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Sun J, Shen X, Liu H, Lu S, Peng J, Kuang H. Caloric restriction in female reproduction: is it beneficial or detrimental? Reprod Biol Endocrinol 2021; 19:1. [PMID: 33397418 PMCID: PMC7780671 DOI: 10.1186/s12958-020-00681-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/06/2020] [Indexed: 12/20/2022] Open
Abstract
Caloric restriction (CR), an energy-restricted intervention with undernutrition instead of malnutrition, is widely known to prolong lifespan and protect against the age-related deteriorations. Recently it is found that CR significantly affects female reproduction via hypothalamic (corticotropin releasing hormone, neuropeptide Y, agouti-related peptide) and peripheral (leptin, ghrelin, insulin, insulin-like growth factor) mediators, which can regulate the energy homeostasis. Although CR reduces the fertility in female mammals, it exerts positive effects like preserving reproductive capacity. In this review, we aim to discuss the comprehensive effects of CR on the central hypothalamus-pituitary-gonad axis and peripheral ovary and uterus. In addition, we emphasize the influence of CR during pregnancy and highlight the relationship between CR and reproductive-associated diseases. Fully understanding and analyzing the effects of CR on the female reproduction could provide better strategies for the management and prevention of female reproductive dysfunctions.
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Affiliation(s)
- Jiayi Sun
- Department of Physiology, Basic Medical College, Nanchang University, Nanchang, Jiangxi 330006 People’s Republic of China
- Department of Clinical medicine, School of Queen Mary, Nanchang University, Nanchang, China
| | - Xin Shen
- Department of Physiology, Basic Medical College, Nanchang University, Nanchang, Jiangxi 330006 People’s Republic of China
| | - Hui Liu
- Department of Physiology, Basic Medical College, Nanchang University, Nanchang, Jiangxi 330006 People’s Republic of China
| | - Siying Lu
- Department of Physiology, Basic Medical College, Nanchang University, Nanchang, Jiangxi 330006 People’s Republic of China
| | - Jing Peng
- Department of Gynecology, Nanchang HongDu Hospital of Traditional Chinese Medicine, 264 MinDe Road, Nanchang, Jiangxi 330006 People’s Republic of China
| | - Haibin Kuang
- Department of Physiology, Basic Medical College, Nanchang University, Nanchang, Jiangxi 330006 People’s Republic of China
- Jiangxi Provincial Key Laboratory of Reproductive Physiology and Pathology, Medical Experimental Teaching Center of Nanchang University, Nanchang, China
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Necrotizing Sialometaplasia and Bulimia: A Case Report. ACTA ACUST UNITED AC 2020; 56:medicina56040188. [PMID: 32325833 PMCID: PMC7231379 DOI: 10.3390/medicina56040188] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 04/13/2020] [Accepted: 04/16/2020] [Indexed: 12/16/2022]
Abstract
Bulimia is an eating disorder with a great prevalence in young women. Due to its multifactor ethiology, bulimia has systemic consequences. In the literature, necrotising sialometaplasia is seldom associated with bulimia. Its etiopathogenesis is discussed by several authors; nevertheless, the consensus does not consider the relevance of local trauma associated with induced vomiting. A case of necrotising sialomethaplasia, presented with a single hard palatal ulcer in a bulimic woman is described in the present report. The patient did not present significant systemic laboratorial values, nor physical weight variations, which highlights the relevance of performing a complete medical clinical history when diagnosing this rare pathology.
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Dogan S, Ray A, Cleary MP. The influence of different calorie restriction protocols on serum pro-inflammatory cytokines, adipokines and IGF-I levels in female C57BL6 mice: short term and long term diet effects. Meta Gene 2017; 12:22-32. [PMID: 28373962 PMCID: PMC5375115 DOI: 10.1016/j.mgene.2016.12.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Calorie restriction (CR) is an effective intervention to prevent chronic diseases including cancer. Although many factors, i.e., sex hormones, IGF-I and mTOR have been studied in response to CR, the molecular mechanisms of CR remain to be identified. Our objective was to determine the short and long-term effects of different CR protocols on pro-inflammatory cytokines. Our hypothesis was that Intermittent CR (ICR) would result in greater inhibition of pro-inflammatory serum cytokines compared to Chronic CR (CCR) as we previously found ICR to be more protective in the prevention of mammary tumor development. From ten weeks of age female C57BL6 mice were maintained on either ad libitum (AL) fed, ICR or CCR protocols (overall CR of ~75% of AL) for up to 74 weeks of age. Blood samples were collected for measurements of serum interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), adiponectin, leptin, IGF-I and insulin at specified ages. For ICR mice samples were collected following 3 weeks of restriction (ICR-R) and after one week of refeeding (ICR-RF). In general, both modes of CR significantly reduced serum IL-6, TNF-α, IGF-I and leptin levels compared to AL with IL-6 levels 24 and 3.5 fold and TNF-α levels t 11 and 1.5 fold lower in ICR and CCR groups, respectively at study termination. There was a trend for adiponectin and insulin to be highest in ICR-RF mice. Body weights were positively correlated with IL-6, TNF-α, insulin and leptin but negatively correlated with adiponectin-to-leptin ratio. Moreover, there was a positive correlation between IL-6 and TNF-α. Beneficial effects of ICR may function through pro-inflammatory cytokine pathways.
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Affiliation(s)
- Soner Dogan
- University of Minnesota, Hormel Institute Medical Research Center, Austin, MN, USA
- Yeditepe University, School of Medicine, Department of Medical Biology, Istanbul, Turkey
| | - Amitabha Ray
- University of Minnesota, Hormel Institute Medical Research Center, Austin, MN, USA
| | - Margot P. Cleary
- University of Minnesota, Hormel Institute Medical Research Center, Austin, MN, USA
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Hilibrand MJ, Hammoud S, Bishop M, Woods D, Fredrick RW, Dodson CC. Common injuries and ailments of the female athlete; pathophysiology, treatment and prevention. PHYSICIAN SPORTSMED 2015; 43:403-11. [PMID: 26458108 DOI: 10.1080/00913847.2015.1092856] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
With increasing numbers of women competing in high school and collegiate athletics, it is important that physicians become familiar with injury patterns and medical conditions unique to the female athlete. Observations and clinical data have elucidated unique biomechanical, anatomic and hormonal factors that predispose skeletally mature female athletes to anterior cruciate ligament (ACL) injuries, patellofemoral disorders and lower extremity stress fractures. Additionally, younger female athletes are particularly at risk of developing components of the "Female Athlete Triad" (more recently included under the syndrome of "Relative Energy Deficiency in Sport" [RED-S]): disordered eating, amenorrhea and osteoporosis. An understanding of the pathophysiology of these conditions has led to the development of programs that can treat their underlying causes, decrease susceptibility to injury, and improve the long-term health of the female athlete. This paper is intended to provide physicians with a review of the sex-specific etiology, prevention and treatment of injuries common to the female athlete.
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Affiliation(s)
- Miryl J Hilibrand
- a Sidney Kimmel Medical College of Thomas Jefferson University , Philadelphia, PA, USA
| | - Sommer Hammoud
- a Sidney Kimmel Medical College of Thomas Jefferson University , Philadelphia, PA, USA.,b The Rothman Institute , Philadelphia PA 19107, USA
| | - Meghan Bishop
- c Department of Orthopaedic Surgery, Sidney Kimmel Medical College of Thomas Jefferson University , Philadelphia, PA, USA
| | - Daniel Woods
- d Orthopedic Sports Medicine, Orlin & Cohen Orthopedic Associates , Long Island, NY, USA
| | - Robert W Fredrick
- a Sidney Kimmel Medical College of Thomas Jefferson University , Philadelphia, PA, USA.,b The Rothman Institute , Philadelphia PA 19107, USA
| | - Christopher C Dodson
- a Sidney Kimmel Medical College of Thomas Jefferson University , Philadelphia, PA, USA.,b The Rothman Institute , Philadelphia PA 19107, USA
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Stergioti E, Deligeoroglou E, Economou E, Tsitsika A, Dimopoulos KD, Daponte A, Katsioulis A, Creatsas G. Gene receptor polymorphism as a risk factor for BMD deterioration in adolescent girls with anorexia nervosa. Gynecol Endocrinol 2013; 29:716-9. [PMID: 23772785 DOI: 10.3109/09513590.2013.798275] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Anorexia nervosa is a serious eating disorder that is associated with decreased bone mineral density and greater lifetime risk for fractures. This case-controlled study, analyzed single nucleotide polymorphisms of genes encoding vitamin D receptor, estrogen receptor alpha (ESR1), collagen type I and calcitonin receptor (CTR). Relationships between genotype and body mass index, cycling status and lumbar spine bone mineral density (LBMD) were determined in 40 adolescent girls with anorexia nervosa and 10 age-matched controls. The distribution of CTR-AluI genotypes differed between groups, but this polymorphism was not associated with LBMD Z-score. Distribution of ESR1-XbaI genotypes did not differ between groups, but the AA genotype was associated with decreased LBMD Z-score (≤-1) (OR = 24.79, 95% CI, 1.01-606.08). Carriers of the A allele were more likely to have decreased LBMD Z-scores compared with carriers of the G allele (OR = 4.12, 95% CI, 1.23-13.85, p = 0.022). In conclusion, our study shows that anorexic patients with wild-type genotype ESR-XbaI receptor are in greater risk for decreased BMD in relation to those with the mutated gene. Prompt recognition of these patients is crucial because early administration of the proper therapeutic treatment may contribute to the prevention of adverse sequelae on bone metabolism.
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Affiliation(s)
- E Stergioti
- Division of Pediatric - Adolescent Gynecology and Reconstructive Surgery, 2nd Obstetrics and Gynecology Department, Aretaieion University Hospital, Athens, Greece.
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Waters N. What goes up must come down! A primary care approach to preventing injuries amongst highflying cheerleaders. J Am Assoc Nurse Pract 2013; 25:55-64. [PMID: 23347241 DOI: 10.1111/1745-7599.12000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE This article provides information regarding the most common nonlife-threatening and catastrophic injuries that occur during cheerleading, and describes the role of the nurse practitioner (NP) in managing patients who participate in cheerleading. DATA SOURCES Literature review of evidence-based research articles, epidemiological reports, and current guidelines. CONCLUSIONS Cheerleading is one of the most popular sports among adolescent females, and participation has increased rapidly in recent years. Rates of injury have also increased as the difficulty of this activity reaches new heights. Several factors such as body changes during puberty, societal pressures affecting nutrition, and lack of safety regulations place cheerleaders at risk for injury. Sprains/strains are the most common injury, and concussions are the most common traumatic injury. Injuries occur as a result of tumbling, stunting, falling, spotting, and unsafe practice surfaces. IMPLICATIONS FOR PRACTICE The role of the NP in injury prevention is to identify risk factors during preparticipation physicals, initiate conditioning and strength training routines, and implement safety measures during practices and competitions. The NP should also provide education and guidance to cheerleaders, parents, and coaches.
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Affiliation(s)
- Nicole Waters
- School of Nursing, Columbia University, New York, NY 10032, USA.
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Thein-Nissenbaum JM, Rauh MJ, Carr KE, Loud KJ, McGuine TA. Menstrual irregularity and musculoskeletal injury in female high school athletes. J Athl Train 2013; 47:74-82. [PMID: 22488233 DOI: 10.4085/1062-6050-47.1.74] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT The female athlete triad describes the interrelatedness of energy availability, menstrual function, and bone density. Although associations between triad components and musculoskeletal injury (INJ) have been reported in collegiate athletes, limited information exists about menstrual irregularity (MI) and INJ in the high school population. OBJECTIVE To determine the prevalence of and relationship between MI and INJ in high school athletes. DESIGN Cross-sectional study. SETTING High schools. PATIENTS OR OTHER PARTICIPANTS The sample consisted of 249 female athletes from 3 high schools who competed in 33 interscholastic, school-sponsored sport teams, dance teams, and cheerleading or pom-pon squad during the 2006-2007 school year. Each athlete remained on the roster throughout the season. MAIN OUTCOME MEASURE(S) Participants completed a survey regarding injury type, number of days of sport participation missed, and menstrual history in the past year. RESULTS The prevalences of M I and INJ were 19.7% and 63.1 %, respectively. Athletes who reported MI sustained a higher percentage of severe injuries (missing ≥ 22 days of practice or competition) than did athletes who reported normal menses. Although the trend was not significant, athletes with MI were almost 3 times more likely to sustain an injury resulting in 7 or more days of time lost from sport (odds ratio = 2.7, 95% confidence interval = 0.8, 8.8) than those who sustained an injury resulting in 7 or fewer days of time lost. CONCLUSIONS The incidences of MI and INJ in this high school population during the study period were high. Athletes who reported MI sustained a higher percentage of severe injuries than did athletes who reported normal menses. Education programs to increase knowledge and improve management of MI and its potential effects on injury in female high school athletes are warranted.
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Affiliation(s)
- Jill M Thein-Nissenbaum
- Graduate Program in Orthopaedic and Sports Science, Rocky Mountain University of Health Professions, Provo, UT, USA.
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Meczekalski B, Podfigurna-Stopa A, Genazzani AR. Hypoestrogenism in young women and its influence on bone mass density. Gynecol Endocrinol 2010; 26:652-7. [PMID: 20504098 DOI: 10.3109/09513590.2010.486452] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
One of the most important hormonal factors responsible for bone health is estradiol. Genetic factors, adequacy of hormonal functioning, nutrition and physical activity may be the markers of bone status and development in young women. During adolescence, women reach peak bone acquisition and develop a skeletal mass. This process is largely regulated by endocrine factors mainly such as adequate levels of gonadal, adrenal and pituitary hormones. The crucial role played by estradiol and its impact on bones are very multiple. Estradiol induces growth factors' activation, receptor activator of nuclear factor kappa B ligand (RANKL) production inhibition and is mainly referred to antiresorptive activity. Clinical situations leading to hypoestrogenism has been linked to decreased bone mineral density leading to osteopenia and osteoporosis. This status both in fertile and perimenopausal women can increase the risk of pathological fractures. Such conditions as hypothalamic-pituitary insufficiency (functional hypothalamic amenorrhea, anorexia nervosa, Kallmann syndrome, hyperprolactinemia), ovarian failure (gonadal dysgenesis, premature ovarian failure) and iatrogenic treatment (surgery, chemotherapy, radiotherapy) can cause hypoestrogenism. The treatment of osteopenia and osteoporosis caused by hypoestrogenism is very essential and multidirectional. The crucial role of the therapy is the achievement of proper serum estradiol concentration and eliminate the causes of hypoestrogenism.
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Affiliation(s)
- Blazej Meczekalski
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 60-535 Poznan, Poland.
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Mendelsohn FA, Warren MP. Anorexia, bulimia, and the female athlete triad: evaluation and management. Endocrinol Metab Clin North Am 2010; 39:155-67, x. [PMID: 20122456 DOI: 10.1016/j.ecl.2009.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The female athlete triad is an increasingly prevalent condition involving disordered eating, amenorrhea, and osteoporosis. An athlete can suffer from all 3 components of the triad, or just 1 or 2 of the individual conditions. The main element underlying all the aspects of the triad is an adaptation to a negative caloric balance. Screening for these disorders should be an important component of an athlete's care. Prevention and treatment should involve a team approach, including a physician, a nutritionist, and a mental health provider.
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Affiliation(s)
- Felicia A Mendelsohn
- Department of Obstetrics and Gynecology, Columbia College of Physicians and Surgeons, Greenwich, CT 06831, USA.
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