651
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Moderate-severely bothersome vasomotor symptoms are associated with lowered psychological general wellbeing in women at midlife. Maturitas 2015; 81:487-92. [DOI: 10.1016/j.maturitas.2015.06.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 06/03/2015] [Accepted: 06/04/2015] [Indexed: 11/21/2022]
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652
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Daan NMP, Fauser BCJM. Menopause prediction and potential implications. Maturitas 2015; 82:257-65. [PMID: 26278873 DOI: 10.1016/j.maturitas.2015.07.019] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 07/22/2015] [Indexed: 02/05/2023]
Abstract
Reproductive ageing in women is characterized by a decline in both the quantity and quality of oocytes. Menopause is reached upon exhaustion of the resting primordial follicle pool, occurring on average at 51 years of age (range 40-60 years). The mean global age at natural menopause (ANM) appears robust, suggesting a distinct genetic control. Accordingly, a strong correlation in ANM is observed between mothers and daughters. Few specific genetic determinants of ANM have been identified. Substantial efforts have been made to predict ANM by using anti-Müllerian hormone (AMH) levels. AMH serum concentrations at reproductive age predict ANM, but precision is currently limited. Early ANM is associated with early preceding fertility loss, whereas late menopause is associated with reduced morbidity and mortality later in life. Menopause affects various women's health aspects, including bone density, breast, the cardiovascular system, mood/cognitive function and sexual well-being. If the current trend of increasing human life expectancy persists, women will soon spend half their life postmenopause. Unfortunately, increased longevity does not coincide with an equal increase in years spend in good health. Future research should focus on determinants of long term health effects of ANM, and efforts to improve women's postmenopausal health and quality of life.
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Affiliation(s)
- Nadine M P Daan
- Department of Reproductive Medicine & Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Bart C J M Fauser
- Department of Reproductive Medicine & Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands
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653
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Effects of lifestyle intervention improve cardiovascular disease risk factors in community-based menopausal transition and early postmenopausal women in China. Menopause 2015; 21:1263-8. [PMID: 24781851 DOI: 10.1097/gme.0000000000000248] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to test the efficacy of a 12-month lifestyle intervention in improving cardiovascular disease risk factors in community-based menopausal transition and early postmenopausal women in China. METHODS One hundred healthy menopausal transition and early postmenopausal women aged 40 to 60 years were randomly assigned to receive either lifestyle change intervention (n = 53) or usual care (n = 47). Menopause status was defined by the menstrual change criteria of the Stages of Reproductive Aging Workshop + 10 based on prospective menstrual calendars. Women in the intervention group were provided with a colorful booklet that included dietary and physical activity recommendations, were individually interviewed, and completed biophysical cardiovascular risk assessments at the Women's Health Center (Beijing, China). Women were encouraged to follow a healthy eating pattern and to increase their aerobic activity (moderate level, 3 d/wk, 40 min/d). Women in the control group continued their usual eating patterns and activities. Weight, body mass index (BMI), waist circumference-to-hip circumference ratio (WHR), waist circumference (WC), body composition, blood pressure (BP), blood glucose, and serum lipids were assessed at baseline, 3 months, 6 months, and 12 months in both groups. RESULTS Women in the intervention group were observed to have significant decreases in weight, BMI, WC, WHR, systolic BP, total cholesterol, and low-density lipoprotein cholesterol compared with women in the control group. At 3 months, there were significant decreases in weight (-0.28 vs 0.68 kg, P = 0.002), BMI (-0.06 vs 0.44 kg/m2, P = 0.003), WC (-0.28 vs 1.43 cm, P = 0.001), and WHR (-0.01 vs 0.01, P = 0.045) in the intervention group compared with the control group. At 6 months, there were significant decreases in WC (-0.73 vs 1.02 cm, P = 0.012), WHR (-0.02 vs -0.003, P = 0.020), and systolic BP (-7.52 vs -0.63 mm Hg, P = 0.012) favoring the intervention group over the control group. At 12 months, there were significant decreases in total cholesterol (-0.07 vs 0.03 mmol/L, P = 0.045) and low-density lipoprotein cholesterol (-0.13 vs 0.01 mmol/L, P = 0.022) in the intervention group versus the control group. CONCLUSIONS Lifestyle intervention may be an effective means for reducing cardiovascular disease risk factors in menopausal transition and early postmenopausal women in China.
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654
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Examining the relationship between subjective sleep disturbance and menopause: a systematic review and meta-analysis. Menopause 2015; 21:1301-18. [PMID: 24800878 DOI: 10.1097/gme.0000000000000240] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study was to conduct a systematic review and meta-analysis of the relationship between menopausal stages and sleep disturbance reported using subjective methods. Secondary aims included examining the influence of culture/ethnicity on the relationship between menopausal stages and sleep disturbance. METHODS Multiple electronic databases were searched from the first available year to November 2013, and a manual search of the reference lists of review articles identified was also conducted. Twenty-four studies with a total of 63,542 midlife women were identified, coded, and analyzed. RESULTS The crude and adjusted odds of experiencing sleep disturbance were small but statistically significant for perimenopausal and postmenopausal women, using premenopause as the reference group. The ethnicity of the samples influenced effect sizes; Asian and white women both experienced an increased rate of sleep disturbance at the perimenopausal and postmenopausal stages compared with the premenopausal stage, whereas Hispanic women experienced no change in sleep disturbance across the menopausal transition. CONCLUSIONS The prevalence of sleep disturbance is higher in perimenopausal, postmenopausal, and surgical menopausal women than in premenopausal women. There is an independent relationship between menopausal stages and sleep disturbance beyond the effects of aging and other confounders, although the magnitude of the relationship is small. Culture, ethnicity, or both might affect the levels of sleep disturbance at various menopausal stages.
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655
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Freeman EW, Sammel MD, Gross SA, Pien GW. Poor sleep in relation to natural menopause: a population-based 14-year follow-up of midlife women. Menopause 2015; 22:719-26. [PMID: 25549066 PMCID: PMC4481144 DOI: 10.1097/gme.0000000000000392] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study aims to estimate the prevalence and predictors of moderate/severe poor sleep in relation to the final menstrual period (FMP) in midlife women. METHODS Annual assessments were conducted in a population-based cohort of 255 women. All were premenopausal at cohort enrollment and reached natural menopause during the 16-year follow-up. The outcome measure was severity of poor sleep, as reported by participants in annual interviews for 16 years and as evaluated in relation to the FMP. RESULTS The annual prevalence of moderate/severe poor sleep largely ranged from about 28% to 35%, with no significant differences in any year relative to the FMP for the sample overall. When sleep status was stratified at premenopausal baseline, premenopausal sleep status strongly predicted poor sleep around the FMP. Women with moderate/severe poor sleep in premenopause were approximately 3.5 times more likely to have moderate/severe poor sleep around menopause than those with no poor sleep at baseline in adjusted analysis (odds ratio, 3.58; 95% CI, 2.50-5.11; P < 0.0001), whereas mild poor sleepers in premenopause were approximately 1.5 times more likely to have moderate/severe poor sleep around menopause (odds ratio, 1.57; 95% CI, 0.99-2.47; P = 0.053). There was no significant association between poor sleep and time relative to the FMP among women who had no poor sleep at premenopausal baseline. Hot flashes were significantly associated with poor sleep (odds ratio, 1.79; 95% CI, 1.44-2.21; P < 0.0001 in adjusted analysis) but had no interaction with baseline sleep severity (interaction P = 0.25), indicating that hot flashes contributed to poor sleep regardless of baseline sleep status. CONCLUSIONS Findings show a high prevalence of moderate/severe poor sleep in midlife women, with only a small "at-risk" subgroup having a significant increase in poor sleep in relation to the FMP. Sleep status at premenopausal baseline and concurrent hot flashes strongly and consistently predict poor sleep in the menopausal transition. Overall, poor sleep does not increase around the FMP and frequently occurs in the absence of hot flashes, indicating that sleep difficulties in the menopausal transition in generally healthy women are not simply associated with ovarian decline.
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Affiliation(s)
- Ellen W. Freeman
- Department of Obstetrics and Gynecology and Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Mary D. Sammel
- the Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania
| | - Stephanie A. Gross
- the Center for Research in Reproduction and Women's Health, Perelman School of Medicine, University of Pennsylvania
| | - Grace W. Pien
- the Division of Pulmonary and Critical Care Medicine, Johns Hopkins University
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656
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Moderate to severe vasomotor and sexual symptoms remain problematic for women aged 60 to 65 years. Menopause 2015; 22:694-701. [DOI: 10.1097/gme.0000000000000383] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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657
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Zhang L, Wang Z, Liu X, Zhou Z, Zhao Y, Shi D, Liu Y, Liang J, Yang L, Chai M, Zhou Y. Women With Early Menopause Have Higher Rates of Target Lesion Revascularization After Percutaneous Coronary Intervention. Angiology 2015; 67:311-6. [PMID: 26032851 DOI: 10.1177/0003319715589247] [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: 11/16/2022]
Abstract
Early menopause has been found to be associated with higher risk of cardiovascular disease. Our objective was to investigate the impact of early menopause on clinical outcomes for women undergoing percutaneous coronary intervention (PCI). We observed female patients with coronary artery disease (CAD) undergoing PCI and found that women with early menopause (≤46 years old) were more likely to have CAD risk factors and more severe coronary lesions. During the 18-month follow-up, early menopause was associated with similar risk of death and myocardial infarction but higher risk of target lesion revascularization (TLR; 7.8% vs 5.3%, P = .003) and major adverse cardiovascular events (MACEs; 11.3% vs 9.0%, P = .007). After adjustment, early menopause was an independent risk factor for 18-month MACEs (hazard ratio [HR], 1.54; 95% confidence interval [CI] 1.18-2.00) and TLR (HR 1.61; 95% CI 1.21-2.13). In conclusion, for women undergoing PCI, early menopause is associated with higher risk of MACE, which is mainly driven by risk of TLR.
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Affiliation(s)
- Linlin Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing 100029, China
| | - Zhijian Wang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing 100029, China
| | - Xiaoli Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing 100029, China
| | - Zhiming Zhou
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing 100029, China
| | - Yingxin Zhao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing 100029, China
| | - Dongmei Shi
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing 100029, China
| | - Yuyang Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing 100029, China
| | - Jing Liang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing 100029, China
| | - Lixia Yang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing 100029, China
| | - Meng Chai
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing 100029, China
| | - Yujie Zhou
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing 100029, China
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658
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Davis SR, Tan A, Bell RJ. Targeted assessment of fracture risk in women at midlife. Osteoporos Int 2015; 26:1705-12. [PMID: 25630574 DOI: 10.1007/s00198-015-3046-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 01/18/2015] [Indexed: 10/24/2022]
Abstract
UNLABELLED This study establishes a profile for women at midlife, referred for a dual energy X-ray absorptiometry (DXA), most likely to have osteoporosis, and from this, a pre-DXA screening tool has been developed. These findings inform much needed evidence-based guidelines for targeted and effective screening for osteoporosis and osteoporotic fracture prevention in women at midlife. INTRODUCTION There is no consensus as to whether women at midlife should undergo screening dual energy X-ray absorptiometry (DXA) to identify osteoporosis (T-score < -2.5). METHODS We investigated the prevalence of osteoporosis in women, aged 40-65 years, referred to 42 community-based Australian radiology centres, and identified the characteristics that best predict osteoporosis in women having a screening DXA. RESULTS One thousand four hundred and two women completed the study questionnaire and had DXA reports available. After excluding women with an established indication for a DXA (58 %), users of bone-specific medication (10.5 %) and cancer (7.6 %), 466 women were classified as having a screening DXA. Forty of these women had osteoporosis at the lumbar spine (n = 32, 6.9 %) or femoral neck (n = 17, 3.6 %). Three predictors of osteoporosis (postmenopausal, nonuse of hormonal therapy and body mass index) were identified and incorporated into the Monash Osteoporosis Risk Score for women at midlife (MORS). In the screened study population, the MORS had a sensitivity of 70 % and specificity of 66 %, with a positive predictive value of 16.2 % and negative predictive value of 95.9 % for osteoporosis. CONCLUSIONS Very few women referred for a screening DXA scan will be found to have osteoporosis. The MORS, a simple decision tool, would have identified 70 % of the women in our screening DXA study population and would have eliminated over 60 % of the screening DXA studies. Hence, use of the MORS may reduce unnecessary DXA scans and facilitate identification of the majority of cases of osteoporosis in women aged 40 to 65 years.
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Affiliation(s)
- S R Davis
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Level 6 The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - A Tan
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Level 6 The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia
| | - R J Bell
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Level 6 The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia
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659
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Brand JS, Onland-Moret NC, Eijkemans MJC, Tjønneland A, Roswall N, Overvad K, Fagherazzi G, Clavel-Chapelon F, Dossus L, Lukanova A, Grote V, Bergmann MM, Boeing H, Trichopoulou A, Tzivoglou M, Trichopoulos D, Grioni S, Mattiello A, Masala G, Tumino R, Vineis P, Bueno-de-Mesquita HB, Weiderpass E, Redondo ML, Sánchez MJ, Castaño JMH, Arriola L, Ardanaz E, Duell EJ, Rolandsson O, Franks PW, Butt S, Nilsson P, Khaw KT, Wareham N, Travis R, Romieu I, Gunter MJ, Riboli E, van der Schouw YT. Diabetes and onset of natural menopause: results from the European Prospective Investigation into Cancer and Nutrition. Hum Reprod 2015; 30:1491-8. [PMID: 25779698 PMCID: PMC6284789 DOI: 10.1093/humrep/dev054] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 12/05/2014] [Indexed: 01/10/2023] Open
Abstract
STUDY QUESTION Do women who have diabetes before menopause have their menopause at an earlier age compared with women without diabetes? SUMMARY ANSWER Although there was no overall association between diabetes and age at menopause, our study suggests that early-onset diabetes may accelerate menopause. WHAT IS KNOWN ALREADY Today, more women of childbearing age are being diagnosed with diabetes, but little is known about the impact of diabetes on reproductive health. STUDY DESIGN, SIZE, DURATION We investigated the impact of diabetes on age at natural menopause (ANM) in 258 898 women from the European Prospective Investigation into Cancer and Nutrition (EPIC), enrolled between 1992 and 2000. PARTICIPANTS/MATERIALS, SETTING, METHODS Determinant and outcome information was obtained through questionnaires. Time-dependent Cox regression analyses were used to estimate the associations of diabetes and age at diabetes diagnosis with ANM, stratified by center and adjusted for age, smoking, reproductive and diabetes risk factors and with age from birth to menopause or censoring as the underlying time scale. MAIN RESULTS AND THE ROLE OF CHANCE Overall, no association between diabetes and ANM was found (hazard ratio (HR) = 0.94; 95% confidence interval (CI) 0.89-1.01). However, women with diabetes before the age of 20 years had an earlier menopause (10-20 years: HR = 1.43; 95% CI 1.02-2.01, <10 years: HR = 1.59; 95% CI 1.03-2.43) compared with non-diabetic women, whereas women with diabetes at age 50 years and older had a later menopause (HR = 0.81; 95% CI 0.70-0.95). None of the other age groups were associated with ANM. LIMITATIONS, REASONS FOR CAUTION Strengths of the study include the large sample size and the broad set of potential confounders measured. However, results may have been underestimated due to survival bias. We cannot be sure about the sequence of the events in women with a late age at diabetes, as both events then occur in a short period. We could not distinguish between type 1 and type 2 diabetes. WIDER IMPLICATIONS OF THE FINDINGS Based on the literature, an accelerating effect of early-onset diabetes on ANM might be plausible. A delaying effect of late-onset diabetes on ANM has not been reported before, and is not in agreement with recent studies suggesting the opposite association. STUDY FUNDING/COMPETING INTERESTS The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l'Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ) and Federal Ministry of Education and Research (BMMF) (Germany); Ministry of Health and Social Solidarity, Stavros Niarchos Foundation and Hellenic Health Foundation (Greece); Italian Association for Research on Cancer (AIRC) and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); ERC-2009-AdG 232997 and Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health (Norway); Health Research Fund (FIS), Regional Governments of Andalucía, Asturias, Basque Country, Murcia (no. 6236) and Navarra, ISCIII RETIC (RD06/0020) (Spain); Swedish Cancer Society, Swedish Scientific Council and Regional Government of Skåne and Västerbotten (Sweden); Cancer Research UK, Medical Research Council, Stroke Association, British Heart Foundation, Department of Health, Food Standards Agency, and Wellcome Trust (UK). None of the authors reported a conflict of interest.
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Affiliation(s)
- J S Brand
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - N C Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M J C Eijkemans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - A Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - N Roswall
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - K Overvad
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - G Fagherazzi
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, F-94805 Villejuif, France
| | - F Clavel-Chapelon
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, F-94805 Villejuif, France
| | - L Dossus
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, F-94805 Villejuif, France
| | - A Lukanova
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany Department of Medical Biosciences, University of Umeå, Umeå, Sweden
| | - V Grote
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - M M Bergmann
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Potsdam, Germany
| | - H Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Potsdam, Germany
| | - A Trichopoulou
- WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, 75 M. Asias Street, Goudi GR-115 27, Athens, Greece Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece
| | - M Tzivoglou
- Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece
| | - D Trichopoulos
- Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA Bureau of Epidemiologic Research, Academy of Athens, 28 Panepistimiou Street, Athens GR-106 79, Greece
| | - S Grioni
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Mattiello
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - G Masala
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy
| | - R Tumino
- Cancer Registry and Histopathology Unit, 'Civic - M.P. Arezzo' Hospital, ASP Ragusa, Italy
| | - P Vineis
- School of Public Health, Imperial College, London, UK HuGeF Foundation, Torino, Italy
| | - H B Bueno-de-Mesquita
- Dt. for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands Dt. of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands Dt. of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom Dt. of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - E Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway Cancer Registry of Norway, Oslo, Norway Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Samfundet Folkhälsan, Helsinki, Finland
| | | | - M J Sánchez
- Andalusian School of Public Health, Instituto de Investigación Biosanitaria ibs.GRANADA. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - J M Huerta Castaño
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain
| | - L Arriola
- Public Health Department of Gipuzkoa, Instituto BIO-Donostia, Basque Government, CIBERESP, San Sebastian, Spain
| | - E Ardanaz
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Navarre Public Health Institute, Pamplona, Spain
| | - E J Duell
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - O Rolandsson
- Department of Public Health and Clinical Medicine, Family Medicine Umeå University, 901 87 Umeå, Sweden
| | - P W Franks
- Department of Clinical Sciences, Genetic & Molecular Epidemiology Unit, Clinical Research Center, Skåne University Hospital, Lund University, Malmö, Sweden Department of Medicine, Umeå University, Umeå, Sweden
| | - S Butt
- Department of Surgery, Institute of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden
| | - P Nilsson
- Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmo, Sweden
| | - K T Khaw
- University of Cambridge, Cambridge, UK
| | - N Wareham
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - R Travis
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | - I Romieu
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - M J Gunter
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - E Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Y T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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660
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Im EO, Ham OK, Chee E, Chee W. Physical activity and depressive symptoms in four ethnic groups of midlife women. West J Nurs Res 2015; 37:746-66. [PMID: 24879749 PMCID: PMC4344416 DOI: 10.1177/0193945914537123] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to determine the associations between physical activity and depression and the multiple contextual factors influencing these associations in four major ethnic groups of midlife women in the United States. This was a secondary analysis of the data from 542 midlife women. The instruments included questions on background characteristics and health and menopausal status; the Depression Index for Midlife Women (DIMW); and the Kaiser Physical Activity Survey (KPAS). The data were analyzed using chi-square tests, the ANOVA, two-way ANOVA, correlation analyses, and hierarchical multiple regression analyses. The women's depressive symptoms were negatively correlated with active living and sports/exercise physical activities whereas they were positively correlated with occupational physical activities (p < .01). Family income was the strongest predictor of their depressive symptoms. Increasing physical activity may improve midlife women's depressive symptoms, but the types of physical activity and multiple contextual factors need to be considered in intervention development.
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Affiliation(s)
- Eun-Ok Im
- University of Pennsylvania, Philadelphia, USA
| | | | - Eunice Chee
- University of Pennsylvania, Philadelphia, USA
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661
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Jiang C, Hou X, Wang C, May JV, Butnev VY, Bousfield GR, Davis JS. Hypoglycosylated hFSH Has Greater Bioactivity Than Fully Glycosylated Recombinant hFSH in Human Granulosa Cells. J Clin Endocrinol Metab 2015; 100:E852-60. [PMID: 25915568 PMCID: PMC4454802 DOI: 10.1210/jc.2015-1317] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
CONTEXT Previous studies suggest that aging in women is associated with a reduction in hypoglycosylated forms of FSH. OBJECTIVE Experiments were performed to determine whether glycosylation of the FSHβ subunit modulates the biological activity of FSH in human granulosa cells. DESIGN AND SETTING Recombinant human FSH (hFSH) derived from GH3 pituitary cells was purified into fractions containing hypoglycosylated hFSH(21/18) and fully glycosylated hFSH(24). The response to FSH glycoforms was evaluated using the well-characterized, FSH-responsive human granulosa cell line, KGN at an academic medical center. INTERVENTIONS Granulosa cells were treated with increasing concentrations of fully- or hypoglycosylated FSH glycoforms for periods up to 48 hours. MAIN OUTCOME MEASURE(S) The main outcomes were indices of cAMP-dependent cell signaling and estrogen and progesterone synthesis. RESULTS We observed that hypoglycosylated FSH(21/18) was significantly more effective than fully glycosylated FSH(24) at stimulating cAMP accumulation, protein kinase A (PKA) activity, and cAMP response element binding protein (CREB) (S133) phosphorylation. FSH(21/18) was also much more effective than hFSH(24) on the stimulation CREB-response element-mediated transcription, expression of aromatase and STAR proteins, and synthesis of estrogen and progesterone. Adenoviral-mediated expression of the endogenous inhibitor of PKA, inhibited FSH(21/18)- and FSH(24)-stimulated CREB phosphorylation, and steroidogenesis. CONCLUSIONS Hypoglycosylated FSH(21/18) has greater bioactivity than fully glycosylated hFSH(24), suggesting that age-dependent decreases in hypoglycosylated hFSH contribute to reduced ovarian responsiveness. Hypoglycosylated FSH may be useful in follicle stimulation protocols for older patients using assisted reproduction technologies.
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Affiliation(s)
- Chao Jiang
- The Olson Center for Women's Health, Department of Obstetrics and Gynecology (C.J., X.H., C.W., J.S.D.), University of Nebraska Medical Center, Omaha, Nebraska 68198; Nebraska-Northwest Iowa VA Medical Center (X.H., J.S.D.), Omaha, Nebraska 68105; Department of Biological Sciences (J.V.M., V.Y.B., G.R.B.), Wichita State University, Wichita, Kansas 67260; and Department of Biochemistry and Molecular Biology (J.S.D.), University of Nebraska Medical Center, Omaha, Nebraska 68198
| | - Xiaoying Hou
- The Olson Center for Women's Health, Department of Obstetrics and Gynecology (C.J., X.H., C.W., J.S.D.), University of Nebraska Medical Center, Omaha, Nebraska 68198; Nebraska-Northwest Iowa VA Medical Center (X.H., J.S.D.), Omaha, Nebraska 68105; Department of Biological Sciences (J.V.M., V.Y.B., G.R.B.), Wichita State University, Wichita, Kansas 67260; and Department of Biochemistry and Molecular Biology (J.S.D.), University of Nebraska Medical Center, Omaha, Nebraska 68198
| | - Cheng Wang
- The Olson Center for Women's Health, Department of Obstetrics and Gynecology (C.J., X.H., C.W., J.S.D.), University of Nebraska Medical Center, Omaha, Nebraska 68198; Nebraska-Northwest Iowa VA Medical Center (X.H., J.S.D.), Omaha, Nebraska 68105; Department of Biological Sciences (J.V.M., V.Y.B., G.R.B.), Wichita State University, Wichita, Kansas 67260; and Department of Biochemistry and Molecular Biology (J.S.D.), University of Nebraska Medical Center, Omaha, Nebraska 68198
| | - Jeffrey V May
- The Olson Center for Women's Health, Department of Obstetrics and Gynecology (C.J., X.H., C.W., J.S.D.), University of Nebraska Medical Center, Omaha, Nebraska 68198; Nebraska-Northwest Iowa VA Medical Center (X.H., J.S.D.), Omaha, Nebraska 68105; Department of Biological Sciences (J.V.M., V.Y.B., G.R.B.), Wichita State University, Wichita, Kansas 67260; and Department of Biochemistry and Molecular Biology (J.S.D.), University of Nebraska Medical Center, Omaha, Nebraska 68198
| | - Viktor Y Butnev
- The Olson Center for Women's Health, Department of Obstetrics and Gynecology (C.J., X.H., C.W., J.S.D.), University of Nebraska Medical Center, Omaha, Nebraska 68198; Nebraska-Northwest Iowa VA Medical Center (X.H., J.S.D.), Omaha, Nebraska 68105; Department of Biological Sciences (J.V.M., V.Y.B., G.R.B.), Wichita State University, Wichita, Kansas 67260; and Department of Biochemistry and Molecular Biology (J.S.D.), University of Nebraska Medical Center, Omaha, Nebraska 68198
| | - George R Bousfield
- The Olson Center for Women's Health, Department of Obstetrics and Gynecology (C.J., X.H., C.W., J.S.D.), University of Nebraska Medical Center, Omaha, Nebraska 68198; Nebraska-Northwest Iowa VA Medical Center (X.H., J.S.D.), Omaha, Nebraska 68105; Department of Biological Sciences (J.V.M., V.Y.B., G.R.B.), Wichita State University, Wichita, Kansas 67260; and Department of Biochemistry and Molecular Biology (J.S.D.), University of Nebraska Medical Center, Omaha, Nebraska 68198
| | - John S Davis
- The Olson Center for Women's Health, Department of Obstetrics and Gynecology (C.J., X.H., C.W., J.S.D.), University of Nebraska Medical Center, Omaha, Nebraska 68198; Nebraska-Northwest Iowa VA Medical Center (X.H., J.S.D.), Omaha, Nebraska 68105; Department of Biological Sciences (J.V.M., V.Y.B., G.R.B.), Wichita State University, Wichita, Kansas 67260; and Department of Biochemistry and Molecular Biology (J.S.D.), University of Nebraska Medical Center, Omaha, Nebraska 68198
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662
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Ryu S, Suh BS, Chang Y, Kwon MJ, Yun KE, Jung HS, Kim CW, Kim BK, Kim YJ, Choi Y, Ahn J, Cho YK, Kim KH, Ahn Y, Park HY, Chung EC, Shin H, Cho J. Menopausal stages and non-alcoholic fatty liver disease in middle-aged women. Eur J Obstet Gynecol Reprod Biol 2015; 190:65-70. [PMID: 25988514 DOI: 10.1016/j.ejogrb.2015.04.017] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 04/23/2015] [Accepted: 04/27/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVES There is no established evidence regarding the influence of the menopausal transition period on non-alcoholic fatty liver disease (NAFLD). The goal of this study was to examine the association between menopausal stages and the prevalence of NAFLD in middle-aged Korean women. METHODS This study was a cross-sectional analysis of 1559 women aged 44-56 years, who underwent a comprehensive health screening examination in the Kangbuk Samsung Hospital Total Healthcare Centers during 2012 and 2013. Information regarding menopause status was collected using a standardized, self-administered questionnaire. The presence of fatty liver was determined using ultrasonography. Menopausal stages were defined according to the criteria of the Stages of Reproductive Aging Workshop (STRAW+10) as follows: early menopausal transition was defined as a persistent difference in consecutive menstrual cycle length of seven or more days; late menopausal transition was defined as having an interval of amenorrhea of 60 days or more; post-menopause was defined as the absence of menstrual periods for 12 or more months since the last period; pre-menopause was defined as having a regular menstrual cycle and not meeting the above criteria. Odds ratios and 95% confidence intervals for NAFLD were estimated by menopausal stages. RESULTS Of the 1559 women, 334 had NAFLD. A higher prevalence of NAFLD was observed across menopausal stages (p for trend <0.05). After adjusting for age, center, BMI, smoking status, alcohol intake, physical activity, educational level, parity and age at menarche, the odds ratios (95% CIs) for NAFLD comparing early transition, late transition, and post-menopause to pre-menopause were 1.07 (0.68-1.67), 1.87 (1.23-2.85), and 1.67 (1.01-2.78), respectively. CONCLUSIONS This study performed in middle-aged Korean women suggests that there is an increased prevalence of NAFLD in the late menopausal transition as well as post-menopausal stages, independent of a variety of potential confounders. The findings of this study suggest that early intervention strategies implemented before women begin to experience the menopausal transition are needed to reduce the risk of NAFLD.
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Affiliation(s)
- Seungho Ryu
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea.
| | - Byung-Seong Suh
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea.
| | - Yoosoo Chang
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Min-Jung Kwon
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Kyung Eun Yun
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Hyun-Suk Jung
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Chan-Won Kim
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Bo-Kyoung Kim
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Yoo Jin Kim
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Yuni Choi
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Jiin Ahn
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Yong Kyun Cho
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kye-Hyun Kim
- Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Younjhin Ahn
- Division of Cardiovascular and Rare Diseases, Center for Biomedical Sciences, National Institute of Health, Chungbuk, South Korea
| | - Hyun-Young Park
- Division of Cardiovascular and Rare Diseases, Center for Biomedical Sciences, National Institute of Health, Chungbuk, South Korea
| | - Eun Chul Chung
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul, South Korea
| | - Hocheol Shin
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Juhee Cho
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, South Korea
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663
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Health in middle-aged and elderly women: A conceptual framework for healthy menopause. Maturitas 2015; 81:93-8. [DOI: 10.1016/j.maturitas.2015.02.010] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 02/24/2015] [Indexed: 11/21/2022]
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664
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Abstract
Women generally spend the last third of their lifetime in menopause, after their reproductive years have ended. During menopause, women experience a variety of predictable symptoms and conditions related to changes in sex hormone levels and aging. The menopausal transition precedes menopause by several years and is usually characterized by irregularity of the menstrual cycle and by hot flashes and night sweats. After menopause, genitourinary symptoms predominate, including vulvovaginal atrophy and dryness and lower urinary tract symptoms, including urinary frequency, urgency, and nocturia. Hormonal treatment is effective for vasomotor and genitourinary symptoms, but the understanding of its impact on cardiovascular disease, cognitive dysfunction, and depression continues to evolve.
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Affiliation(s)
- Traci A Takahashi
- Department of Medicine, University of Washington School of Medicine, and VA Puget Sound Health Care System, 1660 South Columbian Way, S-123-PCC, Seattle, WA 98108, USA.
| | - Kay M Johnson
- Department of Medicine, University of Washington School of Medicine, and VA Puget Sound Health Care System, 1660 South Columbian Way, S-111-HSM, Seattle, WA 98108, USA
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665
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Ryu S, Chang Y, Choi Y, Kwon MJ, Kim CW, Yun KE, Jung HS, Kim BK, Kim YJ, Ahn J, Cho YK, Kim KH, Chung EC, Shin H, Cho J. Age at menarche and non-alcoholic fatty liver disease. J Hepatol 2015; 62:1164-70. [PMID: 25500721 DOI: 10.1016/j.jhep.2014.11.041] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 11/03/2014] [Accepted: 11/26/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND & AIMS The goal of this study was to examine the association between age at menarche and non-alcoholic fatty liver disease (NAFLD) in Korean women and to explore whether any observed associations were mediated by adult adiposity. METHODS A cross-sectional study was performed for 95,183 Korean women, aged 30 or older, who underwent a regular health screening examination between March 2011 and April 2013. Information regarding age at menarche was collected using standardized, self-administered questionnaires. The presence of fatty liver was determined using ultrasonographic findings. Poisson regression models with robust variance were used to evaluate the association between age at menarche and NAFLD. RESULTS Of the 76,415 women evaluated in this study, 9601 had NAFLD. Age at menarche was inversely associated with the prevalence of NAFLD. In a multivariable-adjusted model, the prevalence ratios (95% CIs) for NAFLD comparing menarche at <12, 12, 14, 15, and 16-18 years to menarche at 13 years were 1.31 (1.18-1.45), 1.05 (0.97-1.13), 0.93 (0.87-0.99), 0.87 (0.82-0.93), and 0.78 (0.73-0.84), respectively (p for trend <0.001). Adjusting for adult BMI or percent fat mass (%) substantially reduced these associations; however, they remained statistically significant. The association between age at menarche and NAFLD was modified by age. CONCLUSIONS We identified an inverse association between age at menarche and NAFLD in a large sample of middle-aged women. This association was partially mediated by adiposity. The findings of this study suggest that obesity prevention strategies are needed in women who undergo early menarche to reduce the risk of NAFLD.
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Affiliation(s)
- Seungho Ryu
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea.
| | - Yoosoo Chang
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Yuni Choi
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Min-Jung Kwon
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Chan-Won Kim
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Kyung Eun Yun
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Hyun-Suk Jung
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Bo-Kyoung Kim
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Yoo Jin Kim
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Jiin Ahn
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Yong Kyun Cho
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Kye-Hyun Kim
- Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Eun Chul Chung
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Hocheol Shin
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Juhee Cho
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, South Korea
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666
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Neves-e-Castro M, Birkhauser M, Samsioe G, Lambrinoudaki I, Palacios S, Borrego RS, Llaneza P, Ceausu I, Depypere H, Erel CT, Pérez-López FR, Schenck-Gustafsson K, van der Schouw YT, Simoncini T, Tremollieres F, Rees M. EMAS position statement: The ten point guide to the integral management of menopausal health. Maturitas 2015; 81:88-92. [DOI: 10.1016/j.maturitas.2015.02.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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667
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Abstract
Menopause is an inevitable component of ageing and encompasses the loss of ovarian reproductive function, either occurring spontaneously or secondary to other conditions. It is not yet possible to accurately predict the onset of menopause, especially early menopause, to give women improved control of their fertility. The decline in ovarian oestrogen production at menopause can cause physical symptoms that may be debilitating, including hot flushes and night sweats, urogenital atrophy, sexual dysfunction, mood changes, bone loss, and metabolic changes that predispose to cardiovascular disease and diabetes. The individual experience of the menopause transition varies widely. Important influential factors include the age at which menopause occurs, personal health and wellbeing, and each woman's environment and culture. Management options range from lifestyle assessment and intervention through to hormonal and non-hormonal pharmacotherapy, each of which has specific benefits and risks. Decisions about therapy for perimenopausal and postmenopausal women depend on symptomatology, health status, immediate and long-term health risks, personal life expectations, and the availability and cost of therapies. More effective and safe therapies for the management of menopausal symptoms need to be developed, particularly for women who have absolute contraindications to hormone therapy. For an illustrated summary of this Primer, visit: http://go.nature.com/BjvJVX.
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668
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Thurston RC, Maki PM, Derby CA, Sejdić E, Aizenstein HJ. Menopausal hot flashes and the default mode network. Fertil Steril 2015; 103:1572-8.e1. [PMID: 25910572 DOI: 10.1016/j.fertnstert.2015.03.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 03/12/2015] [Accepted: 03/12/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To test whether more physiologically assessed hot flashes were associated with more connectivity in the default mode network (DMN), the network of brain regions active during rest. We particularly focus on DMN networks supporting the hippocampus as this region is rich in estrogen (E) receptors (ER) and has previously been linked to hot flashes. DESIGN Women underwent 24 hours of physiologic and diary hot flash monitoring, functional magnetic resonance imaging (MRI), 72 hours of sleep actigraphy monitoring, a blood draw, questionnaires, and physical measures. SETTING University medical center. PATIENT(S) Twenty midlife women aged 40-60 years who had their uterus and both ovaries and were not taking hormone therapy (HT). INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) The DMN functional connectivity. RESULT(S) Controlling for age, race, and education, more physiologically-monitored hot flashes were associated with greater DMN connectivity (beta, B [SE] = 0.004 [0.002]), particularly hippocampal DMN connectivity (B [SE] = 0.005 [0.002]). Findings were most pronounced for sleep physiologic hot flashes (with hippocampal DMN, B [SE] = 0.02 [0.007]). Associations also persisted controlling for sleep, depressive symptoms, and serum E2 concentrations. CONCLUSION(S) More physiologically-monitored hot flashes were associated with more DMN connectivity, particularly networks supporting the hippocampus. Findings were most pronounced for sleep hot flashes. Findings underscore the importance of continued investigation of the central nervous system in efforts to understand this classic menopausal phenomenon.
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Affiliation(s)
- Rebecca C Thurston
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.
| | - Pauline M Maki
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | - Carol A Derby
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York
| | - Ervin Sejdić
- Department of Electrical and Computer Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Howard J Aizenstein
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
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669
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Fairweather D. Sex differences in inflammation during atherosclerosis. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2015; 8:49-59. [PMID: 25983559 PMCID: PMC4405090 DOI: 10.4137/cmc.s17068] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 02/02/2015] [Accepted: 02/09/2015] [Indexed: 12/17/2022]
Abstract
Atherosclerosis is the leading cause of death in the United States and worldwide, yet more men die from atherosclerosis than women, and at a younger age. Women, on the other hand, mainly develop atherosclerosis following menopause, and particularly if they have one or more autoimmune diseases, suggesting that the immune mechanisms that increase disease in men are different from those in women. The key processes in the pathogenesis of atherosclerosis are vascular inflammation, lipid accumulation, intimal thickening and fibrosis, remodeling, and plaque rupture or erosion leading to myocardial infarction and ischemia. Evidence indicates that sex hormones alter the immune response during atherosclerosis, resulting in different disease phenotypes according to sex. Women, for example, respond to infection and damage with increased antibody and autoantibody responses, while men have elevated innate immune activation. This review describes current knowledge regarding sex differences in the inflammatory immune response during atherosclerosis. Understanding sex differences is critical for improving individualized medicine.
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Affiliation(s)
- DeLisa Fairweather
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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670
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Risk of long-term hot flashes after natural menopause: evidence from the Penn Ovarian Aging Study cohort. Menopause 2015; 21:924-32. [PMID: 24473530 DOI: 10.1097/gme.0000000000000196] [Citation(s) in RCA: 159] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE This study aims to estimate the risk of hot flashes relative to natural menopause and to evaluate the associations of hormone levels, behavioral variables, and demographic variables with the risk of hot flashes after menopause. METHODS We performed annual assessment of 255 women who were premenopausal at baseline and reached natural menopause within 16 years of follow-up. RESULTS The prevalence of moderate/severe hot flashes increased in each premenopausal year, reaching a peak of 46% in the first 2 years after the final menstrual period (FMP). Hot flashes decreased slowly after menopause and did not return to premenopausal levels until 9 years after the FMP. The mean (SD) duration of moderate/severe hot flashes after the FMP was 4.6 (2.9) years (for any hot flashes, 4.9 [3.1] y). One third of women at 10 years or more after menopause continued to experience moderate/severe hot flashes. African-American women (obese and nonobese) and obese white women had significantly greater risks of hot flashes compared with nonobese white women (interaction, P = 0.01). In multivariable analysis, increasing follicle-stimulating hormone levels before the FMP (P < 0.001), decreasing estradiol (odds ratio, 0.87; 95% CI, 0.78-0.96; P = 0.008), and increasing anxiety (odds ratio, 1.05; 95% CI, 1.03-1.06; P < 0.001) were significant risk factors for hot flashes, whereas higher education levels were protective (odds ratio, 0.66; 95% CI, 0.47-0.91; P = 0.011). CONCLUSIONS Moderate/severe hot flashes continue, on average, for nearly 5 years after menopause; more than one third of women observed for 10 years or more after menopause have moderate/severe hot flashes. Continuation of hot flashes for more than 5 years after menopause underscores the importance of determining individual risks/benefits when selecting hormone or nonhormone therapy for menopausal symptoms.
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671
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Keskin Kurt R, Nacar AB, Güler A, Silfeler DB, Buyukkaya E, Karateke A, Kurt M, Tanboga IH. Menopausal cardiomyopathy: does it really exist? A case-control deformation imaging study. J Obstet Gynaecol Res 2015; 40:1748-53. [PMID: 24888943 DOI: 10.1111/jog.12368] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 12/02/2013] [Indexed: 11/27/2022]
Abstract
AIM We aimed to evaluate and compare the left ventricular (LV) functions of pre- and postmenopausal women at similar ages with none of the known cardiovascular risk factors, by both conventional and advanced echocardiographic methods such as 2-D strain imaging via speckle tracking echocardiography. METHODS The study population consisted of 40 healthy postmenopausal women aged 45-50 years and 40 healthy premenopausal women of the same age group. None of the subjects had any cardiovascular risk factors and were on hormone replacement therapy. LV strain and strain rate parameters were measured by 2-D strain imaging. The main outcome measure was effect of menopause on LV function. RESULTS There were no significant differences between the pre- and postmenopausal groups with regard to conventional echocardiographic parameters. LV longitudinal strain and LV early diastolic strain rate values were significantly lower in the postmenopausal group when compared to the premenopausal group. Also, there was a significant negative correlation between LV global strain and serum follicle-stimulating hormone (r = -0.349, P = 0.002). CONCLUSION Our study results demonstrated that healthy postmenopausal women had lower LV longitudinal strain values when compared to the healthy premenopausal women of the same age group by speckle tracking echocardiography.
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Affiliation(s)
- Raziye Keskin Kurt
- Department of Obstetrics and Gynecology, Mustafa Kemal University Medical School, Hatay, Turkey
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672
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Bone Density and Fractures in HIV-infected Postmenopausal Women: A Systematic Review. J Assoc Nurses AIDS Care 2015; 26:387-98. [PMID: 26066693 DOI: 10.1016/j.jana.2015.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Accepted: 03/31/2015] [Indexed: 01/28/2023]
Abstract
With the development of effective antiretroviral therapy, HIV-infected women are living longer and transitioning through menopause. The purpose of our study was to systematically examine the evidence that menopause is an additional risk predictor for osteoporosis and fractures in HIV-infected women. Electronic databases were searched for studies of low bone density or fractures in HIV-infected postmenopausal women. Studies that met the inclusion criteria (n = 10) were appraised using a validated quality assessment tool. The majority of studies were rated as good quality and the remaining were fair. The prevalence of osteoporosis reported in these studies ranged from 7.3% to 84% and 0.7% to 23% in HIV-infected and uninfected postmenopausal women, respectively. In the two qualifying studies, postmenopausal status was not a predictor of fractures in HIV-infected women. Findings suggest that HIV care providers should accurately assess postmenopausal status and modifiable risk factors for osteoporosis in all older HIV-infected women.
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673
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Choi Y, Chang Y, Kim BK, Kang D, Kwon MJ, Kim CW, Jeong C, Ahn Y, Park HY, Ryu S, Cho J. Menopausal stages and serum lipid and lipoprotein abnormalities in middle-aged women. Maturitas 2015; 80:399-405. [PMID: 25631350 DOI: 10.1016/j.maturitas.2014.12.016] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 12/26/2014] [Accepted: 12/26/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Whether menopausal stage is associated with abnormalities in serum lipid and lipoprotein profiles remains unclear; studies have been conducted mostly in Western populations. This study aimed to examine the prevalence of lipid and lipoprotein abnormalities by recently updated menopausal stages in middle-aged women. STUDY DESIGN This study was cross-sectional analysis of 1553 women aged 44-56 years, who underwent a comprehensive health screening examination in the Kangbuk Samsung Hospital Total Healthcare Centers, Korea, during 2012-2013. Lipid and lipoprotein profiles including total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), lipoprotein (a) (Lp(a)), apolipoprotein A1 (Apo A1), apolipoprotein B (Apo B) were assessed. Prevalence ratios and 95% confidence intervals for lipid and lipoprotein abnormalities were estimated by menopausal stages as defined by the 2011 Stages of Reproductive Aging Workshop+10 criteria. RESULTS Increased prevalence of lipid and lipoprotein abnormalities were observed across menopausal stages. The increased prevalence of high non-HDL-C was associated with the late menopausal transition and post-menopausal stages and was more pronounced in women with body mass index (BMI) <23 kg/m(2) than in those with BMI ≥23 kg/m(2) (P for interaction=0.006). Similarly, there was an interaction between BMI and menopausal stages in relation to high Apo B (P for interaction=0.05) and high Apo B/Apo A1 ratio (P for interaction=0.06). CONCLUSIONS Our findings extend previous results and suggest that the increased prevalence of lipid and lipoprotein abnormalities was associated not only with the post-menopausal stage but also late menopausal transition period.
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Affiliation(s)
- Yuni Choi
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea
| | - Yoosoo Chang
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea
| | - Bo-Kyoung Kim
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea
| | - Danbee Kang
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Min-Jung Kwon
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea
| | - Chan-Won Kim
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea
| | - Chul Jeong
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea
| | - Younjhin Ahn
- Division of Cardiovascular and Rare Diseases, Center for Biomedical Sciences, National Institute of Health, Chungbuk, Republic of Korea
| | - Hyun-Young Park
- Division of Cardiovascular and Rare Diseases, Center for Biomedical Sciences, National Institute of Health, Chungbuk, Republic of Korea
| | - Seungho Ryu
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea.
| | - Juhee Cho
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea; Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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674
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Yin F, Yao J, Sancheti H, Feng T, Melcangi RC, Morgan TE, Finch CE, Pike CJ, Mack WJ, Cadenas E, Brinton RD. The perimenopausal aging transition in the female rat brain: decline in bioenergetic systems and synaptic plasticity. Neurobiol Aging 2015; 36:2282-2295. [PMID: 25921624 DOI: 10.1016/j.neurobiolaging.2015.03.013] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 02/20/2015] [Accepted: 03/25/2015] [Indexed: 01/03/2023]
Abstract
The perimenopause is an aging transition unique to the female that leads to reproductive senescence which can be characterized by multiple neurological symptoms. To better understand potential underlying mechanisms of neurological symptoms of perimenopause, the present study determined genomic, biochemical, brain metabolic, and electrophysiological transformations that occur during this transition using a rat model recapitulating fundamental characteristics of the human perimenopause. Gene expression analyses indicated two distinct aging programs: chronological and endocrine. A critical period emerged during the endocrine transition from regular to irregular cycling characterized by decline in bioenergetic gene expression, confirmed by deficits in fluorodeoxyglucose-positron emission tomography (FDG-PET) brain metabolism, mitochondrial function, and long-term potentiation. Bioinformatic analysis predicted insulin/insulin-like growth factor 1 and adenosine monophosphate-activated protein kinase/peroxisome proliferator-activated receptor gamma coactivator 1 alpha (AMPK/PGC1α) signaling pathways as upstream regulators. Onset of acyclicity was accompanied by a rise in genes required for fatty acid metabolism, inflammation, and mitochondrial function. Subsequent chronological aging resulted in decline of genes required for mitochondrial function and β-amyloid degradation. Emergence of glucose hypometabolism and impaired synaptic function in brain provide plausible mechanisms of neurological symptoms of perimenopause and may be predictive of later-life vulnerability to hypometabolic conditions such as Alzheimer's.
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Affiliation(s)
- Fei Yin
- Department of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, Los Angeles, CA, USA
| | - Jia Yao
- Department of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, Los Angeles, CA, USA
| | - Harsh Sancheti
- Department of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, Los Angeles, CA, USA
| | - Tao Feng
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Roberto C Melcangi
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Todd E Morgan
- Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Caleb E Finch
- Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Christian J Pike
- Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Wendy J Mack
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Enrique Cadenas
- Department of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, Los Angeles, CA, USA
| | - Roberta D Brinton
- Department of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, Los Angeles, CA, USA; Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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675
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Menopausal status and physical performance in middle aged women: a cross-sectional community-based study in Northeast Brazil. PLoS One 2015; 10:e0119480. [PMID: 25822526 PMCID: PMC4378898 DOI: 10.1371/journal.pone.0119480] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 01/14/2015] [Indexed: 11/30/2022] Open
Abstract
Objective To examine associations between menopausal status and physical performance in middle-aged women from the Northeast region of Brazil. Methods Cross-sectional study of women between 40 to 65 years old living in Parnamirim. Women were recruited by advertisements in primary care neighborhood centers across the city. Physical performance was assessed by grip strength, gait speed and chair stands. Menopausal status was determined using the Stages of Reproductive Aging Workshop classification and women were classified in: premenopausal, perimenopausal or postmenopausal. Multiple linear regression analyses were performed to model the effect of menopausal status on each physical performance measure, adjusting for covariates (age, family income, education, body mass index, parity and age at first birth). Results The premenopausal women were significantly stronger and performed better in chair stands than perimenopausal and postmenopausal women. Gait speed did not vary significantly by menopausal status. In multivariate analyses, menopausal status remained statistically significant only for grip strength. In fully adjusted analyses, premenopausal women had grip strength mean of 2.226 Kgf (95% CI: 0.361 – 4.091) higher than the postmenopausal group. Conclusions This study provides further evidence for the associations between menopause and physical performance in middle-aged women, since grip strength is weaker in peri and postmenopausal women compared to premenopausal, even adjusted for age and other covariates.
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676
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Sipilä S, Finni T, Kovanen V. Estrogen influences on neuromuscular function in postmenopausal women. Calcif Tissue Int 2015; 96:222-33. [PMID: 25359124 DOI: 10.1007/s00223-014-9924-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 10/18/2014] [Indexed: 02/07/2023]
Abstract
Exposure to ovarian sex steroids during different life phases has long-term effects on women's health and wellbeing. Menopause is characterized by rapid decline in ovarian sex steroids already during mid-life, between the ages of 46 and 52. Due to the menopause-related hormonal changes, women in most western countries live more than one-third of their lives in postmenopausal status. The role of ovarian steroids on neuromuscular function in middle-aged and older women has been investigated since the 1980s with increasing volume of research during the last decades. This review considers how different components of the neuromuscular system may be influenced by estrogens and so affects neuromuscular function in postmenopausal women. The main focus is on muscle strength and power, which are closely associated with mobility and functional capacity among older populations. In the end of the review, we summarize recent findings on the underlying biological mechanisms in skeletal muscle that could explain the association between hormone replacement therapy and neuromuscular function among postmenopausal women.
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Affiliation(s)
- S Sipilä
- Department of Health Sciences, Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland,
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677
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Oxidative stress contributes to large elastic arterial stiffening across the stages of the menopausal transition. Menopause 2015; 21:624-32. [PMID: 24149926 DOI: 10.1097/gme.0000000000000116] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE It is unclear how changes in ovarian hormones during the menopausal transition contribute to age-associated arterial stiffening. We sought to evaluate differences in arterial stiffness and the role of oxidative stress across the stages of the menopausal transition in healthy women. METHODS Arterial stiffness (carotid artery compliance and ultrasound) was measured during immediate infusions of saline (control) and ascorbic acid (experimental model to immediately decrease oxidative stress) in 97 healthy women (22-70 y) classified as premenopausal (n = 24; mean [SD] age, 33 [7] y), early perimenopausal (n = 21; 49 [3] y) or late perimenopausal (n = 21; 50 [4] y), or postmenopausal (n = 31; 57 [5] y). RESULTS Basal carotid artery compliance was different among the groups (P < 0.001). Mean [SD] compliance was highest in premenopausal women (1.31 [0.25] mm/mm Hg × 10), with progressive decrements in perimenopausal (early perimenopausal, 0.98 [0.31] mm/mm Hg × 10; late perimenopausal, 0.90 [0.25] mm/mm Hg × 10) and postmenopausal (0.75 [0.24] mm/mm Hg × 10) women. Ascorbic acid infusion improved compliance in late perimenopausal (15% [18%] increase, P = 0.001) and postmenopausal (17% [26%] increase, P = 0.002) women but not in early perimenopausal or premenopausal women. CONCLUSIONS Arterial stiffening worsens across the stages of the menopausal transition in healthy women. This seems to be mediated, in part, by oxidative stress, particularly during the late perimenopausal and postmenopausal periods. It remains uncertain whether this is specifically caused by loss of ovarian function or aging.
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678
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Evidence for prolonged and unique amenorrhea-related symptoms in women with premature ovarian failure/primary ovarian insufficiency. Menopause 2015; 22:166-74. [DOI: 10.1097/gme.0000000000000286] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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679
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Scheffers CS, Armstrong S, Cantineau AEP, Farquhar C, Jordan V. Dehydroepiandrosterone for women in the peri- or postmenopausal phase. Cochrane Database Syst Rev 2015; 1:CD011066. [PMID: 25879093 PMCID: PMC10662543 DOI: 10.1002/14651858.cd011066.pub2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND During menopause a decreasing ovarian follicular response generally causes a fluctuation and eventual decrease in estrogen levels. This can lead to the development of various perimenopausal and postmenopausal symptoms (for example hot flushes, night sweats, vaginal dryness). Dehydroepiandrosterone (DHEA) is one of the main precursors of androgens, which in turn are converted to testosterone and estrogens. It is possible that the administration of DHEA may increase estrogen and testosterone levels in peri- and postmenopausal women to alleviate their symptoms and improve general wellbeing and sexual function (for example libido, dyspareunia, satisfaction). Treatment with DHEA is controversial as there is uncertainty about its effectiveness and safety. This review should clearly outline the evidence for DHEA in the treatment of menopausal symptoms and evaluate its effectiveness and safety by combining the results of randomised controlled trials. OBJECTIVES To assess the effectiveness and safety of administering DHEA to women with menopausal symptoms in the peri- or postmenopausal phase. SEARCH METHODS The databases that we searched (3 June 2014) with no language restrictions applied were the Cochrane Menstrual Disorders and Subfertility Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO, CINAHL and LILACS. We also searched conference abstracts and citation lists in the ISI Web of Knowledge. Ongoing trials were searched in the trials registers. Reference lists of retrieved articles were checked. SELECTION CRITERIA We included randomised controlled trials comparing any dose and form of DHEA by any route of administration versus any other active intervention, placebo or no treatment for a minimal treatment duration of seven days in peri- and postmenopausal women. DATA COLLECTION AND ANALYSIS Two authors independently extracted data after assessing eligibility for inclusion and quality of studies. Authors were contacted for additional information. MAIN RESULTS Twenty-eight trials with 1273 menopausal women were included in this review. Data could be extracted from 16 trials to conduct the meta-analysis. The overall quality of the studies was moderate to low with the majority of studies that were included in the meta-analysis having reasonable methodology. Compared to placebo, DHEA did not improve quality of life (standardised mean difference (SMD) 0.16, 95% confidence interval (CI) -0.03 to 0.34, P = 0.10, 8 studies, 287 women (132 from parallel and 155 from crossover trials), I² = 0%, moderate quality evidence; one trial of the nine that reported on this outcome was removed in a sensitivity analysis as it was judged to be at high risk of bias). DHEA was found to be associated with androgenic side effects (mainly acne) (odds ratio (OR) 3.77, 95% CI 1.36 to 10.4, P = 0.01, 5 studies, 376 women, I² = 10%, moderate quality evidence) when compared to placebo. No associations were found with other adverse effects. It was unclear whether DHEA affected menopausal symptoms as the results from the trials were inconsistent and could not easily be pooled to provide an overall effect due to different types of measurement (for example continuous, dichotomous, change and end scores). DHEA was found to improve sexual function (SMD 0.31, 95% CI 0.07 to 0.55, P = 0.01, 5 studies, 261 women (239 women from parallel trials and 22 women from crossover trials), I² = 0%; one trial judged to be at high risk of bias was removed during sensitivity analysis) compared to placebo.There was no difference in the acne associated with DHEA when comparing studies that used oral DHEA (OR 2.16, 95% CI 0.47 to 9.96, P = 0.90, 3 studies, 136 women, I² = 5%, very low quality evidence) to one study that used skin application of DHEA (OR 2.74, 95% CI 0.10 to 74.87, P = 0.90, 1 study, 22 women, very low quality evidence). The effects did not differ for sexual function when studies using oral DHEA (SMD 0.11, 95% CI -0.13 to 0.35, P = 0.36, 5 studies, 340 women, I² = 0) were compared to a study using intravaginal DHEA (SMD 0.42, 95% CI 0.03 to 0.81, 1 study, 218 women). Test for subgroup differences: Chi² = 1.77, df = 1 (P = 0.18), I² = 43.4%. Insufficient data were available to assess quality of life and menopausal symptoms for this comparison.There were insufficient data available to compare the effects of DHEA to hormone therapy (HT) for quality of life, menopausal symptoms, and adverse effects. No large differences in treatment effects were found for sexual function when comparing DHEA to HT (mean difference (MD) 1.26, 95% CI -0.21 to 2.73, P = 0.09, 2 studies, 41 women, I² = 0%). AUTHORS' CONCLUSIONS There is no evidence that DHEA improves quality of life but there is some evidence that it is associated with androgenic side effects. There is uncertainty whether DHEA decreases menopausal symptoms, but DHEA may slightly improve sexual function compared with placebo.
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Affiliation(s)
- Carola S Scheffers
- University of Groningen, Antonius Deusinglaan 1, Groningen, 9713 AV, Netherlands.
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680
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Pope SM, Elek IV S, Wilcox T, Riley JK. Menopause. Fam Med 2015. [DOI: 10.1007/978-1-4939-0779-3_111-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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681
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Posadzy-Malaczynska A, Rajpold K, Woznicka-Leskiewicz L, Marcinkowska J. Hemodynamic and metabolic effects of estrogen plus progestin therapy in hypertensive postmenopausal women treated with an ACE-inhibitor or a diuretic. Clin Res Cardiol 2015; 104:38-50. [PMID: 25216597 PMCID: PMC4300408 DOI: 10.1007/s00392-014-0755-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 08/11/2014] [Indexed: 01/01/2023]
Abstract
OBJECTIVES The aim of the study was to assess the hemodynamic and metabolic actions of estrogen plus progestin therapy (EPT) in hypertensive, postmenopausal women treated with perindopril (ACEI) or hydrochlorothiazide (HCTZ). A group of normotensive postmenopausal women was also studied. METHODS 100 hypertensive and 40 normotensive postmenopausal women were recruited for the study. The hypertensive females were randomly assigned to receive ACEI or HCTZ for 12 months. The patients of the ACEI group and the patients of the HCTZ group, as well as normotensives, were further subdivided into two subgroups each. One subgroup received estrogen plus progestin therapy (EPT+), the other subgroup received no hormone replacement (EPT-). Combined hormone replacement with transdermal patches releasing 17β-estradiol and norethisterone was used. Office and 24-hour ambulatory blood pressure was measured at baseline and during follow-up. Renal plasma flow (RPF) was measured using the clearance of [125I]-iodohippuran. Pulse wave velocity (PWV) was determined with an automatic device. RESULTS In normotensive postmenopausal women, transdermal estrogen plus progestin therapy increases RPF and insulin sensitivity, decreases PWV, decreases total and LDL cholesterol, and decreases uric acid serum levels. Perindopril (4 mg/day) and hydrochlorothiazide (25 mg/day) were equally effective in reducing blood pressure in postmenopausal, hypertensive subjects. In these females, perindopril increased RPF and decreased PWV and plasma insulin levels. These effects of the ACEI were not altered by estrogen plus progestin therapy. Hydrochlorothiazide decreased RPF and increased plasma insulin and uric acid concentrations in hypertensive subjects whom were not receiving estrogen plus progestin therapy. CONCLUSIONS The unfavorable metabolic and hemodynamic actions of the diuretic were counteracted by estrogen plus progestin therapy. Concomitant estrogen plus progestin therapy may be a method to avoid unfavorable hemodynamic and metabolic effects of thiazide diuretics in hypertensive, postmenopausal women.
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Affiliation(s)
- Anna Posadzy-Malaczynska
- Department of Family Medicine, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355, Poznan, Poland,
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682
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Evaluation of the relationship between 5-HTT and MAO gene polymorphisms, mood and level of anxiety among postmenopausal women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 12:268-81. [PMID: 25547397 PMCID: PMC4306861 DOI: 10.3390/ijerph120100268] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 12/15/2014] [Indexed: 11/21/2022]
Abstract
Objective: The aim of this study was to analyze how mood and anxiety level are related to the functional genetic polymorphism in the promoter region of SLC6A4 (5-HTTLPR) and the 30-bp VNTR polymorphism in the MAO A promoter region. Methods: The study involved 272 postmenopausal women from Poland. The authors employed the State-Trait Anxiety Inventory for measuring levels of anxiety, the Mood Adjective Check List for measuring mood, and genetic tests. Results: Analysis did not show any statistically significant differences in the mean levels of anxiety, and mood disorders in women in relation to genotypes of the 5-HTTLPR (SLC6A4) polymorphism and the 30-bp VNTR polymorphism in the MAO A promoter region. However, these problems were more severe among women with s/s genotype. In the case of MAO A gene polymorphism, the level of anxiety was higher in women with a 4/4 genotype. Conclusions: The study did not prove the possibility of the identification of homogeneous groups of women with an elevated risk of developing anxiety and mood disorders during the post-menopausal period. Nevertheless, it showed that respondents with s/s genotype of the 44-bp polymorphism in the 5-HTT (SLC6A4) promoter region had the highest average anxiety levels both as a state and as a trait. Furthermore, the analysis of the 30-bp VNTR polymorphism in the MAO A promoter region demonstrated slight differences in anxiety levels between the women, indicating that those with a 4/4 genotype had higher severity of anxiety symptoms.
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683
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Bove R, Healy BC, Secor E, Vaughan T, Katic B, Chitnis T, Wicks P, De Jager PL. Patients report worse MS symptoms after menopause: findings from an online cohort. Mult Scler Relat Disord 2014; 4:18-24. [PMID: 25787049 DOI: 10.1016/j.msard.2014.11.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 10/17/2014] [Accepted: 11/25/2014] [Indexed: 01/05/2023]
Abstract
BACKGROUND Many women with multiple sclerosis (MS) are postmenopausal, yet the impact of menopause on MS symptoms is unknown. OBJECTIVE To investigate patient-reported impact of menopause in a large online research platform, PatientsLikeMe (PLM). METHODS A detailed reproductive history survey was deployed to PLM members, and responses were linked to PLM׳s prospectively collected patient-reported severity score (MS Rating Scale, MSRS). The MSRS has previously shown good correlation with physician-derived EDSS scores. RESULTS Of the 513 respondents, 55% were postmenopausal; 54% of these reported induced menopause. Median age at natural menopause was 51. Surgical menopause occurred at an earlier age (p<0.001) and was associated with more hormone replacement therapy use (p=0.02) than natural menopause. Postmenopausal status, surgical menopause, and earlier age at menopause were all associated with worse MSRS scores (p≤0.01) in regressions adjusting for age, disease type and duration. CONCLUSION Postmenopausal patients in this study reported worse MS disease severity. Further, this study highlights a utility for online research platforms, which allow for rapid generation of hypotheses that then require validation in clinical settings.
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Affiliation(s)
- R Bove
- Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women׳s Hospital, Brookline, MA 02445, USA; Harvard Medical School, Boston, MA 02115, USA; Center for Neurologic Diseases, Harvard Medical School, 77 Avenue Louis Pasteur, NRB168, Boston, MA 02115, USA.
| | - B C Healy
- Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women׳s Hospital, Brookline, MA 02445, USA; Harvard Medical School, Boston, MA 02115, USA; Center for Neurologic Diseases, Harvard Medical School, 77 Avenue Louis Pasteur, NRB168, Boston, MA 02115, USA; Massachusetts General Hospital Biostatistics Center, Boston, MA 02114, USA.
| | - E Secor
- Center for Neurologic Diseases, Harvard Medical School, 77 Avenue Louis Pasteur, NRB168, Boston, MA 02115, USA.
| | - T Vaughan
- PatientsLikeMe, Inc., Cambridge, MA, USA.
| | - B Katic
- PatientsLikeMe, Inc., Cambridge, MA, USA.
| | - T Chitnis
- Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women׳s Hospital, Brookline, MA 02445, USA; Harvard Medical School, Boston, MA 02115, USA; Center for Neurologic Diseases, Harvard Medical School, 77 Avenue Louis Pasteur, NRB168, Boston, MA 02115, USA.
| | - P Wicks
- PatientsLikeMe, Inc., Cambridge, MA, USA.
| | - P L De Jager
- Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women׳s Hospital, Brookline, MA 02445, USA; Harvard Medical School, Boston, MA 02115, USA; Center for Neurologic Diseases, Harvard Medical School, 77 Avenue Louis Pasteur, NRB168, Boston, MA 02115, USA.
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684
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Increased hot flash severity and related interference in perimenopausal human immunodeficiency virus-infected women. Menopause 2014; 21:403-9. [PMID: 23820600 DOI: 10.1097/gme.0b013e31829d4c4c] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE As women with human immunodeficiency virus (HIV) are living longer, more are entering perimenopause. Prior studies suggest that HIV-infected women are more likely to have hot flashes than non-HIV-infected women. However, little is known regarding hot flash severity and hot flash-related interference with daily function, mood, and quality of life in this population. METHODS Perimenopausal HIV-infected and non-HIV-infected women matched by age, race, and menstrual patterns completed the Menopause Rating Scale (to assess hot flash severity) and the Hot Flash Related Daily Interference Scale (HFRDIS). Menopause Rating Scale and HFRDIS scores and subscores were compared between the groups. RESULTS Thirty-three HIV-infected women and 33 non-HIV-infected women who were similar in age (median [interquartile range], 47 [45-48] vs 47 [46-49] y), race (64% vs 52% nonwhite, P = 0.32), and menstrual patterns (number of periods in the past year; 5 [4-9] vs 6 [4-10], P = 0.53) were studied. Perimenopausal HIV-infected women reported greater hot flash severity (HIV vs non-HIV: 2 [1-3] vs 1 [0-3], P = 0.03) and hot flash-related interference (HFRDIS total score, 37 [10-60] vs 6 [0-20], P = 0.001). CONCLUSIONS Perimenopausal HIV-infected women experience greater hot flash severity and related interference compared with non-HIV-infected perimenopausal women. Increased distress secondary to hot flashes may reduce quality of life and negatively impact important health-promoting behaviors, including adherence to antiretroviral therapy, in HIV-infected women.
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685
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Reigota RB, Pedro AO, de Souza Santos Machado V, Costa-Paiva L, Pinto-Neto AM. Prevalence of urinary incontinence and its association with multimorbidity in women aged 50 years or older: A population-based study. Neurourol Urodyn 2014; 35:62-8. [PMID: 25358890 DOI: 10.1002/nau.22679] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 08/27/2014] [Indexed: 11/12/2022]
Abstract
AIMS To evaluate the prevalence and associated risk factors for urinary incontinence, as well as its association with multimorbidity among Brazilian women aged 50 or over. METHODS This was a secondary analysis of a cross-sectional population-based study including 622 women 50 years or older, conducted in the city of Campinas-SP-Brazil. The dependent variable was Urinary Incontinence (UI), defined as any complaint of urine loss. The independent variables were sociodemographic data, health-related habits, self-perception of health and functional capacity evaluation. Statistical analysis was carried out using the Chi-square test and Poisson regression. RESULTS The mean age of the women was 64. UI was prevalent in 52.3% of these women: Mixed UI (26.6%), Urge UI (13.2%) and Stress UI (12.4%). Factors associated with a higher prevalence of UI were hypertension (OR 1.21, CI 1:01-1:47, P = 0.004), osteoarthritis (OR 1.24, CI 1:03-1:50, P = 0.022), physical activity ≥3 days/week (OR 1.21, CI 1:01-1:44, P = 0.039), BMI ≥ 25 at the time of the interview (OR 1.25, CI 1:04-1:49, P = 0.018), negative self-perception of health (OR 1.23, CI 1:06-1:44 P = 0.007) and limitations in daily living activities (PR 1:56 CI 1:16-2:10, P = 0.004). CONCLUSIONS The prevalence of UI was high. Mixed incontinence was the most frequent type of UI. Many associated factors can be prevented or improved. Thus, health policies targeted at these combined factors could reduce their prevalence rate and possibly decrease the prevalence of UI.
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Affiliation(s)
- Renata B Reigota
- State University of Campinas (UNICAMP), School of Medicine, Campinas, SP, Brazil
| | - Adriana Orcesi Pedro
- State University of Campinas (UNICAMP), School of Medicine, Campinas, SP, Brazil
| | | | - Lúcia Costa-Paiva
- Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Aarão M Pinto-Neto
- Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil
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686
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Scherzer R, Bacchetti P, Messerlian G, Goderre J, Maki PM, Seifer DB, Anastos K, Karim R, Greenblatt RM. Impact of CD4+ lymphocytes and HIV infection on Anti-Müllerian Hormone levels in a large cohort of HIV-infected and HIV-uninfected women. Am J Reprod Immunol 2014; 73:273-84. [PMID: 25339186 DOI: 10.1111/aji.12332] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 09/23/2014] [Indexed: 12/21/2022] Open
Abstract
PROBLEM Effects of HIV infection on ovarian function and aging are unclear. METHOD OF STUDY Anti-Müllerian Hormone (AMH) levels were analyzed in 2621 HIV-infected and 941 uninfected participants using left-censored longitudinal models. RESULTS Age-adjusted AMH levels were 16% lower in women with undetectable viraemia and 26% lower in detectable viraemia, relative to uninfected women. Current CD4 count associated with higher AMH in both HIV-infected and HIV-uninfected women. After controlling for current and nadir CD4, AMH was ~15% higher in HIV-infected relative to uninfected women, regardless of HIV viraemia. Gravidity, amenorrhea, and nadir total lymphocyte counts associated with higher AMH; hormonal contraceptive use and past weight loss associated with lower AMH. CONCLUSIONS CD4 + lymphocyte counts were associated with AMH in both HIV-infected and uninfected women. After adjustment for CD4 counts and age, HIV infection was associated with higher AMH. CD4 T cells and cellular activation may influence ovarian granulosa cell function.
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Affiliation(s)
- Rebecca Scherzer
- Department of Medicine, San Francisco School of Medicine, University of California, San Francisco, CA, USA; San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
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687
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Green SM, Key BL, McCabe RE. Cognitive-behavioral, behavioral, and mindfulness-based therapies for menopausal depression: a review. Maturitas 2014; 80:37-47. [PMID: 25458709 DOI: 10.1016/j.maturitas.2014.10.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 10/09/2014] [Indexed: 10/24/2022]
Abstract
Menopause is a natural transition that all women go through in their lives that is often accompanied by a number of physical and emotional symptoms. Upwards of 40% of women report depression symptoms associated with menopause (Timur & Sahin, 2010) [1]. Treatments for menopausal depression include pharmacological agents such as antidepressants and hormone therapy (HT) as well as psychological approaches. This paper provides a review of cognitive-behavioral, behavioral, and mindfulness based (CBBMB) therapies in treating depression during the menopausal transition. After conducting an electronic database search, only two studies specifically using CBBMB methods were found, both had positive results. Since so few studies existed that specifically evaluated CBBMB treatments for menopausal depression (n=2), a larger net was cast. Studies that assessed depression symptoms as an outcome measure in an evaluation of CBBMB treatments for hot flashes or menopausal symptoms more broadly, were included. The review revealed that interventions targeting hot flashes or menopausal symptoms using CBBMB methods mostly proved to have had a positive impact on depression symptoms in the mild range of severity. Directions for future research are discussed including the need for more CBBMB interventions targeting depression during the menopausal transition to establish their efficacy.
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Affiliation(s)
- Sheryl M Green
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; St. Joseph's Healthcare, Hamilton, ON, Canada.
| | - Brenda L Key
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Randi E McCabe
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; St. Joseph's Healthcare, Hamilton, ON, Canada
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688
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Yalamanchi S, Dobs A, Greenblatt RM. Gonadal function and reproductive health in women with human immunodeficiency virus infection. Endocrinol Metab Clin North Am 2014; 43:731-41. [PMID: 25169564 PMCID: PMC4151241 DOI: 10.1016/j.ecl.2014.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Most human immunodeficiency virus (HIV) infections among women occur early in reproductive life, which highlights the importance of understanding the impact of HIV on reproductive functions, and also the potential implications of reproductive function and aging on the course of HIV disease. Ovarian function is a crucial component of reproductive biology in women, but standard assessment methods are of limited applicability to women with chronic diseases such as HIV. Pregnancy can now be achieved without transmission of HIV to sexual partner or newborn, but complications of pregnancy may be more common in women infected with HIV than uninfected women.
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Affiliation(s)
- Swaytha Yalamanchi
- Department of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, 1830 Monument Street, Baltimore, MD 21287, USA
| | - Adrian Dobs
- Department of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, 1830 Monument Street, Baltimore, MD 21287, USA
| | - Ruth M Greenblatt
- Department of Clinical Pharmacy, University of California, San Francisco Schools of Pharmacy and Medicine, 405 Irving Street, Second Floor, San Francisco, CA 94122, USA; Department of Medicine, University of California, San Francisco Schools of Pharmacy and Medicine, 405 Irving Street, Second Floor, San Francisco, CA 94122, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco Schools of Pharmacy and Medicine, 405 Irving Street, Second Floor, San Francisco, CA 94122, USA.
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689
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RETIRED: Managing Menopause Chapter 7 Ongoing Management of Menopausal Women and Those With Special Considerations. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2014. [DOI: 10.1016/s1701-2163(15)30463-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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690
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Mukhtarova SM, Omarova GK, Yoldasheva AI. Satisfaction with surgical correction of stress urinary incontinence in women: A pilot study in Almaty, Kazakhstan. Cent Asian J Glob Health 2014; 3:142. [PMID: 29755890 PMCID: PMC5927734 DOI: 10.5195/cajgh.2014.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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691
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Stefanska A, Ponikowska I, Cwiklinska-Jurkowska M, Sypniewska G. Association of FSH with metabolic syndrome in postmenopausal women: a comparison with CRP, adiponectin and leptin. Biomark Med 2014; 8:921-30. [DOI: 10.2217/bmm.14.49] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: The aim of this study was to evaluate the usefulness of follicle-stimulating hormone (FSH) determination in the postmenopausal women with metabolic syndrome (MetS) in a comparative analysis with biomarkers such as C-reactive protein (CRP), adiponectin, leptin and leptin-to-adiponectin ratio (L/A). Material & methods: 135 postmenopausal women with MetS and 153 without MetS were subjected to examinations. Results: The increase in the probability of MetS, when the value of the marker concentration decreased or increased by 1 standard deviation, was two times higher for FSH-based models than for models including CRP and leptin, and was similar to models including adiponectin and L/A. The areas under the ROC curves were 0.78 for FSH, 0.68 for CRP, 0.72 for leptin, 0.76 for adiponectin and 0.80 for L/A. Conclusions: Our results suggest that the FSH concentration assesses the probability of MetS similarly to L/A or adiponectin and better than CRP or leptin in postmenopausal women.
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Affiliation(s)
- Anna Stefanska
- Department of Laboratory Medicine, Collegium Medicum, Nicholas Copernicus University, Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland
| | - Irena Ponikowska
- Department of Balneology, Collegium Medicum, Nicholas Copernicus University, Leśna 3, 87-720 Ciechocinek, Poland
| | - Malgorzata Cwiklinska-Jurkowska
- Department of Theoretical Foundations of Biomedical Sciences & Medical Computer Science, Collegium Medicum, Nicholas Copernicus University, Jagiellonska 15, 85-067 Bydgoszcz, Poland
| | - Grazyna Sypniewska
- Department of Laboratory Medicine, Collegium Medicum, Nicholas Copernicus University, Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland
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692
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Su HCI, Haunschild C, Chung K, Komrokian S, Boles S, Sammel MD, DeMichele A. Prechemotherapy antimullerian hormone, age, and body size predict timing of return of ovarian function in young breast cancer patients. Cancer 2014; 120:3691-8. [PMID: 25081546 DOI: 10.1002/cncr.28942] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 05/13/2014] [Accepted: 06/25/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Endocrine measures of ovarian reserve before breast cancer treatment may predict postchemotherapy ovarian function, providing prognostic information at the time of cancer diagnosis. The objectives of this study were 1) to determine whether prechemotherapy levels of antimullerian hormone (AMH), follicle-stimulating hormone (FSH), and inhibin B (inhB) are associated with the return of ovarian function after chemotherapy and 2) to generate a prognostic score for ovarian recovery in young women with breast cancer. METHODS A prospective cohort study recruited 109 participants (median age, 39 years; age range, 23-45 years) before chemotherapy from 2 breast clinics and followed them longitudinally. By using time-to-event analysis, the authors tested the association between prechemotherapy AMH, FSH, and inhB levels and the time to return of ovarian function, as measured by menstrual pattern. RESULTS After a median follow-up of 163 days (range, 4-1009 days) after chemotherapy, 62 participants (57%) experienced return of ovarian function. In adjusted analyses, AMH levels >0.7 ng/mL (hazard ratio, 2.9; 95% confidence interval, 1.5-5.6) and FSH levels ≤10 IU/L (hazard ratio, 4.7; 95% confidence interval, 1.3-16.8) were associated with a shorter time to ovarian recovery, whereas inhB levels were not related. A prognostic score based on age <40 years, AMH >0.7 ng/mL, and body mass index ≥25 kg/m(2) was used to estimate the timing of recovery. CONCLUSIONS In reproductive-aged women with newly diagnosed breast cancer, prechemotherapy AMH and FSH levels were associated with the return of ovarian function, independent of age. A novel prognostic score incorporating AMH, age, and body size was capable of estimating the time to ovarian recovery. Pending validation, these data support using prechemotherapy ovarian reserve measures, particularly AMH, to prospectively counsel young patients on future ovarian function. Because ovarian function is not equivalent to fertility, follow-up studies on predicting fertility are needed.
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Affiliation(s)
- Hui-Chun Irene Su
- Department of Reproductive Medicine, University of California-San Diego, San Diego, California; Moores Cancer Center, University of California-San Diego, La Jolla, California
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693
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Dias FCF, Khan MIR, Adams GP, Sirard MA, Singh J. Granulosa cell function and oocyte competence: Super-follicles, super-moms and super-stimulation in cattle. Anim Reprod Sci 2014; 149:80-9. [PMID: 25107564 DOI: 10.1016/j.anireprosci.2014.07.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 07/13/2014] [Accepted: 07/14/2014] [Indexed: 11/29/2022]
Abstract
The review presents an overview of studies that examined the effects of follicular aging and maternal aging in the bovine model. The first of three main sections is a discussion of the developmental competence of oocytes from (1) the ovulatory follicle of 2-wave and 3-wave estrous cycles, (2) dominant follicles that develop under high or low LH pulse frequency, and (3) natural versus FSH-stimulated ovulatory follicles. The second section highlights the effects of maternal aging. Maternal aging in cattle is associated with (1) elevated circulating FSH concentrations, (2) reduced response to superstimulatory treatment, and (3) markedly decreased early embryonic development in cows >12 year of age. The third and final section on superstimulation protocols addresses the effects of the duration of FSH stimulation and withdrawal (i.e., FSH "starvation" or "coasting") on oocyte competence. Ovarian superstimulation for 4 days altered the expression of genes related to angiogenesis, and activated oxidative stress-response genes. Extending the duration of FSH stimulation from 4 to 7 days resulted in a greater and more synchronous ovulatory response and optimal oocyte maturation. The highest rates of blastocyst development in vitro were obtained when FSH support was discontinued for 44 to 68h and granulosa cell SMAD7 mRNA was predictive of this period. Longer periods of FSH starvation resulted in a loss of oocyte competence or ovulatory capability. By extending the bovine model to the transcriptome level, new approaches and treatments may be devised to resolve subfertility in women and animals.
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Affiliation(s)
- F C F Dias
- Department of Veterinary Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, Canada S7N 5B4
| | - M I R Khan
- Department of Veterinary Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, Canada S7N 5B4
| | - G P Adams
- Department of Veterinary Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, Canada S7N 5B4
| | - M A Sirard
- Centre de Recherche en Biologie de la Reproduction, INAF, Université Laval, Québec, QC, Canada G1V 0A6
| | - J Singh
- Department of Veterinary Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, Canada S7N 5B4.
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694
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Nio AQX, Stöhr EJ, Shave R. The female human heart at rest and during exercise: A review. Eur J Sport Sci 2014; 15:286-95. [DOI: 10.1080/17461391.2014.936323] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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695
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696
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Weber MT, Maki PM, McDermott MP. Cognition and mood in perimenopause: a systematic review and meta-analysis. J Steroid Biochem Mol Biol 2014; 142:90-8. [PMID: 23770320 PMCID: PMC3830624 DOI: 10.1016/j.jsbmb.2013.06.001] [Citation(s) in RCA: 172] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 04/07/2013] [Accepted: 06/04/2013] [Indexed: 12/22/2022]
Abstract
OBJECTIVE It is suggested that declines in estrogen around menopause are associated with declines in cognitive functioning as well as increased risk of depressive symptoms and depressive disorders. Existing studies of objective cognitive function and mood have differed in the criteria used to stage the menopausal transition and in the outcome measures used. The purpose of this review was to synthesize the existing studies of the relationship between menopausal stage and neuropsychological performance and depression. DESIGN A search of the literature of observational studies was performed using PubMed. Four cross-sectional studies on menopausal transition stage and cognitive function and four longitudinal studies on menopausal transition stage and risk of depression, as measured by symptom inventories and structured clinical interviews, were selected. For the cognitive outcomes, fixed effects models were used to estimate overall standardized effect sizes. For the depression outcomes, the results of group comparisons were summarized using the log odds ratio and its estimated standard error. RESULTS Postmenopausal women performed significantly worse than pre- and perimenopausal women on delayed verbal memory tasks, and significantly worse than perimenopausal women on phonemic verbal fluency tasks. Peri- and postmenopausal women were at significantly increased risk of depression, as measured by standard symptom inventories and structured clinical interviews, than premenopausal women. CONCLUSIONS The menopausal transition is a time of increased vulnerability to cognitive declines and increased risk of depressive symptoms and depressive disorders. However, these results cannot necessarily be generalized beyond the studies included in this review. This article is part of a Special Issue entitled 'Menopause'.
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Affiliation(s)
- Miriam T Weber
- Department of Neurology, University of Rochester, Box 673, 601 Elmwood Avenue, Rochester, NY 14642, United States.
| | - Pauline M Maki
- Department of Psychiatry, University of Illinois at Chicago, 912 South Wood Street, Chicago, IL 60612, United States; Department of Psychology, University of Illinois at Chicago, 912 South Wood Street, Chicago, IL 60612, United States.
| | - Michael P McDermott
- Department of Neurology, University of Rochester, Box 673, 601 Elmwood Avenue, Rochester, NY 14642, United States; Department of Biostatistics and Computational Biology, University of Rochester, 601 Elmwood Avenue, Box 630, Rochester, NY 14642, United States.
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697
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Finch CE. The menopause and aging, a comparative perspective. J Steroid Biochem Mol Biol 2014; 142:132-41. [PMID: 23583565 PMCID: PMC3773529 DOI: 10.1016/j.jsbmb.2013.03.010] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Revised: 03/22/2013] [Accepted: 03/27/2013] [Indexed: 02/05/2023]
Abstract
The neuroendocrinology of menopause is reviewed from a comparative perspective, with emphasis on laboratory rodent models. These changes are compared by the 2011 STRAW criteria (Stages of Reproductive Aging Workshop). Ovarian cell loss begins prenatally in all mammals studied, with exponential depletion of primary follicles and oocytes in association with loss of fecundity by midlife. Rodents and humans also share progressively increasing irregularity in ovulatory cycles and increasing fetal aneuploidy as oocyte depletion become imminent. Hypothalamic impairments of the estrogen-induced surge of pituitary gonadotrophins (luteinizing hormone, LH; follicle stimulating hormone, FSH) are prominent in middle-aged rodents, but sporadic in peri-menopausal women. In aging rodents, hypothalamic impairments of the LH surge have been experimentally associated with prolonged phases of sustained estradiol (E2) and very low progesterone (P4) ('unopposed estradiol'). Although peri-menopausal women also show hyper-estrogenic cycles, there is no indication for irreversible hypothalamic desensitization by E2. Ongoing cognitive assessments in clinical trials of estrogen therapy with and without P4 or other progestins may further inform about possible persisting effects of unopposed estrogens.This article is part of a Special Issue entitled 'Menopause'.
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Affiliation(s)
- Caleb E Finch
- Davis School of Gerontology, and Department of Neurobiology, Dornsife College, 3715 McClintock Ave, University of Southern California, Los Angeles, CA 90089-0191, United States.
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698
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Bener A, Falah A. A measurement-specific quality-of-life satisfaction during premenopause, perimenopause and postmenopause in Arabian Qatari women. J Midlife Health 2014; 5:126-34. [PMID: 25316998 PMCID: PMC4195185 DOI: 10.4103/0976-7800.141190] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The aim of this study was to use an instrument, the menopause-specific quality-of-life satisfaction in the state of Qatar for the premenopausal, menopause and postmenopausal period. DESIGN A cross-sectional descriptive study was used to generate menopause symptoms experienced by Arabian Gulf women. Measurement-specific quality-of-life satisfaction questionnaires and face-to-face interviews were performed. SETTING Primary Health Care (PHC) Centers in Qatar. MATERIALS AND METHODS A multistage sampling design was used and a representative sample of 1,500 women aged 40-60 years were included during July 2012 and November 2013, and 1,158 women agreed to participate (77.2%) and responded to the study. RESULTS The mean age and standard deviation of the subjects was 50.9 ± 6.1. The median age of natural menopause in the present study was 49 years [mean and standard deviation 49.9 ± 2.7]. The rate of consanguineous marriages in the sample was found to be 30.3%. There were statistically significance differences between menopausal stages with regard to ethnicity, education level, occupation, type of housing condition, and consanguinity. There were statistically significance differences between menopausal stages concerning BMI groups, Systolic BP, Diastolic BP, physical activity, parity, and sheesha smoking habits. Meanwhile, the present study revealed that the most common disease was found to be diabetes mellitus (11.4%), followed by hypertension (6.6%), asthma (5.6%) and CHD (2.5%), and the majority of subjects (69.5%) had no specific disease. The most frequent symptom was aches in the back and neck (49.2%), night sweat (37.2%), low backache (35.7%), feeling nervous (35.4%) followed by aches in the muscles/joints (34.6%), hot flashes (33.3%), decreased social activities (28.3%), decreased leisure activities (47.6%), difficulty sleeping (28.9%), mood swings (25.4%), and decreased concentration (28.3%), sexual activity (24.1%) and total energy level (26.7%). The lowest reported symptoms were facial hair at 16.1% followed by dissatisfied with my personal life at 18.1%. Cronbach's alpha scores, measuring the internal consistency of questions in each domain for physical, vasomotor, psychosocial and sexual were 0.883, 0.853, 0.697 and 0.805, respectively. The Spearman's rank correlation coefficient between domains indicated that there is highly significant concordance between the four domains (P < 0.001). CONCLUSION A large number of factors were associated with experiencing menopausal symptoms and which had negative effects on the quality of life among Arabian women. The current study showed that climacteric symptom in menopausal Arab women is less than Western women, which may be influenced by socio-economic, genetics, environment and parity.
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Affiliation(s)
- Abdulbari Bener
- Department of Medical Statistics and Epidemiology, Hamad Medical Corporation, Doha, Qatar
- Department of Public Health, Weill Cornell Medical College, Qatar and New York, USA
- Department Evidence for Population Health Unit, School of Epidemiology and Health Sciences, The University of Manchester, Manchester, UK
| | - Anas Falah
- Department of Medical Statistics and Epidemiology, Hamad Medical Corporation, Doha, Qatar
- Department of Public Health, Weill Cornell Medical College, Qatar and New York, USA
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699
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Stefanska A, Ponikowska I, Sypniewska G. A-FABP concentration is more strongly associated with cardiometabolic risk factors and the occurrence of metabolic syndrome in premenopausal than in postmenopausal middle-aged women. BIOMED RESEARCH INTERNATIONAL 2014; 2014:645762. [PMID: 24971341 PMCID: PMC4058146 DOI: 10.1155/2014/645762] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 05/09/2014] [Accepted: 05/09/2014] [Indexed: 02/07/2023]
Abstract
We aimed at the evaluation of the relationship between adipocyte fatty acid binding protein (A-FABP) and cardiometabolic risk factors in premenopausal and postmenopausal women. Additionally, we compared A-FABP with adipokines related to metabolic syndrome (MetS) such as leptin and adiponectin. 94 premenopausal and 90 early postmenopausal middle-aged Caucasian women were subject to examinations. Postmenopausal women had higher A-FABP than premenopausal; this difference became insignificant after controlling for age. We found significantly higher correlation coefficients between A-FABP and TC/HDL-C ratio and number of MetS components in premenopausal women, compared to postmenopausal. Each 1 ng/dL increase in A-FABP concentration significantly increased the probability of occurrence of atherogenic lipid profile in premenopausal women, even after multivariate adjustment. All odds ratios became insignificant after controlling for BMI in postmenopausal women. A-FABP was more strongly associated with MetS than leptin and adiponectin in premenopausal women. Adiponectin concentration was a better biomarker for MetS after menopause. Our results suggest that the A-FABP is more strongly associated with some cardiometabolic risk factors in premenopausal than in postmenopausal women. Higher values of A-FABP after menopause are mainly explained by the fact that postmenopausal women are older. Because of the limitation of study, these results should be interpreted with caution.
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Affiliation(s)
- Anna Stefanska
- Department of Laboratory Medicine, Collegium Medicum, Nicholas Copernicus University, Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland
| | - Irena Ponikowska
- Department of Balneology, Collegium Medicum, Nicholas Copernicus University, Leśna 3, 87-720 Ciechocinek, Poland
| | - Grazyna Sypniewska
- Department of Laboratory Medicine, Collegium Medicum, Nicholas Copernicus University, Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland
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700
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