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Song M, Jayasekara H, Pelucchi C, Rabkin CS, Johnson KC, Hu J, Palli D, Ferraroni M, Liao LM, Bonzi R, Zaridze D, Maximovitch D, Aragonés N, Martin V, Castaño-Vinyals G, Guevara M, Tsugane S, Hamada GS, Hidaka A, Negri E, Ward MH, Sinha R, Lagiou A, Lagiou P, Boffetta P, Curado MP, Lunet N, Vioque J, Zhang ZF, La Vecchia C, Camargo MC. Reproductive factors, hormonal interventions, and gastric cancer risk in the Stomach cancer Pooling (StoP) Project. Cancer Causes Control 2024; 35:727-737. [PMID: 38123742 DOI: 10.1007/s10552-023-01829-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Gastric cancer incidence is higher in men, and a protective hormone-related effect in women is postulated. We aimed to investigate and quantify the relationship in the Stomach cancer Pooling (StoP) Project consortium. METHODS A total of 2,084 cases and 7,102 controls from 11 studies in seven countries were included. Summary odds ratios (ORs) and 95% confidence intervals (CIs) assessing associations of key reproductive factors and menopausal hormone therapy (MHT) with gastric cancer were estimated by pooling study-specific ORs using random-effects meta-analysis. RESULTS A duration of fertility of ≥ 40 years (vs. < 20), was associated with a 25% lower risk of gastric cancer (OR = 0.75; 95% CI: 0.58-0.96). Compared with never use, ever, 5-9 years and ≥ 10 years use of MHT in postmenopausal women, showed ORs of 0.73 (95% CI: 0.58-0.92), 0.53 (95% CI: 0.34-0.84) and 0.71 (95% CI: 0.50-1.00), respectively. The associations were generally similar for anatomical and histologic subtypes. CONCLUSION Our results support the hypothesis that reproductive factors and MHT use may lower the risk of gastric cancer in women, regardless of anatomical or histologic subtypes. Given the variation in hormones over the lifespan, studies should address their effects in premenopausal and postmenopausal women. Furthermore, mechanistic studies may inform potential biological processes.
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Affiliation(s)
- Minkyo Song
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Harindra Jayasekara
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Claudio Pelucchi
- Branch of Medical Statistics, Biometry, and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Charles S Rabkin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Kenneth C Johnson
- School of Epidemiology and Public Health, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Jinfu Hu
- Harbin Medical University, Harbin, China
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy
| | - Monica Ferraroni
- Branch of Medical Statistics, Biometry, and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Linda M Liao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Rossella Bonzi
- Branch of Medical Statistics, Biometry, and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - David Zaridze
- Department of Clinical Epidemiology, N.N. Blokhin National Medical Research Center for Oncology, Moscow, Russia
| | - Dmitry Maximovitch
- Department of Clinical Epidemiology, N.N. Blokhin National Medical Research Center for Oncology, Moscow, Russia
| | - Nuria Aragonés
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Cancer Registration and Surveillance Unit, Public Health Division, Department of Health of Madrid, Madrid, Spain
| | - Vicente Martin
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Biomedicina (IBIOMED), Universidad de León, León, Spain
| | - Gemma Castaño-Vinyals
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Barcelona Institute for Global Health-ISGlobal, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Marcela Guevara
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Salud Pública y Laboral de Navarra, 31003, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008, Pamplona, Spain
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | | | - Akihisa Hidaka
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Eva Negri
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Mary H Ward
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Rashmi Sinha
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Areti Lagiou
- Department of Public and Community Health, School of Public Health, University of West Attica, Athens, Greece
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA
| | - Maria Paula Curado
- Centro Internacional de Pesquisa, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - Nuno Lunet
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
- Laboratório Para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Jesus Vioque
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernandez (ISABIAL-UMH), Alicante, Spain
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Carlo La Vecchia
- Branch of Medical Statistics, Biometry, and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - M Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
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Von Holle A, Adami HO, Baglietto L, Berrington de Gonzalez A, Bertrand KA, Blot W, Chen Y, DeHart JC, Dossus L, Eliassen AH, Fournier A, Garcia-Closas M, Giles G, Guevara M, Hankinson SE, Heath A, Jones ME, Joshu CE, Kaaks R, Kirsh VA, Kitahara CM, Koh WP, Linet MS, Park HL, Masala G, Mellemkjaer L, Milne RL, O'Brien KM, Palmer JR, Riboli E, Rohan TE, Shrubsole MJ, Sund M, Tamimi R, Tin Tin S, Visvanathan K, Vermeulen RC, Weiderpass E, Willett WC, Yuan JM, Zeleniuch-Jacquotte A, Nichols HB, Sandler DP, Swerdlow AJ, Schoemaker MJ, Weinberg CR. BMI and breast cancer risk around age at menopause. Cancer Epidemiol 2024; 89:102545. [PMID: 38377945 PMCID: PMC10942753 DOI: 10.1016/j.canep.2024.102545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND A high body mass index (BMI, kg/m2) is associated with decreased risk of breast cancer before menopause, but increased risk after menopause. Exactly when this reversal occurs in relation to menopause is unclear. Locating that change point could provide insight into the role of adiposity in breast cancer etiology. METHODS We examined the association between BMI and breast cancer risk in the Premenopausal Breast Cancer Collaborative Group, from age 45 up to breast cancer diagnosis, loss to follow-up, death, or age 55, whichever came first. Analyses included 609,880 women in 16 prospective studies, including 9956 who developed breast cancer before age 55. We fitted three BMI hazard ratio (HR) models over age-time: constant, linear, or nonlinear (via splines), applying piecewise exponential additive mixed models, with age as the primary time scale. We divided person-time into four strata: premenopause; postmenopause due to natural menopause; postmenopause because of interventional loss of ovarian function (bilateral oophorectomy (BO) or chemotherapy); postmenopause due to hysterectomy without BO. Sensitivity analyses included stratifying by BMI in young adulthood, or excluding women using menopausal hormone therapy. RESULTS The constant BMI HR model provided the best fit for all four menopausal status groups. Under this model, the estimated association between a five-unit increment in BMI and breast cancer risk was HR=0.87 (95% CI: 0.85, 0.89) before menopause, HR=1.00 (95% CI: 0.96, 1.04) after natural menopause, HR=0.99 (95% CI: 0.93, 1.05) after interventional loss of ovarian function, and HR=0.88 (95% CI: 0.76, 1.02) after hysterectomy without BO. CONCLUSION The BMI breast cancer HRs remained less than or near one during the 45-55 year age range indicating that the transition to a positive association between BMI and risk occurs after age 55.
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Affiliation(s)
- Ann Von Holle
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Hans-Olov Adami
- Clinical Effectiveness Group, Institute of Health and Society, University of Oslo, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinksa Institutet, Stockholm, Sweden
| | - Laura Baglietto
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | | | - William Blot
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yu Chen
- Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Jessica Clague DeHart
- School of Community and Global Health, Claremont Graduate University, Claremont, CA, USA
| | - Laure Dossus
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - A Heather Eliassen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Agnes Fournier
- Centre for Research in Epidemiology and Statistics, Paris, France
| | - Montse Garcia-Closas
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom
| | - Graham Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Marcela Guevara
- Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain
| | - Susan E Hankinson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - Alicia Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Michael E Jones
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom
| | - Corinne E Joshu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center, DKFZ, Heidelberg, Germany
| | | | - Cari M Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Martha S Linet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Hannah Lui Park
- Department of Pathology and Laboratory Medicine, Department of Epidemiology, UC Irvine School of Medicine, Irvine, CA, USA
| | - Giovanna Masala
- Institute for the Study and Prevention of Cancer, Florence, Italy
| | - Lene Mellemkjaer
- Diet, Cancer and Health, Danish Cancer Institute, Copenhagen, Denmark
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia; Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Katie M O'Brien
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Julie R Palmer
- Slone Epidemiology Center, Boston University, Boston, MA, USA
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | | | | | - Malin Sund
- Department of Surgical and perioperative Sciences/Surgery, Umea University, Sweden
| | - Rulla Tamimi
- Department of Population Health Sciences, Weill Cornell Medical College, NY, USA
| | - Sandar Tin Tin
- Cancer Epidemiology Unit, Oxford Population Health, University of Oxford, United Kingdom
| | - Kala Visvanathan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Roel Ch Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Walter C Willett
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Jian-Min Yuan
- Division of Cancer Control and Population Science, University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center, Pittsburgh, PA, USA; Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Hazel B Nichols
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Anthony J Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom; Division of Breast Cancer Research, The Institute of Cancer Research, London, United Kingdom
| | | | - Clarice R Weinberg
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
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Kim KJ, Lee JH, Kim SJ, Yu BY, Kang JH. Relationship between Serum Total Testosterone Concentration and Metabolic Syndrome in Premenopausal Obese Women. Korean J Fam Med 2024:kjfm.23.0089. [PMID: 38414373 DOI: 10.4082/kjfm.23.0089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/03/2023] [Indexed: 02/29/2024] Open
Abstract
Background Men with low testosterone levels are at an increased risk of developing metabolic syndrome, irrespective of age or obesity. However, the relationship between metabolic syndrome and testosterone levels in women remains unclear. We compared the total testosterone concentrations between premenopausal obese women with and without metabolic syndrome and identified the factors affecting these concentrations. Methods A single-center retrospective analysis was conducted using the medical records of 580 premenopausal women with obesity. The diagnostic criteria for metabolic syndrome were established using the National Cholesterol Education Program Adult Treatment Panel III guidelines. Results The mean±standard deviation age, weight, and body mass index were 38.8±8.4 years, 78.0±11.8 kg, and 30.0±4.1 kg/m2, respectively. The mean total testosterone concentration was lower in the metabolic syndrome group than in the non-metabolic syndrome group (n=385 vs. n=195; 0.22±0.10 ng/mL vs. 0.24±0.11 ng/mL; P<0.001). In a model adjusted for age, body mass index, skeletal muscle mass, body fat mass, and body fat percentage, the odds ratio for metabolic syndrome with respect to the total testosterone level was 0.128 (P=0.028). Testosterone concentration was negatively correlated with age (r=-0.334), systolic blood pressure (r=-0.084), and triglyceride concentration (r=-0.093) but positively correlated with weight (r=0.144), body mass index (r=0.140), waist circumference (r=0.133), body fat mass (r=0.167), and body fat percentage (r=0.167). Stepwise regression analysis revealed that age (β=-0.004, P<0.001), body mass index (β=0.003, P=0.004), and high-density lipoprotein cholesterol concentration (β=0.001, P=0.019) were independently associated with total testosterone concentration (adjusted R2=12.6%). Conclusion Metabolic syndrome and obesity may be independently associated with testosterone levels in premenopausal women with obesity.
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Affiliation(s)
- Kyu-Jin Kim
- Department of Family Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| | - Jun-Ho Lee
- Department of Family Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| | - Seong-Ju Kim
- Department of Family Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| | - Byung-Yeon Yu
- Department of Family Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| | - Jee-Hyun Kang
- Department of Family Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
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Li X, Li J, Hu Q, Zhang X, Chen F. Association of physical weight statuses defined by body mass index (BMI) with molecular subtypes of premenopausal breast cancer: a systematic review and meta-analysis. Breast Cancer Res Treat 2024; 203:429-447. [PMID: 37882920 DOI: 10.1007/s10549-023-07139-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/25/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND AND PURPOSE The association between overweight/obesity and postmenopausal breast cancer has been proven. However, uncertainty exists regarding the association between physical weight statuses and premenopausal breast cancer subtypes. This study aimed to explore the association of body weight statuses with molecular subtypes of premenopausal breast cancer. METHOD A systematic search of Medline, PubMed, Embase, and Web of Science was performed. The Newcastle-Ottawa Scale (NOS) and the Joanna Briggs Institute (JBI) Critical Appraisal tools were used to evaluate the quality of the literature. STATA and R software were used to analyze the extracted data. RESULT The meta-analysis included 35 observational studies with a total of 41,049 premenopausal breast cancer patients. The study showed that the proportion of underweight patients was 4.8% (95% CI = 3.9-5.8%, P = 0.01), overweight was 29% (95%CI = 27.1-30.9%, P < 0.01), obesity was 17.8% (95% CI = 14.9-21.2%, P < 0.0001), and normal weight was 51.6% (95% CI = 46.7-56.5%, P < 0.0001). The pooled results showed that in comparison to the normal weight group, being physically underweight is related to a 1.44-fold risk (OR = 1.44, 95%CI = 1.28-1.63, P < 0.0001) of HER2 + breast cancer. Overweight is related to a 1.16-fold risk (OR = 1.16, 95%CI = 1.06-1.26, P = 0.002) of TNBC and a 16% lower risk (OR = 0.84, 95%CI = 0.75-0.93, P = 0.001) of ER + breast cancer. When compared to underweight/normal weight populations, both overweight (OR = 0.74, 95%CI = 0.56-0.97, P = 0.032) and obesity (OR = 0.70, 95%CI = 0.50-0.98, P = 0.037) can reduce the risk of ER + PR + breast cancer. CONCLUSION In the premenopausal breast cancer population, the distribution of patients' numbers with different weight statuses was significantly distinct among the various breast cancer subtypes. Additionally, the associations between physical weight statuses and the risk of premenopausal breast cancer subtypes are divergent.
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Affiliation(s)
- Xuchu Li
- Department of Medical, Queen Mary School, Nanchang University, 461 Bayi Avenue, Donghu District, Nanchang City, 330006, Jiangxi Province, China
| | - Jinping Li
- Department of General Medical, People's Hospital of Fu City, Yan'an, 727505, Shaanxi Province, China
| | - Qirui Hu
- College of Food Science, Nanchang University, Nanchang, 330047, Jiangxi Province, China
| | - Xu Zhang
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, 330006, Jiangxi Province, China
| | - Fang Chen
- College of Food Science, Nanchang University, Nanchang, 330047, Jiangxi Province, China.
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, 330006, Jiangxi Province, China.
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Hachul H, Hachul de Campos B, Lucena L, Tufik S. Sleep During Menopause. Sleep Med Clin 2023; 18:423-433. [PMID: 38501515 DOI: 10.1016/j.jsmc.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
Postmenopause is defined retrospectively after 12 consecutive months of amenorrhea. It represents the end of the reproductive period and ovarian failure. A decrease in estrogen leads to several changes in the short and long term. Among the early changes, vasomotor symptoms (hot flashes) are particularly common, occurring in about 70% of women. In addition, there are changes in mood, anxiety, depression, and insomnia. Insomnia occurs in almost 60% of postmenopausal women. Psychosocial aspects may also affect sleep. Proper diagnosis may lead to adequate treatment of sleep disturbances during menopause. Hormonal or other complementary therapies can improve sleep quality.
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Affiliation(s)
- Helena Hachul
- Department of Psychobiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil; Department of Ginecology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.
| | | | - Leandro Lucena
- Department of Psychobiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Sergio Tufik
- Department of Psychobiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
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Zürcher A, Knabben L, Janka H, Stute P. Influence of the levonorgestrel-releasing intrauterine system on the risk of breast cancer: a systematic review. Arch Gynecol Obstet 2023; 307:1747-1761. [PMID: 35716207 PMCID: PMC10147797 DOI: 10.1007/s00404-022-06640-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/18/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE The intention of this systematic review was to analyze the literature on breast cancer (BC) and the use of the levonorgestrel-releasing intrauterine system (LNG-IUS). METHODS The literature was searched in Medline, Embase, Cochrane Library, CINAHL, Web of Science and ClinicalTrials.com and included search terms related to breast cancer and LNG-IUS. After elimination of duplicates, 326 studies could be identified and were assessed according to inclusion and exclusion criteria. In the end, 10 studies met the defined criteria and were included in the systematic review. RESULTS 6 out of the 10 selected studies were cohort studies, three were case-control studies and one a systematic review/meta-analysis. 6 found a positive association between BC and the use of LNG-IUS. One study only found an increased risk for invasive BC in the subgroup of women aged 40-45 years. In contrast, three studies showed no indication of a higher BC risk. CONCLUSION The results imply an increased BC risk in LNG-IUS users, especially in postmenopausal women and with longer duration of use. Positive effects of the LNG-IUS such as reduced risks for other hormonal cancers have been observed, were, however, not focus of this systematic review. The heterogeneity of the analyzed studies and vast number of confounding factors call for further investigations in this issue. Patients should be advised according to their individual risk profile and hormone-free alternatives may be considered for women with a history of BC.
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Affiliation(s)
| | - Laura Knabben
- Department of Obstetrics and Gynecology, Inselspital, University Clinic Bern, University of Bern, Friedbühlstrasse 19, 3010, Bern, Switzerland
| | - Heidrun Janka
- Medical Library, University Library Bern, University of Bern, Bern, Switzerland
| | - Petra Stute
- Department of Obstetrics and Gynecology, Inselspital, University Clinic Bern, University of Bern, Friedbühlstrasse 19, 3010, Bern, Switzerland.
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Chikwati RP, Mahyoodeen NG, Jaff NG, Ramsay M, Micklesfield LK, Wade AN, Agongo G, Asiki G, Choma SSR, Boua PR, George JA, Crowther NJ. Cardiometabolic disease risk factors in pre- and postmenopausal women from four sub-Saharan African countries: A cross-sectional study. Maturitas 2023; 172:60-68. [PMID: 37116348 PMCID: PMC10278059 DOI: 10.1016/j.maturitas.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 03/17/2023] [Accepted: 04/14/2023] [Indexed: 04/30/2023]
Abstract
OBJECTIVE To compare the risk factors for cardiometabolic disease between pre- and postmenopausal women from four sub-Saharan African countries. STUDY DESIGN This cross-sectional study included 3609 women (1740 premenopausal and 1869 postmenopausal) from sites in Ghana (Navrongo), Burkina Faso (Nanoro), Kenya (Nairobi), and South Africa (Soweto and Dikgale). Demographic, anthropometric and cardiometabolic variables were compared between pre- and postmenopausal women, within and across sites using multivariable regression analyses. The sites represent populations at different stages of the health transition, with those in Ghana and Burkina Faso being rural, whilst those in Kenya and South Africa are more urbanised. MAIN OUTCOME MEASURES Anthropometric and cardiometabolic variables. RESULTS The prevalence rates of risk factors for cardiometabolic disease were higher in South (Soweto and Dikgale) and East (Nairobi) Africa than in West Africa (Nanoro and Navrongo), irrespective of menopausal status. Regression models in combined West African populations demonstrated that postmenopausal women had a larger waist circumference (β = 1.28 (95 % CI: 0.58; 1.98) cm), log subcutaneous fat (β =0.15 (0.10; 0.19)), diastolic (β = 3.04 (1.47; 4.62) mm Hg) and log systolic (β = 0.04 (0.02; 0.06)) blood pressure, log carotid intima media thickness (β = 0.03 (0.01; 0.06)), low-density lipoprotein cholesterol (β = 0.14 (0.04; 0.23) mmol/L) and log triglyceride (β= 0.10 (0.04; 0.16)) levels than premenopausal women. No such differences were observed in the South and East African women. CONCLUSIONS Menopause-related differences in risk factors for cardiometabolic disease were prominent in West but not East or South African study sites. These novel findings should inform cardiometabolic disease prevention strategies in midlife women specific to rural and urban and peri-urban locations in sub-Saharan Africa.
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Affiliation(s)
- Raylton P Chikwati
- Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Nasrin Goolam Mahyoodeen
- Department of Internal Medicine, Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicole G Jaff
- Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Michele Ramsay
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lisa K Micklesfield
- South African Medical Research Council/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Alisha N Wade
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Godfred Agongo
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana; Department of Biochemistry and Forensic Science, School of Chemical and Biochemical Sciences, C. K. Tedam University of Technology and Applied Science, Navrongo, Ghana
| | - Gershim Asiki
- African Population and Health Research Center, Nairobi, Kenya
| | - Solomon S R Choma
- Department of Pathology and Medical Sciences, DIMAMO HDSS, University of Limpopo, Polokwane, South Africa
| | - Palwende R Boua
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Santé, Burkina Faso
| | - Jaya A George
- Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Chemical Pathology, National Health Laboratory Service, Johannesburg, South Africa
| | - Nigel J Crowther
- Department of Chemical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Chemical Pathology, National Health Laboratory Service, Johannesburg, South Africa
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Lee D, Jung W, Shin DW. Association of Coffee or Green Tea with Ferritin or Hemoglobin in Premenopausal Women. Korean J Fam Med 2023; 44:87-94. [PMID: 36966738 PMCID: PMC10040265 DOI: 10.4082/kjfm.22.0133] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/05/2022] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND This study aimed to examine the association between coffee or green tea consumption and ferritin or hemoglobin levels in premenopausal women. METHODS We used the fifth Korea National Health and Nutrition Examination Survey (2010-2012), and a total of 4,322 individuals were surveyed. In women of reproductive age, average ferritin and hemoglobin levels were calculated according to coffee or green tea consumption. Covariates included in the analysis were demographic variables, such as age, body mass index, education, drinking, smoking, history of hypertension, history of diabetes diagnosis, physical activity, total energy intake, and daily iron intake. RESULTS In 4,322 participants, the average hemoglobin level was 12.90±0.02 g/dL, and the average level of ferritin was 31.95±0.67 ng/mL. As a result of testing, correlation between ferritin and coffee intake and difference in ferritin levels according to coffee consumption was significant (P<0.05). In this study, a post hoc test indicated that ferritin level significantly differed between one and two cups, two and three cups, and three and one cup groups (overall P<0.001). Additionally, there was a negative correlation between ferritin level and coffee intake; ferritin level decreased by 2.09 ng/mL with a one-cup increase in daily coffee consumption. CONCLUSION In premenopausal women, coffee intake is associated with low serum ferritin levels. Our results indicate that drinking >2 cups of coffee significantly affect ferritin levels in Korean premenopausal women.
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Affiliation(s)
- Dagyeong Lee
- Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Wonyoung Jung
- Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Wook Shin
- Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology, Sungkyunkwan University, Seoul, Korea
- Corresponding Author: Dong Wook Shin https://orcid.org/0000-0001-8128-8920 Tel: +82-2-3410-5252, Fax: +82-2-3410-0388, E-mail:
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Refaei M, Mardanpour S, Masoumi SZ, Parsa P. Women's experiences in the transition to menopause: a qualitative research. BMC Womens Health 2022; 22:53. [PMID: 35219295 PMCID: PMC8882304 DOI: 10.1186/s12905-022-01633-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/21/2022] [Indexed: 11/16/2022] Open
Abstract
Background Around the time of transition to menopausal period, women experience mental, and psychological disorders that require adequate attention to these symptoms. This study aimed to explore the experiences of women in the face of premenopausal symptoms.
Methods This qualitative study was conducted using a content analysis method in Javanrood, Iran, in 2020. The data were collected through in-depth semi-structured face to face interviews with 16 premenopausal using interview guide in a private room in comprehensive health centers. The women inclusion criteria were approaching menopause, having irregular menstruation, and having no disease or medication that affects menstruation. Furthermore, the exclusion criteria were the absence of menstruation for more than 12 months, and the women's refusal to continue the interview. The participants were selected using purposive sampling and sampling continued until data saturation. The collected data were analyzed with MAXQDA10 software following the multi-step method proposed by Graneheim and Lundman. Results The participants' mean age was 47 ± 2.98 years. The data analysis revealed 5 categories including: "menopause and aging", "life transformation", confrontation of fear and hope", "life adjustment", and "need to facilitate the transition time". Conclusion This study suggested the women's experience of the transition to menopause was characterized by the fear of the future and its consequences and the need for reassurance about it. Besides, the women sought solutions to their problems in health care providers, peers, and the family.
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Affiliation(s)
- Mansoureh Refaei
- Department of Mother and Child Health, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Soraya Mardanpour
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyedeh Zahra Masoumi
- Department of Midwifery and Reproductive Health, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Parisa Parsa
- Department of Midwifery and Reproductive Health, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
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10
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Lee J, Chang Y, Kim Y, Park B, Ryu S. Insulin resistance and the development of breast cancer in premenopausal women: the Kangbuk Samsung Health Study. Breast Cancer Res Treat 2022. [PMID: 34997879 DOI: 10.1007/s10549-022-06513-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/03/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Research on the role of insulin resistance (IR) in breast cancer risk in premenopausal women is scarce. We aimed to investigate the relationship between IR and the development of breast cancer in premenopausal women. METHODS We analyzed the prospective association of IR and incident breast cancer in premenopausal women without breast cancer at baseline using a subsample of the Kangbuk Samsung Health Study. RESULTS Among 134,488 Korean premenopausal women, 696 women developed incident breast cancers during a median follow-up of 4.34 years. After adjustment for dense breast and other potential confounders, HR (95% CI) for incident breast cancer comparing HOMA-IR quintiles 2, 3, 4, and 5 to the first quintile was 0.91 (0.71-1.17), 0.89 (0.69-1.15), 0.75 (0.57-0.98), and 0.87 (0.65-1.16), respectively (P for trend = 0.117), while HR (95% CI) comparing insulin quintiles 2, 3, 4, and 5 to the first quintile was 1.02 (0.80-1.30), 0.90 (0.69-1.16), 0.72 (0.54-0.96), and 0.96 (0.72-1.28), respectively (P for trend = 0.151). This pattern did not significantly differ by obesity. These results were attenuated and no longer significant in time-dependent analyses where updated status of insulin and other covariates over time were treated as time-varying covariates. CONCLUSION Our findings do not support the positive relationship of IR with the development of breast cancer in premenopausal women, unlike in postmenopausal women. Thus, the role of IR as a risk factor for breast cancer may differ by menopausal status.
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11
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Sylvawani M, Setyohadi B, Purnamasari D, Abdullah M, Kurniawan MR. Comparison of insulin-like growth factor-1 and sclerostin levels between premenopausal women with and without diabetes mellitus. J Taibah Univ Med Sci 2021; 16:719-723. [PMID: 34690653 PMCID: PMC8498714 DOI: 10.1016/j.jtumed.2021.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 04/02/2021] [Accepted: 05/01/2021] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This study assesses the serum levels of insulin-like growth factor-1 (IGF-1) and sclerostin as markers of decreased bone formation in premenopausal women with type 2 diabetes mellitus. METHODS A cross-sectional study was conducted to measure serum levels of IGF-1 and sclerostin in 40 premenopausal women with and without diabetes mellitus using an enzyme-linked immunosorbent assay. The levels of IGF-1 and sclerostin were compared between the groups using the Mann Whitney test and unpaired t-test, respectively. RESULTS The median IGF-1 serum levels were 40.60 ng/mL and 42.7 ng/mL in the diabetic and non-diabetic groups, respectively, with no significant difference. The serum levels of sclerostin were significantly higher in the diabetic group than in the non-diabetic group (132.1 pg/mL and 96.0 pg/mL, respectively; p < 0.001). CONCLUSION The levels of sclerostin were significantly higher in premenopausal women with diabetes mellitus than in the non-diabetic group. Since sclerostin influences the differentiation and maturation of osteoblasts, serum sclerostin might potentially be useful as a marker of decreased bone formation in premenopausal women with diabetes.
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Affiliation(s)
- Mahriani Sylvawani
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Bambang Setyohadi
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Dyah Purnamasari
- Division of Metabolism and Endocrinology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Murdani Abdullah
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Muhammed R. Kurniawan
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
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12
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Velie EM, Marcus LR, Pathak DR, Hamilton AS, DiGaetano R, Klinger R, Gollapudi B, Houang R, Carnegie N, Olson LK, Allen A, Zhang Z, Modjesk D, Norman G, Lucas DR, Gupta S, Rui H, Schwartz K. Theory, methods, and operational results of the Young Women's Health History Study: a study of young-onset breast cancer incidence in Black and White women. Cancer Causes Control 2021; 32:1129-1148. [PMID: 34292440 PMCID: PMC8416838 DOI: 10.1007/s10552-021-01461-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 06/11/2021] [Indexed: 11/29/2022]
Abstract
Purpose The etiology of young-onset breast cancer (BC) is poorly understood, despite its greater likelihood of being hormone receptor-negative with a worse prognosis and persistent racial and socioeconomic inequities. We conducted a population-based case–control study of BC among young Black and White women and here discuss the theory that informed our study, exposures collected, study methods, and operational results. Methods Cases were non-Hispanic Black (NHB) and White (NHW) women age 20–49 years with invasive BC in metropolitan Detroit and Los Angeles County SEER registries 2010–2015. Controls were identified through area-based sampling from the U.S. census and frequency matched to cases on study site, race, and age. An eco-social theory of health informed life-course exposures collected from in-person interviews, including socioeconomic, reproductive, and energy balance factors. Measured anthropometry, blood (or saliva), and among cases SEER tumor characteristics and tumor tissue (from a subset of cases) were also collected. Results Of 5,309 identified potentially eligible cases, 2,720 sampled participants were screened and 1,812 completed interviews (682 NHB, 1140 NHW; response rate (RR): 60%). Of 24,612 sampled control households 18,612 were rostered, 2,716 participants were sampled and screened, and 1,381 completed interviews (665 NHB, 716 NHW; RR: 53%). Ninety-nine% of participants completed the main interview, 82% provided blood or saliva (75% blood only), and SEER tumor characteristics (including ER, PR and HER2 status) were obtained from 96% of cases. Conclusions Results from the successfully established YWHHS should expand our understanding of young-onset BC etiology overall and by tumor type and identify sources of racial and socioeconomic inequities in BC. Supplementary Information The online version of this article contains supplementary material available (10.1007/s10552-021-01461-x).
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Affiliation(s)
- Ellen M Velie
- Zilber School of Public Health, University of WI - Milwaukee, 1240 N. 10th Street, Milwaukee, WI, 53201, USA. .,Departments of Medicine and Pathology, Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI, 53226, USA.
| | - Lydia R Marcus
- Zilber School of Public Health, University of WI - Milwaukee, 1240 N. 10th Street, Milwaukee, WI, 53201, USA.,Departments of Medicine and Pathology, Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI, 53226, USA
| | - Dorothy R Pathak
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, 909 Wilson Road Room B601, East Lansing, MI, 48824, USA
| | - Ann S Hamilton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto St, Los Angeles, CA, 90089-9239, USA
| | | | - Ron Klinger
- Westat Inc., 1650 Research Blvd, Rockville, MD, 20850, USA
| | - Bibi Gollapudi
- Westat Inc., 1650 Research Blvd, Rockville, MD, 20850, USA
| | - Richard Houang
- Department of Education, Michigan State University, 620 Farm Ln, East Lancing, MI, 48824, USA
| | - Nicole Carnegie
- Department of Mathematics, Montana State University, 732 Grant St, Bozeman, MT, 59717, USA
| | - L Karl Olson
- Department of Physiology, Michigan State University, 567 Wilson Rd, East Lansing, MI, 48824, USA
| | - Amani Allen
- Departments of Community Health Sciences and Epidemiology, School of Public Health, University of California Berkeley, 2121 Berkeley Way, Berkeley, CA, 94720, USA
| | - Zhenzhen Zhang
- Division of Oncological Sciences, Knight Cancer Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Mail Code: KCRB-PROS, Portland, OR, 97239, USA
| | - Denise Modjesk
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto St, Los Angeles, CA, 90089-9239, USA
| | - Gwendolyn Norman
- College of Liberal Arts and Sciences, Wayne State University, 4841 Cass Avenue, Detroit, MI, 48201, USA
| | - Darek R Lucas
- Zilber School of Public Health, University of WI - Milwaukee, 1240 N. 10th Street, Milwaukee, WI, 53201, USA.,Departments of Medicine and Pathology, Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI, 53226, USA
| | - Sapna Gupta
- Cancer Research Informatics Core, University of Southern California Norris Cancer Center, NRT LG507, 1450 Biggy St, Los Angeles, CA, 90033, USA
| | - Hallgeir Rui
- Department of Pathology, Medical College of Wisconsin, 8701 Watertown Plank RD., Milwaukee, WI, 53226, USA
| | - Kendra Schwartz
- Department of Family Medicine and Public Health Sciences, Wayne State University, 3939 Woodward Ave, Detroit, MI, 48201, USA
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Abstract
Genetic and epigenetic factors have an important role during the development of osteoporosis. Receptor activator of nuclear factor-κ B (NF-κB) (RANK)/receptor activator of NF-κB ligand (RANKL) pathway is important for the bone remodeling, and NFATC1 and FOS are the downtargets of this pathway. Here, we report methylation status of NFATC1 and FOS genes in post- and premenopausal women. In this study, 30 premenopausal and 35 postmenopausal women were included. Methylation sensitive-high resolution melting (MS-HRM) analysis was used for identification of NFATC1 and FOS genes methylation. The NFATC1 gene was methylated in 11 of the 35 postmenopausal women, and the FOS gene was methylated in six of the postmenopausal women (p >0.005). Here, we found statistically significant association between unmethylation of the NFATC1 gene and postmenopausal status. This result explains the epigenetic regulation of osteoclasts during the menopausal transition, and for the first time, our results can be used for epigenetic explanation of postmenopausal osteoporosis in the literature. However, the limited number of studies in this field makes our results crucial. Our results showed great value of epigenetic profiles of postmenopausal women.
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Moon JS, Jin MH, Koh HM. Association between Serum Osteocalcin Levels and Metabolic Syndrome according to the Menopausal Status of Korean Women. J Korean Med Sci 2021; 36:e56. [PMID: 33650335 PMCID: PMC7921371 DOI: 10.3346/jkms.2021.36.e56] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 12/16/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Osteocalcin is known to regulate energy metabolism. Recently, metabolic syndrome (MetS) has been found to be associated with reduced levels of osteocalcin in men, as well as in postmenopausal women. The aim of this study was to investigate the association between serum osteocalcin and MetS in premenopausal women, compared with that in postmenopausal women. METHODS This cross-sectional study was based on 5,896 participants who completed a health screening examination. They were classified according to their menopausal status. Each group was subdivided into non-MetS and MetS groups according to the modified National Cholesterol Education Program-Adult Treatment Panel III criteria. Serum osteocalcin levels were measured using the electrochemiluminescence immunoassay. RESULTS Serum osteocalcin level was significantly lower in women with MetS than in those without MetS, after adjusting for confounders (14.12 ± 0.04 vs. 13.17 ± 0.13 [P = 0.004] in premenopausal women, and 20.34 ± 0.09 vs. 19.62 ± 0.21 [P < 0.001] in postmenopausal women), regardless of their menopausal status. Serum osteocalcin levels decreased correspondingly with an increasing number of MetS elements (P for trend < 0.001). Multiple regression analysis demonstrated that waist circumference (β = -0.085 [P < 0.001] and β = -0.137 [P < 0.001]) and hemoglobin A1c (β = -0.09 [P < 0.001] and β = -0.145 [P < 0.001]) were independent predictors of osteocalcin in premenopausal and postmenopausal women. Triglyceride levels were also independently associated with osteocalcin levels in premenopausal women (β = -0.004 [P < 0.013]). The odds ratio (OR) for MetS was significantly higher in the lowest quartile than in the highest quartile of serum osteocalcin levels after adjusting for age, alkaline phosphatase, uric acid, high sensitivity C-reactive protein, and body mass index in all women (OR, 2.00; 95% confidence interval [CI], 1.49-2.68) as well as in premenopausal (OR, 2.23; 95% CI, 1.39-3.58) and postmenopausal (OR, 2.01; 95% CI, 1.26-3.23) subgroups. CONCLUSION Lower serum osteocalcin concentrations were significantly associated with MetS in both premenopausal and postmenopausal women and were therefore independent of menopausal status.
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Affiliation(s)
- Jin Sook Moon
- Department of Family Medicine, Samsung Changwon Hospital, School of Medicine, Sungkyunkwan University, Changwon, Korea
- Department of Family Medicine, Pusan National University Graduate School of Medicine, Busan, Korea
| | - Mi Hyeon Jin
- Department of Research Support, Samsung Changwon Hospital, School of Medicine, Sungkyunkwan University, Changwon, Korea
| | - Hyun Min Koh
- Department of Family Medicine, Samsung Changwon Hospital, School of Medicine, Sungkyunkwan University, Changwon, Korea.
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15
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Fancellu A, Zhao XY, Cottu P, Sanna V, Li YP, Zhu Q, Tanda C, Zhang YY, Lai YM, Ginesu GC, Dai SQ, Porcu A. Comparing Clinicopathologic Features and Surgical Treatment of Premenopausal Breast Cancer across Italy and China: Report from a Medical Exchange Program. Breast Care (Basel) 2020; 15:511-518. [PMID: 33223995 DOI: 10.1159/000505448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 12/16/2019] [Indexed: 02/05/2023] Open
Abstract
Background This study investigated the differences in clinicopathologic features and surgical treatment between an Italian and a Chinese cohort of premenopausal women with breast cancer, and highlighted the potential advantages of international medical exchange projects. Methods Premenopausal women who underwent surgical treatment between 2012 and 2016 at one Italian and one Chinese institution participating in a medical exchange program were compared. Factors associated with the probability to receive mastectomy were determined via logistic analysis. Changes in surgical management at the Chinese institution in the period 2018-2019, after the exchange program, were also evaluated. Results A total of 505 patients, 318 from Italy and 187 from China, were evaluated. The Chinese patients had more frequently advanced-stage tumours, large tumour size (30.9 vs. 18.1 mm, p < 0.01), invasive carcinoma (92.5 vs. 83.3%, p < 0.01), positive axillary lymph nodes (54.5 vs. 27.4%, p < 0.01), Her-2 positivity (36.4 vs. 22.0%, p < 0.01), and high proliferative index (55.1 vs. 30.2%, p < 0.01). Positive oestrogen receptor status and rates of triple-negative breast cancer did not differ (77.0 vs. 69.5%, p = 0.09 and 14.2 vs. 16%, p = 0.56, respectively). Mastectomy rates were higher among Chinese women (85 vs. 41%, p < 0.001), whereas use of sentinel node biopsy was more frequent among Italian women (77 vs. 33%, p < 0.001). Chinese women had more than 4-fold higher risk of receiving mastectomy. In the last 2 years, the rates of breast-conserving surgery and sentinel node biopsy at the Chinese institution increased from 15 to 23%, and from 33 to 42%, respectively. Conclusions Tumour features and surgical strategies for premenopausal breast cancer may differ significantly between Italy and China. Since the international exchange program, patients from the Chinese institution have been offered more frequently less invasive surgery. International exchange programs can help in designing epidemiological studies which may be useful for strategies to improve breast cancer management and control.
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Affiliation(s)
- Alessandro Fancellu
- Unit of General Surgery 2-Clinica Chirurgica, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Xue Yun Zhao
- Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
| | - Pietrina Cottu
- Unit of General Surgery 2-Clinica Chirurgica, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Valeria Sanna
- Division of Medical Oncology, AOU Sassari, Sassari, Italy
| | - Yuan Ping Li
- Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
| | - Qin Zhu
- Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
| | - Cinzia Tanda
- Unit of General Surgery 2-Clinica Chirurgica, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Ying Yi Zhang
- Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
| | - Yan Mei Lai
- Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
| | - Giorgio Carlo Ginesu
- Unit of General Surgery 2-Clinica Chirurgica, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Shu Qin Dai
- Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
| | - Alberto Porcu
- Unit of General Surgery 2-Clinica Chirurgica, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
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Middelkoop MA, Harmsen MJ, Manyonda I, Mara M, Ruuskanen A, Daniels J, Mol BWJ, Moss J, Hehenkamp WJK, Wu O. Uterine artery embolization versus surgical treatment in patients with symptomatic uterine fibroids: Protocol for a systematic review and meta-analysis of individual participant data. Eur J Obstet Gynecol Reprod Biol 2020; 256:179-183. [PMID: 33246202 DOI: 10.1016/j.ejogrb.2020.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 11/06/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Uterine fibroids are the most common benign tumours in women of the reproductive age. Symptoms of heavy menstrual bleeding, abdominal discomfort and infertility may seriously affect a woman's quality of life. Uterine artery embolization is a safe and effective alternative treatment to hysterectomy or myomectomy for symptomatic uterine fibroids. Which treatment provides the highest quality of life, least complications, symptom reduction and least chance intervention, has not been established and might depend on strict patient selection. This study aims to identify which specific subgroups benefit most of each treatment by analyzing individual participant data derived from randomized controlled trials of women undergoing embolization or surgical treatment. This study will primarily assess the effectiveness of both treatment groups by evaluating the effect on quality of life of embolization in comparison to surgery on specific patient and fibroid characteristics and the possible need for re-intervention for fibroid-related symptoms. DATA SOURCES PubMed/MEDLINE, Embase and The Cochrane Library were searched up to August 2020. STUDY ELIGIBILITY CRITERIA We will collect individual participant data from randomized controlled trials that studied clinical and procedural outcomes of premenopausal women with symptomatic uterine fibroids, who were randomized between uterine artery embolization and surgery. STUDY APPRAISAL AND SYNTHESIS METHODS Individual participant data from all eligible trials will be sought and analysed according to intention-to-treat principle. Risk of Bias will be done by using version 2 of the Cochrane tool for Risk of Bias in randomized trials. Subgroup analyses to explore the effect of e.g. age, fibroid characteristics and fibroid complaints will be performed, if data is available. This individual patient data meta-analysis will be analysed according to a one-stage model.
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Affiliation(s)
- Mei-An Middelkoop
- Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development, Amsterdam University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands; Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.
| | - Marissa J Harmsen
- Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development, Amsterdam University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands; Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - Isaac Manyonda
- Department of Obstetrics and Gynaecology, St George's Hospital, Blackshaw Road, Tooting, London, SW17 0QT, United Kingdom
| | - Michal Mara
- Department of Obstetrics and Gynaecology, Division of Minimally Invasive Surgery, General Faculty Hospital and 1st Medical Faculty of Charles University, Apolinarska 18, 128 00, Prague 2, Czech Republic
| | - Anu Ruuskanen
- Department of Clinical Radiology, Kuopio University Hospital, P.O. Box 1777, 70211, Kuopio, Finland
| | - Jane Daniels
- Nottingham Clinical Trials Unit, University of Nottingham, University Park, Nottingham, NG7 2RD, United Kingdom
| | - Ben Willem J Mol
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Australia
| | - Jonathan Moss
- Department of Interventional Radiology, Gartnavel General Hospital, 1053 Great Western Road, Glasgow, G12 0YN, United Kingdom
| | - Wouter J K Hehenkamp
- Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development, Amsterdam University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands; Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - Olivia Wu
- Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, United Kingdom
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Iwamoto T, Hara F, Uemura Y, Mukai H, Watanabe T, Ohashi Y. NSAS-BC02 substudy of chemotherapy-induced amenorrhea (CIA) in premenopausal patients who received either taxane alone or doxorubicin(A) cyclophosphamide(C) followed by taxane as postoperative chemotherapy. Breast Cancer Res Treat 2020; 182:325-32. [PMID: 32462261 DOI: 10.1007/s10549-020-05692-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 05/13/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Chemotherapy-induced amenorrhea (CIA) is one of the critical side effects from the chemotherapy in premenopausal patients with breast cancer. The goals of our study are the following: (1) to investigate the factors affecting the incidence of CIA; and (2) to evaluate the prognostic role of CIA in premenopausal patients with breast cancer. METHODS We conducted a post hoc retrospective substudy to examine the incidence of the CIA and the relationship between CIA and prognosis in NSAS-BC02 that compared taxane alone to Doxorubicin(A) Cyclophosphamide(C) followed by taxane in postoperative patients with node-positive breast cancer RESULTS: Of 395 premenopausal women, 287 (72.7%) had CIA due to protocol treatment. Regarding type of protocol regimen, proportion of CIA was 76.9% in AC Paclitaxel(P), 75.2% in AC Docetaxel(D), 62.8% in PTX, and 75.2% in DTX. Predictive factors of CIA were age increase by 5 years (OR 1.50), ER positivity (OR 2.08), and HER2 3 + ( OR 0.40) according to logistic regression analysis. According to the log rank test and the Cox proportional hazards model, CIA group had significantly better disease-free survival than non-CIA group (P < .0001). However, according to time-dependent Cox model that was used to reduce guarantee-time bias, CIA was not a statistically significant prognostic factor in both ER-positive and ER-negative patients. CONCLUSION Treatment with taxane alone caused high frequency of CIA in premenopausal women with breast cancer. CIA did not turn out to be an independent prognostic factor, taking guarantee-time bias into consideration. Further clinical studies are needed to validate these findings.
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Kim SM, Kim AS, Ko HJ, Moon H, Choi HI, Song J. Association between Bone Mineral Density and Serum Iron Indices in Premenopausal Women in South Korea. Korean J Fam Med 2020; 41:175-182. [PMID: 32456385 PMCID: PMC7272370 DOI: 10.4082/kjfm.18.0142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 01/09/2019] [Indexed: 01/11/2023] Open
Abstract
Background Osteoporosis is characterized by a decrease in bone mineral density (BMD) and increased risk of fragility fractures. Serum iron level may interact with bone health status. This study investigated the correlations of BMD with serum iron level, hemoglobin level, and total iron-binding capacity (TIBC). Methods We performed a retrospective analysis of data from the medical records of premenopausal women in South Korea. The women’s BMDs and the Z scores of the BMDs were verified using dual-energy X-ray absorption. The participants were stratified into quartiles for analyses of the associations of BMD with serum iron level, TIBC, and hemoglobin level. Results A simple linear regression analysis revealed associations of changes in BMD with iron level (β=-0.001, standard error [SE]=0.001, P<0.001), hemoglobin level (β=0.015, SE=0.003, P<0.001), and TIBC (β=0.001, SE=0.001, P<0.001). This pattern was also observed in a multiple linear regression analysis. A multivariate logistic regression analysis of iron level and TIBC for low BMD revealed odds ratios of 1.005 (P<0.001) and 0.995 (P<0.001), respectively. Conclusion This study demonstrated clear relationships of changes in BMD with serum iron level and TIBC, and thus confirms the usefulness of these markers in the clinical evaluation of iron storage and BMD in younger women.
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Affiliation(s)
- Sung-Min Kim
- Department of Family Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - A-Sol Kim
- Department of Family Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.,Department of Family Medicine, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Hae-Jin Ko
- Department of Family Medicine, Kyungpook National University Hospital, Daegu, Korea.,Department of Family Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hana Moon
- Department of Family Medicine, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Hye-In Choi
- Department of Family Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Jieun Song
- Department of Family Medicine, Kyungpook National University Hospital, Daegu, Korea
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Jones HJ, Minarik PA, Gilliss CL, Lee KA. Depressive symptoms associated with physical health problems in midlife women: A longitudinal study. J Affect Disord 2020; 263:301-309. [PMID: 31818793 PMCID: PMC6989369 DOI: 10.1016/j.jad.2019.11.166] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 09/11/2019] [Accepted: 11/30/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND It is unclear if the relationship between depression and physical health problems in women is related to age, reproductive stage, obesity or socio-demographic risk factors. METHODS Longitudinal data were obtained every 6 months for 36 months in 264 midlife African American, Caucasian and Latina women who began the study as healthy regularly menstruating 40 to 50-year-olds; 75 transitioned to peri- or post-menopause by 36 months. Scores of 16 or higher on the Center for Epidemiologic Studies-Depression (CES-D) scale were used to estimate depression risk. RESULTS Depression risk was 28% at study initiation and 25% at 36 months. Significantly more women at risk for depression were unemployed, obese, or hypertensive. Women at risk were more likely to become peri- or post-menopausal during the study period. A higher percentage (38%) of overweight and obese women had CES-D scores ≥ 16 compared to normal weight women (23%; p < .001). Over half (58%) of the 73 women at higher depression risk at the initial visit reported a health problem or chronic illness at 36 months, compared to only 36% of the 191 women with CES-D scores <16 (p = .001). LIMITATIONS This was a secondary analysis of data from a relatively healthy sample of women in the decade before menopause. Chronic illness was self-reported and the CES-D is a screening tool for depressive symptoms rather than a clinical diagnostic tool. CONCLUSIONS Health care providers may be underestimating the impact of unemployment on depressive symptoms, obesity and chronic health problems in midlife women.
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Affiliation(s)
| | | | | | - Kathryn A. Lee
- School of Nursing, University of California, San Francisco
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20
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Ferraris C, Ballestra B, Listorti C, Cappelletti V, Reduzzi C, Scaperrotta GP, Pulice I, Ferrari EGA, Folli S, Mariani L, Martelli G. Red clover and lifestyle changes to contrast menopausal symptoms in premenopausal patients with hormone-sensitive breast cancer receiving tamoxifen. Breast Cancer Res Treat 2020; 180:157-165. [PMID: 31975316 DOI: 10.1007/s10549-020-05534-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 01/13/2020] [Indexed: 01/03/2023]
Abstract
PURPOSE To determine whether a red clover preparation plus dietary intervention administered to premenopausal women with breast cancer (BC), improves menopausal symptoms due to anti-oestrogen treatment, and hence promotes compliance with tamoxifen, prevents weight gain and is safe. METHODS Surgically-treated premenopausal women with oestrogen receptor (ER) positive disease taking tamoxifen were recruited to a prospective double-blind randomized trial (NCT03844685). The red clover group (N = 42) received one oral tablet/day (Promensil® Forte) containing 80 mg red clover extract for 24 months. The placebo group (N = 39) received one oral tablet/day without active ingredient. All women were encouraged to follow a Mediterranean-type diet and keep active. Outcomes were Menopausal Rating Score (MRS), body mass index (BMI), waist and hip girth, insulin resistance, and levels of cholesterol, triglycerides, and sex hormones. As safety indicators, endometrial thickness, breast density, and effects of patient serum on ER-positive BC cell lines were investigated. RESULTS MRS reduced significantly (p < 0.0001) with no between-group difference (p = 0.69). The red clover group had significantly greater reductions in BMI and waist circumference (p < 0.0001 both cases). HDL cholesterol increased significantly in both groups (p = 0.01). Hormone levels and insulin resistance changed little. Endometrial thickness remained constant (p = 0.93). Breast density decreased significantly in both groups (p < 0.0001). Proliferation and oestrogen-regulated gene expression didn't differ in cell lines treated with serum from each group. CONCLUSIONS This is the first trial to assess red clover in BC patients on tamoxifen. The preparation proved safe clinically and in vitro, and was associated with reduced BMI and waist circumference, but the diet-lifestyle intervention probably improved the menopausal symptoms.
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Affiliation(s)
- Cristina Ferraris
- Breast Unit, Fondazione IRCCS, Istituto Nazionale Dei Tumori Di Milano, Via Venezian 1, 20133, Milano, Italy
| | - Barbara Ballestra
- Breast Unit, Fondazione IRCCS, Istituto Nazionale Dei Tumori Di Milano, Via Venezian 1, 20133, Milano, Italy
| | - Chiara Listorti
- Breast Unit, Fondazione IRCCS, Istituto Nazionale Dei Tumori Di Milano, Via Venezian 1, 20133, Milano, Italy.
| | - Vera Cappelletti
- Biomarker Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori Di Milano, Via Venezian 1, 20133, Milano, Italy
| | - Carolina Reduzzi
- Biomarker Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori Di Milano, Via Venezian 1, 20133, Milano, Italy
| | - Gianfranco P Scaperrotta
- Breast Radiology, Fondazione IRCCS Istituto Nazionale Dei Tumori Di Milano, Via Venezian 1, 20133, Milano, Italy
| | - Iolanda Pulice
- Clinical Studies Scientific Director's Office, Fondazione IRCCS Istituto Nazionale Dei Tumori Di Milano, Via Venezian 1, 20133, Milano, Italy
| | - Eleonora G A Ferrari
- Pharmacy and Experimental Clinical Studies, Fondazione IRCCS Istituto Nazionale Dei Tumori Di Milano, Via Venezian 1, 20133, Milano, Italy
| | - Secondo Folli
- Breast Unit, Fondazione IRCCS, Istituto Nazionale Dei Tumori Di Milano, Via Venezian 1, 20133, Milano, Italy
| | - Luigi Mariani
- Department of Clinical Epidemiology and Trials Organization, Fondazione IRCCS Istituto Nazionale Dei Tumori Di Milano, Via Venezian 1, 20133, Milano, Italy
| | - Gabriele Martelli
- Breast Unit, Fondazione IRCCS, Istituto Nazionale Dei Tumori Di Milano, Via Venezian 1, 20133, Milano, Italy
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Zhang F, Cao J, Zhang X, Wang J, Yi X. Efficacy of self-made Gengnian decoction on phosphatidylinositol 3-kinases/protein kinase B/mammalian target of rapamycin signaling pathway in perimenopausal rats. J TRADIT CHIN MED 2019; 39:861-866. [PMID: 32186157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To investigate the efficacy of self-made Gengnian decoction on expressions of phosphatidylinositol 3-kinase (PI3K), protein kinase B (Akt) and mammalian target of rapamycin (mTOR) in ovarian tissues of perimenopausal rats. They were identified with symptom pattern of kidney-Yang deficiency in terms of Traditional Chinese Medicine. METHODS Female Sprague-Dawley rats aged 10-12 months were selected. Estrous cycle was observed by vaginal smears of keratinocytes to screen the perimenopausal model rats. The chosen rats were randomly divided into five groups, including perimenopausal model of kidney-Yang deficiency group (24 rats), self-made Gengnian decoction of high-dose group (24 rats), self-made Gengnian decoction of middle-dose group (24 rats), self-made Gengnian decoction of low dose group (24 rats) and tibolone control group (24 rats). In addition, rats aged 4-6 months were selected as young control group. The perimenopausal model rats of kidney-Yang deficiency were prepared by alternative intramuscular injection of hydrocortisone 5 mg·kg-1·d-1 The successfully prepared models in self-made Gengnian decoction of high-dose, middle-dose and low-dose groups and tibolone control group were given self-made Gengnian decoction 26.4, 13.2 and 6.6 mg·kg-1·d-1, and tibolone tablets solvent 0.22 mg·kg-1·d-1, respectively, through intragastric administration. Models group and young control group were given the same dose of normal saline, 1 time a day for 15 consecutive days. 24 h after the last administration, blood and ovarian tissues were collected after anesthesia with 20% ethyl carbamate. The follicles of different levels in ovarian tissue were observed and counted by histopathological hematoxylin-eosin staining. Enzyme linked immunosorbent assay was applied to test insulin-like growth factor-1 (IGF-1) level in the serum of experimental rats. The expression levels of PI3K, phosphorylated-Akt (p-Akt) and phosphorylated-mTOR (p-mTOR) mRNA in ovarian tissue were detected by quantitative real-time polymerase chain reaction. RESULTS The total follicle counts of perimenopausal model rats with kidney-Yang deficiency were significantly reduced, and the number of follicles (mainly increased in preantral follicles and antral follicles) in perimenopausal model rats with kidney-Yang deficiency was significantly increased after intervention of high and middle doses of Gengnian decoction and tibolone (P < 0.05). Compared with normal rats in young control group, the levels of IGF-1 in serum of perimenopausal rats with kidney-Yang deficiency were significantly decreased (P < 0.01), and those intervened by high dose of Gengnian decoction and tibolone were significantly up-regulated. The relative expression levels of PI3K, p-Akt, p-mTOR mRNA in ovarian tissues of perimenopausal rats with kidney-Yang deficiency were significantly lower than those of young rats (P < 0.01), and those intervened by high dose of Gengnian decoction and tibolone were significantly up-regulated (P < 0.05). CONCLUSION Self-made Gengnian decoction can increase the levels of IGF-1, PI3K, Akt and mTOR mRNA expression in serum.
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Affiliation(s)
- Fan Zhang
- the Second Affiliated Hospital of Guiyang University of Traditional Chinese Medicine, Guiyang 550001, China
| | - Junyan Cao
- Guiyang University of Traditional Chinese Medicine, Guiyang 550001, China
| | - Xin Zhang
- Guiyang University of Traditional Chinese Medicine, Guiyang 550001, China
| | - Jing Wang
- Guiyang University of Traditional Chinese Medicine, Guiyang 550001, China
| | - Xu Yi
- Guiyang University of Traditional Chinese Medicine, Guiyang 550001, China
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Kim CY, Lee YJ, Choi JH, Lee SY, Lee HY, Jeong DH, Choi YJ. The Association between Low Vitamin D Status and Autoimmune Thyroid Disease in Korean Premenopausal Women: The 6th Korea National Health and Nutrition Examination Survey, 2013-2014. Korean J Fam Med 2019; 40:323-328. [PMID: 31476853 PMCID: PMC6768840 DOI: 10.4082/kjfm.18.0075] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 07/26/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND This study aimed to analyze the association of low vitamin D status with thyroid autoimmunity and dysfunction in the Korean population according to sex and menopausal status in women. METHODS This study was based on the data acquired from the 6th Korea National Health and Nutrition Examination Survey. We enrolled 4,356 subjects who had data of thyroid function, antithyroid peroxidase antibody (TPOAb), and serum 25-hydroxyvitamin D (25[OH]D) levels. We excluded subjects who were pregnant and who had a history of thyroid disease or thyroid cancer, and those with transient thyroid dysfunction who tested negative for TPOAb (TPOAb[-]). RESULTS TPOAb positivity (TPOAb[+]) with thyroid dysfunction (subclinical and overt hypothyroidism) was more prevalent in the vitamin D deficient group than in the vitamin D insufficient and sufficient groups including premenopausal (P=0.046) and postmenopausal women (P=0.032), although no significant differences were observed in men. The mean serum 25(OH)D level was significantly lower in the TPOAb(+) with thyroid dysfunction group than in the TPOAb(+) with euthyroidism and TPOAb(-) groups of premenopausal women (P=0.001), although no significant differences were observed in men and postmenopausal women. Multivariate binary logistic regression analysis, adjusted for age, body mass index, and current smoking status, showed that vitamin D insufficiency and deficiency were significantly associated with TPOAb(+) with thyroid dysfunction in premenopausal women (P<0.001), although no significant associations were observed in men and postmenopausal women. CONCLUSION Low vitamin D status was significantly associated with thyroid autoimmunity and dysfunction in the Korean population, especially in premenopausal women.
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Affiliation(s)
- Choon-Young Kim
- 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
| | - Soo Yeon Lee
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
| | - Hye Young Lee
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
| | - Da Hye Jeong
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
| | - Yeon Jun Choi
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
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Lu W, Guo W, Cui D, Dong K, Qiu J. Effect of Sex Hormones on Brain Connectivity Related to Sexual Function in Perimenopausal Women: A Resting-State fMRI Functional Connectivity Study. J Sex Med 2019; 16:711-720. [PMID: 30956108 DOI: 10.1016/j.jsxm.2019.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 02/21/2019] [Accepted: 03/02/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND Perimenopause is associated with increased risk of depression, vasomotor symptoms, and sexual dysfunction. AIMS To explore the effect of sex hormones on the functional connectivity (FC) of different brain regions related to sexual function in perimenopausal women. METHODS 32 premenopausal women (mean age, 47.75 ± 1.55 years) and 25 perimenopausal women (mean age, 51.60 ± 1.63 years) underwent sex hormone level measurements and resting-state fMRI. MAIN OUTCOME MEASURES Serum levels of sex hormones, including prolactin (PRL), follicle-stimulating hormone (FSH), luteotropic hormone (LH), estradiol (E2), free testosterone (free-T), and progesterone (P), were measured. 10 brain regions related to sexual function were selected according to a meta-analysis, and FCs of the selected regions of interest were calculated as Pearson's correlation coefficient. RESULTS Compared with premenopausal women, perimenopausal women showed increased FC between the right area 13 (A13_r) and the right medial superior frontal gyrus (mSFG), between the left dorsal granular insula (dIg_L) and the right superior frontal gyrus (SFG) (Gaussian random field-corrected at the voxel level, P < .001, and cluster level, P < .025). Furthermore, the PRL level was negatively correlated with the FC of A13_R with the right mSFG and the FC of dIg_L with the right SFG. CLINICAL TRANSLATION These findings may be applicable to assessing brain dysfunction with FC changes in women approaching menopause. STRENGTHS & LIMITATIONS This study is the first to evaluate a direct relationship between sex hormone levels and brain FC changes in women approaching menopause. Sexual function was not assessed, which may weaken the conclusions related to sexual function. CONCLUSIONS The results show that women approaching menopause suffered from aberrant intrinsic FC in regions related to sexual function, and reveal a direct relationship between serum sex hormone levels and FC changes related to sexual function. Lu W, Guo W, Cui D, et al. Effect of Sex Hormones on Brain Connectivity Related to Sexual Function in Perimenopausal Women: A Resting-State fMRI Functional Connectivity Study. J Sex Med 2019;16:711-720.
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Affiliation(s)
- Weizhao Lu
- Medical Engineering and Technical Center, Taishan Medcial University, Tai'an, China; Department of Radiology, Taishan Medical University, Tai'an, China
| | - Wei Guo
- Affiliated Hospital of Taishan Medical University, Tai'an, China
| | - Dong Cui
- Department of Radiology, Taishan Medical University, Tai'an, China
| | - Kejiang Dong
- Department of Radiology, Taishan Medical University, Tai'an, China
| | - Jianfeng Qiu
- Medical Engineering and Technical Center, Taishan Medcial University, Tai'an, China; Department of Radiology, Taishan Medical University, Tai'an, China.
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Carranza-Lira S, Palacios-Ramírez M. [Depression frequency in premenopausal and postmenopausal women]. Rev Med Inst Mex Seguro Soc 2019; 56:533-536. [PMID: 30889341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND It is known that hormonal changes influences mood, so the woman shows notorious hormonal changes in stages of her life. OBJECTIVE To determine the difference in the frequency of depression in premenopausal and postmenopausal women. METHODS We studied 371 premenopausal and postmenopausal women who didn’t receive hormonal treatment and in which Hamilton depression scale was applied. Descriptive statistics, central tendency and dispersion measures were used. The comparison between the groups was with Student t test, and Chi squared test. Pearson’s correlation analysis was done between age, body mass index and Hamilton scale score. In the postmenopausal women, the time since menopause was also correlated with Hamilton scale score. RESULTS Premenopausal women were predominantly healthy (46.6%). In perimenopausal women predominated minor depression (21.4%) and in postmenopausal women, major depression (59.3%). CONCLUSION Postmenopausal women more frequently had a higher score than those premenopausal.
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Affiliation(s)
- Sebastián Carranza-Lira
- Instituto Mexicano del Seguro Social, Hospital de Gineco Obstetricia No. 4 “Luis Castelazo Ayala”, División de Investigación en Salud. Ciudad de México. México
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Abstract
BACKGROUND Testosterone therapy for women is in widespread use, primarily in the form of compounded preparations and off-label use of formulations for men. The benefits and risks of such therapy remain uncertain. This review will identify and evaluate studies that have examined the effects of testosterone therapy for women on a range of outcomes including sexual function, cardiovascular events, metabolic parameters, musculoskeletal health, wellbeing, cancer events, androgenic effects and withdrawal rates. METHODS Studies meeting our pre-determined inclusion criteria will be identified through searches in Ovid MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL) and Web of Science. Assessing a range of outcomes, we will assess the risk-of-bias of relevant studies and draw conclusions about the strength of evidence for benefits and risks of testosterone therapy for each outcome. DISCUSSION This comprehensive systematic review with meta-analysis will provide the foundation for the development of evidence-based clinical practice guidelines that will address benefits and risks of testosterone therapy, when treatment might be appropriate or inappropriate, areas of clinical uncertainty and the basis for assessment and monitoring of patients. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number: CRD42018104073.
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Affiliation(s)
- Rakibul M. Islam
- Women’s Health Research Program, Monash University, Melbourne, Australia
| | - Robin J. Bell
- Women’s Health Research Program, Monash University, Melbourne, Australia
| | - Sally Green
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Susan R. Davis
- Women’s Health Research Program, Monash University, Melbourne, Australia
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Kim AS, Ko HJ. Atrophic Gastritis as a Risk Factor for Bone Loss in Premenopausal Women in Their 40s: A Retrospective Cohort Study. Calcif Tissue Int 2019; 104:34-41. [PMID: 30191283 DOI: 10.1007/s00223-018-0473-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/03/2018] [Indexed: 12/18/2022]
Abstract
This study assessed the effects of atrophic gastritis on bone mineral density (BMD) in premenopausal women in their 40s. We performed a retrospective analysis of medical records of premenopausal women in their 40s who underwent a health checkup, esophagogastroduodenoscopy, and bone densitometry at least thrice, 24 months apart, between January 2006 and December 2016. Based on first-visit esophagogastroduodenoscopy results, patients were divided into atrophic and non-atrophic gastritis groups; BMD changes over time were analyzed. Patients were further divided into subgroups depending on atrophic gastritis persistence; differences and absolute changes in BMD were assessed. BMD in both groups exhibited group-by-time interaction (p < 0.001). After adjusting for confounding factors, the mean BMD was significantly different at the 24-month and the 48-month follow-up (p = 0.049, p < 0.001, respectively). Subgroup analysis after adjusting for confounding factors showed a mean BMD of 1.128 and 1.104 at baseline, 1.110 and 1.100 at the 24-month follow-up, and 1.106 and 1.065 at the 48-month follow-up for persistent atrophic and non-atrophic gastritis groups, respectively. The difference between mean BMD was not significant at baseline (p = 0.171), but was significant at the 24-month and 48-month follow-ups (p = 0.044 and p < 0.001, respectively). Absolute changes in BMD over 48 months were - 0.010 and - 0.051 for the two subgroups, which was significantly different (p < 0.001). Atrophic gastritis reduces BMD in premenopausal women in their 40s. Patients with atrophic gastritis exhibited lower BMD than patients without, and patients with persistent atrophic gastritis exhibited a greater decrease in BMD.
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Affiliation(s)
- A-Sol Kim
- Department of Family Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, 807 Hoguk-ro, Buk-gu, Daegu, 41404, South Korea
| | - Hae-Jin Ko
- Department of Family Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, 130 Dongduk-ro, Jung-gu, Daegu, 41944, South Korea.
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Kattah AG, Smith CY, Gazzuola Rocca L, Grossardt BR, Garovic VD, Rocca WA. CKD in Patients with Bilateral Oophorectomy. Clin J Am Soc Nephrol 2018; 13:1649-1658. [PMID: 30232136 PMCID: PMC6237067 DOI: 10.2215/cjn.03990318] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 08/20/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Premenopausal women who undergo bilateral oophorectomy are at a higher risk of morbidity and mortality. Given the potential benefits of estrogen on kidney function, we hypothesized that women who undergo bilateral oophorectomy are at higher risk of CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We performed a population-based cohort study of 1653 women residing in Olmsted County, Minnesota who underwent bilateral oophorectomy before age 50 years old and before the onset of menopause from 1988 to 2007. These women were matched by age (±1 year) to 1653 referent women who did not undergo oophorectomy. Women were followed over a median of 14 years to assess the incidence of CKD. CKD was primarily defined using eGFR (eGFR<60 ml/min per 1.73 m2 on two occasions >90 days apart). Hazard ratios were derived using Cox proportional hazards models, and absolute risk increases were derived using Kaplan-Meier curves at 20 years. All analyses were adjusted for 17 chronic conditions present at index date, race, education, body mass index, smoking, age, and calendar year. RESULTS Women who underwent bilateral oophorectomy had a higher risk of eGFR-based CKD (211 events for oophorectomy and 131 for referent women; adjusted hazard ratio, 1.42; 95% confidence interval, 1.14 to 1.77; absolute risk increase, 6.6%). The risk was higher in women who underwent oophorectomy at age ≤45 years old (110 events for oophorectomy and 60 for referent women; adjusted hazard ratio, 1.59; 95% confidence interval, 1.15 to 2.19; absolute risk increase, 7.5%). CONCLUSIONS Premenopausal women who undergo bilateral oophorectomy, particularly those ≤45 years old, are at higher risk of developing CKD, even after adjusting for multiple chronic conditions and other possible confounders present at index date. PODCAST This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2018_10_11_CJASNPodcast_18_1.
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Affiliation(s)
- Andrea G. Kattah
- Division of Nephrology and Hypertension, Department of Internal Medicine
| | | | | | | | - Vesna D. Garovic
- Division of Nephrology and Hypertension, Department of Internal Medicine
| | - Walter A. Rocca
- Epidemiology, Department of Health Sciences Research, and
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
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Hwang YS, Park EJ, Choi JG, Kim HE, Park SG, Yoo SM. Relationship between Age at Menarche and Metabolic Syndrome in Premenopausal Women: Korea National Health and Nutrition Examination Survey 2013-2014. Korean J Fam Med 2018; 39:300-306. [PMID: 30056694 PMCID: PMC6166116 DOI: 10.4082/kjfm.17.0022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 10/12/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Early menarche may be associated with increased risk of cardiovascular disease. The aim of this study was to evaluate the relationship between age at menarche and metabolic syndrome (MetS) in Korean premenopausal women. METHODS We used nationally representative data from the Korea National Health and Nutrition Examination Survey from 2013 to 2014, and 3,023 premenopausal women aged 20-55 years were our subjects. We defined early menarche as age at first menstrual period less than 12 years. Multivariable logistic regression analysis was used to evaluate the relationship between age at menarche and MetS after adjusting for current age, and socioeconomic, lifestyle, and reproductive variables. RESULTS MetS was much more common in women aged 40-55 years than in women aged 20-39 years (4.1% vs. 15.1%). Compared with women who experienced menarche at age 12-15 years, the risk of MetS in the early menarche group was not higher in either age group, after adjusting for current age, and socioeconomic, lifestyle, and reproductive variables (odds ratio [OR], 1.767; 95% confidence interval [CI], 0.718-4.351 in those aged 20-39 years; OR, 1.780; 95% CI, 0.775-4.085 in those aged 40-55 years). The risk of MetS in women with menarche at age ≥16 years was not higher than in women with menarche at age 12-15 years. CONCLUSION Early or late menarche was not associated with an increased risk of MetS in premenopausal Korean women. Even before menopause, current age has a major influence on the development of MetS.
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Affiliation(s)
- Yun-Seo Hwang
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Eun-Joo Park
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Jong-Gi Choi
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Hyo-Eun Kim
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Seung-Guk Park
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Sun-Mi Yoo
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
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Franic D, Iternička Z, Franić-Ivanišević M. Platelet-rich plasma (PRP) for the treatment of vulvar lichen sclerosus in a premenopausal woman: A case report. Case Rep Womens Health 2018; 18:e00062. [PMID: 29785390 DOI: 10.1016/j.crwh.2018.e00062] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 04/08/2018] [Accepted: 04/13/2018] [Indexed: 11/22/2022] Open
Abstract
The use of platelet-rich plasma (PRP) for the treatment of lichen sclerosus (LS) in a 38-year-old premenopausal woman is reported. The diagnosis was confirmed histologically and the symptoms documented using the ICIQ Vaginal Symptoms Questionnaire (ICIQ-VS) and the Female Sexual Function Index (FSFI) questionnaire. PRP was prepared from autologous blood using the Regen Cellular Matrix Kit. PRP was administered twice over two months. Histology at follow-up one month after the second administration showed the epidermis was nearly normal and upper dermal cellularity had been restored. The patient was symptom-free and both her ICIQ-VS and her FSFI scores had improved significantly. PRP is a potential new treatment option for LS which needs further assessment in randomized controlled trials. Lichen sclerosus is an auto-immune inflammatory skin disease. The therapy of choice is clobetasol 0.05% ointment, so far PRP is a regeneration treatment option for LS. Histopathology after PRP proved normal epidermis with returned upper dermal cellularity. After PRP treatment, the ICIQ-VS score and FSFI full scale score range improved significantly.
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Kim J, Kwon H, Heo BK, Joh HK, Lee CM, Hwang SS, Park D, Park JH. The Association between Fat Mass, Lean Mass and Bone Mineral Density in Premenopausal Women in Korea: A Cross-Sectional Study. Korean J Fam Med 2018; 39:74-84. [PMID: 29629038 PMCID: PMC5876052 DOI: 10.4082/kjfm.2018.39.2.74] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 09/30/2016] [Accepted: 10/14/2016] [Indexed: 11/29/2022] Open
Abstract
Background We investigated the association between body composition, especially truncal or non-truncal fat mass (FM), and bone mineral density (BMD) in premenopausal women in Korea. Methods A cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey IV and V (2008–2011). Total lean mass (LM), total FM (TFM), truncal FM, and non-truncal FM, and BMD of the total femur, femoral neck (FN), and lumbar spine were measured using dual-energy X-ray absorptiometry. The association between body composition and BMD was analyzed using multiple linear regression. The risk of low BMD according to quartiles of TFM, truncal FM, and non-truncal FM was calculated using logistic regression. Subgroup analysis according to body mass index was also performed. Results In 4,343 premenopausal women, total LM was positively associated with BMD regardless of weight adjustment. TFM, truncal FM, and non-truncal FM were inversely associated with BMD after adjusting for weight. Odds ratios (ORs) for low BMD and 95% confidence intervals (CIs) of the highest quartile of TFM, truncal FM, and non-truncal FM compared with the lowest quartile were calculated. The risk of low BMD of the FN was higher in the highest quartile of TFM (OR, 4.48; 95% CI, 1.11–18.01) and truncal FM (OR, 5.48; 95% CI, 1.75–17.20). Truncal FM and not-truncal FM had an inverse association with BMD in the non-obese and obese subgroups of women. Conclusion Total LM has a protective effect on BMD and FM can have a detrimental effect on BMD besides its skeletal loading effect.
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Affiliation(s)
- Jeehyun Kim
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hyuktae Kwon
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Bo-Kyoung Heo
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hee-Kyung Joh
- Department of Family Medicine, Seoul National University Health Service Center, Seoul, Korea
| | - Cheol Min Lee
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
| | - Seung-Sik Hwang
- Department of Social and Preventive Medicine, Inha University School of Medicine, Incheon, Korea
| | - Danbee Park
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jae-Hong Park
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
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Purnamasari D, Puspitasari MD, Setiyohadi B, Nugroho P, Isbagio H. Low bone turnover in premenopausal women with type 2 diabetes mellitus as an early process of diabetes-associated bone alterations: a cross-sectional study. BMC Endocr Disord 2017; 17:72. [PMID: 29187183 PMCID: PMC5708100 DOI: 10.1186/s12902-017-0224-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 11/21/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Individuals with Diabetes Mellitus (DM) are at increased risk for fracture due to the decrease in bone strength and quality. Serum procollagen type I intact N-terminal (P1NP) and serum C-terminal cross-linking telopeptide of type I collagen (CTX) as markers of bone formation and resorption, respectively, have been reported to be decreased in T2DM. It remains unclear whether diabetes-associated alterations in the bone turnover of T2DM individuals are related to the longer duration of the disease or may occur earlier. Furthermore, previous studies on BTMs in T2DM individuals have mostly been done in postmenopausal women with T2DM, which might have masked the DM-induced alterations of bone turnover with concurrent estrogen deficiency. This study aims to assess the levels of serum P1NP and CTX as markers of bone turnover in premenopausal women with and without T2DM. METHODS This cross-sectional study involves 41 premenopausal women with T2DM, and 40 premenopausal women without DM. Sampling was done consecutively. P1NP and CTX measurement was done using the electrochemi-luminescence immunoassay (ECLIA) method. Other data collected include levels of HbA1C, ALT, creatinine, eGFR and lipid profile. RESULTS Median (interquartile range) P1NP in T2DM is 29.9 ng/ml (24.7-41.8 ng/ml), while in non-DM is 37.3 ng/ml, (30.8-47.3 ng/ml; p = 0.007). Median (interquartile range) CTX in T2DM is 0.161 ng/ml (0.106-0.227 ng/ml), while in non-DM is 0.202 ng/ml (0.166-0.271 ng/ml; p = 0.0035). Levels of P1NP and CTX in the T2DM group did not correlate with the duration of disease, age, BMI or the levels of HbA1C. CONCLUSIONS Premenopausal women with T2DM indeed have lower bone turnover when compared with non-DM controls. This significantly lower bone turnover process starts relatively early in the premenopausal age, independent of the duration of DM. Gaining understanding of the early pathophysiology of altered bone turnover may be key in developing preventive strategies for diabetoporosis.
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Affiliation(s)
- Dyah Purnamasari
- Division of Metabolism and Endocrinology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jl. Salemba 6, Jakarta, 10430 Indonesia
| | - Melisa D. Puspitasari
- Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Bambang Setiyohadi
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Pringgodigdo Nugroho
- Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Harry Isbagio
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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Masjoudi M, Amjadi MA, Leyli EKN. Severity and Frequency of Menopausal Symptoms in Middle Aged Women, Rasht, Iran. J Clin Diagn Res 2017; 11:QC17-QC21. [PMID: 28969213 PMCID: PMC5620854 DOI: 10.7860/jcdr/2017/26994.10515] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 06/17/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Menopause is a natural event in women's life. Some studies have shown that, these symptoms can lead to low quality of life. AIM To identify the severity and frequency of menopausal symptoms in different stages of menopause, in a group of middle aged women. MATERIALS AND METHODS This cross-sectional study was conducted on 646 women aged 45-60 years in Rasht, Iran, who were included in the study by convenience sampling method. Menopause Rating Scale (MRS) was used to measure the severity of menopausal symptoms. Descriptive and analytical statistics by SPSS software version 19.0 was used for analysis. RESULTS Mean age of women was 50.7± 4.65 years. About half of the participants (49.2%) were postmenopausal. The remaining 18.1% (n=117) and 32.7% (n=211) were perimenopausal and premenopausal, respectively. The score of physical domain for menopause symptoms was higher in postmenopausal women. Joint and muscle problems were the most frequent symptoms in post and perimenopausal women. Also, total score for menopausal symptoms was more in postmenopausal group than other groups (p<0.001). Severe symptoms were seen only in three post-menopausal women and 55.2% of them had mild to moderate symptoms. CONCLUSION The menopause related symptoms differed based on the stage of menopause. Such studies are useful for creating awareness among women so that they can identify common menopausal symptoms and consequently may improve their quality of life.
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Affiliation(s)
- Marzieh Masjoudi
- Instructor, Department of Midwifery, Rasht Branch, Islamic Azad University, Rasht, Iran
| | - Marjan Akhavan Amjadi
- Instructor, Department of Midwifery, Tehran Medical Science Branch, Islamic Azad University, Tehran, Iran
| | - Ehsan Kazem Nezhad Leyli
- Associate Professor, Guilan Road Trauma Research Center, Guilan University of Medical Science University, Rasht, Iran
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Suh KJ, Kim SH, Lee KH, Kim TY, Kim YJ, Han SW, Kang E, Kim EK, Kim K, No JH, Han W, Noh DY, Lee M, Kim HS, Im SA, Kim JH. Bilateral Salpingo-oophorectomy Compared to Gonadotropin-Releasing Hormone Agonists in Premenopausal Hormone Receptor-Positive Metastatic Breast Cancer Patients Treated with Aromatase Inhibitors. Cancer Res Treat 2017; 49:1153-1163. [PMID: 28253566 PMCID: PMC5654164 DOI: 10.4143/crt.2016.463] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Accepted: 02/01/2017] [Indexed: 11/21/2022] Open
Abstract
Purpose Although combining aromatase inhibitors (AI) with gonadotropin-releasing hormone agonists (GnRHa) is becoming more common, it is still not clear if GnRHa is as effective as bilateral salpingo-oophorectomy (BSO). Materials and Methods We retrospectively analyzed data of 66 premenopausal patients with hormone receptor– positive, human epidermal growth factor receptor 2–negative recurrent and metastatic breast cancer who had been treated with AIs in combination with GnRHa or BSO between 2002 and 2015. Results The median patient age was 44 years. Overall, 24 (36%) received BSO and 42 (64%) received GnRHa. The clinical benefit rate was higher in the BSO group than in the GnRHa group (88% vs. 69%, p=0.092). Median progression-free survival (PFS) was longer in the BSO group, although statistical significance was not reached (17.2 months vs. 13.3 months, p=0.245). When propensity score matching was performed, the median PFS was 17.2 months for the BSO group and 8.2 months for the GnRHa group (p=0.137). Multivariate analyses revealed that the luminal B subtype (hazard ratio, 1.67; 95% confidence interval [CI], 1.08 to 2.60; p=0.022) and later-line treatment (≥ third line vs. first line; hazard ratio, 3.24; 95% CI, 1.59 to 6.59; p=0.001) were independent predictive factors for a shorter PFS. Incomplete ovarian suppression was observed in a subset of GnRHa-treated patients whose disease showed progression, with E2 levels higher than 21 pg/mL. Conclusion Both BSO and GnRHa were found to be effective in our AI-treated premenopausal metastatic breast cancer patient cohort. However, further studies in larger populations are needed to determine if BSO is superior to GnRHa.
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Affiliation(s)
- Koung Jin Suh
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Se Hyun Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Kyung-Hun Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Tae-Yong Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yu Jung Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sae-Won Han
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Eunyoung Kang
- Department of Surgery and Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Eun-Kyu Kim
- Department of Surgery and Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Kidong Kim
- Department of 5Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jae Hong No
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Wonshik Han
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Department of Surgery and Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Dong-Young Noh
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Department of Surgery and Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Maria Lee
- Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Seung Kim
- Department of Surgery and Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Seock-Ah Im
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jee Hyun Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Abstract
Historically, endocrine therapy for breast cancer began with ovarian ablation (OA) for the treatment of premenopausal patients. After the identification of estrogen receptors and the development of many antiestrogens, tamoxifen has been approved and used as the standard endocrine therapy for hormonal receptor (HR)-positive premenopausal patients to date. With the development of luteinizing hormone-releasing hormone agonists, the paradigm of endocrine therapy for premenopausal women with HR-positive breast cancer began to change from OA to ovarian function suppression (OFS). To date, the indication for OFS was limited to those premenopausal patients with HR-positive breast cancer who were unable to use tamoxifen as the primary adjuvant endocrine therapy. However, following the definitive demonstration of the therapeutic role of OFS added to tamoxifen or aromatase inhibitor after chemotherapy in large randomized trials, such as Tamoxifen and Exemestane Trial or Suppression of Ovarian Function Trial, the American Society of Clinical Oncology guidelines for the use of endocrine therapy in premenopausal HR-positive breast cancer were recently updated to recommend OFS in high-risk patients who required adjuvant chemotherapy. In contrast, the role of OFS to protect ovarian function during chemotherapy in premenopausal women has remained controversial, and some evidence showing the protective effect of OFS on the ovaries during chemotherapy as well as its therapeutic effect for breast cancer in premenopausal women with HR-negative breast cancer was recently published. Further evaluation is necessary to determine its exact role. In conclusion, the role of OA or OFS has been evolving, not only to improve the efficacy of breast cancer treatment, but also to preserve ovary function. OFS remains a main strategy for premenopausal women with HR-positive early breast cancer, though its exact role should be determined in further studies.
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Affiliation(s)
- Woo-Chan Park
- Department of Surgery, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
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Jehan S, Auguste E, Zizi F, Pandi-Perumal SR, Gupta R, Attarian H, Jean-Louis G, McFarlane SI. Obstructive Sleep Apnea: Women's Perspective. J Sleep Med Disord 2016; 3:1064. [PMID: 28239685 PMCID: PMC5323064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The main characteristics of sleep-disordered breathing (SDB) are airflow limitation, chronic intermittent hypoxia, or apnea; which may lead to tissue hypoperfusion and recurrent arousal from sleep. These episodes of hypoxia or apnea can lead to tissue inflammation, and are causal factors of disturbed sleep in both men and women. Several lines of evidence suggest that sleep patterns differ along the lifespan in both male and female subjects, and this may result from the influence of female gonadotropic hormones on sleep. Compared to men, women have more sleep complaints, as women's sleep is not only influenced by gonadotropins, but also by conditions related to these hormones, such as pregnancy. It is therefore not surprising that sleep disturbances are seen during menopause, too. Factors that may play a role in this type of SDB in women include vasomotor symptoms, changing reproductive hormone levels, circadian rhythm abnormalities, mood disorders, coexistent medical conditions, and lifestyle factors.
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Affiliation(s)
- Shazia Jehan
- Departments of Population Health, Center for Healthful Behavior Change, Health and Behavior, New York University School of Medicine, USA
| | - Evan Auguste
- Departments of Population Health, Center for Healthful Behavior Change, Health and Behavior, New York University School of Medicine, USA
| | - Ferdinand Zizi
- Departments of Population Health, Center for Healthful Behavior Change, Health and Behavior, New York University School of Medicine, USA
| | | | - Ravi Gupta
- Department of Psychiatry, Sleep Clinic, Himalayan Institute of Medical Sciences, India
| | - Hrayr Attarian
- Department of Neurology, Northwestern University Feinberg School of Medicine, USA
| | - Giradin Jean-Louis
- Departments of Population Health, Center for Healthful Behavior Change, Health and Behavior, New York University School of Medicine, USA
| | - Samy I. McFarlane
- Division of Endocrinology and Medicine, SUNY Downstate Medical Center, USA
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Le S, Mao L, Lu D, Yang Y, Tan X, Wiklund P, Cheng S. Effect of aerobic exercise on insulin resistance and central adiposity disappeared after the discontinuation of intervention in overweight women. J Sport Health Sci 2016; 5:166-170. [PMID: 30356533 PMCID: PMC6188741 DOI: 10.1016/j.jshs.2016.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 03/30/2016] [Accepted: 04/02/2016] [Indexed: 06/08/2023]
Abstract
PURPOSE This study aimed to assess whether the benefits of exercise on central adiposity and insulin resistance (HOMA-IR) are maintained after discontinuation of intervention in the overweight/obese (OWOB) women. METHODS The study subjects were from 2 independent studies with similar aerobic exercise (AE) intervention programs. In study I, 15 OWOB postmenopausal women with pre-diabetes (body mass index, BMI = 24-33 kg/m2, aged 52-65 years) completed an 8-month exercise intervention and were followed for 2 years after the intervention. In study II, 12 OWOB (BMI = 25-35 kg/m2, aged 30-50 years) premenopausal women participated in a 6-week AE and were followed for 4 years after the intervention. The exercise program consisted of progressive AE with intensity of 60%-75% of initial fitness level, 30-60 min/time and 3-5 times/week. Fat mass (FM) was assessed by Dual Energy X-ray Absorptiometry (DXA Prodigy; study I) or bioelectrical impedance device (Inbody 720; study II). Plasma glucose and insulin were assessed by chemiluminescent immunoassay and HOMA-IR was calculated. RESULTS Both 8-month and 6-week moderate AE were effective in reducing HOMA-IR (-18.9%, p = 0.012 and -26.7%, p = 0.046, respectively), and 8-month AE reduced FM at upper abdominal region (-6.2%, p = 0.021). However, these improvements were not maintained in either study at the follow-up. CONCLUSION The AE program used in these studies was effective to reduce insulin resistance and/or FM in central body region among overweight and obese women. However, when exercise intervention was discontinued, the beneficial effects following both short- and long-term intervention disappeared. Thus maintaining exercise seems to be required if one wants to reap the benefits of exercise in the long-term.
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Affiliation(s)
- Shenglong Le
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Lijuan Mao
- School of Physical Education and Training, Shanghai University of Sport, Shanghai 200438, China
| | - Dajiang Lu
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Yifan Yang
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Xiao Tan
- Department of Health Sciences, University of Jyväskylä, Jyväskylä FI-40014, Finland
| | - Petri Wiklund
- Department of Health Sciences, University of Jyväskylä, Jyväskylä FI-40014, Finland
| | - Sulin Cheng
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai 200240, China
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
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Kim HA, Ahn SH, Nam SJ, Park S, Ro J, Im SA, Jung YS, Yoon JH, Hur MH, Choi YJ, Lee SJ, Jeong J, Cho SH, Kim SY, Lee MH, Kim LS, Moon BI, Kim TH, Park C, Kim SJ, Jung SH, Park H, Gwak GH, Kang SH, Kim JG, Kim J, Choi SY, Lim CW, Kim D, Yoo Y, Song YJ, Kang YJ, Jung SS, Shin HJ, Lee KJ, Han SH, Lee ES, Han W, Kim HJ, Noh WC. The role of the addition of ovarian suppression to tamoxifen in young women with hormone-sensitive breast cancer who remain premenopausal or regain menstruation after chemotherapy (ASTRRA): study protocol for a randomized controlled trial and progress. BMC Cancer 2016; 16:319. [PMID: 27197523 PMCID: PMC4872354 DOI: 10.1186/s12885-016-2354-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 05/11/2016] [Indexed: 01/24/2023] Open
Abstract
Background Ovarian function suppression (OFS) has been shown to be effective as adjuvant endocrine therapy in premenopausal women with hormone receptor-positive breast cancer. However, it is currently unclear if addition of OFS to standard tamoxifen therapy after completion of adjuvant chemotherapy results in a survival benefit. In 2008, the Korean Breast Cancer Society Study Group initiated the ASTRRA randomized phase III trial to evaluate the efficacy of OFS in addition to standard tamoxifen treatment in hormone receptor-positive breast cancer patients who remain or regain premenopausal status after chemotherapy. Methods Premenopausal women with estrogen receptor-positive breast cancer treated with definitive surgery were enrolled after completion of neoadjuvant or adjuvant chemotherapy. Ovarian function was assessed at the time of enrollment and every 6 months for 2 years by follicular-stimulating hormone levels and bleeding history. If ovarian function was confirmed as premenopausal status, the patient was randomized to receive 2 years of goserelin plus 5 years of tamoxifen treatment or 5 years of tamoxifen alone. The primary end point will be the comparison of the 5-year disease-free survival rates between the OFS and tamoxifen alone groups. Patient recruitment was finished on March 2014 with the inclusion of a total of 1483 patients. The interim analysis will be performed at the time of the observation of the 187th event. Discussion This study will provide evidence of the benefit of OFS plus tamoxifen compared with tamoxifen only in premenopausal patients with estrogen receptor-positive breast cancer treated with chemotherapy. Trial registration ClinicalTrials.gov Identifier NCT00912548. Registered May 31 2009. Korean Breast Cancer Society Study Group Register KBCSG005. Registered October 26 2009.
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Affiliation(s)
- Hyun-Ah Kim
- Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Sei Hyun Ahn
- Department of Surgery, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea
| | - Seok Jin Nam
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of medicine, Seoul, Republic of Korea
| | - Seho Park
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jungsil Ro
- Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Seock-Ah Im
- Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yong Sik Jung
- Department of Surgery, Ajou University, School of Medicine, Suwon, Republic of Korea
| | - Jung Han Yoon
- Department of Surgery, Chonnam National University Hwasun Hospital, Gwangju, Republic of Korea
| | - Min Hee Hur
- Department of Surgery, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Republic of Korea
| | - Yoon Ji Choi
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Soo-Jung Lee
- Department of Surgery, Yeungnam University Hospital, Daegu, Republic of Korea
| | - Joon Jeong
- Department of Surgery, Gangnam Severance Hospital, Yonsei University, Seoul, Republic of Korea
| | - Se-Heon Cho
- Department of Surgery, Dong-A University Hospital, Busan, Republic of Korea
| | - Sung Yong Kim
- Department of Surgery, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Republic of Korea
| | - Min Hyuk Lee
- Department of Surgery, Soonchunhyang University Colleage of Medicine, Seoul, Republic of Korea
| | - Lee Su Kim
- Division of Breast & Endocrine Surgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Republic of Korea
| | - Byung-In Moon
- Department of Surgery, Mokdong Hospital, Ewha Womans University, Seoul, Republic of Korea
| | - Tae Hyun Kim
- Department of Surgery, Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - Chanheun Park
- Department of Surgery, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - Sei Joong Kim
- Department of Surgery, Inha University Hospital, Inha University, Incheon, Republic of Korea
| | - Sung Hoo Jung
- Department of Surgery, Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - Heungkyu Park
- Department of Breast Surgery, Gachon University Gil Hospital, Incheon, Republic of Korea
| | - Geum Hee Gwak
- Department of Surgery, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea
| | - Sun Hee Kang
- Department of Surgery, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Jong Gin Kim
- Departments of Surgery, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Jeryong Kim
- Department of Surgery, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Su Yun Choi
- Department of Surgery, KangDong sacred heart hospital, Hallym university, Seoul, Republic of Korea
| | - Cheol-Wan Lim
- Department of Surgery, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Republic of Korea
| | - Doyil Kim
- Department of Surgery, Kangseo Mizmedi Hospital, Seoul, Republic of Korea
| | - Youngbum Yoo
- Department of Surgery, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Young-Jin Song
- Department of Surgery, Chungbuk National University College of Medicine and Medical Research Institute, Cheongju, Republic of Korea
| | - Yoon-Jung Kang
- Department of Surgery, Eulji University Hospital, Daejeon, Republic of Korea
| | - Sang Seol Jung
- Department of Surgery, Seoul St. Mary's Hospital, Medical College of The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyuk Jai Shin
- Breast and thyroid care center, Department of Surgery, Myongji Hospital, Goyang, Republic of Korea
| | - Kwan Ju Lee
- Department of Surgery, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Republic of Korea
| | - Se-Hwan Han
- Department of Surgery, Ajou University, School of Medicine, Suwon, Republic of Korea
| | - Eun Sook Lee
- Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Wonshik Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hee-Jung Kim
- Department of Surgery, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea
| | - Woo Chul Noh
- Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea.
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Sohn G, Ahn SH, Kim HJ, Son BH, Lee JW, Ko BS, Lee Y, Lee SB, Baek S. Survival Outcome of Combined GnRH Agonist and Tamoxifen Is Comparable to That of Sequential Adriamycin and Cyclophosphamide Chemotherapy Plus Tamoxifen in Premenopausal Patients with Lymph-Node-Negative, Hormone-Responsive, HER2-Negative, T1-T2 Breast Cancer. Cancer Res Treat 2016; 48:1351-1362. [PMID: 27063654 PMCID: PMC5080815 DOI: 10.4143/crt.2015.444] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 03/22/2016] [Indexed: 12/03/2022] Open
Abstract
Purpose The purpose of this study was to compare treatment outcomes between combined gonadotropin-releasing hormone agonist and tamoxifen (GnRHa+T) and sequential adriamycin and cyclophosphamide chemotherapy and tamoxifen (AC->T) in premenopausal patients with hormone-responsive, lymph-node–negative breast cancer. Materials and Methods In total, 994 premenopausal women with T1-T2, lymph-node–negative, hormone-receptor-positive, HER2-negative breast cancer between January 2003 and December 2008 were included in this retrospective cohort study. GnRHa+T and AC->T were administered to 608 patients (61.2%) and 386 patients (38.8%), respectively. Propensity score matching and inverse probability weighting were applied to the original cohort, and 260 patients for each treatment arm were included in the final analysis. Recurrence-free, cancer-specific, and overall survival was compared between the two treatment groups. Results A total of 994 patients were followed up for a median of 7.4 years (range, 0.5 to 11.4 years). The 5-year follow-up rate was 98.7%, and 13 patients were lost to follow-up. In propensity-matched cohorts (n=520), there was no difference in recurrence-free, cancer-specific, and overall survival rates between the two treatment groups (p=0.306, p=0.212, and p=0.102, respectively), and this was maintained after applying inverse probability weighting. Conclusion GnRHa+T is a reasonable alternative to AC->T in patients with premenopausal, hormone-responsive, HER2-negative, lymph-node–negative, T1-T2 breast cancer.
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Affiliation(s)
- Guiyun Sohn
- Division of Breast and Endocrine Surgery, Departments of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sei Hyun Ahn
- Division of Breast and Endocrine Surgery, Departments of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hee Jeong Kim
- Division of Breast and Endocrine Surgery, Departments of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Byung-Ho Son
- Division of Breast and Endocrine Surgery, Departments of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong Won Lee
- Division of Breast and Endocrine Surgery, Departments of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Beom Seok Ko
- Division of Breast and Endocrine Surgery, Departments of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yura Lee
- Division of Breast and Endocrine Surgery, Departments of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sae Byul Lee
- Division of Breast and Endocrine Surgery, Departments of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seunghee Baek
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Zhang ZC, Liu Y, Xiao LL, Li SF, Jiang JH, Zhao Y, Qian SW, Tang QQ, Li X. Upregulation of miR-125b by estrogen protects against non-alcoholic fatty liver in female mice. J Hepatol 2015; 63:1466-75. [PMID: 26272872 DOI: 10.1016/j.jhep.2015.07.037] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 07/12/2015] [Accepted: 07/29/2015] [Indexed: 12/23/2022]
Abstract
BACKGROUND & AIMS Due to the protective effect of estrogen against hepatic fat accumulation, the prevalence of non-alcoholic fatty liver disease (NAFLD) in premenopausal women is lower than that in men at the same age and in postmenopausal women. Our study was to further elucidate an underlying mechanism by which estrogen prevents NAFLD from miRNA perspective in female mice. METHODS miRNA expression was evaluated by TaqMan miRNA assay. Luciferase and ChIP assay were done to validate regulation of miR-125b by estrogen via estrogen receptor alpha (ERα). Nile red and Oil red O staining were used to check lipid content. Overexpressing or inhibiting the physiological role of miR-125b in the liver of mice through injecting adenovirus were used to identify the function of miR-125b in vivo. RESULTS miR-125b expression was activated by estrogen via ERα in vitro and in vivo. miR-125b inhibited lipid accumulation both in HepG2 cells and primary mouse hepatocytes. Consistently, ovariectomized or liver-specific ERα knockdown mice treated with miR-125b overexpressing adenoviruses were resistant to hepatic steatosis induced by high-fat diet, due to decreased fatty acid uptake and synthesis and decreased triglyceride synthesis. Conversely, inhibiting the physiological role of miR-125b with a sponge decoy slightly promoted liver steatosis with a high-fat diet. Notably, we provided evidence showing that fatty acid synthase was a functional target of miR-125b. CONCLUSION Our findings identify a novel mechanism by which estrogen protects against hepatic steatosis in female mice via upregulating miR-125b expression.
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Affiliation(s)
- Zhi-Chun Zhang
- Key Laboratory of Metabolism and Molecular Medicine, Ministry of Education, Department of Biochemistry and Molecular Biology, Fudan University Shanghai Medical College, Shanghai 200032, PR China
| | - Yan Liu
- Key Laboratory of Metabolism and Molecular Medicine, Ministry of Education, Department of Biochemistry and Molecular Biology, Fudan University Shanghai Medical College, Shanghai 200032, PR China
| | - Liu-Ling Xiao
- Key Laboratory of Metabolism and Molecular Medicine, Ministry of Education, Department of Biochemistry and Molecular Biology, Fudan University Shanghai Medical College, Shanghai 200032, PR China
| | - Shu-Fen Li
- Key Laboratory of Metabolism and Molecular Medicine, Ministry of Education, Department of Biochemistry and Molecular Biology, Fudan University Shanghai Medical College, Shanghai 200032, PR China
| | - Jing-Hui Jiang
- Key Laboratory of Metabolism and Molecular Medicine, Ministry of Education, Department of Biochemistry and Molecular Biology, Fudan University Shanghai Medical College, Shanghai 200032, PR China
| | - Yue Zhao
- Key Laboratory of Metabolism and Molecular Medicine, Ministry of Education, Department of Biochemistry and Molecular Biology, Fudan University Shanghai Medical College, Shanghai 200032, PR China
| | - Shu-Wen Qian
- Key Laboratory of Metabolism and Molecular Medicine, Ministry of Education, Department of Biochemistry and Molecular Biology, Fudan University Shanghai Medical College, Shanghai 200032, PR China
| | - Qi-Qun Tang
- Key Laboratory of Metabolism and Molecular Medicine, Ministry of Education, Department of Biochemistry and Molecular Biology, Fudan University Shanghai Medical College, Shanghai 200032, PR China; Institute of Stem Cell and Regenerative Medicine, Institutes of Biomedical Sciences, Fudan University, Shanghai 200032, PR China
| | - Xi Li
- Key Laboratory of Metabolism and Molecular Medicine, Ministry of Education, Department of Biochemistry and Molecular Biology, Fudan University Shanghai Medical College, Shanghai 200032, PR China.
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Safaeiyan A, Pourghassem-Gargari B, Zarrin R, Fereidooni J, Alizadeh M. Randomized controlled trial on the effects of legumes on cardiovascular risk factors in women with abdominal obesity. ARYA Atheroscler 2015; 11:117-25. [PMID: 26405440 PMCID: PMC4568196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 12/30/2014] [Indexed: 11/08/2022]
Abstract
BACKGROUND The effect of legume-based hypocaloric diet on cardiovascular disease (CVD) risk factors in women is unclear. This study provides an opportunity to find effects of high-legume diet on CVD risk factors in women who consumed high legumes at baseline. METHODS This randomized controlled trial was undertaken in 34 premenopausal women with central obesity. After 2 weeks of a run-in period on an isocaloric diet, subjects were randomly assigned into two groups: (1) hypocaloric diet enriched with legumes (HDEL) (n = 17) (two servings per day) and (2) hypocaloric diet without legumes (HDWL) (n = 17) for 6 weeks. The following variables were assessed before intervention, 3, and 6 weeks after it: Waist to hip ratio (WHR), total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), high-sensitive-C-reactive protein (hs-CRP), total antioxidant capacity (TAC), nitric oxides (NOx), and Malondialdehyde (MDA). RESULTS Both hypocaloric diets reduced hs-CRP in 3 weeks and returned it to basal values after 6 weeks (P = 0.004). HDWL significantly reduced WHR [P = 0.010 (3.2%)] and increased TC [P < 0.001 (6.3%)]. Despite the significant effect of HDEL on increasing TAC in 3 weeks [P = 0.050 (4%)], the level of TAC remained the same in 6 weeks. None of the diets had any significant effects on NOx and MDA. CONCLUSION The study indicated that beneficial effects of legumes on TC, LDL-C, and hs-CRP were achieved by three servings per week, and consuming more amounts of these products had no more advantages.
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Affiliation(s)
- Abdolrasoul Safaeiyan
- Department of Vital Statistics and Epidemiology, School of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Bahram Pourghassem-Gargari
- Professor, Nutrition Research Center AND Department of Biochemistry and Dietetics, School of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rasoul Zarrin
- Assistant Professor, Food and Beverages Safety Research Center AND Department of Nutrition, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Javid Fereidooni
- Assistant Professor, Department of English Language, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Mohammad Alizadeh
- Assistant Professor, Food and Beverages Safety Research Center AND Department of Nutrition, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran,Correspondence to: Mohammad Alizadeh,
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Akyildiz ZI, Polat S, Yurekli BS, Kocabas GU, Tuluce K, Tuluce SY, Kocabas U, Bozkaya G, Yuksel A, Nazli C. Epicardial fat, body mass index, and triglyceride are independent contributors of serum fibroblast growth factor 21 level in obese premenopausal women. J Endocrinol Invest 2015; 38:361-6. [PMID: 25312836 DOI: 10.1007/s40618-014-0185-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 09/29/2014] [Indexed: 12/24/2022]
Abstract
PURPOSE The hormone fibroblast growth factor 21 (FGF-21) regulates carbohydrate and lipid homeostasis. FGF-21 represents an attractive novel therapy for obesity since administration of FGF-21 has been shown to improve metabolic abnormalities in obese animal models. We investigated FGF-21 and its relationship with epicardial fat thickness (EFT), metabolic parameters, and inflammatory markers in premenopausal obese women compared to controls with similar Systematic Coronary Risk Evaluation (SCORE) project risk profiles. METHODS Forty-five obese premenopausal women with body mass index (BMI) ≥30 kg/m(2) and 41 control premenopausal women with BMI <25 kg/m(2) with similar SCORE project risk profiles were included in this case-control study. EFT was evaluated by two-dimensional transthoracic echocardiography. Serum FGF-21 was measured with an ELISA kit. RESULTS FGF-21 and EFT were significantly higher in obese women compared to controls (p < 0.001). Multiple stepwise linear regression analysis showed that EFT, BMI, and triglycerides (TG) independently contributed to FGF-21 (R(2) = 0.757, p < 0.001). However, homeostasis model assessment of insulin resistance (HOMA-IR), visceral ectopic fat, and inflammatory markers were not found as a direct contributor to serum FGF-21 level (p > 0.05). CONCLUSIONS EFT, BMI, and TG may play an important role in predicting serum FGF-21 level which may be a potential therapeutic target in cardiometabolic disorders in the future.
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Affiliation(s)
- Z I Akyildiz
- Department of Cardiology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Basin Sitesi, 35360, Izmir, Turkey.
| | - S Polat
- Department of Internal Medicine, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
| | - B S Yurekli
- Department of Endocrinology and Metabolism, Ege University Faculty of Medicine, Izmir, Turkey
| | - G U Kocabas
- Department of Endocrinology, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
| | - K Tuluce
- Department of Cardiology, Izmir Karsiyaka State Hospital, Izmir, Turkey
| | - S Y Tuluce
- Department of Cardiology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Basin Sitesi, 35360, Izmir, Turkey
| | - U Kocabas
- Department of Cardiology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Basin Sitesi, 35360, Izmir, Turkey
| | - G Bozkaya
- Department of Biochemistry, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
| | - A Yuksel
- Department of Internal Medicine, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
| | - C Nazli
- Department of Cardiology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Basin Sitesi, 35360, Izmir, Turkey
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Zhou J, Wu SG, Wang JJ, Sun JY, Li FY, Lin Q, Lin HX, He ZY. Ovarian Ablation Using Goserelin Improves Survival of Premenopausal Patients with Stage II/III Hormone Receptor-Positive Breast Cancer without Chemotherapy-Induced Amenorrhea. Cancer Res Treat 2014; 47:55-63. [PMID: 25187267 PMCID: PMC4296851 DOI: 10.4143/crt.2013.165] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 11/16/2013] [Indexed: 12/29/2022] Open
Abstract
Purpose The purpose of this study was to assess the value of ovarian ablation using goserelin in premenopausal patients with stage II/III hormone receptor-positive breast cancer without chemotherapy-induced amenorrhea (CIA). Materials and Methods We retrospectively reviewed the data of breast patients treated between October 1999 and November 2007 without CIA. The Kaplan-Meier method was used for calculation of the survival rate. Log rank method and Cox regression analysis were used for univariate and multivariate prognostic analysis. Results The median follow-up period was 61 months. Initially, 353 patients remained without CIA after chemotherapy and 98 among those who received goserelin and tamoxifen (TAM). In univariate analysis, goserelin improved locoregional recurrence-free survival (LRFS) (98.9% vs. 94.1%, p=0.041), distant metastasis-free survival (DMFS) (85.4% vs. 71.9%, p=0.006), disease-free survival (DFS) (85.4% vs. 71.6%, p=0.005), and overall survival (OS) (93.5% vs. 83.5%, p=0.010). In multivariate analysis, goserelin treatment was an independent factor influencing DMFS (hazard ratio [HR], 1.603; 95% confidence interval [CI], 1.228 to 2.092; p=0.001), DFS (HR, 1.606; 95% CI, 1.231 to 2.096; p=0.001), and OS (HR, 3.311; 95% CI, 1.416 to 7.742; p=0.006). In addition, treatment with goserelin resulted in significantly improved LRFS (p=0.039), DMFS (p=0.043), DFS (p=0.036), and OS (p=0.010) in patients aged < 40 years. In patients aged ≥ 40 years, goserelin only improved DMFS (p=0.028) and DFS (p=0.027). Conclusion Ovarian ablation with goserelin plus TAM resulted in significantly improved therapeutic efficacy in premenopausal patients with stage II/III hormone receptor-positive breast cancer without CIA.
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Affiliation(s)
- Juan Zhou
- Departments of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - San-Gang Wu
- Departments of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Jun-Jie Wang
- Department of Medical Oncology, The Central Hospital of Xinxiang, Xinxiang, China
| | - Jia-Yuan Sun
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Feng-Yan Li
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Qin Lin
- Departments of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Huan-Xin Lin
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Zhen-Yu He
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
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López-Caudana AE, Castillo-Calderón MG, Ávila-Jiménez L. [Menopause and ultrasonographic measurements of calcaneus]. Rev Med Inst Mex Seguro Soc 2014; 52:144-149. [PMID: 24758851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND In Mexico, calcaneal ultrasound measurements -bone mineral density (BMD), broadband ultrasound attenuation (BUA), speed of sound (SOS), ultrasonic quantitative index (QUI)- and their differences in regards to menopause have not been documented. METHODS It was carried out a cross-sectional study in 862 women from 20 to 90 years old, incorporated through consecutive sample, who were users of the Sistema para el Desarrollo Integral de la Familia (DIF) in Morelos. Sociodemographic, reproductive and life style factors were identified. BMD, BUA, SOS and QUI were measured with quantitative ultrasound (QUS), using a Sunlight Omnisense 7000 S device. Adjusted differences in the mean of these measurements were estimated between pre and postmenopausal women through multiple linear regression. RESULTS The medians were: BMD, 0.455 g/cm² (IQR, interquartile range = 0.378, 0.538); BUA, 66.0 dB/mHz (IQR = 54.3, 78.1); SOS, 1530.7 m/s (IQR = 1509.8, 1551.7); QUI = 83.7 units (IQR = 71.1, 96.6). In postmenopausal women, adjusted mean for BUA was -4.34 dB/mHz (CI 95 % = -8.23,-0.43); for SOS, -4.26 m/s (CI 95 % = -13.82, 5.30) ; for QUI, -4.42 units (CI 95 % = -8.64,-0.19). CONCLUSIONS This report increases information about the clinical applicability of QUS. SOS in calcaneus does not reflect changes related with menopause.
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Affiliation(s)
- Alma Ethelia López-Caudana
- Consulta Externa de Medicina Familiar, Hospital General Regional con Unidad de Medicina Familiar 1, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos, México.
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Choi EJ, Kim KH, Koh YJ, Lee JS, Lee DR, Park SM. Coffee consumption and bone mineral density in korean premenopausal women. Korean J Fam Med 2014; 35:11-8. [PMID: 24501665 PMCID: PMC3912261 DOI: 10.4082/kjfm.2014.35.1.11] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Accepted: 12/30/2013] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Although Asian people are known to have lower bone mass than that of Caucasians, little is known about coffee-associated bone health in Asian. This study aimed to assess the relationship between coffee consumption and bone mineral density (BMD) in Korean premenopausal women. METHODS Data were obtained from the Fourth Korea National Health and Nutrition Examination Survey 2008-2009. The study population consisted of 1,761 Korean premenopausal women (mean age 36 years) who were measured for lumbar spine and femoral neck BMD and who completed a standardized questionnaire about coffee intake frequency. We excluded the participants who took hormone replacement therapy or medication for osteoporosis. The cross-sectional relationship between coffee consumption and impaired bone health (osteopenia or osteoporosis) was investigated by bone densitometry. RESULTS Coffee consumption showed no significant association with BMD of either femoral neck or lumbar spine, independent of other factors. The adjusted odds ratios for BMD for those who consumed once in a day, twice a day and three times a day were 0.94 (0.70-1.26), 0.93 (0.67-1.28), and 1.02 (0.69-1.50), respectively (P for trend = 0.927). CONCLUSION This study does not support the idea that coffee is a risk factor for impaired bone health in Korean premenopausal women.
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Affiliation(s)
- Eun-Joo Choi
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kyae-Hyung Kim
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Young-Jin Koh
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jee-Sun Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Dong-Ryul Lee
- Department of Family Medicine, Wonkwang University Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Korea
| | - Sang Min Park
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Yousefzadeh G, Mahdavi-Jafari F, Shokoohi M, Najafipour H, Haghdoost AA, Modares-Nejad V. Modulation of coronary artery disease risk factors by menopausal status: A population based study among Iranian women (KERCADRStudy). ARYA Atheroscler 2013; 9:332-6. [PMID: 24575135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Accepted: 07/20/2013] [Indexed: 10/27/2022]
Abstract
BACKGROUND Menopause is now viewed as a risk factor for coronary heart diseases (CHD). There is a scarcity of evidence concerning the effects of menopause on coronary artery disease (CAD) risk factors. The present study aimed to evaluate the effects of menopausal status on CAD risk factors. METHODS The present study was designed as part of the Kerman coronary artery disease risk study (KERCADRS) that was a population-based study among a cohort of 6000 individuals aged 15 to 75 years in Kerman, Iran. Only women aged 35 to 60 years were enrolled. Participants were categorized according to reproductive age into the three groups of premenopausal, perimenopausal, and postmenopausal states. RESULTS The premenopausal status was accompanied with lower levels of triglyceride (TG), cholesterol, fasting plasma glucose (FPG), and blood pressure compared with the other two groups (P < 0.001). In addition, women in the postmenopausal group had higher levels of low-density lipoprotein (LDL) in comparison with the other two groups (P < 0.001). After adjusting for age, total cholesterol and LDL levels were significantly higher in the postmenopausal group compared with the other two groups (P < 0.05). In addition, total cholesterol and LDL levels, and systolic blood pressure were statistically different according to menopausal status after adjustment for both age and body mass index (P < 0.05). CONCLUSION The increased risk of cardiovascular disease in postmenopausal period can be explained by elevated levels of lipid profile and increased systolic blood pressure, regardless of effects of advanced age or other anthropometric parameters.
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Abstract
PURPOSE The purpose of this study was to address the difference menopausal symptoms according to sasang constitution and menopausal status among perimenopausal women. METHODS Data for this cross-sectional study was collected by administering questionnaires that elicited general information. The menopause rating scale (MRS) and Questionnaire for the Sasang Constitution Classification II (QSCC II) was given to 284 perimenopausal women who met the eligibility criteria and agreed to participate in the study. RESULTS The study subjects were composed of 27.5% so-yangin, 24.6% so-eumin, 18.7% tae-eumin, and 29.6% undefined category. The total MRS and all subscales were significantly higher for postmenopausal women in comparison to premenopausal women. Especially, so-eumin and tae-eumin displayed significantly higher scores in urogenital symptoms. The MRS score in postmenopausal women who belonged to the group of tae-eumin and so-eumin was significantly higher than those for premenopausal women. However, so-yangin displayed higher scores in psychological and urogenital symptoms than tae-eumin for premenopausal women. So-eumin presented significantly higher scores in urogenital symptoms in comparison to the undefined category for postmenopausal women. CONCLUSION These findings suggest that sasang constitution could be an important factor in understanding the woman's menopausal symptoms and identify the best treatment.
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Dursun P, Bildaci TB, Zeyneloglu HB, Kuscu E, Ayhan A. Transobturator tape operation is more effective in premenopausal women than in postmenopausal women with stress incontinence. Korean J Urol 2011; 52:612-5. [PMID: 22025956 PMCID: PMC3198234 DOI: 10.4111/kju.2011.52.9.612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Accepted: 07/26/2011] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Midurethral synthetic slings for female stress urinary incontinence are minimally invasive polypropylene mesh tapes that are inserted under the midurethra with trocars. In the past decade, this new technology has become the most commonly performed procedure for female stress urinary incontinence, replacing the traditional open procedures. However, its effectiveness in pre- and postmenopausal women has not previously been compared. MATERIALS AND METHODS We assessed the clinical outcome of the transobturator tape (TOT) procedure in premenopausal (n=45) and postmenopausal (n=49) women by means of self-report and the Urinary Distress Inventory 6 (UDI-6) questionnaire. RESULTS The mean age of the pre- and postmenopausal women was 44 and 60 years, respectively. Mean parity was 2.4 and 3, respectively. There were no significant differences with respect to mean operation time, duration of hospitalization, or intraoperative and postoperative complications. However, premenopausal women were more satisfied with the operation than were postmenopausal women (p=0.014). Also, UDI-6 scores were significantly better in premenopausal women (p=0.027). CONCLUSIONS The TOT operation appeared to be more effective in premenopausal women with stress urinary incontinence. However, further studies with larger sample sizes are needed to confirm our results.
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Affiliation(s)
- Polat Dursun
- Department of Obstetrics and Gynecology, Baskent University School of Medicine, Ankara, Turkey
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Hoch AZ, Pajewski NM, Hoffmann RG, Schimke JE, Gutterman DD. Possible relationship of folic Acid supplementation and improved flow-mediated dilation in premenopausal, eumenorrheic athletic women. J Sports Sci Med 2009; 8:123-129. [PMID: 24150565 PMCID: PMC3737801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2008] [Accepted: 02/09/2009] [Indexed: 06/02/2023]
Abstract
The purpose of this study was to determine if six weeks of folic acid supplementation would improve brachial artery endothelial-dependent flow-mediated dilation in eumenorrheic female runners with previously normal serum folate levels. This was a prospective, double-blinded, randomized pilot study with convenience sampling. Sixteen eumenorrheic subjects who were not taking birth control pills and who ran at least 20 miles/week were randomly assigned to 10 mg/day of folic acid supplementation or placebo for at least 6 weeks. Serum folate levels and brachial artery measurements were made during the early follicular phase of the menstrual cycle, in a sedentary state, following an 8 hour fast; a standard ultrasound technique was used. The brachial artery vasodilator response to reactive hyperemia was similar between the folic acid (6.6% ± 0.8%, mean ± SE) and placebo groups (6.5% ± 0.7%) at baseline. After six weeks, there was a significantly higher change in flow-mediated dilation for the folic acid group (3.5% ± 0.6%) compared to the placebo group (0.1% ± 0.2%) (p = 0.01). Serum folate levels also increased significantly in the folic acid group following six weeks of folic acid supplementation. This study demonstrates that brachial artery flow-mediated dilation improves significantly in eumenorrheic female runners with previously normal serum folate levels after 6 weeks of supplementation with folic acid. Key pointsFolic acid improves FMD in eumenorrheic runners.Folic acid improves FMD in women runners.
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Affiliation(s)
- Anne Z Hoch
- Departments of Orthopaedic Surgery/Cardiovascular Center
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