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Hershko Klement A, Asali A, Shalev Ram H, Haikin-Herzberger E, Shlezinger R, Wiser A, Miller N. Cancer-Related Morbidity Among Patients Conceiving Through Oocyte Donation: A Healthcare Registry Cohort Study. J Womens Health (Larchmt) 2024. [PMID: 39177947 DOI: 10.1089/jwh.2024.0248] [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: 08/24/2024] Open
Abstract
Background: Ovarian aging, often leads to increased use of a donor oocyte, which is associated with greater risk for age-related diseases. Objective: To evaluate the association between women conceiving through oocyte donation (OD) and future cancer-related morbidity, as compared with women conceiving through IVF (in vitro fertilization) with autologous oocytes (AO), spontaneous conceptions (SC), and nulliparas. Methods: This retrospective, cohort study was based on the electronic health records of a very large health maintenance organization. The cohort included mothers who delivered before age 45, during 2000-2019. The index date for surveillance was the delivery date of the relevant pregnancy. Each woman from the OD group was matched to a woman the same age at delivery and with the same number of children. Cancer diagnosis was the main outcome. Results: Matching: 664 OD cases to 664 AO, 700 OD cases to 700 SC, and 700 OD cases to 700 nulliparas. Mean follow-up times were 8.9 ± 3.8 OD, 10 ± 4.1 AO, and 6.4 ± 4.1 years SC. Cancer-related morbidity rates were comparable between OD and the other groups, but compared with nulliparas, a trend was noted (1.6% and 3.1%, respectively, p = 0.07). Survival analysis curves were not significantly different, although a trend was shown in the curve comparing to nulliparity (p = 0.07). In a Cox regression model corrected for BMI, smoking and hormone replacement therapy exposure, cancer in the OD group did not differ compared to the other groups. Conclusion: Women conceiving through OD do not have increased risk for cancer-related morbidity in the decade following delivery.
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Affiliation(s)
- Anat Hershko Klement
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Aula Asali
- IVF Unit, Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Hila Shalev Ram
- IVF Unit, Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Einat Haikin-Herzberger
- IVF Unit, Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Roi Shlezinger
- Department of Statistics and Data Science, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Amir Wiser
- IVF Unit, Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Netanella Miller
- IVF Unit, Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Mayanei Hayeshua Medical Center, IVF unit, Bnei Brak, Israel
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Rodriguez de Morales YA, Abramson BL. Cardiovascular and physiological risk factors in women at mid-life and beyond. Can J Physiol Pharmacol 2024; 102:442-451. [PMID: 38739947 DOI: 10.1139/cjpp-2023-0468] [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: 05/16/2024]
Abstract
Cardiovascular disease (CVD) is the leading cause of death in women. After menopause, sex-specific and gender-specific factors may play an important role in increasing CVD risk, with changes in sex hormones, body fat distribution, lipid and metabolic profile, and structural and functional vascular modifications. Premature and early-onset menopause are detrimental to cardiovascular health due to the early cessation of the protective effect of endogenous estrogen. An independent association of menopause with an increased risk of CVD has been documented in early menopause (<45 years). Sex-related differences are relevant in pharmacokinetics and pharmacodynamics; different enzyme formations, drug compatibility, efficacy, and side effects vary for different sexes. Despite some progress in sex and gender research in CVD, disparities remain. Menopausal hormone therapy (MHT) is available at mid-life for symptoms of menopause and may impact cardiovascular risk. Taken early, MHT may reduce CVD morbimortality. However, this is balanced against the risk of increased thrombosis. This paper reviews physiologic changes that contribute to cardiovascular risk in postmenopausal women and discusses clinical implications. Specifically, it explores the atheroprotective effects of estrogen and MHT and the associations between menopause with lipid levels, hypertension, body composition, and diabetes for women at mid-life and beyond.
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Affiliation(s)
- Yenny A Rodriguez de Morales
- Fellow Cardiac Prevention and Ambulatory Care, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Beth L Abramson
- St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
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Bae S, Park SM, Kim SR, Kim MN, Cho DH, Kim HD, Yoon HJ, Kim MA, Kim HL, Hong KS, Shin MS, Jeong JO, Shim WJ. Early menopause is associated with abnormal diastolic function and poor clinical outcomes in women with suspected angina. Sci Rep 2024; 14:6306. [PMID: 38491090 PMCID: PMC10943187 DOI: 10.1038/s41598-024-57058-2] [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: 08/11/2023] [Accepted: 03/13/2024] [Indexed: 03/18/2024] Open
Abstract
Early identification of women at high risk for cardiovascular diseases (CVD), with subsequent monitoring, will allow for improved clinical outcomes and generally better quality of life. This study aimed to identify the associations between early menopause, abnormal diastolic function, and clinical outcomes. This retrospective study included 795 menopausal women from is a nationwide, multicenter, registry of patients with suspected angina visiting outpatient clinic. The patients into two groups: early and normal menopause (menopausal age ≤ 45 and > 45 years, respectively). If participants met > 50% of the diastolic function criteria, they were classified as having normal diastolic function. Multivariable-adjusted Cox models were used to test associations between menopausal age and clinical outcomes including the incidence of major adverse cardiovascular events (MACE), over a median follow-up period of 771 days. Early menopause was associated with increased waist circumference (p = 0.001), diabetes prevalence (p = 0.003), obstructive coronary artery disease (p = 0.005), abnormal diastolic function (p = 0.003) and greater incidences of MACE, acute coronary syndrome, and hospitalization for heart failure. In patients with abnormal diastolic function, early menopause increased MACE risk significantly, with no significant difference in normal diastolic function. These findings highlight early menopause and abnormal diastolic function as being potential risk markers in women for midlife CVD events.
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Affiliation(s)
- SungA Bae
- Department of Cardiology, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Gyeonggi-Do, Republic of Korea
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Goryeodae-Ro 73, Seongbuk-Gu, Seoul, 02841, Republic of Korea
| | - Seong-Mi Park
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Goryeodae-Ro 73, Seongbuk-Gu, Seoul, 02841, Republic of Korea.
| | - So Ree Kim
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Goryeodae-Ro 73, Seongbuk-Gu, Seoul, 02841, Republic of Korea
| | - Mi-Na Kim
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Goryeodae-Ro 73, Seongbuk-Gu, Seoul, 02841, Republic of Korea
| | - Dong-Hyuk Cho
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Goryeodae-Ro 73, Seongbuk-Gu, Seoul, 02841, Republic of Korea
| | - Hee-Dong Kim
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Goryeodae-Ro 73, Seongbuk-Gu, Seoul, 02841, Republic of Korea
- Division of Cardiology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | - Hyun Ju Yoon
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Myung-A Kim
- Department of Cardiology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Hack-Lyoung Kim
- Department of Cardiology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Kyung-Soon Hong
- Department of Cardiology, Hallym University Medical Center, Seoul, Chuncheon, Republic of Korea
| | - Mi-Seung Shin
- Department of Cardiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jin-Ok Jeong
- Department of Cardiology, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Wan-Joo Shim
- Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Goryeodae-Ro 73, Seongbuk-Gu, Seoul, 02841, Republic of Korea
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Xin L, Li F, Yu H, Xiong Q, Hou Q, Meng Y. Honokiol alleviates radiation-induced premature ovarian failure via enhancing Nrf2. Am J Reprod Immunol 2023; 90:e13769. [PMID: 37766410 DOI: 10.1111/aji.13769] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/29/2023] [Accepted: 08/15/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND The ovary is highly sensitive to radiation, and patients receiving radiotherapy are at significant risk of premature ovarian failure (POF). This study aimed to explore the radioprotective effect of honokiol (HKL) on ionizing radiation (IR)-induced POF. METHODS Female C57BL/6 mice were administered intraperitoneally with vehicle or HKL once daily for 7 days. On day 7, the mice in the IR and HKL+IR groups were exposed to 3.2 Gy whole-body radiation for one hour after the intraperitoneal injection and sacrificed 12 or 72 h after radiation exposure. The gonadosomatic index (GSI) was calculated. Blood samples were collected for enzyme-linked immunosorbent assay (ELISA). Ovaries were harvested for histological examination, immunohistochemistry, immunofluorescence, TUNEL, western blot, and qPCR. The fertility assessment was evaluated by calculating live offspring number. RESULTS The optimum dose of HKL against radiation was 10 mg/kg via intraperitoneal injection. POF was induced 72 h after irradiation with significantly downregulated proliferating cell nuclear antigen (PCNA). The numbers of primordial and preantral follicles decreased significantly after irradiation (p < .001), whereas the number of atretic follicles increased (p < .001). The serum levels of estradiol (E2 ) and anti-Müllerian hormone (AMH) decreased to 50% of the control group after irradiation (p < .05). Moreover, the GSI after irradiation was 27% lower than in the control group (p < .05). The number of offspring in the IR group dropped by 50% compared with the control group (p < .05). HKL pretreatment protected the animals' fertility, GSI, PCNA, serum levels of E2 and AMH, and the number of primordial and preantral follicles. Significant upregulation of apoptosis-related proteins such as Pho-P53, Bax, Cyto C, C-caspase-3, C-PARP, and pyroptosis-related proteins such as Pho-NF-κB p65, NLRP3, caspase-1, IL-1β, and IL-18 was observed after irradiation, while the expression of Bcl-2 decreased. HKL pretreatment prevented these changes. After irradiation, malondialdehyde (MDA), Nrf2, and HO-1 were upregulated. HKL treatment activated the expression of Nrf2 and HO-1 and promoted the nucleus translocation of Nrf2. Furthermore, HKL did not affect ovarian reserves under physiological conditions. CONCLUSIONS HKL ameliorated IR-induced POF by inhibiting apoptosis and pyroptosis by enhancing Nrf2 expression and translocation.
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Affiliation(s)
- Lingli Xin
- Department of Graduate Administration, General Hospital of Chinese PLA, Beijing, China
- Department of Obstetrics and Gynecology, PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - Fengsheng Li
- Department of Nuclear Radiation Injury and Monitoring, The PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - Huijie Yu
- Department of Nuclear Radiation Injury and Monitoring, The PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - Qi Xiong
- Department of Oncology, General Hospital of Chinese PLA, Beijing, China
| | - Qingxiang Hou
- Department of Obstetrics and Gynecology, PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - Yuanguang Meng
- Department of Graduate Administration, General Hospital of Chinese PLA, Beijing, China
- Department of Obstetrics and Gynecology, General Hospital of Chinese PLA, Beijing, China
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Jambarsang S, Khodayarian M, Sefidkar R, Yoshany N. Prevalence of premature ovarian insufficiency (POI) and its relationship with female reproductive factors in Iranian women: a cross-sectional study from the Persian (Shahedieh) cohort data. BMC Womens Health 2023; 23:467. [PMID: 37658371 PMCID: PMC10474657 DOI: 10.1186/s12905-023-02620-9] [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: 03/19/2023] [Accepted: 08/24/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND In premature ovarian insufficiency, the cessation of menstruation, and cessation of ovarian function occurs before the age of 40, and this phenomenon is associated with many complications and problems for women. Since several factors can affect this situation, this study was conducted to determine the relationship between fertility history, and premature ovarian failure. METHODS This cross-sectional study was conducted on the data of the first phase of cohort study, which was a sample of 10,000 people from an Iranian adult population (age: 35-70 years). 1276 women were included who naturally experienced menopause from this population. They were separated into three groups based on the age of menopause: premature ovarian failure for those who reached menopause before the age of 40, early menopause for those who reached menopause between the ages of 40 and 45, and natural menopause for those who reached menopause at or after the age of 45. The demographic and fertility characteristics of two groups of women, one with premature ovarian failure and the other with early menopause, were compared with a group of women experiencing normal menopause. The comparison was based on frequency and percentage. Moreover, the odds ratio (OR) of these two groups compared to normal group was crudely calculated, and adjusted based on age at the time of the interview using a logistic regression model. SPSS 23 software was used to fit models and calculations. RESULTS The prevalence of premature ovarian failure was 3%. The likelihood of premature ovarian failure decreases as the number of live births rises. The risk is considerably higher for births ranging from zero to three children compared to those with more than four. Increased duration of breastfeeding is associated to a reduced risk of premature ovarian failure compared to the spontaneous occurrence (OR = 0.98, 95% CI (0.97, 0.99)). This relationship is maintained even after adjusting for age (OR = 0.98, 95% CI (0.97, 0.99). CONCLUSION Based on the results of present study, it can be concluded that the factor of the number of births, and the duration of breastfeeding affect reducing the occurrence of POI, therefore, in health and treatment programs and policies, encouragement to have children, which is now part of the policies population of Iran, and the importance, and benefits of breastfeeding for mother and baby should be emphasized more.
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Affiliation(s)
- Sara Jambarsang
- Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahsa Khodayarian
- Department of Health Education and Health Promotion, Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Reyhane Sefidkar
- Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nooshin Yoshany
- Department of Health Education and Health Promotion, Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Vujović S, Ivović M, Tančić Gajić M, Marina L, Jovičić SP, Pavlović N, Jovičić ME. Alzheimer’s Disease and Premature Ovarian Insufficiency. ENDOCRINES 2023. [DOI: 10.3390/endocrines4020020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
Estradiol promotes neuronal growth, transmission, survival, myelinization, plasticity, synaptogenesis, and dendritic branching and it improves cognitive function. Alzheimer’s disease (AD) is characterized by amyloid plaques, neurofibrillary tangles, and the loss of neuronal connection in the brain. Genomic analysis has concluded that hypoestrogenism influences the APOE gene and increases the risk of AD. Premature ovarian insufficiency (POI) is defined as oligo/amenorrhea in women below 40 years of age, low estradiol, and high-gonadotropin levels. Early symptoms and signs of POI must be detected in time in order to prevent subsequent complications, such as Alzheimer’s disease. Meta-analysis has shown favorable effects of estrogen in preventing Alzheimer’s. We measured some of the typical markers of AD in women with POI such as interleukin 6 (IL-6), interleukin 8 (IL-8), tissue necrosis factor α (TNFα), TAU1, TREM2, and amyloid precursor proteins (APP). While FSH, LH, and IL-8 were significantly higher in POI group, compared to controls, testosterone and DHEAS were lower. A significant decrease in IL-6 was found in the POI group during a 6-month therapy, as well as an increase in amyloid precursor proteins. CONCLUSION: Neurological complications of POI, such as declining short-term memory, cognitive function, and dementia, have to be promptly stopped by initiating estro-progestogen therapy in POI. A long-term continuation of the therapy would be strongly advised.
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Affiliation(s)
- Svetlana Vujović
- Faculty of Medicine, National Center for Infertility and Endocrinology of Gender, Clinic of Endocrinology, Diabetes and Diseases of Metabolism, University Clinical Center, University of Belgrade, 11000 Belgrade, Serbia
| | - Miomira Ivović
- Faculty of Medicine, National Center for Infertility and Endocrinology of Gender, Clinic of Endocrinology, Diabetes and Diseases of Metabolism, University Clinical Center, University of Belgrade, 11000 Belgrade, Serbia
| | - Milina Tančić Gajić
- Faculty of Medicine, National Center for Infertility and Endocrinology of Gender, Clinic of Endocrinology, Diabetes and Diseases of Metabolism, University Clinical Center, University of Belgrade, 11000 Belgrade, Serbia
| | - Ljiljana Marina
- Faculty of Medicine, National Center for Infertility and Endocrinology of Gender, Clinic of Endocrinology, Diabetes and Diseases of Metabolism, University Clinical Center, University of Belgrade, 11000 Belgrade, Serbia
| | - Svetlana Pavlović Jovičić
- Faculty of Medicine, Clinic for Nephrology, University Clinical Center, University of Belgrade, 11000 Belgrade, Serbia
| | - Natalija Pavlović
- Faculty of Medicine, National Center for Infertility and Endocrinology of Gender, Clinic of Endocrinology, Diabetes and Diseases of Metabolism, University Clinical Center, University of Belgrade, 11000 Belgrade, Serbia
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King TL, Bryner BS, Underwood KB, Walters MR, Zimmerman SM, Johnson NK, Mason JB. Estradiol-independent restoration of T-cell function in post-reproductive females. Front Endocrinol (Lausanne) 2023; 14:1066356. [PMID: 36755910 PMCID: PMC9900006 DOI: 10.3389/fendo.2023.1066356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/09/2023] [Indexed: 01/24/2023] Open
Abstract
Aging leads to a general decline in protective immunity. The most common age-associated effects are in seen T-cell mediated immune function. Adult mice whose immune systems show only moderate changes in T-cell subsets tend to live longer than age-matched siblings that display extensive T-cell subset aging. Importantly, at the time of reproductive decline, the increase in disease risks in women significantly outpace those of men. In female mice, there is a significant decline in central and peripheral naïve T-cell subsets at the time of reproductive failure. Available evidence indicates that this naïve T-cell decline is sensitive to ovarian function and can be reversed in post-reproductive females by transplantation of young ovaries. The restoration of naïve T-cell subsets due to ovarian transplantation was impressive compared with post-reproductive control mice, but represented only a partial recovery of what was lost from 6 months of age. Apparently, the influence of ovarian function on immune function may be an indirect effect, likely moderated by other physiological functions. Estradiol is significantly reduced in post-reproductive females, but was not increased in post-reproductive females that received new ovaries, suggesting an estradiol-independent, but ovarian-dependent influence on immune function. Further evidence for an estradiol-independent influence includes the restoration of immune function through the transplantation of young ovaries depleted of follicles and through the injection of isolated ovarian somatic cells into the senescent ovaries of old mice. While the restoration of naïve T-cell populations represents only a small part of the immune system, the ability to reverse this important functional parameter independent of estradiol may hold promise for the improvement of post-reproductive female immune health. Further studies of the non-reproductive influence of the ovary will be needed to elucidate the mechanisms of the relationship between the ovary and health.
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Affiliation(s)
- Tristin L. King
- Department of Animal, Dairy and Veterinary Sciences, Center for Integrated BioSystems, College of Veterinary Medicine, Utah State University, Logan, UT, United States
| | - B. Shaun Bryner
- Department of Animal, Dairy and Veterinary Sciences, Center for Integrated BioSystems, College of Veterinary Medicine, Utah State University, Logan, UT, United States
| | - Kaden B. Underwood
- Department of Animal, Dairy and Veterinary Sciences, Center for Integrated BioSystems, College of Veterinary Medicine, Utah State University, Logan, UT, United States
| | - McKenna R. Walters
- Department of Animal, Dairy and Veterinary Sciences, Center for Integrated BioSystems, College of Veterinary Medicine, Utah State University, Logan, UT, United States
| | - Shawn M. Zimmerman
- Utah Veterinary Diagnostic Laboratory, College of Veterinary Medicine, Utah State University, Logan, UT, United States
| | - Nathan K. Johnson
- Department of Animal, Dairy and Veterinary Sciences, Center for Integrated BioSystems, College of Veterinary Medicine, Utah State University, Logan, UT, United States
| | - Jeffrey B. Mason
- Department of Animal, Dairy and Veterinary Sciences, Center for Integrated BioSystems, College of Veterinary Medicine, Utah State University, Logan, UT, United States
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Chen L, Hu Z, Wang X, Song Y, Chen Z, Zhang L, Zheng C, Vallis J, Zhou H, Cao X, Tian Y, Cai J, Gu R, Huang Y, Wang Z. Age at Menarche and Menopause, Reproductive Lifespan, and Risk of Cardiovascular Events Among Chinese Postmenopausal Women: Results From a Large National Representative Cohort Study. Front Cardiovasc Med 2022; 9:870360. [PMID: 36158833 PMCID: PMC9500155 DOI: 10.3389/fcvm.2022.870360] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background At present, the association between age at menarche and menopause, reproductive lifespan, and cardiovascular disease (CVD) risk among Chinese postmenopausal women is not clear, and some related researches are contradictory. Methods A total of 6,198 Chinese postmenopausal women with a mean age of 63.6 years were enrolled at baseline in 2012-2015 and followed up for 5 years. A standardized questionnaire was used to collect relevant information by well-trained interviewers. Physical examination of the participants was performed by trained medical staff. CVD events were observed during follow-up. Cox proportional hazards models were used to estimate hazard ratios between reproductive characteristics and CVD events. Results Age at menarche was positively associated with CVD events (HR, 1.106; 95%CI, 1.047-1.167). There was a negative association between age at menopause and CVD risk in postmenopausal women with comorbidity (HR, 0.952; 95%CI, 0.909-0.996). Reproductive lifespan was negatively associated with CVD events (HR, 0.938; 95%CI, 0.880-0.999). The CVD risk increased by 10.6% for every 1-year increase in age at menarche. The CVD risk reduced by 6.2% for every 1-year increase in age at menopause in women with comorbidity. The CVD risk reduced by 3.8% for every 1-year increase in reproductive lifespan. Conclusions Based on the large prospective study with a nationally representative sample, Chinese postmenopausal women with late age at menarche and shorter reproductive lifespan have higher risk of CVD events.
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Affiliation(s)
- Lu Chen
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Zhen Hu
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Xin Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yuxin Song
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Zuo Chen
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Linfeng Zhang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Congyi Zheng
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Jillian Vallis
- PGY3 General Surgery, Memorial University of Newfoundland, St. John’s, NL, Canada
| | - Haoqi Zhou
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Xue Cao
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yixin Tian
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Jiayin Cai
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Runqing Gu
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yilin Huang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Zengwu Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
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9
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Idiopathic early ovarian aging: is there a relation with premenopausal accelerated biological aging in young women with diminished response to ART? J Assist Reprod Genet 2021; 38:3027-3038. [PMID: 34599460 DOI: 10.1007/s10815-021-02326-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 09/20/2021] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To evaluate whether young women with idiopathic early ovarian aging, as defined by producing fewer oocytes than expected for a given age over multiple in vitro fertilization (IVF) cycles, have changes in telomere length and epigenetic age indicating accelerated biological aging (i.e., increased risk of morbidity and mortality). METHODS A prospective cohort study was conducted at two Danish public fertility clinics. A total of 55 young women (≤ 37 years) with at least two IVF cycles with ≤ 5 harvested oocytes despite sufficient stimulation with follicle-stimulating hormone (FSH) were included in the early ovarian aging group. As controls, 52 young women (≤ 37 years) with normal ovarian function, defined by at least eight harvested oocytes, were included. Relative telomere length (rTL) and epigenetic age acceleration (AgeAccel) were measured in white blood cells as markers of premenopausal accelerated biological aging. RESULTS rTL was comparable with a mean of 0.46 (± SD 0.12) in the early ovarian aging group and 0.47 (0.14) in the normal ovarian aging group. The AgeAccel of the early ovarian aging group was, insignificantly, 0.5 years older, but this difference disappeared when adjusting for chronological age. Sub-analysis using Anti-Müllerian hormone (AMH) as selection criterion for the two groups did not change the results. CONCLUSION We did not find any indications of accelerated aging in whole blood from young women with idiopathic early ovarian aging. Further investigations in a similar cohort of premenopausal women or other tissues are needed to fully elucidate the potential relationship between premenopausal accelerated biological aging and early ovarian aging.
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Mason JB, Habermehl TL, Underwood KB, Schneider A, Brieño-Enriquez MA, Masternak MM, Parkinson KC. The interrelationship between female reproductive aging and survival. J Gerontol A Biol Sci Med Sci 2021; 77:75-83. [PMID: 34528058 DOI: 10.1093/gerona/glab252] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Indexed: 01/08/2023] Open
Abstract
The link between survival and reproductive function is demonstrated across many species and is under both long-term evolutionary pressures and short-term environmental pressures. Loss of reproductive function is common in mammals and is strongly correlated with increased rates of disease in both males and females. However, the reproduction-associated change in disease rates is more abrupt and more severe in women, who benefit from a significant health advantage over men until the age of menopause. Young women with early ovarian failure also suffer from increased disease risks, further supporting the role of ovarian function in female health. Contemporary experiments where the influence of young ovarian tissue has been restored in post-reproductive-aged females with surgical manipulation were found to increase survival significantly. In these experiments, young, intact ovaries were used to replace the aged ovaries of females that had already reached reproductive cessation. As has been seen previously in primitive species, when the young mammalian ovaries were depleted of germ cells prior to transplantation to the post-reproductive female, survival was increased even further than with germ cell-containing young ovaries. Thus, extending reproductive potential significantly increases survival and appears to be germ cell and ovarian hormone-independent. The current review will discuss historical and contemporary observations and theories that support the link between reproduction and survival and provide hope for future clinical applications to decrease menopause-associated increases in disease risks.
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Affiliation(s)
- Jeffrey B Mason
- Department of Animal, Dairy and Veterinary Sciences, Center for Integrated BioSystems, School of Veterinary Medicine, Utah State University, 4700 Old Main Hill, Logan, UT 84322, USA
| | - Tracy L Habermehl
- Department of Animal, Dairy and Veterinary Sciences, Center for Integrated BioSystems, School of Veterinary Medicine, Utah State University, 4700 Old Main Hill, Logan, UT 84322, USA
| | - Kaden B Underwood
- Department of Animal, Dairy and Veterinary Sciences, Center for Integrated BioSystems, School of Veterinary Medicine, Utah State University, 4700 Old Main Hill, Logan, UT 84322, USA
| | - Augusto Schneider
- Departmento de Nutrição, Universidade Federal de Pelotas, RS, Pelotas, Brazil
| | - Miguel A Brieño-Enriquez
- Magee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michal M Masternak
- College of Medicine, Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL, USA.,Department of Head and Neck Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Kate C Parkinson
- Department of Animal, Dairy and Veterinary Sciences, Center for Integrated BioSystems, School of Veterinary Medicine, Utah State University, 4700 Old Main Hill, Logan, UT 84322, USA
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Su H, Jiang C, Zhang W, Zhu F, Jin Y, Cheng K, Lam T, Xu L. Natural menopausal age and cardiovascular disease risk factors in older Chinese women: Guangzhou Biobank Cohort Study. Menopause 2021; 28:1410-1417. [PMID: 34520415 DOI: 10.1097/gme.0000000000001856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the associations of natural menopausal age with cardiovascular disease risk factors and whether the associations varied by parity in older Chinese women. METHODS Information of demographic characteristics, lifestyles, and reproductive factors was collected by face-to-face interview. Framingham Risk Score was used as an indicator of cardiovascular disease risk, with a score ≥ 10% considered as high cardiovascular disease risk (vs low, dichotomous). Multivariable logistic and linear regressions were used to examine the associations of menopausal age with cardiovascular disease risk factors. RESULTS Of 18,339 women aged 50+ years, the average (standard deviation) age was 61.8 (6.9) years. Compared with women with menopausal age of 45 to 54 years, after adjustment for multiple potential confounders, women with menopausal age <45 years or ≥55 years had higher Framingham Risk Score (0.93%, 95% confidence interval: 0.40-1.46, and 0.69%, 95% confidence interval: 0.18-1.20, respectively). Women with menopausal age <45 or ≥55 years had higher odds of high cardiovascular disease risk (vs low) (odds ratio [95% confidence interval]:1.26 (1.10-1.44) and 1.17 (1.02-1.33), respectively). The associations of menopausal age with the Framingham Risk Score varied by parity (P for interaction ≤0.001). The Framingham Risk Score was higher in those with one to three parity (<45 y: 1.01 [0.43-1.59]; ≥55 y: 1.14 [0.60-1.68]) and lower for parity ≥4 (<45 y: -0.33 [-1.84 to 1.18]; ≥55 y: -2.02 [-3.82 to -0.22]). In nulliparous women, the Framingham Risk Score was highest in menopausal age <45 years (3.97 [1.67-6.26]), but the differences were nonsignificant in menopausal age ≥55 years (0.66 [-1.38 to 2.71]). CONCLUSIONS Both early and late natural menopausal ages were associated with a higher cardiovascular disease risk, and the associations were stronger in those with lower parity.
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Affiliation(s)
- Huimin Su
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chaoqiang Jiang
- Molecular Epidemiology Research Centre, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Weisen Zhang
- Molecular Epidemiology Research Centre, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Feng Zhu
- Molecular Epidemiology Research Centre, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Yali Jin
- Molecular Epidemiology Research Centre, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Karkeung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Taihing Lam
- Molecular Epidemiology Research Centre, Guangzhou Twelfth People's Hospital, Guangzhou, China
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Lin Xu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- School of Public Health, The University of Hong Kong, Hong Kong, China
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Welten SJ, Onland-Moret NC, Boer JM, Verschuren WM, van der Schouw YT. Age at Menopause and Risk of Ischemic and Hemorrhagic Stroke. Stroke 2021; 52:2583-2591. [PMID: 34078111 PMCID: PMC8312566 DOI: 10.1161/strokeaha.120.030558] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 12/09/2020] [Accepted: 03/09/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The few epidemiological studies that addressed the association between age at menopause and ischemic and hemorrhagic stroke risk in women had conflicting findings. We aimed to investigate whether age at (natural and surgical) menopause is a risk factor for total, ischemic, and hemorrhagic stroke in women. METHODS We analyzed data from 16 244 postmenopausal women, aged 26 to 70 years at recruitment who were enrolled in the European Prospective Investigation into Cancer and Nutrition-Netherlands cohort between 1993 and 1997. Participants were followed for the occurrence of stroke until January 1, 2011. At baseline, participants filled in questionnaires about health, reproductive history including age at menopause, diet, and lifestyle. Cox regression was used to investigate the association between age at menopause and stroke. All analyses were adjusted for age, smoking, systolic blood pressure, and body mass index. RESULTS Mean age of menopause was 46.4 (7.0) years. A total of 830 strokes (571 ischemic, 162 hemorrhagic, 97 unclassified) were identified. Earlier menopause was associated with an increased risk of total stroke. Compared with women who experienced menopause between 50 and 54 years old, women who underwent menopause before age 40 years had 1.48× higher risk (95% CI, 1.19-1.85) of total stroke. In continuous analyses, we observed a 2% lower total stroke risk for each year menopause was delayed (hazard ratio, 0.98 [95% CI, 0.97-0.99]). The risk between earlier menopause and stroke was confined to ischemic stroke, earlier menopause was not associated with hemorrhagic stroke. The association with age at menopause was stronger for natural menopause (hazard ratio <40 versus 50-54 years, 1.74 [95% CI, 1.12-2.70]) than for surgical menopause (hazard ratio <40 versus 50-54 years, 1.26 [95% CI, 0.84-1.89]). CONCLUSIONS The risk of total and ischemic stroke decreased with an increase in age at menopause. Whether this should have clinical consequences such as intensified risk factor control should be subject of further studies.
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Affiliation(s)
- Sabrina J.G.C. Welten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands (S.J.G.C.W., N.C.O.-M., W.M.M.V., Y.T.v.d.S.)
- Department of General Practice, Amsterdam University Medical Center, Location VU, Amsterdam Public Health Research Institute, the Netherlands (S.J.G.C.W.)
| | - N. Charlotte Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands (S.J.G.C.W., N.C.O.-M., W.M.M.V., Y.T.v.d.S.)
| | - Jolanda M.A. Boer
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, the Netherlands (J.M.A.B., W.M.M.V.)
| | - W.M. Monique Verschuren
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands (S.J.G.C.W., N.C.O.-M., W.M.M.V., Y.T.v.d.S.)
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, the Netherlands (J.M.A.B., W.M.M.V.)
| | - Yvonne T. van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands (S.J.G.C.W., N.C.O.-M., W.M.M.V., Y.T.v.d.S.)
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Christensen MW, Kesmodel US, Christensen K, Kirkegaard K, Ingerslev HJ. Early ovarian ageing: is a low number of oocytes harvested in young women associated with an earlier and increased risk of age-related diseases? Hum Reprod 2021; 35:2375-2390. [PMID: 32949236 DOI: 10.1093/humrep/deaa188] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/26/2020] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Do young women with early ovarian ageing (EOA), defined as unexplained, and repeatedly few oocytes harvested in ART have an increased risk of age-related events? SUMMARY ANSWER At follow-up, women with idiopathic EOA had an increased risk of age-related events compared to women with normal ovarian ageing (NOA). WHAT IS KNOWN ALREADY Early and premature menopause is associated with an increased risk of cardiovascular diseases (CVDs), osteoporosis and death. In young women, repeated harvest of few oocytes in well-stimulated ART cycles is a likely predictor of advanced menopausal age and may thus serve as an early marker of accelerated general ageing. STUDY DESIGN, SIZE, DURATION A register-based national, historical cohort study. Young women (≤37 years) having their first ART treatment in a public or private fertility clinic during the period 1995-2014 were divided into two groups depending on ovarian reserve status: EOA (n = 1222) and NOA (n = 16 385). Several national registers were applied to assess morbidity and mortality. PARTICIPANTS/MATERIALS, SETTING, METHODS EOA was defined as ≤5 oocytes harvested in a minimum of two FSH-stimulated cycles and NOA as ≥8 oocytes in at least one cycle. Cases with known causes influencing the ovarian reserve (endometriosis, ovarian surgery, polycystic ovary syndrome, chemotherapy etc.) were excluded. To investigate for early signs of ageing, primary outcome was an overall risk of ageing-related events, defined as a diagnosis of either CVD, osteoporosis, type 2 diabetes, cancer, cataract, Alzheimer's or Parkinson's disease, by death of any-cause as well as a Charlson comorbidity index score of ≥1 or by registration of early retirement benefit. Cox regression models were used to assess the risk of these events. Exposure status was defined 1 year after the first ART cycle to assure reliable classification, and time-to-event was measured from that time point. MAIN RESULTS AND THE ROLE OF CHANCE Median follow-up time from baseline to first event was 4.9 years (10/90 percentile 0.7/11.8) and 6.4 years (1.1/13.3) in the EOA and NOA group, respectively. Women with EOA had an increased risk of ageing-related events when compared to women with a normal oocyte yield (adjusted hazard ratio 1.24, 95% CI 1.08 to 1.43). Stratifying on categories, the EOA group had a significantly increased risk for CVD (1.44, 1.19 to 1.75) and osteoporosis (2.45, 1.59 to 3.90). Charlson comorbidity index (1.15, 0.93 to 1.41) and early retirement benefit (1.21, 0.80 to 1.83) was also increased, although not reaching statistical significance. LIMITATIONS, REASONS FOR CAUTION Cycles never reaching oocyte aspiration were left out of account in the inclusion process and we may therefore have missed women with the most severe forms of EOA. We had no information on the total doses of gonadotrophin administered in each cycle. WIDER IMPLICATIONS OF THE FINDINGS These findings indicate that oocyte yield may serve as marker of later accelerated ageing when, unexpectedly, repeatedly few oocytes are harvested in young women. Counselling on life-style factors as a prophylactic effort against cardiovascular and other age-related diseases may be essential for this group of women. STUDY FUNDING/COMPETING INTEREST(S) No external funding was received for this study. All authors declare no conflict of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- M W Christensen
- Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus N, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - U S Kesmodel
- Fertility Unit, Department of Obstetrics and Gynecology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - K Christensen
- Department of Public Health, The Danish Aging Research Center, University of Southern Denmark, Odense C, Denmark
| | - K Kirkegaard
- Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus N, Denmark
| | - H J Ingerslev
- Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark.,Fertility Unit, Department of Obstetrics and Gynecology, Aalborg University Hospital, Aalborg, Denmark
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Zhao W, Smith JA, Bielak LF, Ruiz-Narvaez EA, Yu M, Hood MM, Peyser PA, Kardia SL, Harlow SD. Associations between polygenic risk score for age at menarche and menopause, reproductive timing, and serum hormone levels in multiple race/ethnic groups. Menopause 2021; 28:819-828. [PMID: 33878091 PMCID: PMC8225555 DOI: 10.1097/gme.0000000000001775] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We assessed associations of genetic loci that contribute to age at menarche and menopause with sentinel menopausal traits in multiple race/ethnic groups. METHODS Genetic data from the Study of Women's Health Across the Nation include 738 White, 366 Black, 139 Chinese, and 145 Japanese women aged 42 to 52 at baseline. We constructed standardized polygenic risk scores (PRSs) using single nucleotide polymorphisms identified from large-scale genome-wide association studies meta-analyses of ages at menopause and menarche, evaluating associations with each trait within each race/ethnic group. RESULTS Menopause PRS was significantly associated with age at menopause in White women after Bonferroni correction (P < 0.004) and nominally associated in Chinese and Japanese women (P < 0.05) (7.4-8.5 mo delay for one standard deviation [SD] increase in PRS). Menarche PRS was significantly associated with age at menarche in White (P < 0.004) and nominally associated in Black and Japanese women (P < 0.05) (2.6-4.8 mo delay for one SD increase). In White women, menarche and menopause PRSs were significantly associated (P < 0.004) with shorter and longer (5.9 and 9.6 mo for one SD increase) reproductive lifespans, respectively, and menopause PRS with a longer menopausal transition (7.1 mo for one SD increase). We observed a significant positive association (P < 0.004) between menopause PRS and E2 level 2 years before menopause and a nominal association (P < 0.05) 2 years after menopause in Japanese women. CONCLUSIONS In addition to menopausal timing, PRSs associated with onset and ending of reproductive life were associated with reproductive lifespan, length of the menopausal transition, and E2 levels in different race/ethnic groups.
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Affiliation(s)
- Wei Zhao
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109
| | - Jennifer A. Smith
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109
| | - Lawrence F. Bielak
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109
| | - Edward A. Ruiz-Narvaez
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, 48109
| | - Miao Yu
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109
| | - Michelle M. Hood
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109
| | - Patricia A. Peyser
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109
| | - Sharon L.R. Kardia
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109
| | - Sioban D. Harlow
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109
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Meta-analysis: Early Age at Natural Menopause and Risk for All-Cause and Cardiovascular Mortality. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6636856. [PMID: 33816624 PMCID: PMC7987413 DOI: 10.1155/2021/6636856] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 02/10/2021] [Accepted: 03/01/2021] [Indexed: 11/18/2022]
Abstract
Aims The aim of this meta-analysis was to comprehensively evaluate the association of early age at natural menopause with the risk for all-cause and cardiovascular mortality. Methods Literature retrieval was done on August 4, 2020. Article selection and data extraction were completed independently and in duplicate. Early age at natural menopause was grouped into premature menopause (<40 years), early menopause (40-44 years), and relatively early menopause (45-49 years). Effect-size estimates are summarized as hazard ratio (HR) or relative risk (RR) with 95% confidence interval (CI). Results Sixteen articles involving 321,233 women were meta-analyzed. Overall analyses revealed a statistically significant association of early age at natural menopause with all-cause mortality risk (HRadjusted = 1.08, 95% CI: 1.03 to 1.14, P = 0.002; RRadjusted = 1.05, 95% CI 1.01 to 1.08, P = 0.005), but not with cardiovascular mortality risk. In dose-response analyses, the association with all-cause mortality was significant for premature menopause with (HRadjusted = 1.10; 95% CI: 1.01 to 1.21; P = 0.034) and without (RRadjusted = 1.34; 95% CI: 1.08 to 1.66; P = 0.007) considering follow-up intervals. As for cardiovascular mortality, marginal significance was noted for premature menopause after considering follow-up intervals (HR = 1.09; 95% CI: 1.00-1.19; P = 0.045). Subgroup analyses indicated that gender, country, and follow-up periods were possible causes of heterogeneity. There was an overall low probability of publication bias. Conclusions Our findings indicate that premature menopause is a promising independent risk factor for both all-cause and cardiovascular mortality.
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Yuk JS, Kim M. Incidence and prevalence of primary ovarian insufficiency in South Korea: a population-based study. Arch Gynecol Obstet 2021; 304:823-831. [PMID: 33492427 DOI: 10.1007/s00404-021-05962-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 12/22/2020] [Indexed: 11/25/2022]
Abstract
AIM We investigated the incidence and prevalence of primary ovarian insufficiency (POI) in the Republic of Korea using population-based data. METHODS Data of patients diagnosed with POI from 2009 to 2017 were obtained from the Health Insurance Review and Assessment Service-National Patient Sample (HIRA-NPS). The incidence and prevalence of POI were measured as defined using follicle stimulating hormone (FSH) test, POI diagnostic codes, and age. RESULTS Data from 6,617,139 women were extracted. Of those under the age of 40, 239 had been newly diagnosed with POI. The incidence of POI was 9.2 ± 0.6 per 100,000 (0.0092%). The mean age of the women with newly diagnosed POI was 22.2 ± 0.6 years. Logistic regression analysis determined that the incidence of POI decreased with increasing age at 5 year increments [odds ratio (OR) 0.82; 95% confidence interval (CI) 0.75-0.88]; however, socioeconomic status was not associated with POI (OR 1.12; 95% CI 0.5-2.53). Among diseases in the Charlson comorbidity index (CCI), cancer, diabetes mellitus (DM) without complications, and renal disease were associated with an increased incidence of POI (OR 5.54; 95% CI 2.92-10.49; OR 11.83; 95% CI 6.37-22; OR 7.08; 95% CI 1.41-35.5, respectively). When excluding the Q96 (Turner syndrome) diagnostic code, the incidence of POI was 3.7 ± 0.4 per 100,000 (0.0037%), and the prevalence of POI was 12.3 ± 0.4 per 100,000 (0.0123%). CONCLUSION We found the incidence of POI to be 9.2 ± 0.6 per 100,000 (0.0092%). Cancer, DM without complications, and renal disease were associated with the increased incidence of POI. The incidence and prevalence of POI is considerably lower than reported in previous studies.
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Affiliation(s)
- Jin-Sung Yuk
- Department of Obstetrics and Gynecology, Sanggye Paik Hospital, School of Medicine, Inje University, 1342, Dongil-ro, Nowon-gu, Seoul, 01757, Republic of Korea
| | - Myounghwan Kim
- Department of Obstetrics and Gynecology, Sanggye Paik Hospital, School of Medicine, Inje University, 1342, Dongil-ro, Nowon-gu, Seoul, 01757, Republic of Korea.
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Yao M, Liu H, Li B, Liu Y, Mu Y. The Relationship Between Earlier Onset of Natural Menopause and Elevated Urinary Albumin-Creatinine Ratio in Postmenopausal Chinese Women. Diabetes Metab Syndr Obes 2021; 14:847-856. [PMID: 33658819 PMCID: PMC7920510 DOI: 10.2147/dmso.s292041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 02/05/2021] [Indexed: 12/29/2022] Open
Abstract
PURPOSE There is a close correlation between menopausal age and cardiovascular disease (CVD) risk. Some research suggests that this risk is attributable to an elevated urinary albumin-creatinine ratio (UACR), but further work is needed to explore the link between UACR and age at time of menopause. PATIENTS AND METHODS Data analyzed in the present study were derived from seven regional centers participating in the REACTION study. A total of 21,672 postmenopausal women met with our study inclusion and exclusion criteria, and were split into three groups based upon their age at onset of natural menopause. A UACR ≥ 30 mg/g was the primary outcome measure for this study. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated with a logistic regression approach. RESULTS Relative to women who were 46-50 years old at time of natural menopause, those with an earlier onset of menopause (≤45 years) exhibited an increased risk of UACR elevation following adjustment for confounding variables (OR: 1.18, 95% CI: 1.04-1.33), whereas the opposite was true for women with a later age of menopause onset (>50 years) (OR: 0.86, 95% CI: 0.78-0.94). For every 1-year delay in the onset of menopause, UACR risk fell by 3% (OR: 0.97, 95% CI: 0.96-0.98). CONCLUSION In summary, early menopause (≤45 years old) was linked to a higher risk of UACR elevation in postmenopausal women. However, further work will be needed to understand the mechanistic basis for these findings.
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Affiliation(s)
- Mingyan Yao
- Department of Endocrinology, Chinese People’s Liberation Army General Hospital, Beijing, 100853, People’s Republic of China
- Department of Endocrinology, Baoding NO.1 Central Hospital, Baoding, 071000, People’s Republic of China
| | - Hongzhou Liu
- Department of Endocrinology, Chinese People’s Liberation Army General Hospital, Beijing, 100853, People’s Republic of China
| | - Bing Li
- Department of Endocrinology, Chinese People’s Liberation Army General Hospital, Beijing, 100853, People’s Republic of China
| | - Yang Liu
- Department of Endocrinology, Chinese People’s Liberation Army General Hospital, Beijing, 100853, People’s Republic of China
| | - Yiming Mu
- Department of Endocrinology, Chinese People’s Liberation Army General Hospital, Beijing, 100853, People’s Republic of China
- Correspondence: Yiming Mu Department of Endocrinology, Chinese People’s Liberation Army General Hospital, No. 28 Fuxing Road, Beijing, 100853, People’s Republic of China Email
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Ding N, Harlow SD, Randolph JF, Calafat AM, Mukherjee B, Batterman S, Gold EB, Park SK. Associations of Perfluoroalkyl Substances with Incident Natural Menopause: The Study of Women's Health Across the Nation. J Clin Endocrinol Metab 2020; 105:dgaa303. [PMID: 32491182 PMCID: PMC7418447 DOI: 10.1210/clinem/dgaa303] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 05/20/2020] [Indexed: 01/09/2023]
Abstract
CONTEXT Previous epidemiologic studies of per- and polyfluoroalkyl substances (PFASs) and menopausal timing conducted in cross-sectional settings were limited by reverse causation because PFAS serum concentrations increase after menopause. OBJECTIVES To investigate associations between perfluoroalkyl substances and incident natural menopause. DESIGN AND SETTING A prospective cohort of midlife women, the Study of Women's Health Across the Nation, 1999-2017. PARTICIPANTS 1120 multiracial/ethnic premenopausal women aged 45-56 years. METHODS Serum concentrations of perfluoroalkyls were quantified by high-performance liquid chromatography isotope dilution tandem mass spectrometry. Natural menopause was defined as the bleeding episode prior to at least 12 months of amenorrhea not due to surgery or hormone use. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS Participants contributed 5466 person-years of follow-up, and 578 had incident natural menopause. Compared with the lowest tertile, women at the highest tertile of baseline serum concentrations had adjusted HR for natural menopause of 1.26 (95% CI: 1.02-1.57) for n-perfluorooctane sulfonic acid (n-PFOS) (Ptrend = .03), 1.27 (95% CI: 1.01-1.59) for branched-PFOS (Ptrend = .03), and 1.31 (95% CI: 1.04-1.65) for n-perfluorooctanoic acid (Ptrend = .01). Women were classified into four clusters based on their overall PFAS concentrations as mixtures: low, low-medium, medium-high, and high. Compared with the low cluster, the high cluster had a HR of 1.63 (95% CI: 1.08-2.45), which is equivalent to 2.0 years earlier median time to natural menopause. CONCLUSION This study suggests that select PFAS serum concentrations are associated with earlier natural menopause, a risk factor for adverse health outcomes in later life.
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Affiliation(s)
- Ning Ding
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Siobán D Harlow
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - John F Randolph
- Department of Obstetrics and Gynecology, School of Medicine, University of Michigan, Ann Arbor, Michigan
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Bhramar Mukherjee
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Stuart Batterman
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan
- Department of Civil and Environmental Engineering, College of Engineering, University of Michigan, Ann Arbor, Michigan
| | - Ellen B Gold
- Department of Public Health Sciences, University of California, Davis, School of Medicine, Davis, California
| | - Sung Kyun Park
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan
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19
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Cawthon RM, Meeks HD, Sasani TA, Smith KR, Kerber RA, O'Brien E, Baird L, Dixon MM, Peiffer AP, Leppert MF, Quinlan AR, Jorde LB. Germline mutation rates in young adults predict longevity and reproductive lifespan. Sci Rep 2020; 10:10001. [PMID: 32561805 PMCID: PMC7305191 DOI: 10.1038/s41598-020-66867-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 05/28/2020] [Indexed: 12/22/2022] Open
Abstract
Ageing may be due to mutation accumulation across the lifespan, leading to tissue dysfunction, disease, and death. We tested whether germline autosomal mutation rates in young adults predict their remaining survival, and, for women, their reproductive lifespans. Age-adjusted mutation rates (AAMRs) in 61 women and 61 men from the Utah CEPH (Centre d’Etude du Polymorphisme Humain) families were determined. Age at death, cause of death, all-site cancer incidence, and reproductive histories were provided by the Utah Population Database, Utah Cancer Registry, and Utah Genetic Reference Project. Higher AAMRs were significantly associated with higher all-cause mortality in both sexes combined. Subjects in the top quartile of AAMRs experienced more than twice the mortality of bottom quartile subjects (hazard ratio [HR], 2.07; 95% confidence interval [CI], 1.21–3.56; p = 0.008; median survival difference = 4.7 years). Fertility analyses were restricted to women whose age at last birth (ALB) was ≥ 30 years, the age when fertility begins to decline. Women with higher AAMRs had significantly fewer live births and a younger ALB. Adult germline mutation accumulation rates are established in adolescence, and later menarche in women is associated with delayed mutation accumulation. We conclude that germline mutation rates in healthy young adults may provide a measure of both reproductive and systemic ageing. Puberty may induce the establishment of adult mutation accumulation rates, just when DNA repair systems begin their lifelong decline.
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Affiliation(s)
- Richard M Cawthon
- Department of Human Genetics, University of Utah, Salt Lake City, UT, United States.
| | - Huong D Meeks
- Population Science, Huntsman Cancer Institute, University of Utah Health, Salt Lake City, UT, United States
| | - Thomas A Sasani
- Department of Human Genetics, University of Utah, Salt Lake City, UT, United States
| | - Ken R Smith
- Population Science, Huntsman Cancer Institute, University of Utah Health, Salt Lake City, UT, United States
| | - Richard A Kerber
- Department of Health Management & Systems Sciences, University of Louisville, Louisville, KY, United States
| | - Elizabeth O'Brien
- Department of Health Management & Systems Sciences, University of Louisville, Louisville, KY, United States
| | - Lisa Baird
- Department of Human Genetics, University of Utah, Salt Lake City, UT, United States
| | - Melissa M Dixon
- Department of Pediatrics, University of Utah, Salt Lake City, UT, United States
| | - Andreas P Peiffer
- Department of Pediatrics, University of Utah, Salt Lake City, UT, United States
| | - Mark F Leppert
- Department of Human Genetics, University of Utah, Salt Lake City, UT, United States
| | - Aaron R Quinlan
- Department of Human Genetics, University of Utah, Salt Lake City, UT, United States.,Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, United States.,USTAR Center for Genetic Discovery, University of Utah, Salt Lake City, UT, United States
| | - Lynn B Jorde
- Department of Human Genetics, University of Utah, Salt Lake City, UT, United States.,USTAR Center for Genetic Discovery, University of Utah, Salt Lake City, UT, United States
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20
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Multi-omics network analysis reveals distinct stages in the human aging progression in epidermal tissue. Aging (Albany NY) 2020; 12:12393-12409. [PMID: 32554863 PMCID: PMC7343460 DOI: 10.18632/aging.103499] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 06/01/2020] [Indexed: 01/05/2023]
Abstract
In recent years, reports of non-linear regulations in age- and longevity-associated biological processes have been accumulating. Inspired by methodological advances in precision medicine involving the integrative analysis of multi-omics data, we sought to investigate the potential of multi-omics integration to identify distinct stages in the aging progression from ex vivo human skin tissue. For this we generated transcriptome and methylome profiling data from suction blister lesions of female subjects between 21 and 76 years, which were integrated using a network fusion approach. Unsupervised cluster analysis on the combined network identified four distinct subgroupings exhibiting a significant age-association. As indicated by DNAm age analysis and Hallmark of Aging enrichment signals, the stages captured the biological aging state more clearly than a mere grouping by chronological age and could further be recovered in a longitudinal validation cohort with high stability. Characterization of the biological processes driving the phases using machine learning enabled a data-driven reconstruction of the order of Hallmark of Aging manifestation. Finally, we investigated non-linearities in the mid-life aging progression captured by the aging phases and identified a far-reaching non-linear increase in transcriptional noise in the pathway landscape in the transition from mid- to late-life.
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21
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Choi MC, Chung YS, Lee JW, Kwon BS, Park BK, Kim SI, Shim SH, Lee KB, Seong SJ, Lee SJ, Lee SH, Yoo HJ, Song T, Kim MK, Baek MH, Kang S, Kim YM. Feasibility and efficacy of gonadotropin-releasing hormone agonists for the prevention of chemotherapy-induced ovarian insufficiency in patients with malignant ovarian germ cell tumours (KGOG 3048R). Eur J Cancer 2020; 133:56-65. [PMID: 32442924 DOI: 10.1016/j.ejca.2020.03.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/23/2020] [Accepted: 03/29/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND This study assessed the effects of gonadotropin-releasing hormone agonists (GnRHa) on the prevention of chemotherapy-induced ovarian insufficiency among young patients with malignant ovarian germ cell tumour (MOGCT) receiving chemotherapy. METHODS This multicentre, retrospective study was conducted at 15 sites affiliated with the Korean Gynecologic Oncology Group and enrolled 354 patients between January 1995 and September 2018. Among them, 227 patients were included in this study and divided into two groups according to the use of GnRHa during chemotherapy (GnRHa versus no GnRHa groups). The primary objective was to compare the rates of menstrual resumption between the two groups. We also assessed the clinical determinants affecting menstrual resumption among the study groups. RESULTS There were no significant differences between the GnRHa (n = 63) and no GnRHa (n = 164) groups regarding age at diagnosis, parity, ethnicity, age at menarche, body mass index, International Federation of Gynecology and Obstetrics stage, mode of surgery and surgery type. The rate of menstrual resumption after chemotherapy was 100% (63 of 63) in the GnRHa group and 90.9% (149 of 164) in the no GnRHa group (p = 0.013). The mean periods from last chemotherapy to menstrual resumption were 7.4 and 7.3 months in the GnRHa and no GnRHa groups, respectively. GnRHa co-administration during chemotherapy reduced the likelihood of amenorrhoea after chemotherapy, although statistical significance was not confirmed in the univariate analysis (odds ratio: 0.276; 95% confidence interval, 0.004-1.317; p = 0.077). CONCLUSION Temporary ovarian suppression with GnRHa during chemotherapy does not significantly increase the chances of menstrual resumption in young patients with MOGCT.
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Affiliation(s)
- Min C Choi
- Comprehensive Gynecologic Cancer Center, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, South Korea.
| | - Young S Chung
- Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Jeong-Won Lee
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
| | - Byung S Kwon
- Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Byung K Park
- Center for Pediatric Oncology, National Cancer Center, Goyang, South Korea
| | - Se I Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea
| | - Seung-Hyuk Shim
- Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, South Korea
| | - Kwang-Beom Lee
- Department of Obstetrics and Gynecology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Seok J Seong
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul, South Korea
| | - Sung J Lee
- Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - San H Lee
- Department of Obstetrics and Gynecology, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Heon-Jong Yoo
- Department of Obstetrics and Gynecology, Chungnam National University, School of Medicine, Daejeon, South Korea
| | - Taejong Song
- Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Min K Kim
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Min-Hyun Baek
- Department of Obstetrics and Gynecology, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Sokbom Kang
- Gynecologic Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang, South Korea
| | - Yong-Man Kim
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
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22
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Hazeslip L, Zafar MK, Chauhan MZ, Byrd AK. Genome Maintenance by DNA Helicase B. Genes (Basel) 2020; 11:E578. [PMID: 32455610 PMCID: PMC7290933 DOI: 10.3390/genes11050578] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 12/25/2022] Open
Abstract
DNA Helicase B (HELB) is a conserved helicase in higher eukaryotes with roles in the initiation of DNA replication and in the DNA damage and replication stress responses. HELB is a predominately nuclear protein in G1 phase where it is involved in initiation of DNA replication through interactions with DNA topoisomerase 2-binding protein 1 (TOPBP1), cell division control protein 45 (CDC45), and DNA polymerase α-primase. HELB also inhibits homologous recombination by reducing long-range end resection. After phosphorylation by cyclin-dependent kinase 2 (CDK2) at the G1 to S transition, HELB is predominately localized to the cytosol. However, this cytosolic localization in S phase is not exclusive. HELB has been reported to localize to chromatin in response to replication stress and to localize to the common fragile sites 16D (FRA16D) and 3B (FRA3B) and the rare fragile site XA (FRAXA) in S phase. In addition, HELB is phosphorylated in response to ionizing radiation and has been shown to localize to chromatin in response to various types of DNA damage, suggesting it has a role in the DNA damage response.
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Affiliation(s)
- Lindsey Hazeslip
- Department of Biochemistry and Molecular Biology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (L.H.); (M.K.Z.); (M.Z.C.)
| | - Maroof Khan Zafar
- Department of Biochemistry and Molecular Biology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (L.H.); (M.K.Z.); (M.Z.C.)
| | - Muhammad Zain Chauhan
- Department of Biochemistry and Molecular Biology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (L.H.); (M.K.Z.); (M.Z.C.)
| | - Alicia K. Byrd
- Department of Biochemistry and Molecular Biology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (L.H.); (M.K.Z.); (M.Z.C.)
- Winthrop P. Rockefeller Cancer Institute, Little Rock, AR 72205, USA
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23
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Is it possible to investigate menopausal age? A comparative cross-sectional study of five cohorts between 1968 and 2017 from the Population Study of Women in Gothenburg, Sweden. ACTA ACUST UNITED AC 2020; 27:430-436. [PMID: 31934948 DOI: 10.1097/gme.0000000000001476] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of this study was to examine if the previously found trend of increasing menopausal age is continuing, taking into consideration hormonal use and surgical menopause in both 38- and 50-year-old women of today. METHODS Cohort comparisons of five generations of population-based samples of 38- and 50-year-old women from the Prospective Population Study of Women in Gothenburg with start in 1968/1969, and with follow-ups in 1980/1981, 1992/1993, 2004/2005, and 2016/2017. Across the time periods newly recruited women as well as earlier participants were included. Use of hormonal contraceptives, estrogen plus progestogen therapy (EPT), and time for menopause was registered. Changes between different generations of 38- and 50-year-old women from 1968/1969 until today were studied. The overall sample size across the time periods was 1,873 individuals. RESULTS The prevalence of oral contraceptives in 38-year-old women was about 10% in 1968/1969, increasing from 16% in 2004/2005 to almost 22% in 2016/2017. From 2004/2005 the use of hormonal intrauterine contraceptive method (the Levonorgestrel-releasing intrauterine system [LNG-IUS]) increased from about 11% to 14% in 2016/2017. The same pattern was found in 50-year-old women using LNG-IUS, increasing from 6% to 15.5% between 2004/2005 and 2016/2017. The total hormonal use, including LNG-IUS, oral contraceptives, and EPT, was 28% in 50-year-old women in 2016/2017. The total proportion of hormone use in 50-year-old women increased over the years and together with surgical menopause it reached over 37% in the 2016/2017 survey. CONCLUSIONS This study has shown an increase in the hormonal use, in both 38- and 50-year-old women, making it difficult to determine when the actual menopause occurs. Thus, the previously found increasing secular trend in menopausal age will be more complicated to assess in female generations of today and tomorrow.
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24
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Malek AM, Vladutiu CJ, Meyer ML, Cushman M, Newman R, Lisabeth LD, Kleindorfer D, Lakkur S, Howard VJ. The association of age at menopause and all-cause and cause-specific mortality by race, postmenopausal hormone use, and smoking status. Prev Med Rep 2019; 15:100955. [PMID: 31367516 PMCID: PMC6651856 DOI: 10.1016/j.pmedr.2019.100955] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 07/11/2019] [Accepted: 07/12/2019] [Indexed: 11/29/2022] Open
Abstract
While a mean age at menopause of 51 years has been reported in the United States (U.S.), some U.S. women experience menopause before age 45, possibly increasing risk of cardiovascular mortality; however, the role in all-cause and cerebrovascular-related mortality is unclear. The purpose of this study was to investigate the association between age at menopause and all-cause and cause-specific mortality by race, hormone replacement therapy (HRT) use, and smoking status. REasons for Geographic and Racial Differences in Stroke (REGARDS) is a population-based study of 30,239 participants aged ≥45 years enrolled between 2003 and 2007 of whom 14,361 were postmenopausal women. Age at menopause was defined as <45 (early) or ≥45. All-cause and cause-specific mortality were ascertained through 2013. Cox proportional hazards models estimated hazard ratios (HR) and 95% confidence intervals (CI) for the association between age at menopause and mortality, adjusting for baseline measures. Of 11,287 eligible women (6403 white; 4884 black), mean menopause age was 45.2 (SD 7.9) with 1524 deaths over 7.1 years. Significant interactions were detected between early age at menopause (39%) and HRT use in association with all-cause mortality (p < 0.01), mortality from coronary heart disease (p = 0.06), and mortality from all other causes (p = 0.04). An association between early age at menopause and all-cause mortality was observed among ever-HRT users (HR = 1.31, 95% CI: 1.10–1.56), but not never-HRT users (HR = 1.01, 95% CI: 0.85–1.20). There were no differences in associations examined by race or smoking status. Increased all-cause mortality risk was observed for ever-HRT users with menopause before age 45. Increased all-cause mortality risk in ever-HRT users with menopause before age 45 HRT use modified the association of menopause before age 45 and CHD mortality. There were no differences in associations examined by race or smoking status.
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Key Words
- Age
- BMI, body mass index
- BWHS, Black Women's Health Study
- CHD, coronary heart disease
- CI, confidence interval
- CVD, cardiovascular disease
- Coronary heart disease
- ECG, electrocardiogram
- FDA, Food and Drug Administration
- HR, hazard ratio
- HRT, hormone replacement therapy
- MI, myocardial infarction
- MRR, mortality rate ratio
- Menopause
- Mortality
- NAMS, North American Menopause Society
- NDI, National Death Index
- REGARDS
- REGARDS, REasons for Geographic and Racial Differences in Stroke
- RR, relative risk
- Race
- SD, standard deviation
- Smoking
- U.S., United States
- Women
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Affiliation(s)
- Angela M Malek
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Catherine J Vladutiu
- Department of Obstetrics & Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Michelle L Meyer
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mary Cushman
- Department of Med-Hematology Oncology, University of Vermont, Burlington, VT, USA.,Department of Pathology & Laboratory Medicine, University of Vermont, Burlington, VT, USA
| | - Roger Newman
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA
| | - Lynda D Lisabeth
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA.,Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Dawn Kleindorfer
- Department of Neurology, University of Cincinnati, Cincinnati, OH, USA
| | - Sindhu Lakkur
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Virginia J Howard
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
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25
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Zhang D, Liu Y, Zhang Z, Lv P, Liu Y, Li J, Wu Y, Zhang R, Huang Y, Xu G, Qian Y, Qian Y, Chen S, Xu C, Shen J, Zhu L, Chen K, Zhu B, Ye X, Mao Y, Bo X, Zhou C, Wang T, Chen D, Yang W, Tan Y, Song Y, Zhou D, Sheng J, Gao H, Zhu Y, Li M, Wu L, He L, Huang H. Basonuclin 1 deficiency is a cause of primary ovarian insufficiency. Hum Mol Genet 2019; 27:3787-3800. [PMID: 30010909 DOI: 10.1093/hmg/ddy261] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 07/09/2018] [Indexed: 12/30/2022] Open
Abstract
Primary ovarian insufficiency (POI) leads to infertility and premature menopause in young women. The genetic etiology of this disorder remains unknown in most patients. Using whole exome sequencing of a large Chinese POI pedigree, we identified a heterozygous 5 bp deletion inducing a frameshift in BNC1, which is predicted to result in a non-sense-mediated decay or a truncated BNC1 protein. Sanger sequencing identified another BNC1 missense mutation in 4 of 82 idiopathic patients with POI, and the mutation was absent in 332 healthy controls. Transfection of recombinant plasmids with the frameshift mutant and separately with the missense mutant in HEK293T cells led to abnormal nuclear localization. Knockdown of BNC1 was found to reduce BMP15 and p-AKT levels and to inhibit meiosis in oocytes. A female mouse model of the human Bnc1 frameshift mutation exhibited infertility, significantly increased serum follicle-stimulating hormone, decreased ovary size and reduced follicle numbers, consistent with POI. We report haploinsufficiency of BNC1 as an etiology of human autosomal dominant POI.
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Affiliation(s)
- Dan Zhang
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Yifeng Liu
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Zhou Zhang
- Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Bio-X Institutes, Shanghai Jiao Tong University, Shanghai, China.,Institute of Biliary Tract Disease, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Pingping Lv
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Yun Liu
- Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Jingyi Li
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Yiqing Wu
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Runjv Zhang
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Yun Huang
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Gufeng Xu
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Yeqing Qian
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Yuli Qian
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Songchang Chen
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Chenming Xu
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Jun Shen
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Linling Zhu
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Kai Chen
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Bo Zhu
- Department of Clinical Laboratory, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Xiaoqun Ye
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Yuchan Mao
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Xingsheng Bo
- Department of Clinical Laboratory, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Caiyun Zhou
- Department of Pathology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Tingting Wang
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China.,Vancouver Prostate Center, Department of Urologic Sciences, University of British Columbia, Vancouver, BC Canada V6T, Canada
| | - Dianfu Chen
- Key Laboratory of Conservation Biology for Endangered Wildlife of the Ministry of Education and College of Life Sciences, Zhejiang University, Zhejiang, China
| | - Weijun Yang
- Key Laboratory of Conservation Biology for Endangered Wildlife of the Ministry of Education and College of Life Sciences, Zhejiang University, Zhejiang, China
| | - Yajing Tan
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Yang Song
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Daizhan Zhou
- Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Jianzhong Sheng
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China.,Department of Pathology & Pathophysiology, Zhejiang University School of Medicine, Zhejiang, China
| | - Huijuan Gao
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Yimin Zhu
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Meigen Li
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Liping Wu
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Lin He
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China.,Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Bio-X Institutes, Shanghai Jiao Tong University, Shanghai, China.,Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Hefeng Huang
- Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang, China.,International Peace Maternal and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, China
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Mann C, Mahner S, Thaler CJ. [Menopause]. MMW Fortschr Med 2019; 161:50-57. [PMID: 30778954 DOI: 10.1007/s15006-019-0004-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Corinna Mann
- Hormon- und Kinderwunschzentrum, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der Ludwig Maximilians Universität München, Campus Innenstadt, Maistrasse 11, D-80337, München, Deutschland.
| | - Sven Mahner
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der Ludwig-Maximilians-Universität München, München, Deutschland
| | - Christian J Thaler
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der Ludwig-Maximilians-Universität München, München, Deutschland
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Increased longevity in older users of postmenopausal estrogen therapy: the Leisure World Cohort Study. Menopause 2018; 25:1256-1261. [PMID: 30358721 DOI: 10.1097/gme.0000000000001227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To examine the effect of postmenopausal estrogen therapy (ET), including duration and recency of use, on all-cause mortality in older women. DESIGN As part of a prospective cohort study of residents of a California retirement community begun in the early 1980s, Leisure World Cohort women (median age, 73 y) completed a postal health survey including details on ET use and were followed up for 22 years (1981-2003). Age- and multivariate-adjusted risk ratios (RR) and 95% CIs were calculated using proportional hazard regression. RESULTS Of the 8,801 women, 6,626 died during follow-up (median age, 88 y). ET users had an age-adjusted mortality rate of 52.9 per 1,000 person-years compared with 56.5 among lifetime nonusers (RR = 0.91; 95% CI, 0.87-0.96). Risk of death decreased with both increasing duration of ET and decreasing years since last use (P for trend < 0.001). The risk was lowest among long-term (≥15 y) users (RR = 0.83; 95% CI, 0.74-0.93 for 15-19 y and RR = 0.87; 95% CI, 0.80-0.94 for 201 y). For long-term users, the age-adjusted mortality rate was 50.4 per 1,000 person-years. Lower-dose users (≤0.625 mg) had a slightly better survival rate than higher-dose users (RR = 0.84; 95% CI, 0.78-0.91 vs RR = 0.91; 95% CI, 0.83-0.97). Risk did not differ by route of administration (P = 0.56). Further adjustment for potential confounders had little effect on the observed RRs for ET. CONCLUSION Long-term ET is associated with lower all-cause mortality in older women.
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Abstract
OBJECTIVE Menopause may be a risk factor for hearing loss, and postmenopausal hormone therapy (HT) has been proposed to slow hearing decline; however, there are no large prospective studies. We prospectively examined the independent relations between menopause and postmenopausal HT and risk of self-reported hearing loss. METHODS Prospective cohort study among 80,972 women in the Nurses' Health Study II, baseline age 27 to 44 years, followed from 1991 to 2013. Baseline and updated information was obtained from detailed validated biennial questionnaires. Cox proportional-hazards regression models were used to examine independent associations between menopausal status and postmenopausal HT and risk of hearing loss. RESULTS After 1,410,928 person-years of follow-up, 18,558 cases of hearing loss were reported. There was no significant overall association between menopausal status, natural or surgical, and risk of hearing loss. Older age at natural menopause was associated with higher risk. The multivariable-adjusted relative risk of hearing loss among women who underwent natural menopause at age 50+ years compared with those aged less than 50 years was 1.10 (95% confidence interval [CI] 1.03, 1.17). Among postmenopausal women, oral HT (estrogen therapy or estrogen plus progestogen therapy) was associated with higher risk of hearing loss, and longer duration of use was associated with higher risk (P trend < 0.001). Compared with women who never used HT, the multivariable-adjusted relative risk of hearing loss among women who used oral HT for 5 to 9.9 years was 1.15 (95% CI 1.06, 1.24) and for 10+ years was 1.21 (95% CI 1.07, 1.37). CONCLUSIONS Older age at menopause and longer duration of postmenopausal HT are associated with higher risk of hearing loss.
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Celentano E, Galasso R, Berrino F, Fusconi E, Giurdanella MC, Tumino R, Sacerdote C, Fiorini L, Ciardullo AV, Mattiello A, Palli D, Masala G, Panico S. Correlates of Age at Natural Menopause in the Cohorts of Epic-Italy. TUMORI JOURNAL 2018; 89:608-14. [PMID: 14870825 DOI: 10.1177/030089160308900604] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A large number of studies have investigated the factors correlated to age at natural menopause in several populations. However, information on genetics and life-style factors influencing the age of onset of menopause in different populations is of current scientific interest. Specifically, for Italian women there are no large population-based data. The EPIC-Italy collaboration is a source of data of this kind; moreover, the geographical distribution of the cohorts (recruited in northern, central and southern Italy) is an added value as regards the scientific interest of these data. A number of biological and life-style-related factors have been analyzed to evaluate their association to the age at natural menopause in 14,454 menopausal women of the EPIC-Italy collaboration. As regards life-style and environmental factors, the main results are: a) women living in different areas of the country have different ages of onset of natural menopause; b) educational level is significantly associated to this age and may explain part of the between-center difference; c) cigarette smoking appears as a major correlate and probably determinant of the age at natural menopause across all the Italian cohorts; d) alcohol consumption does not have any relationship with the age at natural menopause; e) the use of oral contraceptives may influence age at natural menopause. As regards biological factors, short cycles and low parity have been found associated with earlier menopause. Overall, the results concerning menstrual cycles, parity, and cigarette smoking are consistent with the hypothesis that the number of oocytes in the ovary is pre-determined and any acceleration or impairment of the ovarian function leads to reduce the duration of the reproductive life.
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Affiliation(s)
- Egidio Celentano
- Flussi Informativi Sanitari, Istituto Nazionale Tumori di Napoli, Fondazione Pascale, Naples, Italy.
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Savonitto S, Colombo D, Prati F. Coronary artery disease after menopause and the role of estrogen replacement therapy. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/jcm.0000000000000596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Burgos N, Cintron D, Latortue-Albino P, Serrano V, Rodriguez Gutierrez R, Faubion S, Spencer-Bonilla G, Erwin PJ, Murad MH. Estrogen-based hormone therapy in women with primary ovarian insufficiency: a systematic review. Endocrine 2017; 58:413-425. [PMID: 29039146 PMCID: PMC5765545 DOI: 10.1007/s12020-017-1435-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 09/20/2017] [Indexed: 12/21/2022]
Abstract
PURPOSE Sex hormones play a role in bone density, cardiovascular health, and wellbeing throughout reproductive lifespan. Women with primary ovarian insufficiency (POI) have lower estrogen levels requiring hormone therapy (HT) to manage symptoms and to protect against adverse long-term health outcomes. Yet, the effectiveness of HT in preventing adverse outcomes has not been systematically assessed. We summarize the evidence regarding effects of HT on bone and cardiovascular health in women with POI. METHODS A comprehensive search of the electronic databases MEDLINE, EMBASE, and Scopus was conducted by a medical reference librarian from database inception to January 2016. Randomized trials and observational cohort studies with an estrogen-based HT intervention in women with POI under the age of 40 were included. Reviewers worked independently and in duplicate to assess eligibility and risk of bias, and extract data of interest from each study. RESULTS The search identified 1670 articles; 12 met inclusion criteria. Four randomized clinical trials and eight cohort studies at high risk of bias enrolled 806 women with POI. The most common HT formulations were transdermal estradiol and oral conjugated equine estrogen combined with medroxyprogesterone acetate. Bone mineral density was the most frequent outcome, with three out of eight studies showing HT associated increase benefits. Only one study reported effects on fractures or vasomotor symptoms and none on cardiovascular mortality. Results regarding lipid profiles were inconsistent. CONCLUSIONS Evidence supporting bone and cardiovascular benefits of HT in women with POI is limited by high risk of bias, reliance on surrogate outcomes, and heterogeneity of trials regarding the formulation, dose, route of administration, and regimen of HT. Further research addressing patient important outcomes such as fractures, stroke, and cardiovascular mortality are crucial to optimize benefits of this therapy.
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Affiliation(s)
- Nydia Burgos
- Internal Medicine Department, VA Caribbean Health Care System, San Juan, PR, 00921, USA
| | - Dahima Cintron
- Mayo Graduate School, Mayo Clinic, Rochester, MN, 55905, USA.
- University of Puerto Rico-Medical Sciences Campus, San Juan, PR, 00921, USA.
| | | | - Valentina Serrano
- Department of Medicine, Knowledge and Evaluation Research Unit in Endocrinology, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, 55905, USA
- Department of Nutrition, Diabetes and Metabolism, Escuela de Medicina, Pontifica Universidad Católica de Chile, Santiago, Chile
| | - Rene Rodriguez Gutierrez
- Department of Medicine, Knowledge and Evaluation Research Unit in Endocrinology, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, 55905, USA
- Department of Medicine, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, 55905, USA
- Department of Internal Medicine, Division of Endocrinology, University Hospital "Dr. Jose E. Gonzalez", Autonomous University of Nuevo Leon, Monterrey, 64460, Mexico
- Laboratorio Nacional para el Estudio y Aplicación de la Medicina Basada en Evidencia, Análisis Crítico de la Información Científica y Farmacoeconomía, Universidad Autónoma de Nuevo León, Monterrey, 66460, Mexico
| | - Stephanie Faubion
- Women's Health Clinic, Division of General Internal Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Gabriela Spencer-Bonilla
- Mayo Graduate School, Mayo Clinic, Rochester, MN, 55905, USA
- Department of Medicine, Knowledge and Evaluation Research Unit in Endocrinology, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, 55905, USA
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Effects of early age at natural menopause on coronary heart disease and stroke in Chinese women. Int J Cardiol 2017; 241:6-11. [DOI: 10.1016/j.ijcard.2017.03.127] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 02/24/2017] [Accepted: 03/27/2017] [Indexed: 11/18/2022]
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Abstract
Background Patterns of symptom clustering in midlife women may suggest common underlying mechanisms or may identify women at risk of adverse health outcomes or, conversely, likely to experience healthy aging. This paper assesses symptom clustering in the Study of Women’s Health Across the Nation (SWAN) longitudinally by stage of reproductive aging and estimates the probability of women experiencing specific symptom clusters. We also evaluate factors that influence the likelihood of specific symptom clusters and assess whether symptom clustering is associated with women’s self-reported health status. Methods This analysis includes 3289 participants in the multiethnic SWAN cohort who provided information on 58 symptoms reflecting a broad range of physical, psychological and menopausal symptoms at baseline and 7 follow-up visits over 16 years. We conducted latent transition analyses to assess symptom clustering and to model symptomatology across the menopausal transition (pre, early peri-, late peri- and post-menopausal). Joint multinomial logistic regression models were used to identify demographic characteristics associated with premenopausal latent class membership. A partial proportional odds regression model was used to assess the association between latent class membership and self-reported health status. Results We identified six latent classes that ranged from highly symptomatic (LC1) across most measured symptoms, to moderately symptomatic across most measured symptoms (LC2), to moderately symptomatic for a subset of symptoms (vasomotor symptoms, pain, fatigue, sleep disturbances and physical health symptoms) (LC3 and LC5) with one class (LC3) including interference in life activities because of physical health symptoms, to numerous milder symptoms, dominated by fatigue and psychological symptoms (LC4), to relatively asymptomatic (LC6). In pre-menopause, 10% of women were classified in LC1, 16% in LC2, 14% in LC3 and LC4, 26% in LC5, and 20% in LC6. Intensity of vasomotor and urogenital symptoms as well as sexual desire) differed minimally by latent class. Classification into the two most symptomatic classes was strongly associated with financial strain, White race/ethnicity, obesity and smoking status. Over time, women were most likely to remain within the same latent class as they transitioned through menopause stages (range 39–76%), although some women worsened or improved. The probability of moving between classes did not differ substantially by menopausal stage. Women in the highly symptomatic classes more frequently rated their health as fair to poor compared to women in the least symptomatic class. Conclusion Clear patterns of symptom clustering were present early in midlife, tended to be stable over time, and were strongly associated with self-perceived health. Notably, vasomotor symptoms tended to cluster with sleep disturbances and fatigue, were present in each of the moderate to highly symptomatic classes, but were not a defining characteristic of the symptom clusters. Clustering of midlife women by symptoms may suggest common underlying mechanisms amenable to interventions. Given that one-quarter of midlife women were highly or moderately symptomatic across all domains in the pre-menopause, addressing symptom burden in early midlife is likely critical to ameliorating risk in the most vulnerable populations. Electronic supplementary material The online version of this article (doi:10.1186/s40695-017-0021-y) contains supplementary material, which is available to authorized users.
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Lockhart PA, Martin P, Johnson MA, Shirtcliff E, Poon LW. The Relationship of Fertility, Lifestyle, and Longevity Among Women. J Gerontol A Biol Sci Med Sci 2017; 72:754-759. [PMID: 27519884 DOI: 10.1093/gerona/glw158] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 07/23/2016] [Indexed: 11/14/2022] Open
Abstract
Longevity in women has been found to be associated with several reproductive factors; the age of women when they give birth, their total number of children, and the age at which they experience menopause. In the context of expectations from the evolutionary theory of aging, the focus of this study examined relationships between lifetime reproduction, age at menopause and longevity, while accounting for various lifestyle factors. The purpose of this study was to assess fertility and age at onset of menopause in 197 women of the Georgia Centenarian Study. It was hypothesized that greater lifetime reproduction would predict earlier menopause and subsequently an earlier death. An independent t test was computed to assess ethnic differences between Caucasian and African American participants. Two block-wise multiple regression analyses were computed to evaluate the impact of low socioeconomic status in childhood, the age at the time of the first childbirth, the total number of children, smoking and alcohol use, incidence of heart disease and stroke, and the age at onset of menopause on longevity. Results from this study suggest a positive association between the total number of children to the age at onset of menopause and longevity. However, when considering the lifestyle factor of smoking, the association of the total number of children to longevity is diminished.
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Affiliation(s)
- Peggy A Lockhart
- Department of Human Development and Family Studies, Iowa State University, Ames
| | - Peter Martin
- Department of Human Development and Family Studies, Iowa State University, Ames
| | | | | | - Leonard W Poon
- Department of Gerontology, University of Georgia, Athens
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Abstract
The relation between fertility and longevity has always been a subject of study and controversy. Indeed, life expectancy extension is found to be tied to late births. This conclusion can be drawn from social-observational studies like the Long Life Family Study in New England and the New England Centenarian Study on which was found that women whose last birth was after 40 years of age are more likely to live longer. Recently, a group in Israel published a review on animal and human studies that shed some understanding on the cellular mechanisms behind the association between pregnancy and tissue regeneration and repair. These studies shed some understanding to draw biological plausibility on the association between late pregnancy and life expectancy.
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Abstract
Primary ovarian insufficiency describes a spectrum of declining ovarian function and reduced fecundity due to a premature decrease in initial follicle number, an increase in follicle destruction, or poor follicular response to gonadotropins. The sequelae of primary ovarian insufficiency include vasomotor symptoms, urogenital atrophy, osteoporosis and fracture, cardiovascular disease, and increased all-cause mortality. In women with primary ovarian insufficiency, systemic hormone therapy (HT) is an effective approach to treat the symptoms of hypoestrogenism and mitigate long-term health risks if there are no contraindications to treatment. Hormone therapy is indicated to reduce the risk of osteoporosis, cardiovascular disease, and urogenital atrophy and to improve the quality of life of women with primary ovarian insufficiency. Although exogenous estrogen replacement is recommended for women with primary ovarian insufficiency, data comparing various hormonal regimens for disease prevention, symptom amelioration, and safety are lacking in this population. As a first-line approach, HT (either orally or transdermally) that achieves replacement levels of estrogen is recommended. Combined hormonal contraceptives prevent ovulation and pregnancy more reliably than HT; despite only modest odds of spontaneous pregnancy in women with primary ovarian insufficiency, this is a critical consideration for those who deem pregnancy prevention a priority. Treatment for all women with primary ovarian insufficiency should continue until the average age of natural menopause is reached (age 50-51 years). Finally, considering the challenges that adolescents and young women may face in coping with the physical, reproductive, and social effects of primary ovarian insufficiency, comprehensive longitudinal management of this condition is essential.
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Shenoy S, Chawla JK, Gupta S, Sandhu JS. Prevalence of low bone health using quantitative ultrasound in Indian women aged 41–60 years: Its association with nutrition and other related risk factors. J Women Aging 2017; 29:334-347. [DOI: 10.1080/08952841.2016.1188620] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Shweta Shenoy
- Faculty of Sports Medicine and Physiotherapy, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Jasmine Kaur Chawla
- Faculty of Sports Medicine and Physiotherapy, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Swati Gupta
- Faculty of Sports Medicine and Physiotherapy, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Jaspal Singh Sandhu
- Faculty of Sports Medicine and Physiotherapy, Guru Nanak Dev University, Amritsar, Punjab, India
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Li X, Jiang Q, Li S, Feldman MW. Female fertility history and mid-late-life health: Findings from China. J Women Aging 2017; 30:62-74. [PMID: 28151095 DOI: 10.1080/08952841.2016.1259445] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
China's middle-aged and older women suffer from poorer health than men. Using national baseline data from the China Health and Retirement Longitudinal Study (CHARLS), a survey conducted from 2011 to 2012, this article applies logistic models to investigate the association between female fertility history (parity, early childbearing, late childbearing) and middle-aged and late-life health. We find that parity is related to the mid-late-life health of women. Women with four children or more are more likely to suffer from activities of daily living (ADL) impairment and poorer self-rated health than those with one to three children. Early childbearing is associated with ADL impairment; however, the correlation is mediated by socioeconomic status. Early childbearing is related to self-rated health in later life by an indirect-only mediation effect via educational attainment and personal income.
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Affiliation(s)
- Xiaomin Li
- a Institute for Population and Development Studies , Xi'an Jiaotong University (China) , Xi'an City , Shaanxi Province, China
| | - Quanbao Jiang
- a Institute for Population and Development Studies , Xi'an Jiaotong University (China) , Xi'an City , Shaanxi Province, China
| | - Shuzhuo Li
- a Institute for Population and Development Studies , Xi'an Jiaotong University (China) , Xi'an City , Shaanxi Province, China
| | - Marcus W Feldman
- b Morrison Institute for Population and Resource Studies , Stanford University , Stanford , California , USA
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Jaspers L, Kavousi M, Erler NS, Hofman A, Laven JS, Franco OH. Fertile lifespan characteristics and all-cause and cause-specific mortality among postmenopausal women: the Rotterdam Study. Fertil Steril 2017; 107:448-456.e1. [DOI: 10.1016/j.fertnstert.2016.11.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 11/03/2016] [Accepted: 11/03/2016] [Indexed: 12/17/2022]
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Links between reproductive factors and general health. Menopause 2017; 24:5-6. [DOI: 10.1097/gme.0000000000000800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Shadyab AH, Macera CA, Shaffer RA, Jain S, Gallo LC, Gass MLS, Waring ME, Stefanick ML, LaCroix AZ. Ages at menarche and menopause and reproductive lifespan as predictors of exceptional longevity in women: the Women's Health Initiative. Menopause 2017; 24:35-44. [PMID: 27465713 PMCID: PMC5177476 DOI: 10.1097/gme.0000000000000710] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of the present study was to investigate associations between reproductive factors and survival to age 90 years. METHODS This was a prospective study of postmenopausal women from the Women's Health Initiative recruited from 1993 to 1998 and followed until the last outcomes evaluation on August 29, 2014. Participants included 16,251 women born on or before August 29, 1924 for whom survival to age 90 during follow-up was ascertained. Women were classified as having survived to age 90 (exceptional longevity) or died before age 90. Multivariable logistic regression models were used to evaluate associations of ages at menarche and menopause (natural or surgical) and reproductive lifespan with longevity, adjusting for demographic, lifestyle, and reproductive characteristics. RESULTS Participants were on average aged 74.7 years (range, 69-81 y) at baseline. Of 16,251 women, 8,892 (55%) survived to age 90. Women aged at least 12 years at menarche had modestly increased odds of longevity (odds ratio [OR], 1.09; 95% CI, 1.00-1.19). There was a significant trend toward increased longevity for later age at menopause (natural or surgical; Ptrend = 0.01), with ORs (95% CIs) of 1.19 (1.04-1.36) and 1.18 (1.02-1.36) for 50 to 54 and at least 55 compared with less than 40 years, respectively. Later age at natural menopause as a separate exposure was also significantly associated with increased longevity (Ptrend = 0.02). Longer reproductive lifespan was significantly associated with increased longevity (Ptrend = 0.008). The odds of longevity were 13% (OR 1.13; 95% CI, 1.03-1.25) higher in women with more than 40 compared with less than 33 reproductive years. CONCLUSIONS Reproductive characteristics were associated with late-age survival in older women.
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Affiliation(s)
- Aladdin H Shadyab
- 1San Diego State University/University of California San Diego Joint-Doctoral Program in Public Health (Epidemiology), San Diego, CA 2Division of Epidemiology, Graduate School of Public Health, San Diego State University, San Diego, CA 3Division of Biostatistics and Bioinformatics, Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, La Jolla, CA 4Department of Psychology, San Diego State University, San Diego, CA 5The North American Menopause Society, Emeritus, Cleveland, OH 6Departments of Quantitative Health Sciences and Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester, MA 7Department of Medicine, Stanford Center for Prevention Research, Stanford University School of Medicine, Stanford, CA 8Division of Epidemiology, Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, La Jolla, CA
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Savonitto S, Colombo D, Franco N, Misuraca L, Lenatti L, Romano IJ, Morici N, Lo Jacono E, Leuzzi C, Corrada E, Aranzulla TC, Petronio AS, Bellia G, Romagnoli E, Cagnacci A, Zoccai GB, Prati F. Age at Menopause and Extent of Coronary Artery Disease Among Postmenopausal Women with Acute Coronary Syndromes. Am J Med 2016; 129:1205-1212. [PMID: 27321972 DOI: 10.1016/j.amjmed.2016.05.031] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 05/30/2016] [Accepted: 05/31/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND Epidemiological studies have shown a higher risk of cardiovascular mortality associated with early menopause, but the relation between menopausal age and extent of coronary artery disease after menopause is unknown. We assessed the relation between menopausal age and extent of coronary disease in postmenopausal women with an acute coronary syndrome. METHODS A prospective study was conducted in patients ≥55 years old undergoing coronary angiography for an acute coronary syndrome. Enrollment was stratified by sex (women/men ratio 2:1) and age (55-64, 65-74, 75-85, and >85 years). Women were administered menopause questionnaires during admission. An independent core lab quantified coronary artery disease extent using the Gensini Score, which classifies both significant (>50%) and nonsignificant lesions. Linear correlation was used to appraise the association between the Gensini score and menopausal age. RESULTS We enrolled 675 patients, 249 men and 426 women (mean age 74 years). The mean Gensini score was 60 ± 36 in men vs 50 ± 32 in women (P <.001), being higher among men at any age. The median menopausal age of women was 50 years. Risk factors and age at first acute coronary syndrome were identical among women below and above the median menopausal age. The Gensini score in women showed a weak association with age (R = 0.127; P = .0129), but not with menopausal age (R = 0.063; P = .228). At multivariable analysis, ejection fraction, female sex, and ST elevation myocardial infarction were independent predictors of the Gensini score in the overall population. CONCLUSIONS Menopausal age was not associated with the extent of coronary artery disease. Age at first acute coronary syndrome presentation, risk factors, and prior cardiovascular events were not affected by menopausal age. (The LADIES ACS study: NCT01997307).
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Affiliation(s)
| | | | | | - Leonardo Misuraca
- Division of Cardiology, Ospedale della Misericordia, Grosseto, Italy
| | - Laura Lenatti
- Division of Cardiology, Ospedale Manzoni, Lecco, Italy
| | | | - Nuccia Morici
- Cardiologia Prima, Emodinamica, Ospedale Niguarda, Milano, Italy
| | - Emilia Lo Jacono
- Division of Cardiology, IRCCS Arcispedale S. Maria Nuova, Reggio Emilia, Italy
| | - Chiara Leuzzi
- Division of Cardiology, IRCCS Arcispedale S. Maria Nuova, Reggio Emilia, Italy
| | - Elena Corrada
- Cardiovascular Department, Humanitas Clinical and Research Center, Rozzano, Italy
| | | | - A Sonia Petronio
- Cardiovascular Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | | | - Enrico Romagnoli
- Division of Cardiology, Ospedale Belcolle, Viterbo, and Centro per la Lotta Contro L'Infarto - CLI Foundation, Rome, Italy
| | - Angelo Cagnacci
- Department of Obstetrics, Gynecology and Pediatricss, Obstetrics and Gynecology Unit, Azienda Ospedaliero-Universitaria of Modena, Italy
| | - Giuseppe Biondi Zoccai
- Department of Medico Surgical Sciences and Biotechnology, Sapienza University of Rome, Latina, Italy
| | - Francesco Prati
- Division of Cardiology, Ospedale San Giovanni Addolorata, and Centro per la Lotta contro l' Infarto - CLI Foundation, Roma, Italy
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Li J, Eriksson M, Czene K, Hall P, Rodriguez-Wallberg KA. Common diseases as determinants of menopausal age. Hum Reprod 2016; 31:2856-2864. [DOI: 10.1093/humrep/dew264] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 09/07/2016] [Accepted: 10/06/2016] [Indexed: 01/02/2023] Open
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Knight JH, Howards PP, Spencer JB, Tsagaris KC, Lim SS. Characteristics related to early secondary amenorrhoea and pregnancy among women diagnosed with systemic lupus erythematosus: an analysis using the GOAL study. Lupus Sci Med 2016; 3:e000139. [PMID: 27752335 PMCID: PMC5051470 DOI: 10.1136/lupus-2015-000139] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 07/30/2016] [Accepted: 09/03/2016] [Indexed: 01/23/2023]
Abstract
Objective Systemic lupus erythematosus (SLE) disproportionately affects women and often develops during their reproductive years. Research suggests that some women who receive cyclophosphamide as treatment for SLE experience earlier decline in menstrual function, but reproductive health among women with SLE who have not taken this drug is less well understood. This study aims to better understand the relation between SLE and reproduction by assessing early secondary amenorrhoea and pregnancy in women treated with and without cyclophosphamide from a population-based cohort with large numbers of African-Americans. Methods Female patients with SLE, ages 20–40 at time of diagnosis, who were 40 years or older at the time of the survey were included in this analysis (N=147). Participants in the Georgians Organized Against Lupus (GOAL) study were asked about their reproductive histories including early secondary amenorrhoea, defined as loss of menstruation before age 40. Results Women who were cyclophosphamide naïve had an increased prevalence of early secondary amenorrhoea compared with population estimates, 13–17% compared with 1–5%. Factors associated with early secondary amenorrhoea in women not treated with cyclophosphamide were marital status and receipt of a kidney transplant. Treatment with cyclophosphamide doubled the prevalence after adjustment for patient characteristics. Over 88% of women reported being pregnant at least once, and about 83% of these had a child, but the majority of pregnancies occurred before diagnosis. Conclusions SLE diagnosed in early adulthood may affect women's reproductive health even if they are not treated with cyclophosphamide. Better understanding of other factors related to reproductive health in this population will improve clinicians' and patients' abilities to make treatment and family planning decisions.
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Affiliation(s)
- Jessica H Knight
- Department of Epidemiology , Rollins School of Public Health, Emory University , Atlanta, Georgia , USA
| | - Penelope P Howards
- Department of Epidemiology , Rollins School of Public Health, Emory University , Atlanta, Georgia , USA
| | - Jessica B Spencer
- Department of Gynecology and Obstetrics , Emory University School of Medicine , Atlanta, Georgia , USA
| | - Katina C Tsagaris
- Department of Rheumatology , Emory University School of Medicine , Atlanta, Georgia , USA
| | - Sam S Lim
- Department of Rheumatology , Emory University School of Medicine , Atlanta, Georgia , USA
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Choi BO, Lee YJ, Choi JH, Cho SW, Im HJ, An JE. The Association between Stress Level in Daily Life and Age at Natural Menopause in Korean Women: Outcomes of the Korean National Health and Nutrition Examination Survey in 2010-2012. Korean J Fam Med 2015; 36:305-9. [PMID: 26634097 PMCID: PMC4666866 DOI: 10.4082/kjfm.2015.36.6.305] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 08/28/2015] [Accepted: 08/30/2015] [Indexed: 11/05/2022] Open
Abstract
Background Although several risk factors associated with reduced age at natural menopause (ANM) have been investigated, the results are inconsistent. Excessive stress, which leads to elevation of stress hormones, can also negatively affect reproductive ability, including by accelerating menopause. However, a direct association between stress level and ANM has not yet been demonstrated. Therefore, the object of this study was to investigate the association between stress level and ANM in Korean women. Methods Study participants were Korean women between 40 and 70 years old who were in natural menopause during the 5th Korean National Health and Nutrition Examination Survey (n=3,176). The level of stress in daily life was estimated based on data from the mental health topics of the survey. We used the t-test and one-way analysis of variance to analyze the correlation between stress level and ANM. Regression (β) coefficients calculated by multiple regression analysis were used to estimate various factors affecting ANM. Results Women who experienced a high level of stress in daily life had a lower mean ANM than women with a low stress level (50.17±3.7 and 50.58±3.5 years, respectively), with a statistically significant correlation (P<0.05). This correlation was still observed after adjusting for age, body mass index, menstrual regularity, and personal income (P<0.05 for variables). Conclusion In Korean women between 40 and 70 years of age who are in natural menopause, there is a statistically significant correlation between stress level and ANM. In particular, women who experience a high level of stress in daily life have reduced ANM.
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Affiliation(s)
- Byoung-O Choi
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
| | - Yeon-Ji Lee
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
| | - Ji-Ho Choi
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
| | - Se-Wook Cho
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
| | - Hyun-Jung Im
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
| | - Jee-Eun An
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
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Association between duration of reproductive lifespan and Framingham risk score in postmenopausal women. Maturitas 2015; 82:431-5. [DOI: 10.1016/j.maturitas.2015.07.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 07/09/2015] [Accepted: 07/10/2015] [Indexed: 11/19/2022]
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Tao XY, Zuo AZ, Wang JQ, Tao FB. Effect of primary ovarian insufficiency and early natural menopause on mortality: a meta-analysis. Climacteric 2015; 19:27-36. [DOI: 10.3109/13697137.2015.1094784] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Gong D, Sun J, Zhou Y, Zou C, Fan Y. Early age at natural menopause and risk of cardiovascular and all-cause mortality: A meta-analysis of prospective observational studies. Int J Cardiol 2015; 203:115-9. [PMID: 26512821 DOI: 10.1016/j.ijcard.2015.10.092] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 10/06/2015] [Accepted: 10/12/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Dandan Gong
- Institute of Molecular Biology & Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu 212002, PR China
| | - Jun Sun
- Department of Gynaecology and Obstetrics, Tieling Central Hospital, Tieling 112000, PR China
| | - Yongjing Zhou
- Institute of Molecular Biology & Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu 212002, PR China
| | - Chen Zou
- Institute of Molecular Biology & Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu 212002, PR China
| | - Yu Fan
- Institute of Molecular Biology & Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu 212002, PR China.
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Shenassa ED, Rossen LM. Telomere length and age-at-menopause in the US. Maturitas 2015; 82:215-21. [PMID: 26297686 PMCID: PMC4669569 DOI: 10.1016/j.maturitas.2015.07.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 07/02/2015] [Accepted: 07/09/2015] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Age-at-menopause and leukocyte telomere length (LTL) are both associated with biologic aging. Therefore, it would be reasonable to hypothesize that LTL may also serve as a marker for reproductive aging as shorter LTL may be associated with earlier age-at-menopause. METHODS We analyzed data from 799 post-menopausal (ages 41-85) participants in the National Health and Nutrition Examination Survey (1999-2002), a nationally representative sample of U.S. women. RESULTS Controlling for behavioral, socio-demographic, and health-related determinants of menopause, we found that among non-Hispanic white women, an increase of one standard deviation in LTL was associated with a 0.43 year higher reported age-at-menopause. Among Mexican-Americans, an increase of one standard deviation in LTL was associated with a 1.56 year earlier menopause. There was no significant association between LTL and age-at-menopause among non-Hispanic black women. CONCLUSIONS Our main finding is evidence of a strong interaction by race/ethnicity in the association between LTL and age-at-menopause. This evidence does not support the hypothesis that shorter LTL is a predictor of earlier age-at-menopause, as the magnitude and direction of the associations between LTL and age-at-menopause varied across racial/ethnic groups.
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Affiliation(s)
- Edmond D Shenassa
- Maternal & Child Health Program, School of Public Health, University of Maryland, College Park, United States; Department of Epidemiology & Biostatistics, School of Public Health, University of Maryland, College Park, United States; Department of Epidemiology, School of Public Health, Brown University, United States; Department of Epidemiology, University of Maryland, Baltimore,United States.
| | - Lauren M Rossen
- Office of Analysis and Epidemiology, National Center for Health Statistics, Centers for Disease Control and Prevention,United States
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Late skeletal effects of early menopause. Menopause 2015; 22:1027-9. [DOI: 10.1097/gme.0000000000000537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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