenders MMJF, Xavier RJ, van der Meer JWM, Dinarello CA, Pavelka N, Wijmenga C, Notebaart RA, Joosten LAB, Netea MG. Host and Environmental Factors Influencing Individual Human Cytokine Responses. Cell 2017; 167:1111-1124.e13. [PMID: 27814508 DOI: 10.1016/j.cell.2016.10.018] [Citation(s) in RCA: 307] [Impact Index Per Article: 43.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 08/03/2016] [Accepted: 10/11/2016] [Indexed: 02/08/2023]
Abstract
Differences in susceptibility to immune-mediated diseases are determined by variability in immune responses. In three studies within the Human Functional Genomics Project, we assessed the effect of environmental and non-genetic host factors of the genetic make-up of the host and of the intestinal microbiome on the cytokine responses in humans. We analyzed the association of these factors with circulating mediators and with six cytokines after stimulation with 19 bacterial, fungal, viral, and non-microbial metabolic stimuli in 534 healthy subjects. In this first study, we show a strong impact of non-genetic host factors (e.g., age and gender) on cytokine production and circulating mediators. Additionally, annual seasonality is found to be an important environmental factor influencing cytokine production. Alpha-1-antitrypsin concentrations partially mediate the seasonality of cytokine responses, whereas the effect of vitamin D levels is limited. The complete dataset has been made publicly available as a comprehensive resource for future studies. PAPERCLIP.
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Affiliation(s)
- Rob Ter Horst
- Department of Internal Medicine and Radboudumc Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Gelderland 6500HB, the Netherlands
| | - Martin Jaeger
- Department of Internal Medicine and Radboudumc Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Gelderland 6500HB, the Netherlands
| | - Sanne P Smeekens
- Department of Internal Medicine and Radboudumc Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Gelderland 6500HB, the Netherlands
| | - Marije Oosting
- Department of Internal Medicine and Radboudumc Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Gelderland 6500HB, the Netherlands
| | - Morris A Swertz
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, Groningen 9700RB, the Netherlands
| | - Yang Li
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, Groningen 9700RB, the Netherlands
| | - Vinod Kumar
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, Groningen 9700RB, the Netherlands
| | - Dimitri A Diavatopoulos
- Laboratory of Pediatric Infectious Diseases and Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Gelderland 6500HB, the Netherlands
| | - Anne F M Jansen
- Department of Internal Medicine and Radboudumc Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Gelderland 6500HB, the Netherlands
| | - Heidi Lemmers
- Department of Internal Medicine and Radboudumc Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Gelderland 6500HB, the Netherlands
| | - Helga Toenhake-Dijkstra
- Department of Internal Medicine and Radboudumc Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Gelderland 6500HB, the Netherlands
| | - Antonius E van Herwaarden
- Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, Gelderland 6500HB, the Netherlands
| | - Matthijs Janssen
- Department of Rheumatology, Rijnstate Hospital, Arnhem, Gelderland 6815AD, the Netherlands
| | - Renate G van der Molen
- Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, Gelderland 6500HB, the Netherlands
| | - Irma Joosten
- Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, Gelderland 6500HB, the Netherlands
| | - Fred C G J Sweep
- Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, Gelderland 6500HB, the Netherlands
| | - Johannes W Smit
- Department of Internal Medicine and Radboudumc Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Gelderland 6500HB, the Netherlands; Division of Endocrinology, Radboud University Medical Center, Nijmegen, Gelderland 6500HB, the Netherlands
| | - Romana T Netea-Maier
- Department of Internal Medicine and Radboudumc Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Gelderland 6500HB, the Netherlands; Division of Endocrinology, Radboud University Medical Center, Nijmegen, Gelderland 6500HB, the Netherlands
| | - Mieke M J F Koenders
- Elkerliek Hospital, Clinical Chemistry, Helmond, Noord-Brabant 5700AB, the Netherlands
| | - Ramnik J Xavier
- Broad Institute of Massachusetts Institute of Technology (MIT), Cambridge, MA 02142, USA; Harvard University, Cambridge, MA 02142, USA; Center for Computational and Integrative Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02139, USA
| | - Jos W M van der Meer
- Department of Internal Medicine and Radboudumc Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Gelderland 6500HB, the Netherlands
| | - Charles A Dinarello
- Department of Internal Medicine and Radboudumc Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Gelderland 6500HB, the Netherlands; Division of Medicine, University of Colorado Denver, Aurora, CO 80045, USA
| | - Norman Pavelka
- Department of Internal Medicine and Radboudumc Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Gelderland 6500HB, the Netherlands; Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (A(∗)STAR), Singapore 138648, Singapore
| | - Cisca Wijmenga
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, Groningen 9700RB, the Netherlands; Centre for Immune Regulation and Department of Immunology, University of Oslo, Oslo University Hospital, Oslo, Oslo 0027, Norway
| | - Richard A Notebaart
- Department of Internal Medicine and Radboudumc Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Gelderland 6500HB, the Netherlands
| | - Leo A B Joosten
- Department of Internal Medicine and Radboudumc Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Gelderland 6500HB, the Netherlands.
| | - Mihai G Netea
- Department of Internal Medicine and Radboudumc Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Gelderland 6500HB, the Netherlands.
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Fedewa MV, Hathaway ED, Higgins S, Das BM, Forehand RL, Schmidt MD, Evans EM. Interactive associations of physical activity, adiposity, and oral contraceptive use on C-reactive protein levels in young women. Women Health 2017; 58:129-144. [PMID: 28277157 DOI: 10.1080/03630242.2017.1292341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Oral contraceptives (OCs) are the most frequently used type of birth control among young women. OC-users have higher C-reactive protein (CRP) values, an indicator of systemic inflammation, than do non-OC-users. In addition, adiposity (percent fat) is positively associated with CRP, and physical activity (PA) is inversely associated with CRP. The present study determined the interactive associations of PA, percent fat, and OC-use with CRP. Data were collected during 2012-2015 at the University of Georgia. Objective PA was measured via pedometers. Percent fat was measured via dual X-ray absorptiometry. The current OC-use was self-reported. High-sensitivity (hs) CRP was determined using venipuncture. Multivariate linear regression determined the interactive associations of percent fat, OC-use, and PA with hs-CRP. Participants (n = 247; mean age 18.9 ± 1.4 years, 60.7 percent white) accumulated a mean of 10,075.7 ± 3,593.4 steps/day. One-third of participants were categorized as overweight/obese by BMI (mean = 24.5 ± 4.8 kg/m2, mean percent fat = 35.2 ± 6.8). The current OC-use was reported by 26.2 percent of the sample (n = 61). A significant three-way interaction (β = 0.01, p = .03) indicated that higher PA was associated with lower hs-CRP in non-OC-users with higher percent fat, but not among OC-users with higher percent fat. These results highlight the need to measure and account for the current OC-use in studies examining the relationship between PA and CRP.
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Affiliation(s)
- Michael V Fedewa
- a Department of Kinesiology , The University of Alabama , Tuscaloosa , Alabama , USA.,b Department of Kinesiology , The University of Georgia , Athens , Georgia , USA
| | - Elizabeth D Hathaway
- a Department of Kinesiology , The University of Alabama , Tuscaloosa , Alabama , USA.,e University of Tennessee at Chattanooga , Chattanooga , Tennessee , USA
| | - Simon Higgins
- b Department of Kinesiology , The University of Georgia , Athens , Georgia , USA
| | - Bhibha M Das
- b Department of Kinesiology , The University of Georgia , Athens , Georgia , USA.,c Department of Kinesiology , East Carolina University , Greenville , North Carolina , USA
| | - Ronald L Forehand
- d University Health Center, The University of Georgia , Athens , Georgia , USA
| | - Michael D Schmidt
- b Department of Kinesiology , The University of Georgia , Athens , Georgia , USA
| | - Ellen M Evans
- b Department of Kinesiology , The University of Georgia , Athens , Georgia , USA
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Cramer DW, Vitonis AF. Signatures of reproductive events on blood counts and biomarkers of inflammation: Implications for chronic disease risk. PLoS One 2017; 12:e0172530. [PMID: 28234958 PMCID: PMC5325665 DOI: 10.1371/journal.pone.0172530] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 02/06/2017] [Indexed: 11/24/2022] Open
Abstract
Whether inflammation mediates how reproductive events affect chronic-disease risk is unclear. We studied inflammatory biomarkers in the context of reproductive events using National Health and Nutrition Examination Survey (NHANES) data. From 15,986 eligible women from the 1999–2011 data cycles, we accessed information on reproductive events, blood counts, C-reactive protein (CRP), and total homocysteine (tHCY). We calculated blood-count ratios including: platelet-lymphocyte (PLR), lymphocyte-monocyte (LMR), platelet-monocyte (PMR), and neutrophil-monocyte (NMR). Using sampling weights per NHANES guidelines, means for counts, ratios, or biomarkers by reproductive events were compared using linear regression. We performed trend tests and calculated p-values with partial sum of squares F-tests. Higher PLR and lower LMR were associated with nulliparity. In postmenopausal women, lower PMR was associated with early age at first birth and higher NMR with later age at and shorter interval since last birth. Lower PNR and higher neutrophils and tHCY were associated with early natural menopause. In all women, the neutrophil count correlated positively with CRP; but, in premenopausal women, correlated inversely with tHCY. Reproductive events leave residual signatures on blood counts and inflammatory biomarkers that could underlie their links to chronic disease risk.
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Affiliation(s)
- Daniel W. Cramer
- Obstetrics and Gynecology Epidemiology Center, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
- * E-mail:
| | - Allison F. Vitonis
- Obstetrics and Gynecology Epidemiology Center, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
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Cauci S, Buligan C, Marangone M, Francescato MP. Oxidative Stress in Female Athletes Using Combined Oral Contraceptives. SPORTS MEDICINE-OPEN 2016; 2:40. [PMID: 27747795 PMCID: PMC5031583 DOI: 10.1186/s40798-016-0064-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 09/13/2016] [Indexed: 12/21/2022]
Abstract
Background Oxidative stress in female athletes is understudied. We investigated oxidative stress in sportswomen of different disciplines according to combined oral contraceptive (OC) use and lifestyle/alimentary habits. Methods Italian sportswomen (n = 144; mean age 23.4 ± 4.2 years; body mass index 21.2 ± 2.2 kg m−2; sport activity 9.2 ± 4.1 h week−1) were analyzed; 48 % were volleyball players, 12.5 % soccer players, 10.4 % track-and-field sports, and followed by other disciplines’ athletes. Oxidative stress was evaluated by free oxygen radical test (FORT) assessing blood hydroperoxides and free oxygen radical defense (FORD) assay evaluating antioxidant capacity in OC users (n = 42) compared to non-OC users. Results Elevated oxidative stress levels (≥310 FORT units) were found in 92.9 % of OC users and in 23.5 % of non-OC users (crude OR = 42, 95 % CI 12–149, p < 0.001; adjusted OR = 60, 95 % CI 11–322, p < 0.001). Continuous values of hydroperoxides were twofold higher in OC users versus non-OC users (median 484 versus 270 FORT units, p < 0.001) and were inversely related to FORD units in OC users (p = 0.01). Hydroperoxides were not associated with weekly hours of exercise. In OC users, lifestyle/alimentary habits were not correlated to hydroperoxides. In non-OC users only, hydroperoxide values were positively correlated with weight and BMI and inversely correlated with chocolate and fish consumption. Conclusions The markedly elevated oxidative stress we revealed in OC-user athletes could be detrimental to physical activity and elevate cardiovascular risk (as thromboembolism). Further research is needed to extend our results, to clarify the biochemical pathways leading to increased hydroperoxides (mainly lipid peroxides) and reduced antioxidant defense, and to elucidate the potential effects on athletic performance. OC use should be considered when developing gender-focused strategies against oxidative stress.
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Affiliation(s)
- Sabina Cauci
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Piazzale Kolbe 4, Udine, 33100, Italy.
| | - Cinzia Buligan
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Piazzale Kolbe 4, Udine, 33100, Italy
| | - Micaela Marangone
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Piazzale Kolbe 4, Udine, 33100, Italy
| | - Maria Pia Francescato
- Department of Medical and Biological Sciences, School of Medicine, University of Udine, Piazzale Kolbe 4, Udine, 33100, Italy
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Ebrahimi M, Heidari-Bakavoli AR, Shoeibi S, Mirhafez SR, Moohebati M, Esmaily H, Ghazavi H, Saberi Karimian M, Parizadeh SMR, Mohammadi M, Mohaddes Ardabili H, Ferns GA, Ghayour-Mobarhan M. Association of Serum hs-CRP Levels With the Presence of Obesity, Diabetes Mellitus, and Other Cardiovascular Risk Factors. J Clin Lab Anal 2016; 30:672-6. [PMID: 26857805 PMCID: PMC6807047 DOI: 10.1002/jcla.21920] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 10/27/2015] [Accepted: 11/16/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Diabetes mellitus remains one of the major health problems of the 21st century and is associated with comorbidities including obesity and metabolic abnormalities. The study was conducted to evaluate serum high-sensitivity C-reactive protein (hs-CRP) levels, as a marker of inflammation, in a large sample of Iranian population without a history of cardiovascular or inflammatory disease and cancer, and to relate this to fasting blood glucose (FBG) and the presence of diabetes mellitus. METHODS The study consisted of 7,762 subjects divided into four groups-nonobese/nondiabetic, obese/nondiabetic, nonobese/diabetic and obese/diabetic-based on the BMI classification and their FBG. Anthropometric characteristics were measured and blood was collected for the evaluation of fasted lipid profile, FBG and serum hs-CRP levels. RESULTS Several clinical and biochemical characteristics were significantly different among the four groups: FBG, P < 0.001; total cholesterol (TC), P < 0.001; and triglyceride (TG), P < 0.001. The subjects with a serum hs-CRP >3 mg/dl had higher TC (P < 0.001), low-density lipoprotein cholesterol (LDL-C, P < 0.001), TG (P < 0.001), fat percentage (P < 0.001), and systolic and diastolic blood pressure (P < 0.001) compared with subjects with a serum hs-CRP <3 mg/dl. Multivariate analysis showed FBG, LDL-C, and waist circumference (WC) associated with increased serum hs-CRP levels (P < 0.001). CONCLUSIONS FBG, LDL-C, WC and gender are independently associated with serum hs-CRP concentrations.
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Affiliation(s)
- Mahmoud Ebrahimi
- Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Reza Heidari-Bakavoli
- Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sara Shoeibi
- Department of Medical Biotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Reza Mirhafez
- Department of Basic Medical Sciences, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Mohsen Moohebati
- Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaily
- Department of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamed Ghazavi
- Department of Medical Biotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Saberi Karimian
- Student Research Committee, Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mohammad Reza Parizadeh
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Mohammadi
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Mohaddes Ardabili
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Division of Medical Education, Brighton & Sussex Medical School, Brighton, Sussex, UK
| | - Majid Ghayour-Mobarhan
- Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Fedewa MV, Hathaway ED, Ward-Ritacco CL. Effect of exercise training on C reactive protein: a systematic review and meta-analysis of randomised and non-randomised controlled trials. Br J Sports Med 2016; 51:670-676. [PMID: 27445361 DOI: 10.1136/bjsports-2016-095999] [Citation(s) in RCA: 164] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2016] [Indexed: 12/21/2022]
Abstract
PURPOSE C-reactive protein (CRP) is a marker of chronic systemic inflammation frequently used in cardiovascular disease risk assessment. The purpose of this meta-analysis was to provide a quantitative estimate of the magnitude of change in CRP following participation in physical exercise interventions. METHODS All studies included in the meta-analysis were peer reviewed and published in English. Human participants were assigned to a non-exercise comparison group or exercise training group, with the intervention lasting ≥2 weeks. CRP levels were measured at baseline, during and/or after completion of the exercise training programme. Random-effects models were used to aggregate a mean effect size (ES), 95% CIs and potential moderators. RESULTS 83 randomised and non-randomised controlled trials met the inclusion criteria and resulted in 143 effects (n=3769). The mean ES of 0.26 (95% CI 0.18 to 0.34, p<0.001) indicated a decrease in CRP following exercise training. A decrease in body mass index (BMI; β=1.20, SE=0.25, p<0.0001) and %Fat (β=0.76, SE=0.21, p=0.0002) were associated with a decrease in CRP, independently accounting for 11.1% and 6.6% of the variation in response, respectively. Exercise training led to a greater reduction in CRP when accompanied by a decrease in BMI (ES=0.38, 95% CI 0.26 to 0.50); however, a significant improvement in CRP occurred in the absence of weight loss (ES=0.19, 95% CI 0.10 to 0.28; both p<0.001). CONCLUSIONS These results suggest that engaging in exercise training is associated with a decrease in CRP levels regardless of the age or sex of the individual; however, greater improvements in CRP level occur with a decrease in BMI or %Fat.
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Affiliation(s)
- Michael V Fedewa
- Department of Kinesiology, The University of Alabama, Tuscaloosa, Alabama, USA
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Scott HA, Gibson PG, Garg ML, Upham JW, Wood LG. Sex hormones and systemic inflammation are modulators of the obese-asthma phenotype. Allergy 2016; 71:1037-47. [PMID: 27007085 DOI: 10.1111/all.12891] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Both systemic inflammation and sex hormones have been proposed as potential mediators of the obese-asthma phenotype. The aim of this study was to examine the associations between sex hormones, oral contraceptive pill (OCP) use, systemic inflammation and airway inflammation in adults with asthma. METHODS Obese (n = 39) and nonobese (n = 42) females and obese (n = 24) and nonobese (n = 25) males with asthma were recruited. Females were further categorized as reproductive-aged (<50 years old; n = 36) or older (>50 years old; n = 45). Thirteen (36.1%) reproductive-aged females were using the OCP. Participants had induced sputum cell counts measured and blood analysed for sex hormones and inflammatory markers. RESULTS Obese reproductive-aged females had higher sputum %neutrophils than nonobese reproductive-aged females (45.4 ± 24.3% vs 27.5 ± 17.5%, P = 0.016); however, there was no difference in sputum neutrophils in obese compared with nonobese males (P = 0.620) or older females (P = 0.087). Multiple linear regression analysis found testosterone and OCP use to be negative predictors of sputum %neutrophils, while C-reactive protein and IL-6 were positive predictors of sputum %neutrophils. BMI and age were not significant predictors in the multivariate model. Reproductive-aged females using the OCP had significantly lower sputum %neutrophils than those not using the OCP (23.2 ± 12.6% vs 42.1 ± 23.8%, P = 0.015). CONCLUSIONS This study suggests that sex hormones and systemic inflammation may be mediating the obese-asthma phenotype. The observation that OCP use was associated with lower sputum %neutrophils in reproductive-aged females warrants further investigation.
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Affiliation(s)
- H. A. Scott
- Centre for Asthma and Respiratory Diseases; Hunter Medical Research Institute; John Hunter Hospital; Newcastle NSW Australia
- School of Biomedical Sciences and Pharmacy; The University of Newcastle; Callaghan NSW Australia
- Lung and Allergy Research Centre; School of Medicine; The University of Queensland; Brisbane Qld Australia
| | - P. G. Gibson
- Centre for Asthma and Respiratory Diseases; Hunter Medical Research Institute; John Hunter Hospital; Newcastle NSW Australia
- School of Medicine and Public Health; The University of Newcastle; Callaghan NSW Australia
| | - M. L. Garg
- School of Biomedical Sciences and Pharmacy; The University of Newcastle; Callaghan NSW Australia
| | - J. W. Upham
- Lung and Allergy Research Centre; School of Medicine; The University of Queensland; Brisbane Qld Australia
| | - L. G. Wood
- Centre for Asthma and Respiratory Diseases; Hunter Medical Research Institute; John Hunter Hospital; Newcastle NSW Australia
- School of Biomedical Sciences and Pharmacy; The University of Newcastle; Callaghan NSW Australia
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Rios-Avila L, Coats B, Ralat M, Chi YY, Midttun Ø, Ueland PM, Stacpoole PW, Gregory JF. Pyridoxine supplementation does not alter in vivo kinetics of one-carbon metabolism but modifies patterns of one-carbon and tryptophan metabolites in vitamin B-6-insufficient oral contraceptive users. Am J Clin Nutr 2015; 102:616-25. [PMID: 26201817 PMCID: PMC4548178 DOI: 10.3945/ajcn.115.113159] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 07/01/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Low chronic vitamin B-6 status can occur in a subset of women who use oral contraceptives (OCs) with uncertain metabolic consequences. An insufficiency of cellular pyridoxal 5'-phosphate (PLP), which is the coenzyme form of vitamin B-6, may impair many metabolic processes including one-carbon and tryptophan metabolism. OBJECTIVE We investigated the effects of vitamin B-6 supplementation on the in vivo kinetics of one-carbon metabolism and the concentration of one-carbon and tryptophan metabolites in vitamin B-6-deficient OC users. DESIGN A primed, constant infusion of [(13)C5]methionine, [3-(13)C]serine, and [(2)H3]leucine was performed on 10 OC users (20-40 y old; plasma PLP concentrations <30 nmol/L) before and after 28 d of supplementation with 10 mg pyridoxine hydrochloric acid/d. In vivo fluxes of total homocysteine remethylation, the remethylation of homocysteine from serine, and rates of homocysteine and cystathionine production were assessed. Targeted metabolite profiling was performed, and data were analyzed by using orthogonal partial least-squares-discriminant analysis and paired t tests adjusted for multiple testing. RESULTS Pyridoxine supplementation increased the mean ± SD plasma PLP concentration from 25.8 ± 3.6 to 143 ± 58 nmol/L (P < 0.001) and decreased the leucine concentration from 103 ± 17 to 90 ± 20 nmol/L (P = 0.007) and glycine concentration from 317 ± 63 to 267 ± 58 nmol/L (P = 0.03). Supplementation did not affect in vivo rates of homocysteine remethylation or the appearance of homocysteine and cystathionine. A multivariate analysis showed a clear overall effect on metabolite profiles resulting from supplementation. Leucine, glycine, choline, cysteine, glutathione, trimethylamine N-oxide, and the ratios glycine:serine, 3-hydroxykynurenine:kynurenine, 3-hydroxykynurenine:3-hydroxyanthranilic acid, and 3-hydroxykynurenine:anthranilic acid were significant discriminating variables. CONCLUSIONS Consistent with previous vitamin B-6-restriction studies, fluxes of one-carbon metabolic processes exhibited little or no change after supplementation in low-vitamin B-6 subjects. In contrast, changes in the metabolic profiles after supplementation indicated perturbations in metabolism, suggesting functional vitamin B-6 deficiency. This study was registered at clinicaltrials.gov as NCT01128244.
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Affiliation(s)
| | - Bonnie Coats
- Department of Medicine, Division of Endocrinology and Metabolism, College of Medicine
| | | | | | | | - Per M Ueland
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Peter W Stacpoole
- Department of Medicine, Division of Endocrinology and Metabolism, College of Medicine, Department of Biochemistry and Molecular Biology, College of Medicine, University of Florida, Gainesville, FL
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Inflammation in venous thromboembolism: Cause or consequence? Int Immunopharmacol 2015; 28:655-65. [PMID: 26253657 DOI: 10.1016/j.intimp.2015.07.044] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 07/23/2015] [Accepted: 07/30/2015] [Indexed: 12/31/2022]
Abstract
Venous thromboembolism (VTE) which includes deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) is a moderately common disease especially in elderly population with high rate of recurrence and complications. Evidence is accumulating that VTE is not restricted to coagulation system and immune system appears to be involved in formation and resolution of thrombus. The present study was aimed at reviewing current evidences on immune system abnormalities such as alterations in cytokines, chemokines and immune cells. Also, current evidences suggest that; a, inflammation in general functions as a double-edged sword, b, inflammation can be both a cause and a consequence of VTE, and c, current anti-coagulation therapies are not well-equipped with the capacity to selectively inhibit inflammatory cells and pathways. Applying such inferences for selective pharmacological targeting of immune mediators in VTE and thereby for adoption of higher effective anti-thromboinflammatory strategies, either therapeutic or prophylactic, is henceforth to be considered as the line of research for future.
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Pre-gravid oral contraceptive use in relation to birth weight: a prospective cohort study. Eur J Epidemiol 2015; 30:1199-208. [PMID: 26076921 DOI: 10.1007/s10654-015-0053-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 05/30/2015] [Indexed: 01/19/2023]
Abstract
Few studies have evaluated the association between pregravid oral contraceptive (OC) use and birth weight, and findings have been conflicting. We conducted a prospective cohort study of 5921 pregnancy planners in Denmark to evaluate recency, duration, and type of OC used before conception in relation to infant birth weight. Participants completed online questionnaires and reported detailed information on contraceptive history and covariates at baseline. Participants completed bimonthly follow-up questionnaires to update their pregnancy status for up to 12 months or until conception occurred. Birth weight data were ascertained from the Danish Medical Birth Registry for 4046 live births delivered by study participants between 2008 and 2010. We used multivariable linear and log-binomial regression analyses to control for confounding. Mean birth weight was higher among women who had used OCs within 0-1 months (mean difference = 97 g, CI 26, 168) or 2-6 months (mean difference = 40 g, CI -5, 85) before conception, compared with more than 12 months before conception. Mean birth weight was lower among women who had used OCs for long durations (mean difference comparing ≥12 with <4 years of OC use = -85 g, CI -158, -11). Our findings indicate that pregravid OC use within 6 months of conception may be associated with a small increase in birth weight, but that long duration of use may have the opposite effect. Results were stronger among male infants, among 2nd and 4th generation OC users, and among users of OCs with a higher estrogen dose.
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Effect of oral and vaginal hormonal contraceptives on inflammatory blood biomarkers. Mediators Inflamm 2015; 2015:379501. [PMID: 25861161 PMCID: PMC4378601 DOI: 10.1155/2015/379501] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 02/16/2015] [Indexed: 01/07/2023] Open
Abstract
The use of combined hormonal contraceptives has been reported to increase the level of C-reactive protein (CRP). We assessed the effect of hormonal contraceptive use on inflammatory cytokines including CRP, monocyte chemotactic protein-1, soluble tumor necrosis factor (sTNF), interleukin-6 (IL-6), and soluble CD40 ligand. We used 79 female subjects (19 to 30 years old) who were combined oral contraceptives users (n = 29), combined vaginal contraceptive users (n = 20), and nonusers (n = 30) with CRP values of ≤1 (n = 46) or ≥3 (n = 33). Information on medical history, physical activities, and dietary and sleeping habits were collected. Both oral and vaginal contraceptive users had higher levels of CRP (P < 0.0001), compared to nonusers. Only oral contraceptive users exhibited elevated sCD40L (P < 0.01). When comparing the groups with CRP ≤ 1 and CRP ≥ 3, levels of IL-6 and sTNF-RI were positively correlated with CRP among oral contraceptive users. We did not observe the same elevation for other inflammatory biomarkers for the CRP ≥ 3 group among vaginal contraceptive users. The clear cause of elevation in CRP level due to the use of different hormonal contraceptive formulations and methods is not well understood. Longitudinal studies with larger sample size are required to better assess the true cause of CRP elevation among hormonal contraceptive users.
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Rios-Avila L, Coats B, Chi YY, Midttun Ø, Ueland PM, Stacpoole PW, Gregory JF. Metabolite profile analysis reveals association of vitamin B-6 with metabolites related to one-carbon metabolism and tryptophan catabolism but not with biomarkers of inflammation in oral contraceptive users and reveals the effects of oral contraceptives on these processes. J Nutr 2015; 145:87-95. [PMID: 25527663 PMCID: PMC4264024 DOI: 10.3945/jn.114.201095] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The use of oral contraceptives (OCs) has been associated with low plasma pyridoxal 5'-phosphate (PLP). The functional consequences are unclear. OBJECTIVES To determine whether functional vitamin B-6 insufficiency occurs in OC users and is attributable to OCs, we investigated the associations of PLP with metabolites of one-carbon metabolism, tryptophan catabolism, and inflammation in OC users, and evaluated the effects of OCs on these metabolites. METHODS Plasma metabolite concentrations were measured in 157 OC users (20-40 y of age). Associations between PLP and the metabolites were analyzed through use of generalized additive models and partial least squares-discriminant analysis (PLS-DA). Additionally, data from 111 of the 157 OC users were compared to previously reported data from 11 nonusers, at adequate and low vitamin B-6 status, with use of multivariate ANOVA. RESULTS PLP showed significant (P < 0.05) negative nonlinear association with homocysteine, glutathione, and ratios of asymmetric dimethylarginine to arginine, 3-hydroxykynurenine to 3-hydroxyanthranilic acid, and 3-hydroxykynurenine to kynurenic acid. PLS-DA supported these conclusions and identified 3-hydroxykynurenine and the 3-hydroxykynurenine-to-kynurenine ratio as discriminating biomarkers in women with PLP ≤30 nmol/L. Among the many differences, OC users had significantly higher plasma pyridoxal (157% at adequate and 195% at low vitamin B-6 status), 4-pyridoxic acid (154% at adequate and 300% at low vitamin B-6 status), xanthurenic acid (218% at low vitamin B-6 status), 3-hydroxyanthranilic acid (176% at adequate and 166% at low vitamin B-6 status), quinolinic acid (127% at low vitamin B-6 status), and nicotinamide (197% at low vitamin B-6 status). Biomarkers of inflammation were not associated with PLP, and no differences were found between the 2 groups. CONCLUSIONS PLP is associated with biomarkers of one-carbon metabolism and tryptophan catabolism but not with biomarkers of inflammation in OC users. Independent of vitamin B-6 status, OCs have effects on metabolites and ratios of one-carbon metabolism and tryptophan catabolism but not on biomarkers of inflammation. This study was registered at clinicaltrials.gov as NCT01128244. The study from which data for nonusers was derived was registered as NCT00877812.
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Affiliation(s)
| | - Bonnie Coats
- Division of Endocrinology and Metabolism, Department of Medicine, College of Medicine
| | | | | | - Per M Ueland
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Peter W Stacpoole
- Division of Endocrinology and Metabolism, Department of Medicine, College of Medicine,Department of Biochemistry and Molecular Biology, College of Medicine, University of Florida, Gainesville, FL
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Palomba S, Materazzo C, Falbo A, Orio F, La Sala GB, Sultan C. Metformin, oral contraceptives or both to manage oligo-amenorrhea in adolescents with polycystic ovary syndrome? A clinical review. Gynecol Endocrinol 2014; 30:335-40. [PMID: 24405081 DOI: 10.3109/09513590.2013.876001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The management of oligo-amenorrhea in adolescent patients with polycystic ovary syndrome (PCOS) represents an important and difficult challenge. Metformin and/or oral contraceptives (OCs) are different strategies widely proposed in these patients. The objective of the current review was to provide an overview on the use of metformin and/or OCs for the management of oligo-amenorrhea in adolescents with PCOS underlining their potential risks and benefits in order to help the clinician to choose the best patients' tailored treatment.
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Affiliation(s)
- Stefano Palomba
- Department of Obstetrics and Gynecology, Arcispedale S. Maria Nuova of Reggio Emilia, IRCCS , Reggio Emilia , Italy
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Kahraman K, Şükür YE, Atabekoğlu CS, Ateş C, Taşkın S, Çetinkaya ŞE, Tolunay HE, Özmen B, Sönmezer M, Berker B. Comparison of two oral contraceptive forms containing cyproterone acetate and drospirenone in the treatment of patients with polycystic ovary syndrome: a randomized clinical trial. Arch Gynecol Obstet 2014; 290:321-8. [DOI: 10.1007/s00404-014-3217-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Accepted: 03/14/2014] [Indexed: 11/29/2022]
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Le-Ha C, Beilin LJ, Burrows S, Oddy WH, Hands B, Mori TA. Gender and the active smoking and high-sensitivity C-reactive protein relation in late adolescence. J Lipid Res 2014; 55:758-64. [PMID: 24577623 DOI: 10.1194/jlr.p045369] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
C-reactive protein (CRP), smoking, and oral contraceptive (OC) use are associated with CVD risk in adults. This study examines the effect of smoking on high-sensitivity CRP (hs-CRP) levels, and the interactive effects of sex and OC use on this relationship in an adolescent cohort. A total of 1,050 adolescents (mean age 17 ± 0.25 years) from the Western Australian Pregnancy Cohort (Raine) Study had anthropometric, lifestyle, and metabolic measures recorded. The association between smoking status and log-transformed hs-CRP was analyzed using multivariable Tobit linear regression models, with adjustment for adiposity, lifestyle, and early-life confounders. A three-level variable (girls not using OCs, girls using OCs, and boys) was employed to assess the interactive effects of sex, OC use, and smoking. Smoking associated with higher hs-CRP levels in girls not using OCs (b = 0.571; P = 0.001), but not in girls using OCs (b = -0.117; P = 0.598) or in boys (b = 0.183; P = 0.2). OC use in nonsmoking girls was the strongest factor associated with higher hs-CRP levels (b = 1.189; P < 0.001). This study has demonstrated a more robust effect of smoking on hs-CRP levels in girls not using OCs compared with boys. The findings may explain why CVD risk conferred by smoking is higher in women than in men.
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Affiliation(s)
- Chi Le-Ha
- Royal Perth Hospital Unit, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
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Karabay CY, Kocabay G, Oduncu V, Kalayci A, Guler A, Karagöz A, Candan O, Basaran O, Zehir R, Izgi A, Esen AM, Kırma C. Drospirenone-containing oral contraceptives and risk of adverse outcomes after myocardial infarction. Catheter Cardiovasc Interv 2013; 82:387-93. [PMID: 23361975 DOI: 10.1002/ccd.24839] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 01/21/2013] [Indexed: 02/05/2023]
Abstract
BACKGROUND The association between oral contraceptives (OC) and myocardial infarction remains controversial. The new generation contraceptive Yasmin (30 µg ethinyl estradiol and 3 mg drospirenone) has a lower estrogen and newer progestin component. To date, there are no data available for the myocardial infarction risk and outcome for drospirenone. We aimed to investigate the effect of Yasmin use on cardiovascular outcomes in patients with acute ST segment elevation myocardial infarction (STEMI) undergoing primary angioplasty. METHODS We retrospectively evaluated 1851 patients who underwent primary angioplasty for acute STEMI. Of them, 440 female patients (23.8%) composed the study population and 12 female (2.7%) were taking the oral contraceptive-Yasmin at the time of infarction. Patients were divided into two groups based on their age (≥50 (n = 339) and <50 years old). Patients under 50 years-old (n = 101) were separated into two groups according to use of OC therapy (OC (+) group n = 12; OC (-) group n = 89). RESULTS Patients who were older than 50-year-old were more likely to have comorbid conditions like diabetes mellitus and hypertension than other groups. Current smoking status was significantly higher in OC (+) group than OC (-) group (P = 0.007). There was a significant difference in favour of OC (+) group when compared with OC (-) group for the increased angiographic thrombus burden according to both TIMI and Yip classification (P = 0.045 and P = 0.029, respectively). The incidence of final TIMI 3 flow and post-procedural complete ST resolution were significantly lower in OC (+) group (P = 0.019, P = 0.002, respectively). In multivariate logistic regression analysis, use of OC was found to be an independent predictor of high grade thrombus burden (OR 5.13, 95% CI 1.07-24.60, P = 0.04). CONCLUSION This is the first study to evaluate the myocardial infarction risk and its subsequent clinical sequelae in women having a STEMI while taking the OC-Yasmin. Women on the oral contraception Yasmin, who underwent coronary revascularization had a lower post-procedural complete ST resolution and worse left ventricular function. Furthermore, OC use with Yasmin is an independent predictor of a high-grade thrombus burden.
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Affiliation(s)
- Can Yucel Karabay
- Department of Cardiology, Kartal Kosuyolu Heart and Research Hospital, Kartal, Istanbul, Turkey
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Harmanci A, Cinar N, Bayraktar M, Yildiz BO. Oral contraceptive plus antiandrogen therapy and cardiometabolic risk in polycystic ovary syndrome. Clin Endocrinol (Oxf) 2013; 78:120-5. [PMID: 22702394 DOI: 10.1111/j.1365-2265.2012.04466.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 04/09/2012] [Accepted: 06/03/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Oral contraceptives alone or in combination with antiandrogens are commonly used in the treatment for polycystic ovary syndrome (PCOS). We aimed to determine the effects of ethinyl estradiol/drospirenone (EE-DRSP) plus spironolactone therapy on inflammation and cardiometabolic risk in PCOS. DESIGN Prospective cohort study. PATIENTS Twenty-three lean, normal glucose-tolerant patients with PCOS and 23 age- and body mass index (BMI)-matched healthy control women. MEASUREMENTS Androgens, high-sensitivity C-reactive protein (hsCRP), homocysteine, lipids, fasting insulin, and glucose levels during a standard 75-g, 2-h oral glucose tolerance test were measured. Patients with PCOS were evaluated before and after receiving EE-DRSP (3 mg/30 μg) plus spironolactone (100 mg/day) for 6 months. Healthy controls were evaluated at baseline only. RESULTS hsCRP, homocysteine, lipids, insulin and glucose levels were similar between patient and control groups at baseline. EE-DRSP plus spironolactone increased hsCRP and homocysteine levels in patients with PCOS (0.50 ± 0.28 vs 1.5 ± 1.3 mg/l, P < 0.05 and 13.1 ± 5.2 vs 17.6 ± 5.3 μm, P < 0.05, respectively). BMI, waist-to-hip ratio, LDL, HDL cholesterol and triglycerides, and glucose tolerance did not change. Modified Ferriman-Gallwey hirsutism scores, testosterone levels and free androgen index improved (9.1 ± 4.2 vs 6.2 ± 3.4, P = 0.001; 80.6 ± 31.1 47.8 ± 20.3 ng/dl, P < 0.05; and 10.5 ± 7.4 vs 1.1 ± 0.8, P < 0.001, respectively). CONCLUSIONS EE-DRSP plus spironolactone therapy in 6 months improves androgen excess in lean PCOS women without any adverse effects on adiposity, glucose tolerance status or lipid profile. However, this combination increases hsCRP and homocysteine levels.
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Affiliation(s)
- Ayla Harmanci
- Endocrinology and Metabolism Unit, Department of Internal Medicine, Hacettepe University School of Medicine, Hacettepe, Ankara, Turkey
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Inflammation markers after randomization to abacavir/lamivudine or tenofovir/emtricitabine with efavirenz or atazanavir/ritonavir. AIDS 2012; 26:1371-85. [PMID: 22546988 DOI: 10.1097/qad.0b013e328354f4fb] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND The effect of specific antiretrovirals on inflammation is unclear. METHODS A5224s was a substudy of A5202, which randomized HIV-infected treatment-naïve patients to blinded abacavir/lamivudine (ABC/3TC) or tenofovir/emtricitabine (TDF/FTC) with open-label efavirenz (EFV) or atazanavir/ritonavir (ATV/r) in a factorial design. Our analysis compared changes in inflammation markers from baseline to week 24 between ABC/3TC and TDF/FTC. Secondary analyses included changes at week 96 and comparisons of EFV vs. ATV/r. RESULTS Analyses included 244 patients (85% male, 48% white non-Hispanic), median age 39 years, HIV-1 RNA 4.6 log10 copies/ml, CD4 240 cells/μl. TNF-α, soluble receptors of TNF-α (sTNFR)-I and II, soluble vascular cellular adhesion molecule (sVCAM)-1 and soluble intercellular adhesion molecule (sICAM)-1 decreased significantly at weeks 24 and 96, without significant differences between components (P ≥ 0.44). At week 24, ABC/3TC had a greater high-sensitivity C-reactive protein (hsCRP) mean fold change than TDF/FTC {1.43 vs. 0.88, estimated mean fold change percentage difference [Δ] 61.5% [95% confidence interval (CI) 13.6%, 129.5%]; P = 0.008}. Similar results were seen at week 96 (P = 0.021). At week 24 (but not 96), EFV had a greater hsCRP mean fold change than ATV/r [1.41 vs. 0.88; Δ = 60.2% (12.6%, 127.7%); P = 0.009]. IL-6 decreased significantly at week 24 with TDF/FTC but not with ABC/3TC (between-components P = 0.019). At week 96, IL-6 decreased significantly in both nucleoside reverse transcriptase inhibitor components (between-components P = 0.11). IL-6 changes were not significantly different between ATV/r and EFV at either time point (P ≥ 0.89). CONCLUSIONS Soluble TNF-receptors and adhesion molecules decreased following treatment initiation and did not differ by regimens. Differences were seen on hsCRP and IL-6 changes with ABC/3TC vs. TDF/FTC and on hsCRP with EFV vs. ATV/r.
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Divani AA, Luo X, Brandy KR, Meyer RM, Joseph MS, Flaherty JD, Rao GHR, Datta YH. Oral versus vaginal combined hormonal contraceptives' effect on coagulation and inflammatory biomarkers among young adult women. Clin Appl Thromb Hemost 2012; 18:487-94. [PMID: 22431858 DOI: 10.1177/1076029612440036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
In order to compare the effect of combined oral contraceptive (COC) and combined vaginal contraceptive (CVC) methods on the inflammation and procoagulation, we recruited female participants in 3 groups: control participants, COC users, and CVC users. We measured different blood biomarkers. The users of both COC and CVC had higher levels of C-reactive protein (P < .0001) and factor VII (P < .0001). However, CD40 ligand was only higher for COC users (P < .0001) and not the CVC users. Even though the levels of thrombin/antithrombin III were not higher for COC and CVC users, as compared to the controls, CVC users had higher levels as compared to COC users (P = .0327). As compared to the control group, we observed higher levels von Willebrand factor among CVC users but not the COC users. Longitudinal studies with larger sample size are needed to better assess the inflammatory and procoagulation response due to CVC use.
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Affiliation(s)
- Afshin A Divani
- Department of Neurology, University of Minnesota, 420 Delaware Street S.E., MMC 295, Minneapolis, MN 55455, USA.
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Kilic S, Yilmaz N, Zulfikaroglu E, Erdogan G, Aydin M, Batioglu S. Inflammatory-metabolic parameters in obese and nonobese normoandrogenemic polycystic ovary syndrome during metformin and oral contraceptive treatment. Gynecol Endocrinol 2011; 27:622-9. [PMID: 21105835 DOI: 10.3109/09513590.2010.530706] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Our aim was to evaluate the optimal treatment strategy addressing cardiovascular risk in obese and nonobese patients with polycystic ovary syndrome (PCOS). We planned a prospectıve randomized clinical study. Normoandrogenemic and oligoamenorrheic women with PCOS and impaired glucose tolerance (n = 96) were enrolled in the study. Six months of treatment with metformin HCL or oral contraceptive pills (OCPs) were given to the patients. Group 1 were obese and receiving metformin. Group 2 were obese and receiving OCPs. Group 3 were nonobese and receiving metformin, and Group 4 were nonobese receiving OCPs. ADMA, homocysteine, high sensitive C-reactive protein (hs-CRP) and homeostasis model assessment estimate of insulin resistance (HOMA-IR) were investigated. ADMA, homocysteine, hs-CRP and HOMA-IR were similar in obese and nonobese groups before the treatment. After 6 months of treatment, a significant decrease was observed in ADMA, homocysteine and HOMA-IR levels in Groups 1 and 3. An increase in ADMA and hs-CRP levels was observed in Groups 2 and 4. In this study, metformin treatment leads to improvement in hormonal and metabolic parameters and decreases ADMA and homocysteine levels possibly independent of BMI. However, the use of oral contraceptives in obese and nonobese patients with PCOS with impaired glucose tolerance increases ADMA and hs-CRP levels and creates an increase in the metabolic risk.
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Affiliation(s)
- Sevtap Kilic
- Zekai Tahir Burak Women's Health Research Hospital, Department of Reproductive Endocrinology, Ankara, Turkey.
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Shikuma CM, Ribaudo HJ, Zheng Y, Gulick RM, Meyer WA, Tashima KT, Bastow B, Kuritzkes DR, Glesby, and the AIDS Clinical Trial MJ. Change in high-sensitivity c-reactive protein levels following initiation of efavirenz-based antiretroviral regimens in HIV-infected individuals. AIDS Res Hum Retroviruses 2011; 27:461-8. [PMID: 20863238 DOI: 10.1089/aid.2010.0154] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Elevations in C-reactive protein (CRP) are associated with increased cardiovascular disease (CVD) risk, increased HIV disease progression, and death in HIV-infected patients. Use of abacavir has been reported to increase CVD risk. We assessed the effect of virologically suppressive efavirenz (EFV)-based antiretroviral therapy on high sensitivity CRP (hsCRP) levels over a 96-week period with particular attention to the effect of gender and abacavir use. Banked sera from entry and week 96 visits of AIDS Clinical Trials Group A5095 participants were assayed for hsCRP, then analyzed by gender, abacavir randomization, and for correlation with changes in fasting metabolic parameters. Analyses of hsCRP were conducted in two phases and involved a total of 145 men and 51 women. hsCRP did not differ by gender at baseline but higher levels were seen at week 96 in women (median 6 mg/liter; Q1, Q3, 1.8, 13.8) compared to men (median 1.6 mg/liter; Q1, Q3, 0.9, 4.2, p < 0.001), with an estimated shift in hsCRP by gender of 2.5 mg/liter (95% CI 1.0, 5.1). There was no difference in hsCRP levels by abacavir use. Changes in hsCRP did not correlate with changes in insulin resistance or with changes in fasting lipids. Durably virologically suppressive therapy with EFV-based regimens did not decrease hsCRP levels over a 96-week period. hsCRP levels increased significantly only in women. Randomization to abacavir had no effect on changes in hsCRP levels. Changes in hsCRP levels did not correlate with changes in fasting metabolic parameters.
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Affiliation(s)
| | | | - Yu Zheng
- Harvard School of Public Health, Boston, Massachusetts
| | | | | | | | - Barbara Bastow
- Social & Scientific Systems Inc., Silver Spring, Maryland
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Hormonal contraceptive use among adolescent girls in Germany in relation to health behavior and biological cardiovascular risk factors. J Adolesc Health 2011; 48:331-7. [PMID: 21402260 DOI: 10.1016/j.jadohealth.2011.01.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Revised: 12/23/2010] [Accepted: 01/04/2011] [Indexed: 10/18/2022]
Abstract
PURPOSE To determine the association between hormonal contraceptive (HC) use, and behavior-related and biological cardiovascular risk factors among teenage girls in Germany. METHODS HC use was assessed among 2,285 girls aged 13-17 years who participated in the health survey for children and adolescents (German Health Interview and Examination Survey for Children and Adolescents, KiGGS), between years 2003 and 2006. Prevalence of HC use was determined according to sociodemographic variables, behavior-related health risks, and overweight status. We compared HC users and nonusers with respect to biological cardiovascular risk factors, including systolic and diastolic blood pressure, and serum concentrations of lipids, lipoproteins, high sensitivity C-reactive protein (hs-CRP), and homocysteine. RESULTS HC users were more likely than nonusers to combine several behavior-related health risks, independent of sociodemographic factors. In particular, HC use was strongly associated with current smoking (odds ratio: 3.4, 95% confidence interval: 2.7-4.3). HC use and behavioral factors showed an additive effect on biological cardiovascular risk factors, explaining between 6% and 30% of the population variance. Relative contributions of HC use ranged from <1% for systolic and diastolic blood pressure to 12% for hs-CRP. CONCLUSIONS HC use among 13-17-year-old girls in Germany is significantly correlated with a more unfavorable cardiovascular risk profile, which is partly explained by a clustering of behavioral risk factors among HC users. When prescribing HC to teenagers, physicians should systematically assess avoidable behavioral cardiovascular risk factors and provide counseling tailored to the risk profile of the individual patient.
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Gode F, Karagoz C, Posaci C, Saatli B, Uysal D, Secil M, Akdeniz B. Alteration of cardiovascular risk parameters in women with polycystic ovary syndrome who were prescribed to ethinyl estradiol–cyproterone acetate. Arch Gynecol Obstet 2010; 284:923-9. [DOI: 10.1007/s00404-010-1790-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2010] [Accepted: 11/23/2010] [Indexed: 10/18/2022]
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Zakharova MY, Meyer RM, Brandy KR, Datta YH, Joseph MS, Schreiner PJ, Rao GH, Divani AA. Risk Factors for Heart Attack, Stroke, and Venous Thrombosis Associated With Hormonal Contraceptive Use. Clin Appl Thromb Hemost 2010; 17:323-31. [DOI: 10.1177/1076029610368670] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The search for a safe and effective method of contraception has been ongoing for centuries. During the last century, a variety of hormonal contraceptives, including combined hormonal oral contraceptives (COCs), have been introduced into the market. COCs have evolved through modifications of different hormonal components to minimize the risk of thrombotic events including stroke, myocardial infarction, and venous thrombosis. The evolution of COC development led to the reduction in the estrogen dose, in an attempt to lower the risk of vascular diseases. Although the risk of thrombotic events due to COC use has been substantially reduced since their inception, the quest for developing safer methods of birth control continues. It is of great interest to study coagulation effects of newer COCs, as well as progestin only, as rigorously as older COCs.
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Affiliation(s)
- Marina Y. Zakharova
- Minnesota Stroke Initiative, Department of Neurology, University of Minnesota, Minneapolis, MN, USA
| | - Rachel M. Meyer
- Minnesota Stroke Initiative, Department of Neurology, University of Minnesota, Minneapolis, MN, USA
| | - Kyle R. Brandy
- Minnesota Stroke Initiative, Department of Neurology, University of Minnesota, Minneapolis, MN, USA
| | - Yvonne H. Datta
- Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Marilyn S. Joseph
- Department of Obstetrics and Gynecology, University of Minnesota, Minneapolis, MN, USA
| | - Pamela J. Schreiner
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Gundu H. Rao
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Afshin A. Divani
- Minnesota Stroke Initiative, Department of Neurology, University of Minnesota, Minneapolis, MN, USA,
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Krintus M, Sypniewska G, Kuligowska-Prusinska M. Effect of second and third generation oral contraceptives on C-reactive protein, lipids and apolipoproteins in young, non-obese, non-smoking apparently healthy women. Clin Biochem 2010; 43:626-8. [DOI: 10.1016/j.clinbiochem.2009.12.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2009] [Revised: 12/10/2009] [Accepted: 12/13/2009] [Indexed: 10/20/2022]
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Increased follistatin levels after oral contraceptive treatment in obese and non-obese women with polycystic ovary syndrome. Hum Reprod 2010; 25:779-85. [DOI: 10.1093/humrep/dep459] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Okun ML, Coussons-Read M, Hall M. Disturbed sleep is associated with increased C-reactive protein in young women. Brain Behav Immun 2009; 23:351-4. [PMID: 19007876 PMCID: PMC2909667 DOI: 10.1016/j.bbi.2008.10.008] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2008] [Revised: 10/14/2008] [Accepted: 10/19/2008] [Indexed: 10/21/2022] Open
Abstract
Evidence links disturbed sleep with an exaggerated inflammatory response and increased risk of adverse health outcomes. An emerging risk factor for many adverse health outcomes is chronic, low-grade inflammation. An exaggerated inflammatory response could provide a biological link between disturbed sleep and adverse health outcomes. The relationship between sleep and chronic, low-grade inflammation has been sparsely examined in otherwise healthy, young women. We evaluated cross-sectional relationships between self-reported sleep and three inflammatory markers. Participants were community dwelling nonpregnant women (N=43, 28.2+/-5.2 years of age). Measures included the Pittsburgh Sleep Quality Index (PSQI), sleep diaries, and serum levels of IL-6, TNF-alpha and C-reactive protein. Poor sleep quality and continuity were associated with higher CRP levels after controlling for covariates. No significant relationships were observed between PSQI scores and IL-6 or TNF-alpha; sleep duration was not related to any of the inflammatory markers. Poor sleep, in young adulthood, may contribute to the chronic, low-grade inflammation associated with an increased risk for future adverse health outcomes. Future work should longitudinally evaluate how these relationships may affect development of gender-specific diseases in apparently healthy young women.
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Affiliation(s)
- Michele L. Okun
- University of Pittsburgh, Western Psychiatric Institute and Clinic, 3811 O’Hara Street, Room E-1116, Pittsburgh, PA 15213, USA,Corresponding author. Fax: +1 412 246 5300. (M.L. Okun)
| | - Mary Coussons-Read
- Department of Psychology, University of Colorado at Denver and Health Sciences Center, Denver, CO USA
| | - Martica Hall
- University of Pittsburgh, Western Psychiatric Institute and Clinic, 3811 O’Hara Street, Room E-1116, Pittsburgh, PA 15213, USA
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Shufelt CL, Bairey Merz CN. Contraceptive hormone use and cardiovascular disease. J Am Coll Cardiol 2009; 53:221-31. [PMID: 19147038 PMCID: PMC2660203 DOI: 10.1016/j.jacc.2008.09.042] [Citation(s) in RCA: 163] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2008] [Revised: 09/23/2008] [Accepted: 09/30/2008] [Indexed: 11/25/2022]
Abstract
Contraceptive hormones, most commonly prescribed as oral contraceptives (OCs), are a widely utilized method to prevent ovulation, implantation, and, therefore, pregnancy. The Women's Health Initiative demonstrated cardiovascular risk linked to menopausal hormone therapy among women without pre-existing cardiovascular disease, prompting a review of the safety, efficacy, and side effects of other forms of hormone therapy. A variety of basic science, animal, and human data suggests that contraceptive hormones have antiatheromatous effects; however, relatively less is known regarding the impact on atherosclerosis, thrombosis, vasomotion, and arrhythmogenesis. Newer generation OC formulations in use indicate no increased myocardial infarction risk for current users, but a persistent increased risk of venous thromboembolism. There are no cardiovascular data available for the newest generation contraceptive hormone formulations, including those that contain newer progestins that lower blood pressure, as well as the nonoral routes (transdermal and vaginal). Current guidelines indicate that, as with all medication, contraceptive hormones should be selected and initiated by weighing risks and benefits for the individual patient. Women 35 years and older should be assessed for cardiovascular risk factors including hypertension, smoking, diabetes, nephropathy, and other vascular diseases, including migraines, prior to use. Existing data are mixed with regard to possible protection from OCs for atherosclerosis and cardiovascular events; longer-term cardiovascular follow-up of menopausal women with regard to prior OC use, including subgroup information regarding adequacy of ovulatory cycling, the presence of hyperandrogenic conditions, and the presence of prothrombotic genetic disorders is needed to address this important issue.
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Affiliation(s)
- Chrisandra L Shufelt
- Women's Heart Center, Division of Cardiology, Department of Medicine, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
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