Menopausal transition and changes of body composition: a prospective study in Chinese perimenopausal women

OBJECTIVES

Whether age or menopause per se influences fat distribution remains controversial. This study aimed to investigate the change of body composition, particularly body fat distribution, in relation to menopausal transition in a 30-month prospective study of perimenopausal women.

METHODS

A total of 438 community-based healthy women aged 44-55 years participated in the Hong Kong Perimenopausal Women Osteoporosis Study. Data were obtained at baseline, and at 9-, 18- and 30-month during the follow-up. Soft tissue measurements consisting of fat mass and lean muscle mass of the trunk and whole body were obtained by the dual energy X-ray absorptiometry. Percentage change of body measurements over the follow-up period was compared between women who remained premenopausal, those who went through menopausal transition, and those who were menopausal since baseline.

RESULTS

A slight decrease in the lean mass but an increase in the total fat mass and trunk fat mass (TFM) over the follow-up period were noted. Multivariate linear regression analysis showed that age was negatively associated with an increase in central obesity. Adjusted for the important predictors--age, age of menarche and education level, menopausal status was a significant and independent predictor of the decrease in lean mass and the increase in percent of body fat, TFM and trunk-leg fat mass ratio.

CONCLUSION

Our 30-month longitudinal study showed that menopause has an independent effect on an increase in fat mass, and an increase in central obesity in perimenopausal Chinese women.

Multiple microRNAs modulate p21Cip1/Waf1 expression by directly targeting its 3' untranslated region

Cyclin-dependent kinase inhibitor 1A (CDKN1A), also known as p21Cip1/Waf1, is a master downstream effector of tumor suppressors. In this study, we experimentally demonstrate through a high-throughput luciferase reporter screen that p21Cip1/Waf1 can be directly targeted by nearly 28 microRNAs (miRNAs). The results were further confirmed by a series of mutational analyses and luciferase reporter assays. These 28 miRNAs can substantially inhibit p21Cip1/Waf1 expression, predominantly at translational level. Many of these miRNAs were upregulated in cancers and might serve as modulators of oncogenesis. Furthermore, 8 of these 28 p21-regulating miRNAs are located in the chromosome 19 miRNA cluster, the largest miRNA gene cluster in humans, and they can clearly promote cell proliferation and cell-cycle progression in choriocarcinoma cells. In conclusion, our screening strategy provides an alternative approach to uncovering miRNA modulators of an individual mRNA, and it has identified multiple miRNAs that can suppress p21Cip1/Waf1 expression by directly targeting its 3' untranslated region.

Antihypertensive and anti-arrhythmic effects of an extract of Radix Stephaniae Tetrandrae in the rat

In this study, we determined the effects of an extract of Radix Stephaniae Tetrandrae (RST) on arterial blood pressure and heart weight in deoxycorticosterone acetate-salt (DOCA-salt) hypertensive rats. We also determined the effects of the extract on arrhythmia and infarct induced by myocardial ischaemia and reperfusion in anaesthetized rats. We further compared the effects of the extract with those of tetrandrine, which makes up 7% of the extract and is known to act as a calcium-channel antagonist, and verapamil, a prototype calcium-channel antagonist. Treatment with RST extract returned the arterial blood pressure, cardiac compliance and coronary flow towards normal, and reduced right ventricular hypertrophy in the DOCA-salt hypertensive rat. In the anaesthetized rat, the RST extract reduced arrhythmia and infarct size induced by myocardial ischaemia and reperfusion; the effects were similar to those of tetrandrine and verapamil. The findings indicate that the RST extract acts like a calcium-channel antagonist. It may be used in the treatment of cardiovascular diseases, as are the calcium-channel antagonist and tetrandrine. More interestingly, the effects of the RST extract were of the same potency as tetrandrine. Since only 7% of the extract was tetrandrine, the observation indicates that tetrandrine was not the only component that was responsible for the actions of the extract.

Analysis of genetically engineered oncolytic herpes simplex viruses in human prostate cancer organotypic cultures

Oncolytic herpes simplex viruses type 1 (oHSVs) such as G47Delta and G207 are genetically engineered for selective replication competence in cancer cells. Several factors can influence the overall effectiveness of oHSV tropism, including HSV-1 receptor expression, extracellular matrix milieu and cellular permissiveness. We have taken advantage of human prostate organ cultures derived from radical prostatectomies to investigate oHSV tropism. In this study, we show that both G47Delta and G207 specifically replicate in epithelial cells of the prostatic glands but not in the surrounding stroma. In contrast, both the epithelial and stromal cell compartments were readily infected by wild-type HSV-1. Analysis of oHSV replication in prostate surgical specimens 3 days post infection showed that G47Delta generated approximately 30-fold more viral progeny than did G207. This correlated with the enhanced expression of G47Delta-derived glycoprotein gB protein levels as compared with G207. In benign prostate tissues, G207 and G47Delta titers were notably reduced, whereas strain F titers were maintained at similar levels compared with prostate cancer specimens. Overall, our results show that these oncolytic herpes vectors show both target specificity and replication competence in human prostate cancer specimens and point to the utility of using human prostate organ cultures in assessing oHSV tropism and cellular specificity.

Gender-Dependent Penetrance of Small Heterodimer Partner (SHP) Gene Deficiency in Overweight/Obese Chinese Pedigrees

Mutations of the small heterodimer partner ( SHP) gene have been associated with mild obesity in Japanese subjects. This study was designed to investigate whether there was a similar association in 772 Chinese adults. A total of 272 subjects were normal weight, 423 were overweight and 77 were obese. Four non-synonymous mutations (R34X, H53fsdel10, G171A, G189E) were identified in 10 out of the 500 overweight/obese subjects, but were not seen in the normal weight controls (prevalence 2.00% versus 0.00%, respectively). The relatives of proband carriers, including 25 carriers and 33 non-carriers from three generations, were also screened for 10 multigenerational non-consanguineous pedigrees. A gender-dependent penetrance effect was observed in the pedigrees. Furthermore, the frequency of SHP gene mutations was significantly higher in those with type 2 diabetes compared with the non-diabetics (61.5% versus 28.1%, respectively). These data provide evidence of a gender-dependent effect on penetrance for SHP deficiency and suggest that SHP mutations increase susceptibility to type 2 diabetes.

Incidence and correlates of radiation dermatitis in children and adolescents receiving radiation therapy for the treatment of paediatric sarcomas

AIMS

To investigate the relationship between the maximum grade of skin toxicity, radiation dose and clinical variables in children receiving treatment for sarcomas involving the bone and soft tissue.

MATERIALS AND METHODS

Between January 2003 and July 2006, 82 patients with musculoskeletal tumours on an Institutional Review Board (IRB)-approved prospective study at St. Jude Children's Research Hospital received three-dimensional conformal or intensity-modulated radiation therapy for local tumour control. Radiation dermatitis was graded according to the National Cancer Institute's Common Toxicity Criteria version 2.0 during and after radiation therapy. The dose to the skin was calculated for each patient from the radiation treatment plan.

RESULTS

The radiation doses delivered to the primary tumour ranged from 4140 to 7020cGy, with a mean dose of 5040cGy. The maximum recorded grade of skin toxicity was: grade 0: seven patients (8.6%); grade 1: 26 patients (31.7%); grade 2: 37 patients (45.1%); grade 3: 10 patients (12.2%); grade 4: two patients (2.4%). A significant association for increased grade of skin toxicity was observed between dose (P<0.01), volume of skin treated above 4000cGy (P=0.03), use of a bolus (P<0.01), Caucasian race (P<0.01) and related pain (P<0.01).

CONCLUSIONS

These findings suggest that the delivered dose, use of a bolus, the volume treated, and race may be used in the clinical setting to predict patients at risk for skin toxicity. Alterations in treatment technique and early therapeutic intervention may help to reduce or eliminate radiation-induced skin side-effects and associated pain.

Waist circumference, body mass index and waist to hip ratio for prediction of the metabolic syndrome in Chinese

BACKGROUND AND AIMS

To explore the ability of waist circumference (WC), body mass index (BMI) and waist to hip ratio (WHR) to predict two or more non-adipose components of the metabolic syndrome (MetS) among individuals aged 18-85 in North China.

METHODS AND RESULTS

This study is a cluster sample survey of 101,510 individuals, complete data are 75,788 subjects, 59,874 males and 15,914 females. Their ages were 51.9+/-12.7 years (males) and 48.7+/-11.5 years (females). Receiver operating characteristic (ROC) analysis was used to examine discrimination and find optimal cut off values of WC, BMI and WHR to predict two or more non-adipose components of MetS. The area under the ROC curve (AURC) for WC (0.694) and BMI (0.692) in females showed no difference. In males BMI (0.657) had a better discrimination than WC (0.634). WHR was weaker in both sexes. The optimal cut off value of WC in males (86.5 cm) was higher than in females (82.1cm); and that of BMI was about 24 kg/m(2) in both genders. The optimal cut off values of WC, BMI, and WHR, increased with age in both sexes.

CONCLUSIONS

BMI and WC are more useful than WHR for predicting two or more non-adipose components of MetS. Cut off values for WC in males, and those of BMI and WHR in both sexes are lower than that in present MetS criteria; WC in females is slightly higher. Cut off values of WC, BMI and WHR were increased with age in the Chinese.

Adaptive regularization using the entire solution surface

Several sparseness penalties have been suggested for delivery of good predictive performance in automatic variable selection within the framework of regularization. All assume that the true model is sparse. We propose a penalty, a convex combination of the L₁- and L_∞-norms, that adapts to a variety of situations including sparseness and nonsparseness, grouping and nongrouping. The proposed penalty performs grouping and adaptive regularization. In addition, we introduce a novel homotopy algorithm utilizing subgradients for developing regularization solution surfaces involving multiple regularizers. This permits efficient computation and adaptive tuning. Numerical experiments are conducted using simulation. In simulated and real examples, the proposed penalty compares well against popular alternatives.

A perspective on medical infrared imaging

Since the early days of thermography in the 1950s, image processing techniques, sensitivity of thermal sensors and spatial resolution have progressed greatly, holding out fresh promise for infrared (IR) imaging techniques. Applications in civil, industrial and healthcare fields are thus reaching a high level of technical performance. The relationship between body temperature and disease was documented since 400 bc. In many diseases there are variations in blood flow, and these in turn affect the skin temperature. IR imaging offers a useful and non-invasive approach to the diagnosis and treatment (as therapeutic aids) of many disorders, in particular in the areas of rheumatology, dermatology, orthopaedics and circulatory abnormalities. This paper reviews many usages (and hence the limitations) of thermography in biomedical fields.

The effect of miniscalpel-needle versus steroid injection for trigger thumb release

This study compared the result of percutaneous release using a miniscalpel-needle and steroid injection in 93 trigger thumbs in 83 patients. The patients were randomly assigned to either miniscalpel-needle percutaneous release (group A) or steroid injection (group B). Visual analogue pain scales and patients' satisfaction were evaluated at baseline, 1 and 12 months. One patient in group A and two patients in group B were lost to follow-up. Forty-four of the 46 trigger thumbs in group A and 12 of 47 trigger thumbs in group B had satisfactory results at 12 months. No digital nerve injury occurred in either group. Percutaneous release with a miniscalpel-needle had a higher success rate than steroid injection.

Composite tissue allotransplantation: past, present and future-the history and expanding applications of CTA as a new frontier in transplantation

Composite tissue allotransplantation (CTA) transplantation is currently being performed with increasing frequency in the clinic. The feasibility of the procedure has been confirmed in over 40 successful hand transplants, 3 facial reconstructions, and vascularized knee, esophageal, abdominal wall, and tracheal allografts. The toxicity of chronic, nonspecific immunosuppression remains a major limitation to the widespread availability of CTA and is associated with opportunistic infections, nephrotoxicity, end-organ damage, and an increased rate of malignancy. Methods to reduce or eliminate the requirement for immunosuppression would represent a significant step forward in the field. Mixed chimerism induces tolerance to solid organ and tissue allografts, including CTA. This overview focuses on the history and expanding applications of CTA as a new frontier in transplantation, and considers the important hurdles that must be overcome through research to allow widespread clinical application.