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Staudt A, Kiechl SJ, Gande N, Hochmayr C, Bernar B, Stock K, Geiger R, Egger A, Griesmacher A, Knoflach M, Kiechl-Kohlendorfer U. Influence of Oral Contraceptives on Lipid Profile and Trajectories in Healthy Adolescents-Data From the EVA-Tyrol Study. J Adolesc Health 2024:S1054-139X(24)00226-X. [PMID: 39001754 DOI: 10.1016/j.jadohealth.2024.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 03/19/2024] [Accepted: 04/09/2024] [Indexed: 07/15/2024]
Abstract
PURPOSE Oral contraception is one of the most popular contraceptive methods both in adults and adolescents. However, the effects of oral contraception on lipids in adolescents are not well studied. METHODS Lipid profiles were measured and contraceptive use was assessed in 14- to 19-year-old female participants of the prospective population-based Early Vascular Ageing-Tyrol Study between 2015 and 2018, twice on average 22 months apart. RESULTS For this analysis, data from 828 young women with a median age of 17.0 years were available. Of them, 317 (38%) used oral contraceptives (OCs). OC users had a slightly higher systolic and diastolic blood pressure and larger changes over time and were more likely to use cigarettes than nonusers. Total cholesterol (179.6 vs. 162.4 mg/dL), low-density lipoprotein-cholesterol (106.4 vs. 94.6 mg/dL), and triglycerides (104.0 vs. 67.0 mg/dL) were significantly higher in OC users after multivariable adjustment in linear regression models. No difference in high-density lipoprotein-cholesterol between the two groups was found. In 558 females, follow-up data were available. Those who initiated OC use had on average 15.4 mg/dL higher low-density lipoprotein-cholesterol and 36.2 mg/dL higher triglyceride level changes between baseline and follow-up than never users. Duration of OC use did not show a significant association with lipid levels and changes. DISCUSSION We showed an independent association between OC use and blood lipids as well as lipid trajectories over time in a large cohort of healthy adolescents. These changes are especially relevant to consider in adolescents with other risk factors for dyslipidemia or other cardiovascular risk factors.
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Affiliation(s)
- Anna Staudt
- Department of Pediatrics II, Medical University of Innsbruck, Innsbruck, Austria
| | - Sophia J Kiechl
- VASCage, Centre on Clinical Stroke Research, Innsbruck, Austria; Department of Neurology, Hochzirl Hospital, Zirl, Austria
| | - Nina Gande
- Department of Pediatrics II, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Hochmayr
- Department of Pediatrics II, Medical University of Innsbruck, Innsbruck, Austria
| | - Benoît Bernar
- Department of Pediatrics II, Medical University of Innsbruck, Innsbruck, Austria; Department of Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria
| | - Katharina Stock
- Department of Pediatrics III, Medical University of Innsbruck, Innsbruck, Austria
| | - Ralf Geiger
- Department of Pediatrics III, Medical University of Innsbruck, Innsbruck, Austria
| | - Alexander Egger
- Central Institute for Medical and Chemical Laboratory Diagnosis, Medical University of Innsbruck, Innsbruck, Austria
| | - Andrea Griesmacher
- Central Institute for Medical and Chemical Laboratory Diagnosis, Medical University of Innsbruck, Innsbruck, Austria
| | - Michael Knoflach
- VASCage, Centre on Clinical Stroke Research, Innsbruck, Austria; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
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Donangelo CM, Cornes R, Sintes C, Bezerra FF. Combined Oral Contraceptives: Association with Serum 25-Hydroxyvitamin D and Calcium and Bone Homeostasis. J Womens Health (Larchmt) 2024; 33:805-815. [PMID: 38417038 DOI: 10.1089/jwh.2023.0657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024] Open
Abstract
Background: Use of combined oral contraceptives (COCs) has been found to increase serum 25-hydroxyvitamin D [25(OH)D] but effects on calcium and bone homeostasis are unclear. Materials and Methods: Serum 25(OH)D, parathyroid hormone (PTH), alkaline phosphatase (ALK) and estradiol, dietary intake of bone-related nutrients and foods, bone mineral density (BMD), and body fat were compared in adult women (20-35 years; body mass index 21.5 ± 2.3 kg/m2) users (+COC, n = 32) and nonusers (-COC, n = 20) of COC. Biochemical markers were measured by automated assays. BMD at total body (TB), lumbar spine (LS), femoral neck (FN) and trochanter (TR), and body fat, were measured by dual-energy X-ray absorptiometry. Dietary intake was assessed by a food frequency questionnaire. Results: Intake of calcium, dairy foods, and fruits and vegetables, were adequate and did not differ by COC. Mean 25(OH)D was 35% higher in +COC (110.4 ± 27.3 nmol/L, 44.2 ± 1.8 ng/mL) compared with -COC (81.7 ± 22.8 nmol/L, 32.7 ± 2.3 ng/mL; p < 0.001). Mean PTH, ALK, and estradiol were 28%, 12%, and 62% lower, respectively, in +COC compared with -COC (p ≤ 0.05). Mean BMD z-scores (all sites) were adequate and did not differ by COC. There were no correlations between 25(OH)D and dietary, biochemical, and body composition variables. PTH was inversely correlated with TR-BMD z-score in -COC (r = -0.47; p = 0.04), and ALK was inversely correlated with TB-, TR-, and LS-BMD z-scores in -COC (r ≤ -0.43; p ≤ 0.04), but not in +COC. Conclusions: Increased serum 25(OH)D with COC use was paralleled by expected physiologic adjustments in calcium and bone homeostasis, and adequate bone mass status, in nonobese young adult women consuming bone-healthy diets.
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Affiliation(s)
| | - Rafael Cornes
- Escuela de Nutrición, Universidad de la República, Montevideo, Uruguay
| | - Celia Sintes
- Escuela de Nutrición, Universidad de la República, Montevideo, Uruguay
| | - Flavia F Bezerra
- Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
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de Souza IS, Laporta GZ, Zangirolami-Raimundo J, Sorpreso ICE, Silva dos Santos HCL, Soares Júnior JM, Raimundo RD. Association between the use of oral contraceptives and the occurrence of systemic hypertension: A systematic review with statistical comparison between randomized clinical trial interventions. Eur J Obstet Gynecol Reprod Biol X 2024; 22:100307. [PMID: 38736524 PMCID: PMC11088268 DOI: 10.1016/j.eurox.2024.100307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 04/04/2024] [Accepted: 04/16/2024] [Indexed: 05/14/2024] Open
Abstract
Introduction In the WHO eligibility criteria, there is agreement that hypertensive women taking Oral Contraceptive Hormonal Combined (OCHC) may be at increased risk of cardiovascular disease. The risk-to-benefit ratio hinges on the severity of the condition. While a mild increase in blood pressure is a common occurrence in consumers of OCHC, the potential for developing high blood pressure exists during oral contraceptive use. Consequently, there is a possibility of increased cardiovascular risk, with limited available data on this issue. Objective To evaluate the potential effects of OCHC on blood pressure through a systematic review with statistical analysis of existing randomized controlled trials. Method This systematic review with statistical comparison adheres to the recommendations outlined in the PRISMA (Principal Reporting Items for Systematic Reviews and Meta-analyses) guidelines. The analysis strategy involves comparing the mean difference in blood pressure change according to the type of treatment, in addition to the calculation of clinically relevant outcomes (CRO). Results Our findings suggest a clinically relevant outcome related to the increase in blood pressure in users of ethinyl estradiol combined with gestodene in a cyclic regimen over 6 months. Conversely, a decrease in blood pressure was observed among users of ethinyl estradiol combined with chlormadinone over 24 months of usage. Conclusion While our study found minor variations in blood pressure across varying forms of oral contraceptives, these differences are not significant enough to warrant specific clinical recommendations. However, the results suggest that individuals with hypertension should exercise caution with ethinyl estradiol, particularly when administered cyclically alongside gestodene, due to the potential risk of increased blood pressure. Additionally, the use of oral contraceptives containing ethinyl estradiol paired with chlormadinone acetate or ethinyl estradiol combined with drospirenone may be more suitable for individuals at a high risk of developing hypertension.
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Affiliation(s)
- Ingrid Soares de Souza
- Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André, São Paulo, Brazil
| | - Gabriel Zorello Laporta
- Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André, São Paulo, Brazil
| | - Juliana Zangirolami-Raimundo
- Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André, São Paulo, Brazil
- Laboratório de investigação médica em ginecologia estrutural e molecular, Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, São Pauloṭ, Brazil
| | - Isabel Cristina Esposito Sorpreso
- Laboratório de investigação médica em ginecologia estrutural e molecular, Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, São Pauloṭ, Brazil
| | | | - José Maria Soares Júnior
- Laboratório de investigação médica em ginecologia estrutural e molecular, Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, São Pauloṭ, Brazil
| | - Rodrigo Daminello Raimundo
- Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André, São Paulo, Brazil
- Laboratório de investigação médica em ginecologia estrutural e molecular, Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, São Pauloṭ, Brazil
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Calcagno M, Serra P, Etrusco A, Margioula-Siarkou C, Terzic S, Giannini A, Garzon S, Ferrari F, Dellino M, Laganà AS. A bitter pill to swallow: adjustments to oral contraceptive pill use in polycystic ovary syndrome. Expert Opin Pharmacother 2024; 25:1137-1143. [PMID: 38904185 DOI: 10.1080/14656566.2024.2371977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 06/20/2024] [Indexed: 06/22/2024]
Abstract
INTRODUCTION This Special Report aims to highlight the importance of tailored therapies in women with Polycystic Ovary Syndrome (PCOS), avoiding prescribing generalized or unsuitable therapies based on oral contraceptive pills (OCPs). AREAS COVERED This article discusses the benefits and risks of OCP-based therapy, highlighting the possible undesirable effects, especially in those patients exhibiting risk factors as women with PCOS, and the importance of carefully evaluated tailored therapeutic approaches. Literature searches were performed with the use of PubMed, Google Scholar, and Web of Science between January and February 2024. EXPERT OPINION Considering the recent re-analysis of PCOS Rotterdam Criteria by the Expert Group on Inositol in Basic and Clinical Research, and on PCOS (EGOI-PCOS), the traditional Rotterdam phenotypes can be reclassified to achieve more efficacious therapy choices. Using personalized therapies that consider the specific clinical characteristics of the patient allows to improve the management of the syndrome, thus avoiding the generalized use of OCPs, which risk treating only symptoms of PCOS rather than the underlying cause. In cases when contraceptive purpose is desired, patients may benefit from combined therapy with diet or insulin-sensitizer agents, as inositol, to rebalance the metabolic profile, thus reducing the risk of developing future complications.
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Affiliation(s)
- Marco Calcagno
- Department of Obstetrics and Gynecology, Santo Spirito Hospital, Rome, Italy
| | - Pietro Serra
- Unit of Obstetrics and Gynecology, "Paolo Giaccone" Hospital, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Andrea Etrusco
- Unit of Obstetrics and Gynecology, "Paolo Giaccone" Hospital, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | | | - Sanja Terzic
- Department of Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan
| | - Andrea Giannini
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Rome, Italy
- Gynecology Division, Department of Medical and Surgical Sciences and Translational Medicine, Sant'Andrea University Hospital, Rome, Italy
| | - Simone Garzon
- Unit of Obstetrics and Gynecology, Department of Surgery, Dentistry, Pediatrics, and Gynecology, University of Verona, Verona, Italy
| | - Federico Ferrari
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Miriam Dellino
- 1st Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine, University of Bari 'Aldo Moro', Bari, Italy
| | - Antonio Simone Laganà
- Unit of Obstetrics and Gynecology, "Paolo Giaccone" Hospital, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
- The Experts Group on Inositol in Basic and Clinical Research, and on PCOS, Rome, Italy
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Fabunmi OA, Dludla PV, Nkambule BB. High-dose oral contraceptives induce hyperinsulinemia without altering immune activation in diet-induced obesity which persists even following a dietary low-fat diet intervention. J Reprod Immunol 2024; 163:104234. [PMID: 38479054 DOI: 10.1016/j.jri.2024.104234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 02/24/2024] [Accepted: 03/07/2024] [Indexed: 06/03/2024]
Abstract
Combined oral contraceptives (COCs) are known to cause weight gain and alter metabolic and immunological pathways. However, modifications in arterial or venous thrombotic risk profiles of women of reproductive ages on COC remain unclear. The study aimed at assessing the impact of COC on immune activation in diet-induced obesity. We further established whether the dietary intervention of switching from a high-fat diet (HFD) to a low-fat diet (LFD) attenuates immunological responses. Twenty (n=20) five-week-old female Sprague Dawley rats were randomly divided into two diet groups of HFD (n=15) and LFD (n=5) and were monitored for eight weeks. After eight weeks, animals in the HFD group switched diets to LFD and were randomly assigned to receive high-dose COC (HCOC) or low-dose COC (LCOC) for six weeks. Animals on HFD significantly gained weight and had a higher lee index when compared to the LFD group (p < 0.05). Moreover, the triglyceride-glucose index, insulin, and other metabolic parameters also increased in the HFD group compared to the LFD group (p < 0.001). Consistently, the levels of interleukin (IL)-6 and tumor necrosis factor-alpha (TNF-α), were elevated in the HFD group when compared to the LFD group (p < 0.05). Upon switching from a high-fat to a low-fat diet, insulin levels persistently increased in animals receiving HCOC treatment compared to the LFD and HFD/LFD groups (p < 0.05). Thus, in a rat model of HFD-feeding, short-term HCOC treatment induces long-term metabolic dysregulation, which persists despite dietary intervention. However, further studies are recommended to confirm these findings.
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Affiliation(s)
- Oyesanmi A Fabunmi
- School of Laboratory Medicine and Medical Sciences (SLMMS), College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa; Health-awareness, Exercise and Cardio-immunologic Research Unit (HECIRU), Department of Physiology, College of Medicine, Ekiti State University, Ado-Ekiti 5363, Nigeria.
| | - Phiwayinkosi V Dludla
- Cochrane South Africa, South African Medical Research Council, Tygerberg 7505, South Africa; Department of Biochemistry and Microbiology, University of Zululand, KwaDlangezwa 3880, South Africa
| | - Bongani B Nkambule
- School of Laboratory Medicine and Medical Sciences (SLMMS), College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa.
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Barlow A, Blodgett JM, Williams S, Pedlar CR, Bruinvels G. Injury Incidence, Severity, and Type Across the Menstrual Cycle in Female Footballers: A Prospective Three Season Cohort Study. Med Sci Sports Exerc 2024; 56:1151-1158. [PMID: 38227488 DOI: 10.1249/mss.0000000000003391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
PURPOSE The aim of the study was to assess the influence of menstrual cycle phase on injury incidence, severity, and type in elite female professional footballers over three seasons. METHODS Time-loss injuries and menstrual cycle data were prospectively recorded for 26 elite female football players across three seasons. The menstrual cycle was categorized into four phases using a standardized model: menstruation (phase 1; P1), remainder of follicular phase (phase 2; P2), early luteal (phase 3; P3), and premenstrual phase (phase 4; P4). Injury incidence rates (IIR) and ratios (IIRR) were calculated for overall injuries, injury severity, type, contact vs noncontact, and game/training. RESULTS A total of 593 cycles across 13,390 d were tracked during the study, and 74 injuries from 26 players were eligible for analysis. When comparing IIR between phases (reference: P1), overall injury rates were highest in P4 (IIRR, 2.30 (95% confidence interval, 0.99-5.34; P = 0.05)). When examining rates by injury severity and type, IIR values were also highest in P4 for ≤7 d' time-loss (4.40 (0.93-20.76; P = 0.06)), muscle-specific (6.07 (1.34-27.43; P = 0.02)), and noncontact (3.05 (1.10-8.50; P = 0.03)) injuries. Muscle-specific (IIRR P3/P1, 5.07 (1.16-22.07; P = 0.03)) and ≤7 d' time-loss (4.47 (1.01-19.68; P = 0.05)) injury risk was also significantly higher in P3. Muscle injuries were the most prevalent subtype ( n = 41). No anterior cruciate ligament injuries were recorded across the monitoring period. CONCLUSIONS Injury risk was significantly elevated during the luteal phase of the menstrual cycle (P3 and P4) among elite female professional footballers. Further research is urgently needed to better understand the influence of the menstrual cycle on injury risk and to develop interventions to mitigate risk.
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Affiliation(s)
- Ally Barlow
- Centre for Health, and Injury & Illness Prevention in Sport, Department for Health, University of Bath, Bath, UNITED KINGDOM
| | - Joanna M Blodgett
- Institute of Sport, Exercise and Health, Division of Surgery and Interventional Science, University College London, UNITED KINGDOM
| | - Sean Williams
- Centre for Health, and Injury & Illness Prevention in Sport, Department for Health, University of Bath, Bath, UNITED KINGDOM
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Shepherd R, Angus LM, Mansell T, Arman B, Kim BW, Lange K, Burgner D, Kerr JA, Pang K, Zajac JD, Saffery R, Cheung A, Novakovic B. Impact of Distinct Anti-Androgen Exposures on the Plasma Metabolome in Feminizing Gender-Affirming Hormone Therapy. J Clin Endocrinol Metab 2024:dgae226. [PMID: 38609170 DOI: 10.1210/clinem/dgae226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/06/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024]
Abstract
CONTEXT The plasma metabolome is a functional readout of metabolic activity and is associated with phenotypes exhibiting sexual dimorphism, such as cardiovascular disease. Sex hormones are thought to play a key role in driving sexual dimorphism. OBJECTIVE Gender-affirming hormone therapy (GAHT) is a cornerstone of transgender care, but longitudinal changes in the plasma metabolome with feminizing GAHT have not been described. METHODS Blood samples were collected at baseline and after three and six months of GAHT from transgender women (n = 53). Participants were randomized to different anti-androgens, cyproterone acetate or spironolactone. NMR-based metabolomics was used to measure 249 metabolic biomarkers in plasma. Additionally, we used metabolic biomarker data from an unrelated cohort of children and their parents (n = 3,748) to identify sex- and age-related metabolite patterns. RESULTS We identified 43 metabolic biomarkers altered after six months in both anti-androgen groups, most belonging to the very low- or low-density lipoprotein subclasses, with all but one showing a decrease. We observed a cyproterone acetate-specific decrease in glutamine, glycine, and alanine levels. Notably, of the metabolic biomarkers exhibiting the most abundant 'sex- and age-related' pattern (higher in assigned female children and lower in assigned female adults, relative to assigned males), 80% were significantly lowered after GAHT, reflecting a shift toward the adult female profile. CONCLUSION Our results suggest an anti-atherogenic signature in the plasma metabolome after the first six months of feminizing GAHT, with cyproterone acetate also reducing specific plasma amino acids. This study provides novel insight into the metabolic changes occurring across feminizing GAHT.
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Affiliation(s)
- Rebecca Shepherd
- Molecular Immunity, Infection and Immunity Theme, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
| | - Lachlan M Angus
- Department of Medicine (Austin Health), The University of Melbourne, Parkville, VIC, Australia
- Department of Endocrinology, Austin Health, Heidelberg, VIC, Australia
| | - Toby Mansell
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Inflammatory Origins, Infection and Immunity Theme, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
| | - Bridget Arman
- Therapeutics Discovery and Vascular Function Group, Department of Obstetrics and Gynaecology, University of Melbourne, Mercy Hospital for Women, Heidelberg, Victoria, Australia
- Mercy Perinatal, Mercy Hospital for Women, Heidelberg, Victoria, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Mercy Hospital for Women, Heidelberg, Victoria, Australia
| | - Bo Won Kim
- Molecular Immunity, Infection and Immunity Theme, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Katherine Lange
- The Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - David Burgner
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Inflammatory Origins, Infection and Immunity Theme, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
| | - Jessica A Kerr
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- University of Otago, Department of Psychological Medicine, Christchurch, New Zealand
- Murdoch Children's Research Institute, Centre for Adolescent Health, Population Health Theme, Parkville, VIC, Australia
- University of Melbourne, Department of Paediatrics, Parkville, VIC, Australia
| | - Ken Pang
- Brain and Mind Research, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
- Department of Adolescent Medicine, Royal Children's Hospital, Parkville, VIC, Australia
| | - Jeffrey D Zajac
- Department of Medicine (Austin Health), The University of Melbourne, Parkville, VIC, Australia
- Department of Endocrinology, Austin Health, Heidelberg, VIC, Australia
| | - Richard Saffery
- Molecular Immunity, Infection and Immunity Theme, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Ada Cheung
- Department of Medicine (Austin Health), The University of Melbourne, Parkville, VIC, Australia
- Department of Endocrinology, Austin Health, Heidelberg, VIC, Australia
| | - Boris Novakovic
- Molecular Immunity, Infection and Immunity Theme, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
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Parker J, O’Brien CL, Yeoh C, Gersh FL, Brennecke S. Reducing the Risk of Pre-Eclampsia in Women with Polycystic Ovary Syndrome Using a Combination of Pregnancy Screening, Lifestyle, and Medical Management Strategies. J Clin Med 2024; 13:1774. [PMID: 38541997 PMCID: PMC10971491 DOI: 10.3390/jcm13061774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/12/2024] [Accepted: 03/17/2024] [Indexed: 05/04/2024] Open
Abstract
Polycystic ovary syndrome (PCOS) is a multisystem disorder that presents with a variety of phenotypes involving metabolic, endocrine, reproductive, and psychological symptoms and signs. Women with PCOS are at increased risk of pregnancy complications including implantation failure, miscarriage, gestational diabetes, fetal growth restriction, preterm labor, and pre-eclampsia (PE). This may be attributed to the presence of specific susceptibility features associated with PCOS before and during pregnancy, such as chronic systemic inflammation, insulin resistance (IR), and hyperandrogenism, all of which have been associated with an increased risk of pregnancy complications. Many of the features of PCOS are reversible following lifestyle interventions such as diet and exercise, and pregnant women following a healthy lifestyle have been found to have a lower risk of complications, including PE. This narrative synthesis summarizes the evidence investigating the risk of PE and the role of nutritional factors in women with PCOS. The findings suggest that the beneficial aspects of lifestyle management of PCOS, as recommended in the evidence-based international guidelines, extend to improved pregnancy outcomes. Identifying high-risk women with PCOS will allow targeted interventions, early-pregnancy screening, and increased surveillance for PE. Women with PCOS should be included in risk assessment algorithms for PE.
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Affiliation(s)
- Jim Parker
- School of Medicine, University of Wollongong, Wollongong 2522, Australia
| | - Claire Louise O’Brien
- Faculty of Science and Technology, University of Canberra, Canberra 2617, Australia;
| | - Christabelle Yeoh
- Next Practice Genbiome, 2/2 New McLean Street, Edgecliff 2027, Australia;
| | - Felice L. Gersh
- College of Medicine, University of Arizona, Tucson, AZ 85004, USA;
| | - Shaun Brennecke
- Department of Maternal-Fetal Medicine, Pregnancy Research Centre, The Royal Women’s Hospital, Melbourne 3052, Australia;
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne 3052, Australia
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Clayton GL, Borges MC, Lawlor DA. The impact of reproductive factors on the metabolic profile of females from menarche to menopause. Nat Commun 2024; 15:1103. [PMID: 38320991 PMCID: PMC10847109 DOI: 10.1038/s41467-023-44459-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 12/14/2023] [Indexed: 02/08/2024] Open
Abstract
We explore the relation between age at menarche, parity and age at natural menopause with 249 metabolic traits in over 65,000 UK Biobank women using multivariable regression, Mendelian randomization and negative control (parity only). Older age of menarche is related to a less atherogenic metabolic profile in multivariable regression and Mendelian randomization, which is largely attenuated when accounting for adult body mass index. In multivariable regression, higher parity relates to more particles and lipids in VLDL, which are not observed in male negative controls. In multivariable regression and Mendelian randomization, older age at natural menopause is related to lower concentrations of inflammation markers, but we observe inconsistent results for LDL-related traits due to chronological age-specific effects. For example, older age at menopause is related to lower LDL-cholesterol in younger women but slightly higher in older women. Our findings support a role of reproductive traits on later life metabolic profile and provide insights into identifying novel markers for the prevention of adverse cardiometabolic outcomes in women.
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Affiliation(s)
- Gemma L Clayton
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | - Maria Carolina Borges
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, Bristol, UK
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Athar F, Karmani M, Templeman N. Metabolic hormones are integral regulators of female reproductive health and function. Biosci Rep 2024; 44:BSR20231916. [PMID: 38131197 PMCID: PMC10830447 DOI: 10.1042/bsr20231916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 11/29/2023] [Accepted: 12/21/2023] [Indexed: 12/23/2023] Open
Abstract
The female reproductive system is strongly influenced by nutrition and energy balance. It is well known that food restriction or energy depletion can induce suppression of reproductive processes, while overnutrition is associated with reproductive dysfunction. However, the intricate mechanisms through which nutritional inputs and metabolic health are integrated into the coordination of reproduction are still being defined. In this review, we describe evidence for essential contributions by hormones that are responsive to food intake or fuel stores. Key metabolic hormones-including insulin, the incretins (glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1), growth hormone, ghrelin, leptin, and adiponectin-signal throughout the hypothalamic-pituitary-gonadal axis to support or suppress reproduction. We synthesize current knowledge on how these multifaceted hormones interact with the brain, pituitary, and ovaries to regulate functioning of the female reproductive system, incorporating in vitro and in vivo data from animal models and humans. Metabolic hormones are involved in orchestrating reproductive processes in healthy states, but some also play a significant role in the pathophysiology or treatment strategies of female reproductive disorders. Further understanding of the complex interrelationships between metabolic health and female reproductive function has important implications for improving women's health overall.
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Affiliation(s)
- Faria Athar
- Department of Biology, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
| | - Muskan Karmani
- Department of Biology, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
| | - Nicole M. Templeman
- Department of Biology, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
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Grobler T, Opperman M, Bester J, Swanepoel AC, du Preez I. Metabolomic Profiling of Hormonal Contraceptive Use in Young Females Using a Commercially Available LC-MS/MS Kit. Metabolites 2023; 13:1092. [PMID: 37887417 PMCID: PMC10609319 DOI: 10.3390/metabo13101092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/16/2023] [Accepted: 10/17/2023] [Indexed: 10/28/2023] Open
Abstract
Oral hormonal contraceptive users carry the risk of venous thrombosis and increased mortality. This study aimed to comprehensively profile the serum metabolome of participants using a combination of drospirenone (DRSP) and ethinyl estradiol (EE) containing oral contraceptives (COCs). The MxP Quant 500 kit for liquid chromatography mass tandem spectrometry (LC-MS/MS) was used to analyse the 22 controls and 44 COC users (22 on a low EE dose (DRSP/20EE) and 22 on a higher EE dose (DRSP/30EE)). The kit's results were compared to our internally developed untargeted and targeted metabolomics methods previously applied to this cohort. Of the 630 metabolites included in the method, 277 provided desirable results (consistently detected above their detection limits), and of these, 5 had p-values < 0.05, including betaine, glutamine, cortisol, glycine, and choline. Notably, these variations were observed between the control and COC groups, rather than among the two COC groups. Partial least squares-discriminant analysis revealed 49 compounds with VIP values ≥ 1, including amino acids and their derivatives, ceramides, phosphatidylcholines, and triglycerides, among others. Ten differential compounds were consistent with our previous studies, reinforcing the notion of COCs inducing a prothrombotic state and increased oxidative stress. Although only a limited number of compounds were deemed usable, these were quantified with high reliability and facilitated the identification of meaningful biological differences among the sample groups. In addition to substantiating known drug-induced variations, new hypotheses were also generated.
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Affiliation(s)
- Tania Grobler
- Centre for Human Metabolomics, North-West University, Potchefstroom 2531, South Africa
| | - Monique Opperman
- Centre for Human Metabolomics, North-West University, Potchefstroom 2531, South Africa
| | - Janette Bester
- Department of Physiology, Faculty of Health Sciences, School of Medicine, University of Pretoria, Pretoria 0002, South Africa
| | - Albe Carina Swanepoel
- Centre for Human Metabolomics, North-West University, Potchefstroom 2531, South Africa
| | - Ilse du Preez
- Centre for Human Metabolomics, North-West University, Potchefstroom 2531, South Africa
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12
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Kangasniemi MH, Arffman RK, Haverinen A, Luiro K, Hustad S, Heikinheimo O, Tapanainen JS, Piltonen TT. Effects of estradiol- and ethinylestradiol-based contraceptives on adrenal steroids: A randomized trial. Contraception 2022; 116:59-65. [PMID: 36084710 DOI: 10.1016/j.contraception.2022.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/16/2022] [Accepted: 08/26/2022] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Ethinylestradiol (EE)-based combined oral contraceptives (COC) affect adrenal function by altering steroid and corticosteroid-binding globulin (CBG) synthesis that may contribute to adverse effects related to these drugs. The effects of COCs containing natural estrogens remain unclear. We compared the effects of COCs containing estradiol valerate (EV) and EE on cortisol and other adrenal steroid hormones. STUDY DESIGN A spin-off study of a randomized, open-label trial. Fifty-nine healthy women were allocated to groups that engaged in the continuous use of EV+dienogest (DNG), EE+DNG, or DNG only for 9 weeks. We measured changes in adrenal steroids, CBG, and the free cortisol index (FCI). RESULTS Treatment with EE+DNG increased total cortisol (mean increment 668 nmol/L, p < 0.001) and cortisone (10 nmol/L, p= 0.001) levels, whereas the change from the baseline was insignificant for the EV+DNG and DNG-only groups. Dehydroepiandrosterone sulfate decreased by 24% in the EE+DNG group but remained unchanged in the EV+DNG and DNG-only groups. Aldosterone and 17-hydroxyprogesterone levels did not differ between the groups. All preparations increased CBG, but the increase in the EE+DNG group (median increment 42 µg/mL, p < 0.001) was 9- and 49-fold higher than that in the EV+DNG and DNG-only groups, respectively. The FCI remained unchanged in all study groups, indicating that cortisol and CBG mainly increased in parallel, although some individuals demonstrated larger alterations in the cortisol-CBG balance. CONCLUSION In COCs, EV had a milder effect on circulating CBG and adrenal steroid levels than EE; however, further research is necessary to determine the long-term effects. TRIAL REGISTRATION ClinicalTrials.gov NCT02352090 IMPLICATIONS: EV-based COC had reduced effects on circulating CBG and adrenal steroids compared to EE, probably due to a lower hepatic impact. Whether the sensitization of the adrenals to ACTH varies according to COC contents and whether it relates to experienced side effects needs to be investigated. These results encourage further research and development of contraceptives containing natural estrogens.
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Affiliation(s)
- Marika H Kangasniemi
- Department of Obstetrics and Gynecology, University of Oulu, Oulu University Hospital and Medical Research Centre PEDEGO Research Unit, Oulu, Finland.
| | - Riikka K Arffman
- Department of Obstetrics and Gynecology, University of Oulu, Oulu University Hospital and Medical Research Centre PEDEGO Research Unit, Oulu, Finland
| | - Annina Haverinen
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Kaisu Luiro
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Steinar Hustad
- Department of Clinical Science and Core Facility for Metabolomics, University of Bergen, Norway
| | - Oskari Heikinheimo
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Juha S Tapanainen
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Terhi T Piltonen
- Department of Obstetrics and Gynecology, University of Oulu, Oulu University Hospital and Medical Research Centre PEDEGO Research Unit, Oulu, Finland
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13
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PÍREK O, BUDINSKAYA K, NOVÁKOVÁ Z. Effects of peroral hormonal contraception on cardiovascular system: analysis of selected cardiovascular parameters in an adolescent cohort; a pilot project. Physiol Res 2022; 71:S203-S210. [PMID: 36647908 PMCID: PMC9906664 DOI: 10.33549/physiolres.934997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Oral contraceptive pills (OCPs) have some strong advantages over more traditional types of contraception, including their consistently high contraceptive effect as well as multiple additional positive side effects. OCPs went through decades of intense pharmaceutical development and current formulas are well optimized - however, a handful of their negative side effects remain, including some that affect cardiovascular system, for example higher risk of hypertension, venous thromboembolism and increased arterial stiffness. The gold standard for arterial stiffness assessment is currently applanation tonometry, a method that relies on arterial pulse wave velocity measurement (PWV). Another possible method for arterial stiffness measurement is the use of the VaSera device, which measures cardio-ankle vascular index (CAVI). The aim of this study was to discover the effect of OCPs use on selected cardiovascular parameters related to arterial stiffness. We measured these cardiovascular parameters in the OCPs using group (OCP) and in the control group (CTRL) using applanation tonometer Sphygmocor and the VaSera device. Comparison of the data from both groups showed us significantly increased diastolic blood pressure (DBP) and carotid-radial pulse wave velocity (crPWV) as well as significantly lower subendocardial viability index (SVI) in the OCP. These results imply a negative effect of hormonal contraceptives on the cardiovascular system with most of the negative changes affecting the peripheral arteries. Despite this evidence supporting the hypothesis of OCPs having a negative effect on cardiovascular health, further research is necessary.
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Affiliation(s)
- Ondřej PÍREK
- Department of Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Ksenia BUDINSKAYA
- Department of Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Zuzana NOVÁKOVÁ
- Department of Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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14
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Kangasniemi MH, Arffman RK, Joenväärä S, Haverinen A, Luiro K, Tohmola T, Renkonen R, Heikinheimo O, Tapanainen JS, Piltonen TT. Ethinylestradiol in combined hormonal contraceptive has a broader effect on serum proteome compared with estradiol valerate: a randomized controlled trial. Hum Reprod 2022; 38:89-102. [PMID: 36416543 PMCID: PMC9825269 DOI: 10.1093/humrep/deac250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/19/2022] [Indexed: 11/24/2022] Open
Abstract
STUDY QUESTION Does an estradiol-based combined oral contraceptive (COC) have a milder effect on the serum proteome than an ethinylestradiol (EE)-based COC or dienogest (DNG) only? SUMMARY ANSWER The changes in serum proteome were multifold after the use of a synthetic EE-based COC compared to natural estrogen COC or progestin-only preparation. WHAT IS KNOWN ALREADY EE-based COCs widely affect metabolism, inflammation, hepatic protein synthesis and blood coagulation. Studies comparing serum proteomes after the use of COCs containing EE and natural estrogens are lacking. STUDY DESIGN, SIZE, DURATION This was a spin-off from a randomized, controlled, two-center clinical trial. Women (n = 59) were randomized to use either EE + DNG, estradiol valerate (EV) + DNG or DNG only continuously for 9 weeks. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants were healthy, young, white volunteer women. Serum samples were collected before and after 9 weeks of hormonal exposure. Samples from 44 women were available for analysis (EE + DNG n = 14, EV + DNG n = 16 and DNG only n = 14). Serum proteins were analyzed by quantitative, discovery-type label-free proteomics. MAIN RESULTS AND THE ROLE OF CHANCE Altogether, 446 proteins/protein families with two or more unique peptides were detected and quantified. The number of proteins/families that altered over the 9-week period within the study groups was 121 for EE + DNG and 5 for EV + DNG, while no changes were detected for DNG only. When alterations were compared between the groups, significant differences were detected for 63 proteins/protein families, of which 58 were between the EE + DNG and EV + DNG groups. The most affected functions during the use of EE + DNG were the complement system, acute phase response signaling, metabolism and the coagulation system. The results were validated by fetuin-B and cortisol-binding globulin ELISA and sex hormone-binding globulin immunoassay. LARGE SCALE DATA Data are available via ProteomeXchange with identifiers PXD033617 (low abundance fraction) and PXD033618 (high abundance fraction). LIMITATIONS, REASONS FOR CAUTION The power analysis of the trial was not based on the proteomic analysis of this spin-off study. In the future, targeted proteomic analysis with samples from another trial should be carried out in order to confirm the results. WIDER IMPLICATIONS OF THE FINDINGS The EE-based COC exerted a broader effect on the serum proteome than the EV-based COC or the DNG-only preparation. These results demonstrate that the effects of EE in COCs go far beyond the established endpoint markers of estrogen action, while the EV combination is closer to the progestin-only preparation. The study indicates that EV could provide a preferable option to EE in COCs in the future and signals a need for further studies comparing the clinical health outcomes of COCs containing EE and natural estrogens. STUDY FUNDING/COMPETING INTEREST(S) Funding for this researcher-initiated study was obtained from the Helsinki University Hospital research funds, the Hospital District of Helsinki and Uusimaa, the Sigrid Juselius Foundation, the Academy of Finland, the Finnish Medical Association, the University of Oulu Graduate School, the Emil Aaltonen Foundation, the Swedish Cultural Foundation in Finland, the Novo Nordisk Foundation, Orion Research Foundation and the Northern Ostrobothnia Regional Fund. The funders had no role in study design, data collection and analysis, publishing decisions or manuscript preparation. T.P. has received honoraria for lectures, consultations and research grants from Exeltis, Gedeon Richter, MSD, Merck, Pfizer, Roche, Stragen and Mithra Pharmaceuticals. O.H. occasionally serves on advisory boards for Bayer AG and Gedeon Richter and has designed and lectured at educational events for these companies. The other authors have nothing to disclose. O.H. occasionally serves on advisory boards for Bayer AG and Gedeon Richter and has designed and lectured at educational events for these companies. The other authors have nothing to disclose. TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT02352090. TRIAL REGISTRATION DATE 27 January 2015. DATE OF FIRST PATIENT’S ENROLMENT 1 April 2015.
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Affiliation(s)
- M H Kangasniemi
- Correspondence address. Department of Obstetrics and Gynecology, Clinical Research Unit, Medical Research Center, Oulu University Hospital, University of Oulu, 90014 Oulu, Finland. E-mail:
| | - R K Arffman
- Department of Obstetrics and Gynecology, Clinical Research Unit, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - S Joenväärä
- Transplantation Laboratory, Haartman Institute, University of Helsinki, Helsinki, Finland,HUS Diagnostic Center, Helsinki University Hospital, Helsinki, Finland
| | - A Haverinen
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - K Luiro
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - T Tohmola
- Transplantation Laboratory, Haartman Institute, University of Helsinki, Helsinki, Finland,HUS Diagnostic Center, Helsinki University Hospital, Helsinki, Finland
| | - R Renkonen
- Transplantation Laboratory, Haartman Institute, University of Helsinki, Helsinki, Finland,HUS Diagnostic Center, Helsinki University Hospital, Helsinki, Finland
| | - O Heikinheimo
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - J S Tapanainen
- Department of Obstetrics and Gynecology, Clinical Research Unit, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland,Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - T T Piltonen
- Department of Obstetrics and Gynecology, Clinical Research Unit, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
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15
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Wu J, Shaidani S, Theodossiou SK, Hartzell EJ, Kaplan DL. Localized, on-demand, sustained drug delivery from biopolymer-based materials. Expert Opin Drug Deliv 2022; 19:1317-1335. [PMID: 35930000 PMCID: PMC9617770 DOI: 10.1080/17425247.2022.2110582] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 08/03/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Local drug delivery facilitiates higher concentrations of drug molecules at or near the treatment site to enhance treatment efficiency and reduce drug toxicity and other systemic side effects. However, local drug delivery systems face challenges in terms of encapsulation, delivery, and controlled release of therapeutics. AREAS COVERED We provide an overview of naturally derived biopolymer-based drug delivery systems for localized, sustained, and on-demand treatment. We introduce the advantages and limitations of these systems for drug encapsulation, delivery, and local release, as well as recent applications. EXPERT OPINION Naturally derived biopolymers like cellulose, silk fibroin, chitosan, alginate, hyaluronic acid, and gelatin are good candidates for localized drug delivery because they are readily chemically modified, biocompatible, biodegradable (with the generation of metabolically compatible degradation products), and can be processed in aqueous and ambient environments to maintain the bioactivity of various therapeutics. The tradeoff between the effective treatment dosage and the response by local healthy tissue should be balanced during the design of these delivery systems. Future directions will be focused on strategies to design tunable and controlled biodegradation rates, as well as to explore commercial utility in substituting biopolymer-based systems for currently utilized synthetic polymers for implants for drug delivery.
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Affiliation(s)
- Junqi Wu
- Department of Biomedical Engineering, Tufts University, 4 Colby St., Medford, USA, 02155
| | - Sawnaz Shaidani
- Department of Biomedical Engineering, Tufts University, 4 Colby St., Medford, USA, 02155
| | - Sophia K. Theodossiou
- Department of Biomedical Engineering, Tufts University, 4 Colby St., Medford, USA, 02155
| | - Emily J. Hartzell
- Department of Biomedical Engineering, Tufts University, 4 Colby St., Medford, USA, 02155
| | - David L. Kaplan
- Department of Biomedical Engineering, Tufts University, 4 Colby St., Medford, USA, 02155
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16
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Quotah OF, Poston L, Flynn AC, White SL. Metabolic Profiling of Pregnant Women with Obesity: An Exploratory Study in Women at Greater Risk of Gestational Diabetes. Metabolites 2022; 12:metabo12100922. [PMID: 36295825 PMCID: PMC9612230 DOI: 10.3390/metabo12100922] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 11/16/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is one of the most prevalent obstetric conditions, particularly among women with obesity. Pathways to hyperglycaemia remain obscure and a better understanding of the pathophysiology would facilitate early detection and targeted intervention. Among obese women from the UK Pregnancies Better Eating and Activity Trial (UPBEAT), we aimed to compare metabolic profiles early and mid-pregnancy in women identified as high-risk of developing GDM, stratified by GDM diagnosis. Using a GDM prediction model combining maternal age, mid-arm circumference, systolic blood pressure, glucose, triglycerides and HbA1c, 231 women were identified as being at higher-risk, of whom 119 women developed GDM. Analyte data (nuclear magnetic resonance and conventional) were compared between higher-risk women who developed GDM and those who did not at timepoint 1 (15+0−18+6 weeks) and at timepoint 2 (23+2−30+0 weeks). The adjusted regression analyses revealed some differences in the early second trimester between those who developed GDM and those who did not, including lower adiponectin and glutamine concentrations, and higher C-peptide concentrations (FDR-adjusted p < 0.005, < 0.05, < 0.05 respectively). More differences were evident at the time of GDM diagnosis (timepoint 2) including greater impairment in β-cell function (as assessed by HOMA2-%B), an increase in the glycolysis-intermediate pyruvate (FDR-adjusted p < 0.001, < 0.05 respectively) and differing lipid profiles. The liver function marker γ-glutamyl transferase was higher at both timepoints (FDR-adjusted p < 0.05). This exploratory study underlines the difficulty in early prediction of GDM development in high-risk women but adds to the evidence that among pregnant women with obesity, insulin secretory dysfunction may be an important discriminator for those who develop GDM.
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Affiliation(s)
- Ola F. Quotah
- Department of Women and Children’s Health, School of Life Course and Population Sciences, King’s College London, 10th Floor North Wing, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, UK
- Department of Clinical Nutrition, Faculty of Applied Medical Science, King Abdulaziz University, Jeddah 999088, Saudi Arabia
| | - Lucilla Poston
- Department of Women and Children’s Health, School of Life Course and Population Sciences, King’s College London, 10th Floor North Wing, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, UK
| | - Angela C. Flynn
- Department of Women and Children’s Health, School of Life Course and Population Sciences, King’s College London, 10th Floor North Wing, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, UK
- Department of Nutritional Sciences, School of Life Course and Population Sciences, King’s College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK
| | - Sara L. White
- Department of Women and Children’s Health, School of Life Course and Population Sciences, King’s College London, 10th Floor North Wing, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, UK
- Correspondence:
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17
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Toffol E, Heikinheimo O, Jousilahti P, But A, Joensuu A, Latvala A, Partonen T, Erlund I, Haukka J. Metabolomics profile of 5649 users and non-users of hormonal intrauterine devices in Finland. Am J Obstet Gynecol 2022; 227:603.e1-603.e29. [PMID: 35697093 DOI: 10.1016/j.ajog.2022.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/03/2022] [Accepted: 06/06/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Use of hormonal intrauterine devices has grown during the last decades. Although the hormonal intrauterine devices act mostly via local effects on uterus, measurable concentrations of levonorgestrel are absorbed into the systemic circulation. The possible metabolic changes and large scale biomarker profiles associated with the hormonal intrauterine devices have not yet been studied in detail. OBJECTIVES To examine, through the metabolomics approach, the metabolic profile of the hormonal intrauterine device use, its associations as a function of the duration of use, as well as those with after discontinuation of the hormonal intrauterine device use. STUDY DESIGN The study consists of cross-sectional analyses of five population-based surveys (FINRISK and FinHealth studies), spanning 1997-2017. All fertile aged (18-49 years) participants in the surveys with available information on hormonal contraceptive use and metabolomics data (n=5649), were included in the study. Altogether 211 metabolic measures in users of hormonal intrauterine devices (n=1006) were compared to those in non-users of hormonal contraception (n=4643) via multivariable linear regression models. In order to allow the comparison across multiple measures, association magnitudes are reported in SD units of difference in biomarker concentration compared to the reference group. RESULTS After adjustment for covariates, levels of 141 metabolites differed in current users of hormonal intrauterine devices compared to non-users of hormonal contraception (median difference in biomarker concentration: 0.09 SD): lower levels of particle concentration of larger lipoprotein subclasses, triglycerides, cholesterol and derivatives, apolipoproteins A and B, fatty acids, glycoprotein acetyls and aromatic amino acids. The metabolic pattern of the hormonal intrauterine device use did not change according to the duration of use. When comparing previous users and never-users of hormonal intrauterine devices, no significant metabolic differences emerged. CONCLUSIONS The use of hormonal intrauterine devices was associated with several moderate metabolic changes, previously associated with reduced arterial cardiometabolic risk. The metabolic effects were independent of the duration of use of the hormonal intrauterine devices. Moreover, the metabolic profiles were similar after discontinuation of the hormonal intrauterine devices and in never-users.
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Affiliation(s)
- Elena Toffol
- Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Oskari Heikinheimo
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pekka Jousilahti
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Anna But
- Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anni Joensuu
- Department of Knowledge Brokers, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Antti Latvala
- Institute of Criminology and Legal Policy, University of Helsinki, Helsinki, Finland
| | - Timo Partonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Iris Erlund
- Department of Government Services, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jari Haukka
- Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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18
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Robinson GA, Pineda-Torra I, Ciurtin C, Jury EC. Sex Differences in Lipid Metabolism: Implications for Systemic Lupus Erythematosus and Cardiovascular Disease Risk. Front Med (Lausanne) 2022; 9:914016. [PMID: 35712086 PMCID: PMC9197418 DOI: 10.3389/fmed.2022.914016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/02/2022] [Indexed: 11/13/2022] Open
Abstract
It is known that healthy women during childbearing years have a lower risk of cardiovascular disease (CVD) and coronary heart disease compared to age matched men. Various traditional risk factors have been shown to confer differential CVD susceptibilities by sex. Atherosclerosis is a major cause of CVD and mortality and sex differences in CVD risk could be due to reduced atherogenic low and very low-density lipoproteins (LDL and VLDL) and increased atheroprotective high density lipoproteins (HDLs) in women. In contrast, patients with systemic lupus erythematosus (SLE), a chronic inflammatory disease that predominately affects women, have an increased atherosclerotic and CVD risk. This increased CVD risk is largely associated with dyslipidaemia, the imbalance of atherogenic and atheroprotective lipoproteins, a conventional CVD risk factor. In many women with SLE, dyslipidaemia is characterised by elevated LDL and reduced HDL, eradicating the sex-specific CVD protection observed in healthy women compared to men. This review will explore this paradox, reporting what is known regarding sex differences in lipid metabolism and CVD risk in the healthy population and transgender individuals undergoing cross-sex hormone therapy, and provide evidence for how these differences may be compromised in an autoimmune inflammatory disease setting. This could lead to better understanding of mechanistic changes in lipid metabolism driving the increased CVD risk by sex and in autoimmunity and highlight potential therapeutic targets to help reduce this risk.
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Affiliation(s)
- George A. Robinson
- Division of Medicine, Centre for Rheumatology Research, University College London, London, United Kingdom
- Division of Medicine, Centre for Adolescent Rheumatology Versus Arthritis, University College London, London, United Kingdom
| | - Ines Pineda-Torra
- Division of Medicine, Centre for Cardiometabolic and Vascular Science, University College London, London, United Kingdom
| | - Coziana Ciurtin
- Division of Medicine, Centre for Rheumatology Research, University College London, London, United Kingdom
- Division of Medicine, Centre for Adolescent Rheumatology Versus Arthritis, University College London, London, United Kingdom
| | - Elizabeth C. Jury
- Division of Medicine, Centre for Rheumatology Research, University College London, London, United Kingdom
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19
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He W, Dam TV, Thøgersen R, Hansen M, Bertram HC. Fluctuations in Metabolites and Bone Markers Across the Menstrual Cycle in Eumenorrheic Women and Oral Contraceptive Users. J Clin Endocrinol Metab 2022; 107:1577-1588. [PMID: 35213728 DOI: 10.1210/clinem/dgac112] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Indexed: 12/15/2022]
Abstract
CONTEXT Little is known about changes in circulating metabolites during the menstrual cycle and how use of oral contraceptives (OCs) affects these changes. OBJECTIVES To study fluctuations in circulating metabolite and bone marker levels during the menstrual/pill cycle in eumenorrheic women and OC users. METHODS Plasma samples were collected from 28 eumenorrheic women and 10 OC users at 7 to 9 time points across a menstrual/pill cycle. Longitudinal and cross-sectional analyses were performed to examine the cycle- and OC-induced variations in the plasma metabolite and bone turnover marker levels. RESULTS In eumenorrheic women, plasma levels of alanine, glutamine, threonine, and tyrosine varied significantly across the menstrual cycle, and all dropped to the lowest level around day 21 of the menstrual cycle. These amino acid concentrations were negatively correlated with fluctuations in progesterone and/or estrogen levels. A between-group analysis showed that plasma levels of alanine, glutamine, glycine, proline, and tyrosine were lower in OC users than in nonusers. Concomitantly, plasma C-terminal telopeptide of type I collagen (CTX) and N-terminal propeptide of type I procollagen (PINP) levels were lower in OC users. Intriguingly, when all data were pooled, variations in CTX and PINP levels were positively correlated with fluctuations in proline and glycine concentrations (r > 0.5 or 0.3 < r < 0.5, P < 0.05). CONCLUSIONS The menstrual cycle and the use of OCs alter plasma levels of metabolites and bone turnover markers in young women. While the impact of these findings remains to be established, the lower glycine level among OC users and the accompanying lower CTX level supports that the use of OCs lowers collagen turnover in young women and may thereby have long-term implications for bone health among OC users.
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Affiliation(s)
- Weiwei He
- Department of Food Science, Aarhus University, Aarhus N, Denmark
| | - Tine Vrist Dam
- Section for Sport Science, Department of Public Health, Aarhus University, Aarhus C, Denmark
| | | | - Mette Hansen
- Section for Sport Science, Department of Public Health, Aarhus University, Aarhus C, Denmark
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Sex Hormone-Binding Globulin and Its Association to Cardiovascular Risk Factors in an Italian Adult Population Cohort. REPORTS 2022. [DOI: 10.3390/reports5010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abnormal sex hormone-binding globulin (SHBG) and sex hormone concentrations are the cause or the consequence of cardiometabolic diseases, however, the clinical correlates of SHBG is clearly less understood. In our study we investigate sex- and age-specific serum SHBG levels and their association with cardiovascular risk (CVR) factors and high-risk conditions in an adult cohort of Italian population. Data from 1176 men and 2236 women, aged 20–81 were analyzed and serum SHBG determined in stored samples using an immunoassay. SHBG concentrations, higher in women than in men in the younger age groups, exhibited a curvilinear increase with age in men and a U-shaped curve across the lifespan in women, with a decrease from the 2nd to the 6th decade of age and an increase after the 6th decade when SHBG concentrations were similar in both sexes. Low SHBG serum levels correlated with the traditional CVR factors diabetes, obesity, and hypertension, whereas high level of SHBG correlated with cholesterol HDL. These associations were more numerous in women than in men, in whom decreased with age. The sex- and age specific differences observed in our population-based cohort should be considered in establishing reference ranges and clinical cut-off points to improve CVR score charts and therapeutic approaches.
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21
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Gold JI, Gold NB, DeLeon DD, Ganetzky R. Contraceptive use in women with inherited metabolic disorders: a retrospective study and literature review. Orphanet J Rare Dis 2022; 17:41. [PMID: 35135572 PMCID: PMC8822780 DOI: 10.1186/s13023-022-02188-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Reproductive planning is an emerging concern for women with inherited metabolic disease (IMD). Anticipatory guidance on contraception is necessary to prevent unintended pregnancies in this population. Few resources exist to aid informed decision-making on contraceptive choice. A retrospective case-control study was performed to examine trends in reproductive planning for adolescent and adult women seen at the Children's Hospital of Philadelphia (CHOP). Literature review on contraception and IMD was performed to assess global use. RESULTS In a cohort of 221 reproductive-aged female IMD patients, 29.4% reported routine contraceptive use. Anticipatory guidance on contraception was provided by metabolic physicians to 36.8% of patients during the study period. Contraception discussion was more likely to occur in women older than 21 years, who lived independently and were followed by gynecology. Women who received contraception counseling from their metabolic physician were 40-fold more likely to use regular contraception. Use of combined hormonal contraceptives was most commonly reported, but contraception choice varied by age and IMD. CONCLUSION Metabolic physicians are ideally suited to provide guidance on contraception to women with IMD. Reproductive planning should be addressed routinely using shared decision-making. Contraceptives should be selected for their efficacy, effects on metabolism, and likelihood of patient adherence.
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Affiliation(s)
- Jessica I Gold
- Division of Human Genetics, Section of Biochemical Genetics, The Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA.
| | - Nina B Gold
- Division of Medical Genetics and Metabolism, Massachusetts General Hospital for Children, Boston, MA, USA
| | - Diva D DeLeon
- Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca Ganetzky
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,Division of Human Genetics, Section of Biochemical Genetics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
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22
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Eun Y, Yoo JE, Han K, Kim D, Lee KN, Lee J, Lee DY, Lee DH, Kim H, Shin DW. Female reproductive factors and risk of joint replacement arthroplasty of the knee and hip due to osteoarthritis in postmenopausal women: a nationwide cohort study of 1.13 million women. Osteoarthritis Cartilage 2022; 30:69-80. [PMID: 34774788 DOI: 10.1016/j.joca.2021.10.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 10/10/2021] [Accepted: 10/25/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Previous studies of the relationships between female reproductive factors and osteoarthritis (OA) have shown conflicting results. In this study, we aimed to explore the relationships between reproductive factors and joint replacement arthroplasty of the knee (TKRA) and hip (THRA) in a large nationwide population-based cohort of postmenopausal Korean women. METHODS We included 1,134,680 subjects who participated in national health examinations in 2009 in the study. The study outcomes were incident THRA or TKRA due to severe hip or knee OA. The relationships between reproductive factors and THRA or TKRA were evaluated using a multivariable-adjusted proportional hazards model. RESULTS During a mean follow-up duration of 8.2 years, 1,610 incident THRA cases and 60,670 incident TKRA cases were observed. Later age at menarche, longer breastfeeding, HRT and OC use were associated with increased risk of TKRA for severe knee OA, while later age at menopause and longer reproductive span were associated with decreased risk. With regard to THRA for severe hip OA, later menarche, longer breastfeeding, HRT more than 5 years, and OC use more than 1 year were associated with higher risk. The associations between reproductive factors and severe OA were more pronounced in underweight and younger subjects. CONCLUSION We found that shorter estrogen exposure was associated with higher risk of TKRA due to severe knee OA, and such associations were more pronounced in underweight and younger subjects. The association between shorter estrogen exposure and THRA was not robust.
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Affiliation(s)
- Y Eun
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - J E Yoo
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, South Korea
| | - K Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea
| | - D Kim
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea
| | - K N Lee
- Department of Biomedicine and Health Science, The Catholic University of Korea, Seoul, South Korea
| | - J Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - D-Y Lee
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - D-H Lee
- Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - H Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Medical Humanities, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
| | - D W Shin
- Department of Family Medicine and Supportive Care Centre, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design and Evaluation/ Department of Digital Health, Samsung Advanced Institute for Health Science and Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea.
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Combined Intranasal Insulin/Saxagliptin/Metformin Therapies Ameliorate the Effect of Combined Oral Contraceptive- (COC-) Induced Metabolic Syndrome (MetS) with a Major Target on Glucose Metabolism in Adult Female Wistar Rats. Int J Reprod Med 2021; 2021:9693171. [PMID: 34938803 PMCID: PMC8687792 DOI: 10.1155/2021/9693171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/12/2021] [Accepted: 11/12/2021] [Indexed: 11/17/2022] Open
Abstract
Objective To evaluate the effect of the chronic use of combined oral contraceptives (COCs: ethinyl estradiol and levonorgestrel) on the indices of metabolic syndrome in adult female Wistar rats and possible therapeutic management. Materials and Methods 64 female Wistar rats received either distilled water, norethindrone (NOR), COC, intranasal insulin (INI), metformin (MET), saxagliptin (SAX), INI+MET, and INI+SAX. After 8 weeks of exposure to COC, the animals were sorted into the therapeutic groups. Several parameters were assayed for, such as body weight changes, fasting blood glucose (FBG) level, insulin levels, inflammatory cytokines, and glycated hemoglobin (Hb1Ac). Results The levels of FBG, insulin, and Hb1Ac were increased consequent upon COC treatment. Treatment with INI+SAX and INI+MET reduced significantly the levels of FBG and Hb1Ac; in addition, the level of insulin was significantly increased in the INI+MET groups (p ≤ 0.05). Serum lipid profile analysis showed a statistical reduction in high-density lipoprotein (HDL) level; this reduction was also significantly reversed in the INI+SAX group. Reduced catalase activity observed in the COC group was reversed in the INI+MET group (p ≤ 0.05). A nonsignificant increase in the level of TNF-α as a result of COC treatment was reversed by INI and INI+MET treatment. Liver GLUT4 and G-6-phosphate levels were significantly increased by COC treatment, and this effect was reversed by INI+SAX in both assays, respectively (p ≤ 0.01). Conclusions The use of MET and SAX in combination with INI has been shown to reverse some indices of MetS. This study proposes a clinical phase to backup and ascertain these preclinical findings.
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Robinson GA, Peng J, Peckham H, Radziszewska A, Butler G, Pineda-Torra I, Jury EC, Ciurtin C. Sex hormones drive changes in lipoprotein metabolism. iScience 2021; 24:103257. [PMID: 34761181 PMCID: PMC8567005 DOI: 10.1016/j.isci.2021.103257] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/08/2021] [Accepted: 10/07/2021] [Indexed: 02/06/2023] Open
Abstract
Women have a reduced cardiovascular disease (CVD) risk compared with men, which could be partially driven by sex hormones influencing lipid levels post puberty. The interrelationship between sex hormones and lipids was explored in pre-pubertal children, young post-pubertal cis-men/women, and transgender individuals on cross-sex-hormone treatment (trans-men/women) using serum metabolomics assessing 149 lipids. High-density lipoproteins (HDL, typically atheroprotective) were significantly increased and very-low- and low-density lipoproteins (typically atherogenic) were significantly decreased in post-pubertal cis-women compared with cis-men. These differences were not observed pre-puberty and were induced appropriately by cross-sex-hormone treatment in transgender individuals, supporting that sex hormones regulate lipid metabolism in vivo. Only atheroprotective apolipoprotein (Apo)A1 expressing lipoproteins (HDL) were differentially expressed between all hormonally unique comparisons. Thus, estradiol drives a typically atheroprotective lipid profile through upregulation of HDL/ApoA1, which could contribute to the sexual dimorphism observed in CVD risk post puberty. Together, this could inform sex-specific therapeutic strategies for CVD management.
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Affiliation(s)
- George A. Robinson
- Centre for Rheumatology Research, Division of Medicine, University College London, Rayne Building, London WC1E 6JF, UK
- Centre for Adolescent Rheumatology Research, Division of Medicine, University College London, Rayne Building, London WC1E 6JF, UK
| | - Junjie Peng
- Centre for Adolescent Rheumatology Research, Division of Medicine, University College London, Rayne Building, London WC1E 6JF, UK
| | - Hannah Peckham
- Centre for Adolescent Rheumatology Research, Division of Medicine, University College London, Rayne Building, London WC1E 6JF, UK
| | - Anna Radziszewska
- Centre for Adolescent Rheumatology Research, Division of Medicine, University College London, Rayne Building, London WC1E 6JF, UK
| | - Gary Butler
- Department of Paediatric and Adolescent Endocrinology, UCLH and Great Ormond Street Institute of Child Health, University College London, London, UK
- Gender Identity Development Service (GIDS), Tavistock and Portman NHS Foundation Trust, London, UK
| | - Ines Pineda-Torra
- Centre for Cardiometabolic and Vascular Science, Department of Medicine, University College London, London WC1E 6JF, UK
| | - Elizabeth C. Jury
- Centre for Rheumatology Research, Division of Medicine, University College London, Rayne Building, London WC1E 6JF, UK
| | - Coziana Ciurtin
- Centre for Rheumatology Research, Division of Medicine, University College London, Rayne Building, London WC1E 6JF, UK
- Centre for Adolescent Rheumatology Research, Division of Medicine, University College London, Rayne Building, London WC1E 6JF, UK
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Effects of dexmedetomidine, propofol, sevoflurane and S-ketamine on the human metabolome: A randomised trial using nuclear magnetic resonance spectroscopy. Eur J Anaesthesiol 2021; 39:521-532. [PMID: 34534172 DOI: 10.1097/eja.0000000000001591] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Pharmacometabolomics uses large-scale data capturing methods to uncover drug-induced shifts in the metabolic profile. The specific effects of anaesthetics on the human metabolome are largely unknown. OBJECTIVE We aimed to discover whether exposure to routinely used anaesthetics have an acute effect on the human metabolic profile. DESIGN Randomised, open-label, controlled, parallel group, phase IV clinical drug trial. SETTING The study was conducted at Turku PET Centre, University of Turku, Finland, 2016 to 2017. PARTICIPANTS One hundred and sixty healthy male volunteers were recruited. The metabolomic data of 159 were evaluable. INTERVENTIONS Volunteers were randomised to receive a 1-h exposure to equipotent doses (EC50 for verbal command) of dexmedetomidine (1.5 ng ml-1; n = 40), propofol (1.7 μg ml-1; n = 40), sevoflurane (0.9% end-tidal; n = 39), S-ketamine (0.75 μg ml-1; n = 20) or placebo (n = 20). MAIN OUTCOME MEASURES Metabolite subgroups of apolipoproteins and lipoproteins, cholesterol, glycerides and phospholipids, fatty acids, glycolysis, amino acids, ketone bodies, creatinine and albumin and the inflammatory marker GlycA, were analysed with nuclear magnetic resonance spectroscopy from arterial blood samples collected at baseline, after anaesthetic administration and 70 min postanaesthesia. RESULTS All metabolite subgroups were affected. Statistically significant changes vs. placebo were observed in 11.0, 41.3, 0.65 and 3.9% of the 155 analytes in the dexmedetomidine, propofol, sevoflurane and S-ketamine groups, respectively. Dexmedetomidine increased glucose, decreased ketone bodies and affected lipoproteins and apolipoproteins. Propofol altered lipoproteins, fatty acids, glycerides and phospholipids and slightly increased inflammatory marker glycoprotein acetylation. Sevoflurane was relatively inert. S-ketamine increased glucose and lactate, whereas branched chain amino acids and tyrosine decreased. CONCLUSION A 1-h exposure to moderate doses of routinely used anaesthetics led to significant and characteristic alterations in the metabolic profile. Dexmedetomidine-induced alterations mirror α2-adrenoceptor agonism. Propofol emulsion altered the lipid profile. The inertness of sevoflurane might prove useful in vulnerable patients. S-ketamine induced amino acid alterations might be linked to its suggested antidepressive properties. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02624401. URL: https://clinicaltrials.gov/ct2/show/NCT02624401.
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Swanepoel A, Bester J, Kruger Y, Davoren E, du Preez I. The effect of combined oral contraceptives containing drospirenone and ethinylestradiol on serum levels of amino acids and acylcarnitines. Metabolomics 2021; 17:75. [PMID: 34409503 DOI: 10.1007/s11306-021-01825-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 07/27/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Metabolome variations have long been associated with normal hormonal fluctuations, and similar effects, related to the use of early generation synthetic hormones as a means of contraception, have also been identified. OBJECTIVE We investigated the serum amino acid and acylcarnitine profiles induced by the use of combined oral contraceptives (COCs) consisting of Ethinylestradiol (EE) and a 4th generation progestin, Drospirenone (DRSP). METHOD Gas chromatography mass spectrometry and liquid chromatography with tandem mass spectrometry was used to identify and quantify the serum amino acids and acyl carnitine levels in 24 controls, 25 DRSP/20EE users and 26 DRSP/30EE users. RESULTS Of the 26 amino acid compounds measured, 13 showed significant variations in abundance between the control and COC user groups. Although none of the 21 acylcarnitine compounds detected were statistically significant with regards to group variations, a trend, related the EE concentration, was observed. The detected metabolome disparities corresponded to that identified for earlier generation COCs, all pointing toward increased oxidative stress levels in the user groups. CONCLUSION These findings suggest that the clinical complications associated with these COCs could, to some extent, be alleviated by the simultaneous use of antioxidants. The study also highlights the role that targeted metabolomics could play in the elucidation of the underlying mechanisms of drug-induced severe effects.
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Affiliation(s)
- Albe Swanepoel
- Faculty of Health Sciences, Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa.
| | - Janette Bester
- Department of Physiology, Faculty of Health Sciences, School of Medicine, University of Pretoria, Pretoria, South Africa
| | - Yolanda Kruger
- Human Metabolomics, Faculty of Natural and Agricultural Sciences, North-West University, Potchefstroom, South Africa
| | - Elmarie Davoren
- Human Metabolomics, Faculty of Natural and Agricultural Sciences, North-West University, Potchefstroom, South Africa
| | - Ilse du Preez
- Human Metabolomics, Faculty of Natural and Agricultural Sciences, North-West University, Potchefstroom, South Africa.
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Kar SK, Schokker D, Harms AC, Kruijt L, Smits MA, Jansman AJM. Local intestinal microbiota response and systemic effects of feeding black soldier fly larvae to replace soybean meal in growing pigs. Sci Rep 2021; 11:15088. [PMID: 34302029 PMCID: PMC8302639 DOI: 10.1038/s41598-021-94604-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 07/01/2021] [Indexed: 11/25/2022] Open
Abstract
Black soldier fly (Hermetia illucens; BSF) larvae as dietary protein source have the ability to deliver nutrients and could possess functional properties that positively support animal productivity and health. More knowledge, however, is needed to assess the impact of feeding a BSF based diet on gut and animal health. Sixteen post-weaned male pigs were randomly assigned to two groups and fed for three weeks with iso-caloric and iso-proteinaceous experimental diets prepared with either soybean meal (SBM) as reference protein source or with BSF as single source of dietary protein. At the end of the trial, the pigs were sacrificed to collect relevant digesta, gut tissue and blood samples to study changes induced by the dietary treatments using ~ omics based analyses. Inclusion of BSF in the diet supports the development of the intestinal microbiome that could positively influence intestinal health. By amine metabolite analysis, we identified two metabolites i.e. sarcosine and methionine sulfoxide, in plasma that serve as markers for the ingestion of insect based ingredients. BSF seems to possess functional properties indicated by the appearance of alpha-aminobutyric acid and taurine in blood plasma of pigs that are known to induce health beneficial effects.
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Affiliation(s)
- Soumya K Kar
- Animal Nutrition, Wageningen Livestock Research, Wageningen University & Research, Wageningen, The Netherlands.
| | - Dirkjan Schokker
- Wageningen Livestock Research, Animal Breeding and Genomics, Wageningen University & Research, Wageningen, The Netherlands
| | - Amy C Harms
- Netherlands Metabolomics Centre, Leiden University, Leiden, The Netherlands
- Department of Analytical Biosciences, Leiden University, Leiden, The Netherlands
| | - Leo Kruijt
- Wageningen Livestock Research, Animal Breeding and Genomics, Wageningen University & Research, Wageningen, The Netherlands
| | - Mari A Smits
- Wageningen Livestock Research, Animal Breeding and Genomics, Wageningen University & Research, Wageningen, The Netherlands
| | - Alfons J M Jansman
- Animal Nutrition, Wageningen Livestock Research, Wageningen University & Research, Wageningen, The Netherlands
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Auvinen J, Tapio J, Karhunen V, Kettunen J, Serpi R, Dimova EY, Gill D, Soininen P, Tammelin T, Mykkänen J, Puukka K, Kähönen M, Raitoharju E, Lehtimäki T, Ala-Korpela M, Raitakari OT, Keinänen-Kiukaanniemi S, Järvelin MR, Koivunen P. Systematic evaluation of the association between hemoglobin levels and metabolic profile implicates beneficial effects of hypoxia. SCIENCE ADVANCES 2021; 7:7/29/eabi4822. [PMID: 34261659 PMCID: PMC8279517 DOI: 10.1126/sciadv.abi4822] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 06/01/2021] [Indexed: 05/22/2023]
Abstract
Activation of the hypoxia-inducible factor (HIF) pathway reprograms energy metabolism. Hemoglobin (Hb) is the main carrier of oxygen. Using its normal variation as a surrogate measure for hypoxia, we explored whether lower Hb levels could lead to healthier metabolic profiles in mice and humans (n = 7175) and used Mendelian randomization (MR) to evaluate potential causality (n = 173,480). The results showed evidence for lower Hb levels being associated with lower body mass index, better glucose tolerance and other metabolic profiles, lower inflammatory load, and blood pressure. Expression of the key HIF target genes SLC2A4 and Slc2a1 in skeletal muscle and adipose tissue, respectively, associated with systolic blood pressure in MR analyses and body weight, liver weight, and adiposity in mice. Last, manipulation of murine Hb levels mediated changes to key metabolic parameters. In conclusion, low-end normal Hb levels may be favorable for metabolic health involving mild chronic activation of the HIF response.
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Affiliation(s)
- Juha Auvinen
- Faculty of Medicine, Center for Life Course Health Research, University of Oulu, 90014 Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, 90220 Oulu, Finland
| | - Joona Tapio
- Biocenter Oulu, 90014 Oulu, Finland
- Faculty of Biochemistry and Molecular Medicine, Oulu Center for Cell-Matrix Research, University of Oulu, 90014 Oulu, Finland
| | - Ville Karhunen
- Faculty of Medicine, Center for Life Course Health Research, University of Oulu, 90014 Oulu, Finland
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, W2 1PG London, UK
- Research Unit of Mathematical Sciences, University of Oulu, 90014 Oulu, Finland
| | - Johannes Kettunen
- Faculty of Medicine, Center for Life Course Health Research, University of Oulu, 90014 Oulu, Finland
- Biocenter Oulu, 90014 Oulu, Finland
- Computational Medicine, Faculty of Medicine, University of Oulu, 90014 Oulu, Finland
- NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, 70210 Kuopio, Finland
| | - Raisa Serpi
- Biocenter Oulu, 90014 Oulu, Finland
- Faculty of Biochemistry and Molecular Medicine, Oulu Center for Cell-Matrix Research, University of Oulu, 90014 Oulu, Finland
| | - Elitsa Y Dimova
- Biocenter Oulu, 90014 Oulu, Finland
- Faculty of Biochemistry and Molecular Medicine, Oulu Center for Cell-Matrix Research, University of Oulu, 90014 Oulu, Finland
| | - Dipender Gill
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, W2 1PG London, UK
- Clinical Pharmacology and Therapeutics Section, Institute of Medical and Biomedical Education and Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Pasi Soininen
- Computational Medicine, Faculty of Medicine, University of Oulu, 90014 Oulu, Finland
- NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, 70210 Kuopio, Finland
| | - Tuija Tammelin
- LIKES Research Center for Physical Activity and Health, 40700 Jyväskylä, Finland
| | - Juha Mykkänen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, 20520 Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Katri Puukka
- NordLab Oulu, Medical Research Center Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, 90014 Oulu, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Emma Raitoharju
- Department of Clinical Chemistry, Fimlab Laboratories and Faculty of Medicine and Health Technology, Finnish Cardiovascular Research Center - Tampere, Tampere University, Tampere, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories and Faculty of Medicine and Health Technology, Finnish Cardiovascular Research Center - Tampere, Tampere University, Tampere, Finland
| | - Mika Ala-Korpela
- Faculty of Medicine, Center for Life Course Health Research, University of Oulu, 90014 Oulu, Finland
- Biocenter Oulu, 90014 Oulu, Finland
- Computational Medicine, Faculty of Medicine, University of Oulu, 90014 Oulu, Finland
- NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, 70210 Kuopio, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, 20520 Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, 20520 Turku, Finland
| | - Sirkka Keinänen-Kiukaanniemi
- Faculty of Medicine, Center for Life Course Health Research, University of Oulu, 90014 Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, 90220 Oulu, Finland
| | - Marjo-Riitta Järvelin
- Faculty of Medicine, Center for Life Course Health Research, University of Oulu, 90014 Oulu, Finland.
- Biocenter Oulu, 90014 Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, 90220 Oulu, Finland
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, Middlesex UB8 3PH, UK
| | - Peppi Koivunen
- Biocenter Oulu, 90014 Oulu, Finland.
- Faculty of Biochemistry and Molecular Medicine, Oulu Center for Cell-Matrix Research, University of Oulu, 90014 Oulu, Finland
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Umlauff L, Weil P, Zimmer P, Hackney AC, Bloch W, Schumann M. Oral Contraceptives Do Not Affect Physiological Responses to Strength Exercise. J Strength Cond Res 2021; 35:894-901. [PMID: 33555830 DOI: 10.1519/jsc.0000000000003958] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Umlauff, L, Weil, P, Zimmer, P, Hackney, AC, Bloch, W, and Schumann, M. Oral contraceptives do not affect physiological responses to strength exercise. J Strength Cond Res 35(4): 894-901, 2021-This study investigated the effect of oral contraceptive (OC) use on acute changes in steroid hormone concentrations and tryptophan (TRP) metabolites in response to strength exercise. Twenty-one women (age: 23 ± 3 years), 8 combined OC users (OC group) and 13 naturally cycling women (menstrual cycle [MC] group), participated. Testing was performed during the pill-free interval for the OC group and the follicular phase for the MC group. Subjects completed an intense strength exercise protocol (4 × 10 repetitions back squat). Blood samples were taken at baseline (T0), post-exercise (T1), and after 24 hours (T2) to determine serum concentrations of cortisol, estradiol, testosterone, TRP, and kynurenine (KYN). Statistical significance was defined as p ≤ 0.05. At T0, the OC group showed higher cortisol (OC: 493.7 ± 47.1 ng·mL-1, MC: 299.1 ± 62.7 ng·mL-1, p < 0.001) and blood lactate (OC: 1.81 ± 0.61 mmol·L-1, MC: 1.06 ± 0.30 mmol·L-1, p = 0.001) and lower estradiol (OC: 31.12 ± 4.24 pg·mL-1, MC: 38.34 ± 7.50 pg·mL-1, p = 0.023) and KYN (OC: 1.15 ± 0.23 µmol·L-1, MC: 1.75 ± 0.50 µmol·L-1, p = 0.005). No significant interactions (group × time, p > 0.05) were found for the hormones and TRP metabolites assessed. Oral contraceptive use did not affect the physiological response of steroid hormones and TRP metabolites to acute strength exercise during the low hormone phase of the contraceptive or MC in healthy young women, even when some baseline concentrations differed between groups. Consequently, these findings provide important implications for practitioners testing heterogeneous groups of female athletes.
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Affiliation(s)
- Lisa Umlauff
- Department for Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Peter Weil
- Department for Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Philipp Zimmer
- Department of Performance and Health (Sports Medicine), Institute of Sport and Sport Science, Technical University Dortmund, Dortmund, Germany; and
| | - Anthony C Hackney
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, North Carolina
| | - Wilhelm Bloch
- Department for Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Moritz Schumann
- Department for Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
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Campesi I, Montella A, Sotgiu G, Dore S, Carru C, Zinellu A, Palermo M, Franconi F. Combined oral contraceptives modify the effect of smoking on inflammatory cellular indexes and endothelial function in healthy subjects. Eur J Pharmacol 2020; 891:173762. [PMID: 33253680 DOI: 10.1016/j.ejphar.2020.173762] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/04/2020] [Accepted: 11/06/2020] [Indexed: 12/12/2022]
Abstract
Little information is available on the influence of sex in combination with smoking habits and combined oral contraceptives (COC) use on cellular inflammatory indexes such as neutrophil/lymphocyte ratio (NLR), derived NRL (dNLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), mean platelet volume/platelet count (MPV/PLT), aggregate inflammation systemic index (AISI), and systemic inflammation response index (SIRI), which are cost-effective biomarkers to assessing inflammation. Therefore, the effect of COC was studied alone or in association with smoking and compared with results from healthy COC-free women and men. Furthermore, the association of cellular inflammatory indexes with endothelial function (arginine (Arg), asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA) and lipid peroxidation (malondialdehyde MDA) biomarkers was evaluated. Blood was collected for hematological and biochemical analysis, which were used to calculate PLR, NLR, dNLR, MLR, MPV/PLT, AISI, and SIRI. Serum samples were assayed for Arg, ADMA, SDMA, and MDA. Monocytes, MLR, SIRI, and MPV/PLT were higher in men, while PLT count was higher in women. COC use increased lymphocytes and lowered PLR and MLR. Smoking reduced sexually divergent parameters, especially in COC users: smoking and non-smoking COC-free women displayed six divergent parameters, while COC users displayed only two (monocytes and MPV). In addition, COC affected endothelial function, reducing ADMA and Arg. Moreover, COC-free women had lower Arg levels than men. In conclusion, COC use strongly influence the effects of tobacco smoking, which are sex and parameter specific. Further, these data stress that COC use and smoking attitude select different cohorts indicating that sex and gender studies need intersectionality.
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Affiliation(s)
- Ilaria Campesi
- Dipartimento di Scienze Biomediche, Università Degli Studi di Sassari, 07100, Sassari, Italy; Laboratorio Nazionale di Farmacologia e Medicina di Genere, Istituto Nazionale Biostrutture Biosistemi, 07100, Sassari, Italy.
| | - Andrea Montella
- Dipartimento di Scienze Biomediche, Università Degli Studi di Sassari, 07100, Sassari, Italy; Unità Operativa di Genetica e Biologia Dello Sviluppo, Azienda Ospedaliero Universitaria di Sassari, 07100, Sassari, Italy
| | - Giovanni Sotgiu
- Dipartimento di Scienze Mediche Chirurgiche e Sperimentali, Università Degli Studi di Sassari, 07100, Sassari, Italy
| | - Simone Dore
- Dipartimento di Scienze Mediche Chirurgiche e Sperimentali, Università Degli Studi di Sassari, 07100, Sassari, Italy
| | - Ciriaco Carru
- Dipartimento di Scienze Biomediche, Università Degli Studi di Sassari, 07100, Sassari, Italy
| | - Angelo Zinellu
- Dipartimento di Scienze Biomediche, Università Degli Studi di Sassari, 07100, Sassari, Italy
| | - Mario Palermo
- Unità Operativa di Endocrinologia, Azienda Ospedaliero Universitaria di Sassari, 07100, Sassari, Italy
| | - Flavia Franconi
- Laboratorio Nazionale di Farmacologia e Medicina di Genere, Istituto Nazionale Biostrutture Biosistemi, 07100, Sassari, Italy
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Bruinvels G, Goldsmith E, Blagrove R, Simpkin A, Lewis N, Morton K, Suppiah A, Rogers JP, Ackerman KE, Newell J, Pedlar C. Prevalence and frequency of menstrual cycle symptoms are associated with availability to train and compete: a study of 6812 exercising women recruited using the Strava exercise app. Br J Sports Med 2020; 55:438-443. [PMID: 33199360 DOI: 10.1136/bjsports-2020-102792] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2020] [Indexed: 01/28/2023]
Abstract
OBJECTIVES The menstrual cycle can affect sports participation and exercise performance. There are very few data on specific menstrual cycle symptoms (symptoms during various phases of the cycle, not only during menstruation) experienced by exercising women. We aimed to characterise the most common symptoms, as well as the number and frequency of symptoms, and evaluate whether menstrual cycle symptoms are associated with sporting outcomes. METHODS 6812 adult women of reproductive age (mean age: 38.3 (8.7) years) who were not using combined hormonal contraception were recruited via the Strava exercise app user database and completed a 39-part survey. Respondents were from seven geographical areas, and the questions were translated and localised to each region (Brazil, n=892; France, n=1355; Germany, n=839; Spain, n=834; UK and Ireland, n=1350; and USA, n=1542). The survey captured exercise behaviours, current menstrual status, presence and frequency of menstrual cycle symptoms, medication use for symptoms, perceived effects of the menstrual cycle on exercise and work behaviours, and history of hormonal contraception use. We propose a novel Menstrual Symptom index (MSi) based on the presence and frequency of 18 commonly reported symptoms (range 0-54, where 54 would correspond to all 18 symptoms each occurring very frequently). RESULTS The most prevalent menstrual cycle symptoms were mood changes/anxiety (90.6%), tiredness/fatigue (86.2%), stomach cramps (84.2%) and breast pain/tenderness (83.1%). After controlling for body mass index, training volume and age, the MSi was associated with a greater likelihood of missing or changing training (OR=1.09 (CI 1.08 to 1.10); p≤0.05), missing a sporting event/competition (OR=1.07 (CI 1.06 to 1.08); p≤0.05), absenteeism from work/academia (OR=1.08 (CI 1.07 to 1.09); p≤0.05) and use of pain medication (OR=1.09 (CI 1.08 to 1.09); p≤0.05). CONCLUSION Menstrual cycle symptoms are very common in exercising women, and women report that these symptoms compromise their exercise participation and work capacity. The MSi needs to be formally validated (psychometrics); at present, it provides an easy way to quantify the frequency of menstrual cycle symptoms.
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Affiliation(s)
- Georgie Bruinvels
- Faculty of Sport, Health and Applied Science, St Mary's University Twickenham, Twickenham, London, UK
- Orreco, Galway, Ireland
| | | | - Richard Blagrove
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Andrew Simpkin
- School of Mathematics, Statistics and Applied Mathematics, National University of Ireland Galway, Galway, Ireland
- Insight Centre for Data Analytics, National University of Ireland, Galway, Ireland
| | - Nathan Lewis
- Faculty of Sport, Health and Applied Science, St Mary's University Twickenham, Twickenham, London, UK
- Orreco, Galway, Ireland
| | | | - Ara Suppiah
- University of Central Florida, Orlando, Florida, USA
| | - John P Rogers
- Sports Medicine, Manchester University NHS Foundation Trust, Manchester, Greater Manchester, UK
- Manchester Institute of High Performance, Manchester, UK
| | - Kathryn E Ackerman
- Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - John Newell
- School of Mathematics, Statistics and Applied Mathematics, National University of Ireland Galway, Galway, Ireland
- Insight Centre for Data Analytics, National University of Ireland, Galway, Ireland
| | - Charles Pedlar
- Faculty of Sport, Health and Applied Science, St Mary's University Twickenham, Twickenham, London, UK
- Orreco, Galway, Ireland
- Institute of Sport, Exercise and Health, UCL, London, UK
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Mercer D, Convit L, Condo D, Carr AJ, Hamilton DL, Slater G, Snipe RMJ. Protein Requirements of Pre-Menopausal Female Athletes: Systematic Literature Review. Nutrients 2020; 12:E3527. [PMID: 33207749 PMCID: PMC7696053 DOI: 10.3390/nu12113527] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/11/2020] [Accepted: 11/13/2020] [Indexed: 12/23/2022] Open
Abstract
This systematic literature review aimed to determine the protein requirements of pre-menopausal (e.g., 18-45 years) female athletes and identify if the menstrual cycle phase and/or hormonal contraceptive use influence protein requirements. Four databases were searched for original research containing pre-menopausal female athletes that ingested protein alongside exercise. The Academy of Nutrition and Dietetics Quality Criteria Checklist was used to determine study quality. Fourteen studies, which included 204 recreationally active or competitive females, met the eligibility criteria for inclusion in this review, and all were assessed as positive quality. The estimated average requirement (EAR) for protein intake of pre-menopausal recreational and/or competitive female athletes is similar for those undertaking aerobic endurance (1.28-1.63 g/kg/day), resistance (1.49 g/kg/day) and intermittent exercise (1.41 g/kg/day) of ~60-90 min duration. The optimal acute protein intake and influence of menstrual cycle phase or hormonal contraceptive use on protein requirements could not be determined. However, pre- and post-exercise protein intakes of 0.32-0.38 g/kg have demonstrated beneficial physiological responses in recreational and competitive female athletes completing resistance and intermittent exercise. The protein requirements outlined in this review can be used for planning and assessing protein intakes of recreational and competitive pre-menopausal female athletes.
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Affiliation(s)
- Drew Mercer
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood 3125, Victoria, Australia; (D.M.); (L.C.); (D.C.); (A.J.C.)
| | - Lilia Convit
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood 3125, Victoria, Australia; (D.M.); (L.C.); (D.C.); (A.J.C.)
| | - Dominique Condo
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood 3125, Victoria, Australia; (D.M.); (L.C.); (D.C.); (A.J.C.)
| | - Amelia J. Carr
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood 3125, Victoria, Australia; (D.M.); (L.C.); (D.C.); (A.J.C.)
| | - D. Lee Hamilton
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Victoria, Australia;
| | - Gary Slater
- School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore 4558, Queensland, Australia;
| | - Rhiannon M. J. Snipe
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood 3125, Victoria, Australia; (D.M.); (L.C.); (D.C.); (A.J.C.)
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Sales Vieira C, Celis C, Galán G, Hernández L, Díaz I, López J. Drospirenone: a Latin American perspective for oestrogen-free oral contraception. EUR J CONTRACEP REPR 2020; 26:73-78. [PMID: 33155847 DOI: 10.1080/13625187.2020.1837364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AIM Combined hormonal contraceptives, despite their high efficacy, are associated with an increased relative risk of cardiovascular events. The contraceptive mechanism of action of combined pills depends fundamentally on their progestin component. METHODS A narrative review was performed. RESULTS The drospirenone-only pill, including this synthetic progestogen with antimineralocorticoid and antiandrogenic activity, has high contraceptive efficacy that has been demonstrated with a 24-day schedule of 4-day administration of hormone-free pills. Due to its safety profile, the drospirenone-only pill is suitable even in high-risk populations, such as women with high blood pressure, thromboembolism, smoking or dyslipidemia. CONCLUSION Considering the increasing prevalence of these comorbidities in Latin America, the 4 mg drospirenone-only pill is suggested as one of the strategies of choice in the region for those women who choose oral contraceptives.
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Affiliation(s)
- Carolina Sales Vieira
- Department of Obstetrics and Gynecology of the Medical School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Cuauhtémoc Celis
- The Mexican Federation of Obstetric and Gynecology Colleges, Mexico City, Mexico
| | - Guillermo Galán
- Centro de Capacitación e Investigaciones Clínicas, Santiago, Chile
| | | | - Ivonne Díaz
- Procreación Médicamente Asistida, Bogotá, Colombia
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Al Rashid K, Taylor A, Lumsden MA, Goulding N, Lawlor DA, Nelson SM. Association of the serum metabolomic profile by nuclear magnetic resonance spectroscopy with sperm parameters: a cross-sectional study of 325 men. F&S SCIENCE 2020; 1:142-160. [PMID: 35559925 DOI: 10.1016/j.xfss.2020.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/08/2020] [Accepted: 10/08/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To determine whether 155 circulating metabolic measures relevant to lifestyle and metabolic health are associated with sperm parameters, as measured by concentration, motility, and total motile sperm count (TMSC). STUDY DESIGN Cross sectional. SETTING University hospital. PATIENT(S) Three hundred twenty-five men prospectively recruited between April 1, 2017 and March 31, 2019. INTERVENTION(S) Detailed demographic, lifestyle, fertility, medical history, and semen analysis with quantification of nonfasting serum lipids, lipoprotein subclasses, and low-molecular weight metabolites (including amino acids, glycolysis, and inflammatory markers) by nuclear magnetic resonance (NMR) spectroscopy. MAIN OUTCOME MEASURE(S) Association of serum metabolic profiles with sperm parameters. RESULT(S) The age of the participants was mean 37.2 years, with a median sperm concentration of 35 million/mL and median motility of 53%. Of these men, 76% had a TMSC >15 million, 10% had 5-15 million, and 14% had <5 million. In both univariate and confounder adjusted analyses, an extensive range of lipids and lipoproteins, glycolysis-related metabolites, amino acids, ketone bodies, creatinine, or albumin showed no strong statistically significant association with sperm concentration, motility, or the odds of having a reduced or low TMSC. Higher levels of glycolysis metabolites and ketone bodies were associated with an increased odds of TMSC <15 million compared with ≥15 million (odds ratios of ∼1.2-1.3), and several lipids/lipoprotein concentrations appeared to protect against very low TMSC (<5 million compared with ≥5 million) with odds ratios of ∼0.8 or greater. CONCLUSION(S) Several metabolites exhibited potentially clinically relevant strength of association with the odds of a low TMSC and warrant replication.
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Affiliation(s)
- Karema Al Rashid
- School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, United Kingdom
| | - Amy Taylor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom; Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom; National Institute for Health Research Bristol Biomedical Research Centre, Bristol, United Kingdom
| | - Mary Ann Lumsden
- School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, United Kingdom
| | - Neil Goulding
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom; Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom; Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom; National Institute for Health Research Bristol Biomedical Research Centre, Bristol, United Kingdom
| | - Scott M Nelson
- School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, United Kingdom; National Institute for Health Research Bristol Biomedical Research Centre, Bristol, United Kingdom.
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Swanepoel AC, Bester J, de Lange-Loots Z. Mechanical and Physical Behavior of Fibrin Clot Formation and Lysis in Combined Oral Contraceptive Users. MICROSCOPY AND MICROANALYSIS : THE OFFICIAL JOURNAL OF MICROSCOPY SOCIETY OF AMERICA, MICROBEAM ANALYSIS SOCIETY, MICROSCOPICAL SOCIETY OF CANADA 2020; 26:1007-1013. [PMID: 32778190 DOI: 10.1017/s1431927620024289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Combined oral contraceptives (COCs) are commonly prescribed and increase the risk of venous thromboembolism (VTE). We have previously found that two COCs, both containing drospirenone (DRSP) and ethinyl estradiol (EE), cause spontaneous fibrin formation in whole blood. The aim of this study was, therefore, to use platelet-poor plasma (PPP) from the same cohort of DRSP/EE users to determine the impact of these COCs on the fibrin component, specifically the fibrin clot viscoelasticity, turbidimetry, and biophysical traits. PPP from 25 females per test group and a control group (n = 25) were analyzed using thromboelastography (TEG), turbidimetry, and scanning electron microscopy. The results highlight abnormal fibrin clot formation, lysis, and architecture; DRSP/20EE showed the greatest effect. DRSP/EE use increased the fibrin fiber diameter and showed dense matted clots. Only when the influence of COCs on the structural properties and behavior of fibrin fibers during thrombus formation and lysis is better understood are we able to predict and prevent coagulopathies associated with these synthetic hormones. Clinical practitioners should take this into consideration for female patients that either have comorbidities, which could burden the coagulation system, or may be exposed to external factors that could increase their risk for VTE.
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Affiliation(s)
- Albe Carina Swanepoel
- Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia0007, South Africa
- Centre of Excellence for Nutrition, North-West University, Potchefstroom Campus, Private Bag X6001, Potchefstroom2520, South Africa
| | - Janette Bester
- Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia0007, South Africa
| | - Zelda de Lange-Loots
- Centre of Excellence for Nutrition, North-West University, Potchefstroom Campus, Private Bag X6001, Potchefstroom2520, South Africa
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Kangasniemi MH, Haverinen A, Luiro K, Hiltunen JK, Komsi EK, Arffman RK, Heikinheimo O, Tapanainen JS, Piltonen TT. Estradiol Valerate in COC Has More Favorable Inflammatory Profile Than Synthetic Ethinyl Estradiol: A Randomized Trial. J Clin Endocrinol Metab 2020; 105:5821528. [PMID: 32303765 DOI: 10.1210/clinem/dgaa186] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 04/17/2020] [Indexed: 01/08/2023]
Abstract
CONTEXT Combined oral contraceptives (COCs) alter inflammatory status and lipid metabolism. Whether different estrogens have different effects is poorly understood. OBJECTIVE We compared the effects of COCs containing ethinyl estradiol (EE) or estradiol valerate (EV) and dienogest (DNG) with those containing DNG only on inflammation and lipid metabolism. DESIGN Randomized, controlled, open-label clinical trial. SETTING Two-center study in Helsinki and Oulu University Hospitals. PARTICIPANTS Fifty-nine healthy, young, nonsmoking women with regular menstrual cycles. Age, body mass index, and waist-to-hip ratio were comparable in all study groups at the beginning. Fifty-six women completed the study (EV + DNG, n = 20; EE + DNG, n = 19; DNG only, n = 17). INTERVENTIONS Nine-week continuous use of COCs containing either EV + DNG or EE + DNG, or DNG only as control. MAIN OUTCOME MEASURES Parameters of chronic inflammation (high-sensitivity C-reactive protein [hs-CRP], and pentraxin 3 [PTX-3]) and lipid profile (high-density lipoprotein [HDL], low-density lipoprotein [LDL], triglycerides, and total cholesterol). RESULTS Serum hs-CRP increased after 9-week use of EE + DNG (mean change ± standard deviation 1.10 ± 2.11 mg/L) compared with EV + DNG (-0.06 ± 0.97 mg/L, P = 0.001) or DNG only (0.13 ± 0.68 mg/L, P = 0.021). Also, PTX-3 increased in the EE + DNG group compared with EV + DNG and DNG-only groups (P = 0.017 and P = 0.003, respectively). In the EE + DNG group, HDL and triglycerides increased compared with other groups (HDL: EE + DNG 0.20 ± 0.24 mmol/L vs EV + DNG 0.02 ± 0.20 mmol/L [P = 0.002] vs DNG 0.02 ± 0.18 mmol/L [P = 0.002]; triglycerides: EE + DNG 0.45 ± 0.21 mmol/L vs EV + DNG 0.18 ± 0.36 mmol/L [P = 0.003] vs DNG 0.06 ± 0.18 mmol/L [P < 0.001]). CONCLUSIONS EV + DNG and DNG only had a neutral effect on inflammation and lipids, while EE + DNG increased both hs-CRP and PTX-3 levels as well as triglycerides and HDL. TRIAL REGISTRATION ClinicalTrials.gov NCT02352090.
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Affiliation(s)
- Marika H Kangasniemi
- Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Annina Haverinen
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Kaisu Luiro
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - J Kalervo Hiltunen
- Faculty of Biochemistry and Molecular Medicine, University of Oulu, Oulu, Finland
| | - Elina K Komsi
- Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Riikka K Arffman
- Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Oskari Heikinheimo
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Juha S Tapanainen
- Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Terhi T Piltonen
- Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
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Krysa JA, Vine DF, Beilin LJ, Burrows S, Huang RC, Mori TA, Proctor SD. ApoB48-remnant lipoproteins are associated with increased cardiometabolic risk in adolescents. Atherosclerosis 2020; 302:20-26. [DOI: 10.1016/j.atherosclerosis.2020.04.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 04/15/2020] [Accepted: 04/29/2020] [Indexed: 12/24/2022]
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Swanepoel AC, Bester J, Emmerson O, Soma P, Beukes D, van Reenen M, Loots DT, du Preez I. Serum Metabolome Changes in Relation to Prothrombotic State Induced by Combined Oral Contraceptives with Drospirenone and Ethinylestradiol. OMICS-A JOURNAL OF INTEGRATIVE BIOLOGY 2020; 24:404-414. [PMID: 32471328 DOI: 10.1089/omi.2020.0009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The association between hypercoagulability and use of drospirenone (DRSP) and ethinylestradiol (EE) containing combined oral contraceptives (COCs) is an important clinical concern. We have previously reported that the two formulations of DRSP combined with EE (namely, DRSP/20EE and DRSP/30EE) bring about a prothrombotic state in hemostatic traits of female users. We report here the serum metabolomic changes in the same study cohort in relation to the attendant prothrombotic state induced by COC use, thus offering new insights on the underlying biochemical mechanisms contributing to the altered coagulatory profile with COC use. A total of 78 healthy women participated in this study and were grouped as follows: control group not using oral contraceptives (n = 25), DRSP/20EE group (n = 27), and DRSP/30EE group (n = 26). Untargeted metabolomics revealed changes in amino acid concentrations, particularly a decrease in glycine and an increase in both cysteine and lanthionine in the serum, accompanied by variations in oxidative stress markers in the COC users compared with the controls. Of importance, this study is the first to link specific amino acid variations, serum metabolites, and the oxidative metabolic profile with DRSP/EE use. These molecular changes could be linked to specific biophysical coagulatory alterations observed in the same individuals. These new findings lend evidence on the metabolomic substrates of the prothrombotic state associated with COC use in women and informs future personalized/precision medicine research. Moreover, we underscore the importance of an interdisciplinary approach to evaluate venous thrombotic risk associated with COC use.
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Affiliation(s)
- Albe Carina Swanepoel
- Department of Physiology and Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Janette Bester
- Department of Physiology and Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Odette Emmerson
- Department of Physiology and Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Prashilla Soma
- Department of Anatomy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Derylize Beukes
- Human Metabolomics, North-West University, Potchefstroom, South Africa
| | - Mari van Reenen
- Human Metabolomics, North-West University, Potchefstroom, South Africa
| | - Du Toit Loots
- Human Metabolomics, North-West University, Potchefstroom, South Africa
| | - Ilse du Preez
- Human Metabolomics, North-West University, Potchefstroom, South Africa
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Beneficial and Deleterious Effects of Female Sex Hormones, Oral Contraceptives, and Phytoestrogens by Immunomodulation on the Liver. Int J Mol Sci 2019; 20:ijms20194694. [PMID: 31546715 PMCID: PMC6801544 DOI: 10.3390/ijms20194694] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/13/2019] [Accepted: 09/20/2019] [Indexed: 12/11/2022] Open
Abstract
The liver is considered the laboratory of the human body because of its many metabolic processes. It accomplishes diverse activities as a mixed gland and is in continuous cross-talk with the endocrine system. Not only do hormones from the gastrointestinal tract that participate in digestion regulate the liver functions, but the sex hormones also exert a strong influence on this sexually dimorphic organ, via their receptors expressed in liver, in both health and disease. Besides, the liver modifies the actions of sex hormones through their metabolism and transport proteins. Given the anatomical position and physiological importance of liver, this organ is evidenced as an immune vigilante that mediates the systemic immune response, and, in turn, the immune system regulates the hepatic functions. Such feedback is performed by cytokines. Pro-inflammatory and anti-inflammatory cytokines are strongly involved in hepatic homeostasis and in pathological states; indeed, female sex hormones, oral contraceptives, and phytoestrogens have immunomodulatory effects in the liver and the whole organism. To analyze the complex and interesting beneficial or deleterious effects of these drugs by their immunomodulatory actions in the liver can provide the basis for either their pharmacological use in therapeutic treatments or to avoid their intake in some diseases.
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Taylor K, Ferreira DLS, West J, Yang T, Caputo M, Lawlor DA. Differences in Pregnancy Metabolic Profiles and Their Determinants between White European and South Asian Women: Findings from the Born in Bradford Cohort. Metabolites 2019; 9:metabo9090190. [PMID: 31540515 PMCID: PMC6780545 DOI: 10.3390/metabo9090190] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 09/16/2019] [Accepted: 09/17/2019] [Indexed: 12/12/2022] Open
Abstract
There is widespread metabolic disruption in women upon becoming pregnant. South Asians (SA) compared to White Europeans (WE) have more fat mass and are more insulin-resistant at a given body mass index (BMI). Whether these are reflected in other gestational metabolomic differences is unclear. Our aim was to compare gestational metabolic profiles and their determinants between WE and SA women. We used data from a United Kingdom (UK) cohort to compare metabolic profiles and associations of maternal age, education, parity, height, BMI, tricep skinfold thickness, gestational diabetes (GD), pre-eclampsia, and gestational hypertension with 156 metabolic measurements in WE (n = 4072) and SA (n = 4702) women. Metabolic profiles, measured in fasting serum taken between 26–28 weeks gestation, were quantified by nuclear magnetic resonance. Distributions of most metabolic measures differed by ethnicity. WE women had higher levels of most lipoprotein subclasses, cholesterol, glycerides and phospholipids, monosaturated fatty acids, and creatinine but lower levels of glucose, linoleic acid, omega-6 and polyunsaturated fatty acids, and most amino acids. Higher BMI and having GD were associated with higher levels of several lipoprotein subclasses, triglycerides, and other metabolites, mostly with stronger associations in WEs. We have shown differences in gestational metabolic profiles between WE and SA women and demonstrated that associations of exposures with these metabolites differ by ethnicity.
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Affiliation(s)
- Kurt Taylor
- Population Health Science, Bristol Medical School, Bristol BS8 2BN, UK.
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol BS8 2PS, UK.
| | - Diana L Santos Ferreira
- Population Health Science, Bristol Medical School, Bristol BS8 2BN, UK.
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol BS8 2PS, UK.
| | - Jane West
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford BD9 6RJ, UK.
| | - Tiffany Yang
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford BD9 6RJ, UK.
| | - Massimo Caputo
- Translational Science, Bristol Medical School, Bristol BS2 8DZ, UK.
- Bristol NIHR Biomedical Research Center, Bristol BS1 2NT, UK.
| | - Deborah A Lawlor
- Population Health Science, Bristol Medical School, Bristol BS8 2BN, UK.
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol BS8 2PS, UK.
- Bristol NIHR Biomedical Research Center, Bristol BS1 2NT, UK.
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Yu B, Zanetti KA, Temprosa M, Albanes D, Appel N, Barrera CB, Ben-Shlomo Y, Boerwinkle E, Casas JP, Clish C, Dale C, Dehghan A, Derkach A, Eliassen AH, Elliott P, Fahy E, Gieger C, Gunter MJ, Harada S, Harris T, Herr DR, Herrington D, Hirschhorn JN, Hoover E, Hsing AW, Johansson M, Kelly RS, Khoo CM, Kivimäki M, Kristal BS, Langenberg C, Lasky-Su J, Lawlor DA, Lotta LA, Mangino M, Le Marchand L, Mathé E, Matthews CE, Menni C, Mucci LA, Murphy R, Oresic M, Orwoll E, Ose J, Pereira AC, Playdon MC, Poston L, Price J, Qi Q, Rexrode K, Risch A, Sampson J, Seow WJ, Sesso HD, Shah SH, Shu XO, Smith GCS, Sovio U, Stevens VL, Stolzenberg-Solomon R, Takebayashi T, Tillin T, Travis R, Tzoulaki I, Ulrich CM, Vasan RS, Verma M, Wang Y, Wareham NJ, Wong A, Younes N, Zhao H, Zheng W, Moore SC. The Consortium of Metabolomics Studies (COMETS): Metabolomics in 47 Prospective Cohort Studies. Am J Epidemiol 2019; 188:991-1012. [PMID: 31155658 PMCID: PMC6545286 DOI: 10.1093/aje/kwz028] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 01/29/2019] [Accepted: 01/29/2019] [Indexed: 12/11/2022] Open
Abstract
The Consortium of Metabolomics Studies (COMETS) was established in 2014 to facilitate large-scale collaborative research on the human metabolome and its relationship with disease etiology, diagnosis, and prognosis. COMETS comprises 47 cohorts from Asia, Europe, North America, and South America that together include more than 136,000 participants with blood metabolomics data on samples collected from 1985 to 2017. Metabolomics data were provided by 17 different platforms, with the most frequently used labs being Metabolon, Inc. (14 cohorts), the Broad Institute (15 cohorts), and Nightingale Health (11 cohorts). Participants have been followed for a median of 23 years for health outcomes including death, cancer, cardiovascular disease, diabetes, and others; many of the studies are ongoing. Available exposure-related data include common clinical measurements and behavioral factors, as well as genome-wide genotype data. Two feasibility studies were conducted to evaluate the comparability of metabolomics platforms used by COMETS cohorts. The first study showed that the overlap between any 2 different laboratories ranged from 6 to 121 metabolites at 5 leading laboratories. The second study showed that the median Spearman correlation comparing 111 overlapping metabolites captured by Metabolon and the Broad Institute was 0.79 (interquartile range, 0.56-0.89).
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Affiliation(s)
- Bing Yu
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas
| | - Krista A Zanetti
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland
| | - Marinella Temprosa
- Department of Epidemiology and Biostatistics Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Nathan Appel
- Information Management Services, Inc., Rockville, Maryland
| | - Clara Barrios Barrera
- Department of Nephrology, Hospital del Mar, Institut Mar d´Investigacions Mediques, Barcelona, Spain
| | - Yoav Ben-Shlomo
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Eric Boerwinkle
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas
| | - Juan P Casas
- Institute of Health Informatics Research, UCL Institute of Health Informatics, University College London, London, United Kingdom
| | - Clary Clish
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts
| | - Caroline Dale
- Institute of Health Informatics Research, UCL Institute of Health Informatics, University College London, London, United Kingdom
| | - Abbas Dehghan
- Medical Research Council–Public Health England Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Andriy Derkach
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston Massachusetts
| | - Paul Elliott
- Medical Research Council–Public Health England Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- National Institute for Health Research, Imperial College Biomedical Research Center, London, United Kingdom
- Health Data Research UK Center at Imperial College London, London, United Kingdom
| | - Eoin Fahy
- Department of Bioengineering, School of Engineering, University of California, San Diego, La Jolla, California
| | - Christian Gieger
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research
| | - Marc J Gunter
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
| | - Sei Harada
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
- Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan
| | - Tamara Harris
- Laboratory of Epidemiology and Population Science Laboratory
| | - Deron R Herr
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Biology, San Diego State University, San Diego, California
| | - David Herrington
- Department of Internal Medicine, Division of Cardiology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Joel N Hirschhorn
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts
- Division of Endocrinology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Genetics, Harvard Medical School, Boston, Massachusetts
| | - Elise Hoover
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland
| | - Ann W Hsing
- Stanford Prevention Research Center, Stanford Cancer Institute, Stanford, California
| | | | - Rachel S Kelly
- Systems Genetics and Genomics Unit, Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Chin Meng Khoo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Medicine, National University Health System, Singapore
- Duke–National University of Singapore Graduate Medical School, Singapore
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Bruce S Kristal
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Claudia Langenberg
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Jessica Lasky-Su
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Deborah A Lawlor
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
| | - Luca A Lotta
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Massimo Mangino
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, United Kingdom
| | - Loïc Le Marchand
- University of Hawaii Cancer Center, Epidemiology Program, Honolulu, Hawaii
| | - Ewy Mathé
- Department of Biomedical Informatics, College of Medicine, Ohio State University, Columbus, Ohio
| | - Charles E Matthews
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Cristina Menni
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, United Kingdom
| | - Lorelei A Mucci
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston Massachusetts
| | - Rachel Murphy
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Matej Oresic
- Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, Turku, Finland
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Eric Orwoll
- Department of Medicine, Oregon Health and Science University, Portland, Oregon
| | - Jennifer Ose
- Division of Cancer Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Alexandre C Pereira
- Instituto de Pesquisas Rene Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil
| | - Mary C Playdon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
- Division of Cancer Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Lucilla Poston
- Department of Women and Children’s Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King’s College London, St. Thomas’ Hospital, London, United Kingdom
| | - Jackie Price
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Qibin Qi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Kathryn Rexrode
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Women’s Health, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Adam Risch
- Information Management Services, Inc., Rockville, Maryland
| | - Joshua Sampson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Wei Jie Seow
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Howard D Sesso
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston Massachusetts
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Svati H Shah
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina
- Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
- Duke Clinical Research Institute, Durham, North Carolina
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Gordon C S Smith
- Department of Obstetrics and Gynaecology, National Institute for Health Research, Cambridge Comprehensive Biomedical Research Center, University of Cambridge, Cambridge, United Kingdom
| | - Ulla Sovio
- Center for Trophoblast Research, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, United Kingdom
| | - Victoria L Stevens
- Department of Obstetrics and Gynaecology, University of Cambridge, National Institute for Health Research Cambridge Comprehensive Biomedical Research Centre, Cambridge, United Kingdom
| | | | - Toru Takebayashi
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
- Epidemiology Research Program, American Cancer Society, Atlanta, Georgia
| | - Therese Tillin
- Institute of Cardiovascular Sciences, University College London, London, United Kingdom
| | - Ruth Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Ioanna Tzoulaki
- Medical Research Council–Public Health England Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Cornelia M Ulrich
- Division of Cancer Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Ramachandran S Vasan
- Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
- Section of Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
- Framingham Heart Study, Framingham, Massachusetts
| | - Mukesh Verma
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland
| | - Ying Wang
- Department of Obstetrics and Gynaecology, University of Cambridge, National Institute for Health Research Cambridge Comprehensive Biomedical Research Centre, Cambridge, United Kingdom
| | - Nick J Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at University College London, London, United Kingdom
| | - Naji Younes
- Department of Epidemiology and Biostatistics Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Hua Zhao
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Steven C Moore
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
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Mills HL, Patel N, White SL, Pasupathy D, Briley AL, Santos Ferreira DL, Seed PT, Nelson SM, Sattar N, Tilling K, Poston L, Lawlor DA. The effect of a lifestyle intervention in obese pregnant women on gestational metabolic profiles: findings from the UK Pregnancies Better Eating and Activity Trial (UPBEAT) randomised controlled trial. BMC Med 2019; 17:15. [PMID: 30661507 PMCID: PMC6340185 DOI: 10.1186/s12916-018-1248-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 12/21/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Pregnancy is associated with widespread change in metabolism, which may be more marked in obese women. Whether lifestyle interventions in obese pregnant women improve pregnancy metabolic profiles remains unknown. Our objectives were to determine the magnitude of change in metabolic measures during obese pregnancy, to indirectly compare these to similar profiles in a general pregnant population, and to determine the impact of a lifestyle intervention on change in metabolic measures in obese pregnant women. METHODS Data from a randomised controlled trial of 1158 obese (BMI ≥ 30 kg/m2) pregnant women recruited from six UK inner-city obstetric departments were used. Women were randomised to either the UPBEAT intervention, a tailored complex lifestyle intervention focused on improving diet and physical activity, or standard antenatal care (control group). UPBEAT has been shown to improve diet and physical activity during pregnancy and up to 6-months postnatally in obese women and to reduce offspring adiposity at 6-months; it did not affect risk of gestational diabetes (the primary outcome). Change in the concentrations of 158 metabolic measures (129 lipids, 9 glycerides and phospholipids, and 20 low-molecular weight metabolites), quantified three times during pregnancy, were compared using multilevel models. The role of chance was assessed with a false discovery rate of 5% adjusted p values. RESULTS All very low-density lipoprotein (VLDL) particles increased by 1.5-3 standard deviation units (SD) whereas intermediate density lipoprotein and specific (large, medium and small) LDL particles increased by 1-2 SD, between 16 and 36 weeks' gestation. Triglycerides increased by 2-3 SD, with more modest changes in other metabolites. Indirect comparisons suggest that the magnitudes of change across pregnancy in these obese women were 2- to 3-fold larger than in unselected women (n = 4260 in cross-sectional and 583 in longitudinal analyses) from an independent, previously published, study. The intervention reduced the rate of increase in extremely large, very large, large and medium VLDL particles, particularly those containing triglycerides. CONCLUSION There are marked changes in lipids and lipoproteins and more modest changes in other metabolites across pregnancy in obese women, with some evidence that this is more marked than in unselected pregnant women. The UPBEAT lifestyle intervention may contribute to a healthier metabolic profile in obese pregnant women, but our results require replication. TRIAL REGISTRATION UPBEAT was registered with Current Controlled Trials, ISRCTN89971375 , on July 23, 2008 (prior to recruitment).
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Affiliation(s)
- Harriet L Mills
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.,Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nashita Patel
- Division of Women's Health, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Sara L White
- Division of Women's Health, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Dharmintra Pasupathy
- Division of Women's Health, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Annette L Briley
- Division of Women's Health, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Diana L Santos Ferreira
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.,Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Paul T Seed
- Division of Women's Health, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | | | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Kate Tilling
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.,Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK.,NIHR Bristol Biomedical Research Centre, Bristol, UK
| | - Lucilla Poston
- Division of Women's Health, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK. .,Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK. .,NIHR Bristol Biomedical Research Centre, Bristol, UK.
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43
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Palaniswamy S, Piltonen T, Koiranen M, Mazej D, Järvelin MR, Abass K, Rautio A, Sebert S. The association between blood copper concentration and biomarkers related to cardiovascular disease risk - analysis of 206 individuals in the Northern Finland Birth Cohort 1966. J Trace Elem Med Biol 2019; 51:12-18. [PMID: 30466920 DOI: 10.1016/j.jtemb.2018.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 09/04/2018] [Accepted: 09/05/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Copper is an abundant trace element in humans where alterations in the circulating concentration could inform on chronic disease aetiology. To date, data are lacking to study how copper may associate with cardiovascular disease (CVD) risk factors in young and healthy population. Molecular evidence suggests an important role of copper in liver metabolism, an essential organ in maintaining cardiovascular health and inflammation, therefore supporting copper as an associated biomarker of the risk. OBJECTIVE We performed a cross-sectional analysis to examine the possible associations between blood copper levels and risk factors for CVD and pre-inflammatory process. DESIGN The data has been collected from a sub-sample set of the Northern Finland Birth Cohort 1966 (NFBC1966) at 31 years. PARTICIPANTS The study included 206 individuals, 116 men and 90 women. To reduce environmental individual variations affecting both copper and the metabolic profile in the study sample, the participants were selected as: i) being born in Finnish Lapland and ii) living in their birth place for the last five years preceding blood sampling. MAIN OUTCOME MEASURES Fasting blood copper concentration was measured by inductively coupled plasma mass spectrometer. The CVD risk factors included 6 metabolic clusters (30 cardiovascular and pro-inflammatory factors) assessed by nuclear magnetic resonance. Multivariate linear regression analysis was performed to test the linear association between blood copper and 6 metabolic clusters for CVD risk. Associations were assessed under correction for multiple testing. RESULTS Copper (Cu) levels were comparable in men and women, with no difference between sexes (p-value <0.60). In multiple regression models, sex adjusted, copper was associated with 9 metabolites from 4 metabolic clusters. After adjustment with BMI, copper was associated with 4 metabolites from 3 metabolic clusters: glutamine, beta-hydroxybutyrate, alpha-1-acid glycoprotein (AGP) and high-sensitive C-reactive protein (hs-CRP). After correction for multiple testing, Cu was found positively associated with only 2 biomarkers of inflammation including AGP [p = 0.04] and hs-CRP [p = 0.0001]. CONCLUSIONS Considering the strength and limitation of the study design, the present study does not support evidence for an independent role of copper on biomarkers for CVD risk. Nevertheless, we are reporting a robust association of copper with the inflammatory load that is important to consider in light with the inflammatory component of chronic health. In addition, the association of copper with metabolites may be attributable to BMI or environmental factors associated to it, and warrants further research in large population samples.
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Affiliation(s)
- Saranya Palaniswamy
- Center For Life Course Health Research, Faculty of Medicine, University of Oulu, FI-90014, Oulu, Finland; Biocenter Oulu, University of Oulu, FI-90014, Oulu, Finland.
| | - Terhi Piltonen
- Department of Obstetrics and Gynecology, Oulu University Hospital, University of Oulu and PEDEGO Research Unit, P.O. Box 23, FI-90029, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 8000, FI-90014, Oulu, Finland
| | - Markku Koiranen
- Center For Life Course Health Research, Faculty of Medicine, University of Oulu, FI-90014, Oulu, Finland
| | - Darja Mazej
- Department of Environmental Sciences, Jozef Stefan Institute, Jamova cesta 39, 1000, Ljubljana, Slovenia
| | - Marjo-Riitta Järvelin
- Center For Life Course Health Research, Faculty of Medicine, University of Oulu, FI-90014, Oulu, Finland; Biocenter Oulu, University of Oulu, FI-90014, Oulu, Finland; Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, SW7 2AZ, United Kingdom; Oulu University Hospital, Unit of Primary Care, FI-90014, Oulu, Finland; Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Kingston Lane, Uxbridge, Middlesex UB8 3PH, United Kingdom
| | - Khaled Abass
- Arctic Health, Faculty of Medicine, University of Oulu, FI-90014, Oulu, Finland
| | - Arja Rautio
- Arctic Health, Faculty of Medicine, University of Oulu, FI-90014, Oulu, Finland.
| | - Sylvain Sebert
- Center For Life Course Health Research, Faculty of Medicine, University of Oulu, FI-90014, Oulu, Finland; Biocenter Oulu, University of Oulu, FI-90014, Oulu, Finland; Department of Genomics of Complex Diseases, School of Public Health, Imperial College London, London, SW7 2AZ, United Kingdom.
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Lambert M, Begon E, Hocké C. [Contraception for women after 40: CNGOF Contraception Guidelines]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2018; 46:865-872. [PMID: 30424983 DOI: 10.1016/j.gofs.2018.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Choosing contraception for women over 40 can be sometimes difficult but it is crucial since fertility and pregnancy's risks still exist. It requires a thorough evaluation of the situation, in order to identify any vascular and metabolic risk factors, along with the uterine and mammary benign pathologies already diagnosed. OBJECTIVE The objective of this review was to elaborate some guidelines for clinical practice regarding contraception's prescription for women over 40. METHODS A systematic review of the French and English existing literature was conducted. Pubmed and the Cochrane library were used to identify studies about contraception for perimenopausal women. International guidelines published by scientific societies were also reviewed (RCOG, FSRH, ESHRE, ACOG, WHO, HAS). RESULTS No contraceptive methods are contraindicated on the sole basis of age alone. However, because age is a risk factor for vascular and metabolic diseases, combined hormonal contraception and DMPA should not be prescribed at first intention. Copper IUD and progestin-only contraceptives (pill, implant, intrauterine device) should primarily be considered, since they offer good efficacy with lower risks. CONCLUSIONS Contraception for women over 40 should not be put aside. Long acting reversible contraception and progestin-only pill have to be prescribed as first-ine. Contraception is no longer needed for women over 50 who use non-hormonal contraception, after a 12 month-amenorrhea. Patients treated with combined hormonal contraception must stop using it over 50. Measuring hormonal levels while using hormonal contraception is not recommended. An hormonal-contraception-free interval must be considered, while using barrier contraception method. If an ovarian activity persists, a non-hormonal contraception or progestin-only contraception (except for DMPA) should be (re-)established.
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Affiliation(s)
- M Lambert
- Service de gynécologie et de médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie Raba-Léon, 33076 Bordeaux cedex, France.
| | - E Begon
- Service de gynécologie et de médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie Raba-Léon, 33076 Bordeaux cedex, France
| | - C Hocké
- Service de gynécologie et de médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie Raba-Léon, 33076 Bordeaux cedex, France
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46
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Rush EL, Singer AB, Longnecker MP, Haug LS, Sabaredzovic A, Symanski E, Whitworth KW. Oral contraceptive use as a determinant of plasma concentrations of perfluoroalkyl substances among women in the Norwegian Mother and Child Cohort (MoBa) study. ENVIRONMENT INTERNATIONAL 2018; 112:156-164. [PMID: 29274593 PMCID: PMC5899038 DOI: 10.1016/j.envint.2017.12.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 12/08/2017] [Accepted: 12/11/2017] [Indexed: 05/25/2023]
Abstract
OBJECTIVE Because oral contraceptives (OC) tends to lessen menstrual fluid loss - a route of excretion for perfluoroalkyl substances (PFASs) - we hypothesized that such use would be positively associated with PFAS concentrations. METHODS This analysis was based on the Norwegian Mother and Child Cohort (MoBa) study. We included 1090 women from two previous substudies of women enrolled from 2003 to 2007. Characteristics of OC use were obtained at baseline: use in the past 12months, duration and recency of use, age at first use. We examined log-transformed plasma concentrations of seven PFASs (perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluoroundecanoic acid (PFUnDA), perfluorohexane sulfonate (PFHxS), perfluoroheptane sulfonate (PFHpS), and perfluorooctane sulfonate (PFOS)). Linear regression analyses, adjusted for maternal age, menstrual cycle length, parity, and education, were used to examine whether OC use characteristics were determinants of PFAS concentrations. RESULTS Except for PFDA and PFUnDA, women who used OCs in the 12months preceding the baseline interview had 12.9-35.7% higher PFAS concentrations than never OC users. To a lesser extent, past OC use was positively associated with PFASs (estimates ranged from 7.2-32.1%). Compared with never users, using OCs for 10 or more years was associated with increased PFAS concentrations, except for PFDA and PFUnDA (estimates for other PFASs ranged from 18.9-46.2%). We observed little effect of age at first OC use. CONCLUSIONS This analysis shows that characteristics of OC use, and duration of use in particular, may be important considerations when investigating relationships between women's reproductive outcomes and PFASs.
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Affiliation(s)
- Elise L Rush
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, School of Public Health in San Antonio, San Antonio, TX, USA
| | - Alison B Singer
- The Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Matthew P Longnecker
- National Institute for Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Durham, NC, USA
| | - Line S Haug
- Department of Exposure Assessment and Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Azemira Sabaredzovic
- Department of Exposure Assessment and Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Elaine Symanski
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA; Southwest Center for Occupational and Environmental Health, The University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA
| | - Kristina W Whitworth
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, School of Public Health in San Antonio, San Antonio, TX, USA; Southwest Center for Occupational and Environmental Health, The University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA.
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Wang Q, Ferreira DLS, Nelson SM, Sattar N, Ala-Korpela M, Lawlor DA. Metabolic characterization of menopause: cross-sectional and longitudinal evidence. BMC Med 2018; 16:17. [PMID: 29402284 PMCID: PMC5800033 DOI: 10.1186/s12916-018-1008-8] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 01/17/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Women who experience menopause are at higher cardiometabolic risk and often display adverse changes in metabolic biomarkers compared with pre-menopausal women. It remains elusive whether the changes in cardiometabolic biomarkers during the menopausal transition are due to ovarian aging or chronological aging. Well-conducted longitudinal studies are required to determine this. The aim of this study was to explore the cross-sectional and longitudinal associations of reproductive status, defined according to the 2012 Stages of Reproductive Aging Workshop criteria, with 74 metabolic biomarkers, and establish whether any associations are independent of age-related changes. METHODS We determined cross-sectional associations of reproductive status with metabolic profiling in 3,312 UK midlife women. In a subgroup of 1,492 women who had repeat assessments after 2.5 years, we assessed how the change in reproductive status was associated with the changes in metabolic biomarkers. Metabolic profiles were measured by high-throughput quantitative nuclear magnetic resonance metabolomics. In longitudinal analyses, we compared the change in metabolic biomarkers for each reproductive-status category change to that of the reference of being pre-menopausal at both time points. As all women aged by a similar amount during follow-up, these analyses contribute to distinguishing age-related changes from those related to change in reproductive status. RESULTS Consistent cross-sectional and longitudinal associations of menopause with a wide range of metabolic biomarkers were observed, suggesting the transition to menopause induces multiple metabolic changes independent of chronological aging. The metabolic changes included increased concentrations of very small very low-density lipoproteins, intermediate-density lipoproteins, low-density lipoproteins (LDLs), remnant, and LDL cholesterol, and reduced LDL particle size, all toward an atherogenic lipoprotein profile. Increased inflammation was suggested via an inflammatory biomarker, glycoprotein acetyls, but not via C-reactive protein. Also, levels of glutamine and albumin increased during the transition. Most of these metabolic changes seen at the time of becoming post-menopausal remained or became slightly stronger during the post-menopausal years. CONCLUSIONS The transition to post-menopause has effects on multiple circulating metabolic biomarkers, over and above the underlying age trajectory. The adverse changes in multiple apolipoprotein-B-containing lipoprotein subclasses and increased inflammation may underlie women's increased cardiometabolic risk in their post-menopausal years.
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Affiliation(s)
- Qin Wang
- Computational Medicine, Faculty of Medicine, University of Oulu and Biocenter Oulu, Oulu, Finland
| | - Diana L. Santos Ferreira
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Mika Ala-Korpela
- Computational Medicine, Faculty of Medicine, University of Oulu and Biocenter Oulu, Oulu, Finland
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
- NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland
- Systems Epidemiology, Baker Heart and Diabetes Institute, Melbourne, VIC Australia
- Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, School of Public Health and Preventive Medicine, The Alfred Hospital, Monash University, Melbourne, VIC Australia
| | - Debbie A. Lawlor
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
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Würtz P, Kangas AJ, Soininen P, Lawlor DA, Davey Smith G, Ala-Korpela M. Quantitative Serum Nuclear Magnetic Resonance Metabolomics in Large-Scale Epidemiology: A Primer on -Omic Technologies. Am J Epidemiol 2017; 186:1084-1096. [PMID: 29106475 PMCID: PMC5860146 DOI: 10.1093/aje/kwx016] [Citation(s) in RCA: 313] [Impact Index Per Article: 44.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Accepted: 01/19/2017] [Indexed: 12/13/2022] Open
Abstract
Detailed metabolic profiling in large-scale epidemiologic studies has uncovered novel biomarkers for cardiometabolic diseases and clarified the molecular associations of established risk factors. A quantitative metabolomics platform based on nuclear magnetic resonance spectroscopy has found widespread use, already profiling over 400,000 blood samples. Over 200 metabolic measures are quantified per sample; in addition to many biomarkers routinely used in epidemiology, the method simultaneously provides fine-grained lipoprotein subclass profiling and quantification of circulating fatty acids, amino acids, gluconeogenesis-related metabolites, and many other molecules from multiple metabolic pathways. Here we focus on applications of magnetic resonance metabolomics for quantifying circulating biomarkers in large-scale epidemiology. We highlight the molecular characterization of risk factors, use of Mendelian randomization, and the key issues of study design and analyses of metabolic profiling for epidemiology. We also detail how integration of metabolic profiling data with genetics can enhance drug development. We discuss why quantitative metabolic profiling is becoming widespread in epidemiology and biobanking. Although large-scale applications of metabolic profiling are still novel, it seems likely that comprehensive biomarker data will contribute to etiologic understanding of various diseases and abilities to predict disease risks, with the potential to translate into multiple clinical settings.
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Affiliation(s)
- Peter Würtz
- Correspondence to Dr. Peter Würtz, Computational Medicine, Faculty of Medicine, Aapistie 5A, P.O. Box 5000, FI-90014 University of Oulu, Finland (e-mail: ); or Dr. Mika Ala-Korpela, Computational Medicine, Faculty of Medicine, Aapistie 5A, P.O. Box 5000, FI-90014 University of Oulu, Finland (e-mail: )
| | | | | | | | | | - Mika Ala-Korpela
- Correspondence to Dr. Peter Würtz, Computational Medicine, Faculty of Medicine, Aapistie 5A, P.O. Box 5000, FI-90014 University of Oulu, Finland (e-mail: ); or Dr. Mika Ala-Korpela, Computational Medicine, Faculty of Medicine, Aapistie 5A, P.O. Box 5000, FI-90014 University of Oulu, Finland (e-mail: )
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Santalahti K, Havulinna A, Maksimow M, Zeller T, Blankenberg S, Vehtari A, Joensuu H, Jalkanen S, Salomaa V, Salmi M. Plasma levels of hepatocyte growth factor and placental growth factor predict mortality in a general population: a prospective cohort study. J Intern Med 2017; 282:340-352. [PMID: 28682476 DOI: 10.1111/joim.12648] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Circulating levels of growth factors involved in leucocyte production and angiogenesis could be indicative of underlying aberrations of tissue homeostasis and therefore be utilized as predictors of risk for all-cause cardiovascular disease (CVD) or cancer mortality. METHODS Baseline plasma levels of a range of growth factors were measured in two cohorts of the population-based FINRISK study (1997 Discovery cohort, N = 8444, aged 25-74; 2002 Replication cohort, N = 2951, aged 51-74 years) using a multiplexed bead array methodology and ELISA. Participants were followed up by linking them to registry data. RESULTS In the Discovery cohort (653 deaths; 216 CVD-related, 231 cancer-related), fully adjusted Cox proportional hazard regression models showed that increased plasma hepatocyte growth factor (HGF) and placental growth factor (PlGF) were associated with higher risk of 10-year mortality (HR, 1.29 [95% confidence interval (CI), 1.18-1.41] and HR, 1.23 [95% CI, 1.14-1.32], respectively). In the Replication cohort (259 deaths; 83 CVD-related, 90 cancer-related), baseline HGF levels also predicted all-cause mortality (HR, 1.2 [95% CI, 1.08-1.32]; PlGF data not available). By including HGF levels in a CVD mortality model, 9% of all CVD deaths were correctly reclassified in the Discovery cohort (categorical net reclassification improvement [NRI] for events, P = 4.0 × 10-4 ). Moreover, adding HGF to all-cause and CVD mortality models resulted in an overall clinical NRI of 0.10-0.18 in the Discovery cohort and meta-analyses (P < 0.05 for all tests). CONCLUSION Blood levels of HGF and PlGF may serve as new biomarkers for predicting increased risk of death in the general population.
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Affiliation(s)
- K Santalahti
- MediCity Research Laboratory, University of Turku, Turku, Finland.,Department of Medical Microbiology and Immunology, University of Turku, Turku, Finland
| | - A Havulinna
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - M Maksimow
- MediCity Research Laboratory, University of Turku, Turku, Finland.,Department of Medical Microbiology and Immunology, University of Turku, Turku, Finland
| | - T Zeller
- Clinic for General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.,German Center for Cardiovascular Research (DZHK eV), Partner Site Hamburg/Lübeck/Kiel/Hamburg, Germany
| | - S Blankenberg
- Clinic for General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.,German Center for Cardiovascular Research (DZHK eV), Partner Site Hamburg/Lübeck/Kiel/Hamburg, Germany
| | - A Vehtari
- Department of Biomedical Engineering and Computational Science, Aalto University, Espoo, Finland
| | - H Joensuu
- Department of Oncology, Helsinki University Hospital, Helsinki, Finland.,University of Helsinki, Helsinki, Finland
| | - S Jalkanen
- MediCity Research Laboratory, University of Turku, Turku, Finland.,Department of Medical Microbiology and Immunology, University of Turku, Turku, Finland
| | - V Salomaa
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - M Salmi
- MediCity Research Laboratory, University of Turku, Turku, Finland.,Department of Medical Microbiology and Immunology, University of Turku, Turku, Finland
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Christensen JJ, Ulven SM, Retterstøl K, Narverud I, Bogsrud MP, Henriksen T, Bollerslev J, Halvorsen B, Aukrust P, Holven KB. Comprehensive lipid and metabolite profiling of children with and without familial hypercholesterolemia: A cross-sectional study. Atherosclerosis 2017; 266:48-57. [PMID: 28963918 DOI: 10.1016/j.atherosclerosis.2017.09.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 09/01/2017] [Accepted: 09/19/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIMS Individuals with familial hypercholesterolemia (FH) have elevated low-density lipoprotein cholesterol (LDL-C), accelerated atherosclerosis, and premature cardiovascular disease. Whereas children with lifestyle-induced dyslipidemias often present with complex lipid abnormalities, children with FH have isolated hypercholesterolemia. However, to the best of our knowledge, a comprehensive profiling of FH children is lacking. Therefore, we aimed to characterize the lipid-related and metabolic alterations associated with elevated LDL-C in children with FH and healthy children. METHODS We measured plasma metabolites in children with FH (n = 47) and in healthy children (n = 57) using a high-throughput nuclear magnetic resonance (NMR) spectroscopy platform, and compared the differences between FH and healthy children. RESULTS Both statin treated (n = 17) and non-statin treated FH children (n = 30) had higher levels of atherogenic ApoB-containing lipoproteins and lipids, and lipid fractions in lipoprotein subclasses, compared to healthy children (n = 57). FH children displayed alterations in HDL particle concentration and lipid content, compared with healthy children. Interestingly, the small HDL particles were characterized by higher content of cholesteryl esters, and lower levels of free cholesterol and phospholipids. Furthermore, plasma fatty acids were higher in non-statin treated FH children, particularly linoleic acid. Finally, acetoacetate and acetate were lower in FH children compared with healthy children. CONCLUSIONS Hypercholesterolemia in children associates with diverse metabolic repercussions and is more complex than previously believed. In particular, we found that hypercholesterolemia in FH children was paralleled not only by increased atherogenic ApoB-containing lipoproteins and lipid fractions, but also alterations in HDL subfractions that suggest impaired reverse cholesterol transport.
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Affiliation(s)
- Jacob J Christensen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O box 1046 Blindern, 0317 Oslo, Oslo, Norway; The Lipid Clinic, Oslo University Hospital Rikshospitalet, P.O box 4950 Nydalen, 0424 Oslo, Oslo, Norway
| | - Stine M Ulven
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O box 1046 Blindern, 0317 Oslo, Oslo, Norway
| | - Kjetil Retterstøl
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O box 1046 Blindern, 0317 Oslo, Oslo, Norway; The Lipid Clinic, Oslo University Hospital Rikshospitalet, P.O box 4950 Nydalen, 0424 Oslo, Oslo, Norway
| | - Ingunn Narverud
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O box 1046 Blindern, 0317 Oslo, Oslo, Norway; Norwegian National Advisory Unit on Familial Hypercholesterolemia, Oslo University, Hospital Rikshospitalet, P.O box 4950 Nydalen, 0424 Oslo, Oslo, Norway
| | - Martin P Bogsrud
- The Lipid Clinic, Oslo University Hospital Rikshospitalet, P.O box 4950 Nydalen, 0424 Oslo, Oslo, Norway; Norwegian National Advisory Unit on Familial Hypercholesterolemia, Oslo University, Hospital Rikshospitalet, P.O box 4950 Nydalen, 0424 Oslo, Oslo, Norway
| | - Tore Henriksen
- Department of Obstetrics, Oslo University Hospital Rikshospitalet, P.O box 4950 Nydalen, 0424 Oslo, Oslo, Norway; Faculty of Medicine, University of Oslo, P.O box 1046 Blindern, 0317 Oslo, Oslo, Norway
| | - Jens Bollerslev
- Faculty of Medicine, University of Oslo, P.O box 1046 Blindern, 0317 Oslo, Oslo, Norway; Section of Specialized Endocrinology, Department of Endocrinology, Oslo University Hospital Rikshospitalet, P.O box 4950 Nydalen, 0424 Oslo, Oslo, Norway
| | - Bente Halvorsen
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, P.O box 4950 Nydalen, 0424 Oslo, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, P.O box 1171 Blindern 0318 Oslo, Oslo, Norway; K.G. Jebsen Inflammatory Research Center, P.O box 1171 Blindern 0318 Oslo, Oslo, Norway
| | - Pål Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, P.O box 4950 Nydalen, 0424 Oslo, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, P.O box 1171 Blindern 0318 Oslo, Oslo, Norway; K.G. Jebsen Inflammatory Research Center, P.O box 1171 Blindern 0318 Oslo, Oslo, Norway; Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, P.O box 4950 Nydalen, 0424 Oslo, Oslo, Norway
| | - Kirsten B Holven
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O box 1046 Blindern, 0317 Oslo, Oslo, Norway; Norwegian National Advisory Unit on Familial Hypercholesterolemia, Oslo University, Hospital Rikshospitalet, P.O box 4950 Nydalen, 0424 Oslo, Oslo, Norway.
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