Estradiol Levels In Postmenopausal Women Research Articles

Acute Effects of Exposure to Fine Particulate Matter and Its Constituents on Sex Hormone Among Postmenopausal Women - Beijing, Tianjin, and Hebei PLADs, China, 2018-2019.

Exposure to fine particulate matter (PM2.5) was linked to endocrine hormone disruption in the reproductive system. Nonetheless, it was unclear which specific components of PM2.5 were primarily responsible for these associations. The study presented the initial epidemiological evidence that brief exposure to PM2.5 can elevate estradiol levels in postmenopausal women. Various particle components had unique effects, with water-soluble ions and specific inorganic elements like Ag, As, Cd, Hg, Ni, Sb, Se, Sn, and Tl potentially playing significant roles in increasing estradiol levels. The study established that the prevalence of air pollution, along with its specific components, has been recognized as a novel risk factor affecting the balance of sex hormones.

Serum interleukin-17 and estradiol levels in postmenopausal women in relation to osteoporosis

BackgroundIn post-menopausal women, estrogen deficiency leads to instability between bone formation and resorption which is regulated by osteoclastogenic cytokines leading to resorption. Interleukin-17 (IL-17) a proinflammatory cytokine has been found as an important regulator of osteoclast-genesis induced by estrogen deficiency in favor of bone loss in animal studies.The study aimed to evaluate levels of IL-17 and estrogen (E2) in relation to bone mineral density (BMD) and risk of fracture in postmenopausal women with and without osteoporosis.ResultsIL-17 levels were significantly higher and E2 levels were significantly lower in the osteoporotic group compared to the non-osteoporotic group (P value ≤ 0.01). There was a highly significant difference in DEXA score and FRAX index between two groups: with higher values of FRAX and lower values of DEXA score among osteoporotic group (P value ≤ 0.01). IL-17 was inversely correlated to estrogen level and highly significant negative correlation with DEXA as well as a highly significant positive one with FRAX index. IL-17 serum level was able to diagnose osteoporosis at a cutoff level of > 80 pg/mL with 100% sensitivity, 100% specificity, 100% positive predictive value (PPV), and 100% negative predictive value (NPV).ConclusionsSerum IL-17 was significantly elevated in osteoporotic postmenopausal women when compared to healthy postmenopausal ones and was inversely correlated with estrogen level and DEXA.

Evaluation of central corneal thickness with meibomian gland dysfunction in postmenopausal women

Background: Meibomian gland dysfunction is a common chronic disease of eyelid wherein there is reduction in the quantity as well as changes in the composition of meibomian gland secretions, resulting in instability and thinning of the tear film which ultimately interferes with the ocular surface. It has also been observed that postmenopausal women may present with decrease in central corneal thickness due to hormonal changes. Studies have been done regarding the role of meibomian gland dysfunction in central corneal thickness changes.Objectives: To assess and compare the central corneal thickness and estimate estradiol levels in postmenopausal women with and without MGD, as well as and to correlate estradiol levels with severity of MGD in postmenopausal women with MGD.Design: Duration based, comparative two-group study.Participants: 80 participants with 160 eyes among which 40 were postmenopausal women with MGD and 40 were postmenopausal women without MGD.Methods: All female subjects satisfying the inclusion and exclusion criteria in the age group of 52 – 65 years who visited VIMS and RC, Bangalore between January 2018 to February 2020 were included. They underwent full ophthalmological examination – visual acuity assessment, retinoscopy, refraction, slit lamp examination, fundus examination, horizontal and vertical corneal curvature assessment, specular microscopy, tear break up time and Schirmer I test along with estimation of estrogen, progesterone and FSH levels. Results: This study concluded that mean central corneal thickness was reduced in case of postmenopausal women with MGD when compared to postmenopausal women without MGD with statistically significant results.Conclusion: Central corneal thickness was considerably less in postmenopausal women with MGD when compared to postmenopausal women without MGD, CCT assessment must be considered in every woman, especially in elderly patients.

The effect of Fennel seed powder on estradiol levels, menopausal symptoms, and sexual desire in postmenopausal women.

The present study was designed to determine the effect of Fennel seed powder on menopausal symptoms, sexual desire, and serum estradiol levels in postmenopausal women. The present study was conducted on 80 eligible women (45-60 y) who were referred to the Mofatteh Gynecology Clinic in Yasuj, Iran. Participants were randomized into equal intervention and control (control) groups. The intervention and control groups received four capsules of Fennel seed powder (2 gr) and starch-containing capsules (2 gr) daily over 8 weeks, respectively. Menopausal symptoms and sexual desire of the participants were evaluated using both the menopausal Kupperman index and Hurlbert index of sexual desire. The questionnaires were completed at baseline, week 4 and week 8 of the study by the participants. The serum estradiol levels were measured at baseline and also at the end of the study. The Chi-square test, independent t test, and repeated-measures analysis of variance were used to analyze the data. Menopausal symptoms score significantly decreased from 30.8 ± 6 to 19 ± 5.5 in the intervention group and also from 31.2 ± 6.5 to 26.4 ± 6.2 in the control group (P < 0.05). Treatment with Fennel seed did not significantly enhance the participants sexual desire (P > 0.05). The estradiol levels declined in the intervention (from 60.4 ± 43.4 to 52.6 ± 25.7) and control groups (from 55.1 ± 22.4 to 39.9 ± 26.9). However, this decrease was lower in the intervention group than in the control group. The intergroup differences were not statistically significant (P > 0.05). The results of the present study indicated that daily use of Fennel seed significantly improved menopausal symptoms in postmenopausal women over 8 weeks, though its effect on estradiol levels and sexual desire was not significant. Further studies with a larger sample size and longer duration are needed to verify these findings.

Abstract 587: Highly sensitive and accurate method for measuring serum estradiol in postmenopausal women and other population subgroups

Abstract Meta-analyses consistently show that postmenopausal women with elevated levels of estradiol have an increased risk for certain cancers, such as breast cancer. At the same time, estradiol therapy is used to treat menopausal symptoms. Data on blood levels of estradiol are highly variable, especially in postmenopausal women, which prevents the formulation of generally recognized normal ranges and the consistent treatment of postmenopausal women. Similarly, no generally recognized reference ranges for estradiol exist for men and children. One reason for this variability in estradiol blood levels is the lack of appropriate analytical methods. To overcome these challenges, new, highly sensitive, specific, and standardized methods for measuring estradiol are needed. This study describes a new analytical method for measuring estradiol in serum from post and premenopausal women, men and children, which is standardized to the CDC Hormone Standardization Program (HoSt). Data produced by this analytical method can be compared with data produced by other methods standardized to CDC HoSt. The analytical method optimizes the extraction of estradiol from serum using two liquid-liquid extractions with pH and polarity adjustments prior to LC-MS/MS analysis. All sample handling and extraction procedures are automated using 96-well plates. Chromatographic separation is carried out using a phenyl-hexyl HPLC column and a gradient of methanol and methanol:water. E2 and its C13 internal standard were analyzed by selected reaction monitoring (SRM) in the negative ion mode with transitions of m/z 271 to 145 and 274 to 148, respectively. The mean biases of this method to certified reference materials ranged between −1.3% and −1.7% and were statistically not significant. No significant difference to established metrological reference methods was determined. The limit of detection for estradiol using 200 µL of serum is 11.0 pM (2.99 pg/mL). The method is highly precise with a within-run, among-day (determined over 68 days), and total within-laboratory imprecision ranging between 2.9-5.0%, 1.5-1.8%, and 3.3-5.3% CV, respectively [1]. The sensitivity of the method was found to be suitable for determining estradiol levels in postmenopausal women, men, and children, and is being applied to measure estradiol in postmenopausal women in NHANES 2013-2014. Data generated by this method are comparable to those of other analytical methods that are standardized to the CDC HoSt program. This method allows for the development of generally recognized normal ranges of estradiol in postmenopausal women and other population subgroups.

Physical Activity, Nutrition and Hormone Levels of Postmenopausal Women With and Without Endometrial Cancer [40R

INTRODUCTION: This prospective study evaluated anthropometric data, reported physical activity, nutrition, and hormone levels between postmenopausal women undergoing hysterectomy for endometrial cancer and benign disease. METHODS: After IRB approval, participants completed questionnaires on physical activity, nutrition, menstrual history and hormone use, and provided preoperative blood samples. RESULTS: Of the 77 participants, mean age was 64.5 years, mean BMI was 35.0 kg/m2, and 80.5% had endometrial cancer. Few women (20.8%) achieved recommended weekly exercise and 47.2% did not exercise. Only 44.9% of women ate recommended servings of fruits and vegetables and 55.6% ate fast food weekly. Comparing women with and without cancer, a trend towards higher BMI (36.0 vs 31.1 kg/m2, P=.071) was noted but no significant differences with regard to gravidity, exercise, nutrition, glucose or hormone levels except that estradiol level was significantly lower in women with cancer (45.2 vs 53.8 pg/mL, P=.041). Obese women were significantly less likely to rate their health as excellent/very good (28.6% vs 56.5%, P=.022) and had statistically significant lower FSH (P=.021) and SHBG (P<0.001) but higher C-peptide (P=.019) compared to lean patients. Women were divided into 4 groups (obese or lean with and without cancer) with significant differences found in age (lean women with cancer were older, P=.006), FSH (obese women with cancer had lower levels, P=.012), SHBG (highest in lean women without cancer, P=.02) but not estradiol, androstenedione, C-peptide or diet/exercise. CONCLUSION: Estradiol levels in postmenopausal women with cancer were lower than benign patients and did not correlate with obesity or other diet/exercise habits.

Abstract P5-04-16: Total estrogenic activity during neoadjuvant therapy with letrozole and exemestane – An intra-patient cross-over comparison using the AroER tri-screen

Abstract Background. Aromatase inhibitors (AIs), letrozole (Femarâ / Femaraâ) and exemestane (Aromasinâ), are widely used anti-hormonal drugs for breast cancer. Both compounds strongly reduce circulating estradiol levels in postmenopausal women. In the setting of metastatic breast cancer, these drugs may be used after another, causing new responses in selected patients by switching to the alternative drug after progressing on the first choice. This well-known ”lack of cross resistance” has been recognized for some time and is documented by several clinical trials. However, the precise explanation for this clinical observation is still unknown. The availability of mechanistic information may lead to an improved strategy against hormone-sensitive breast cancer. Patients and methods. NEO-LET-EXE was a neoadjuvant, randomized, open-label, intra-patient cross-over trial. Postmenopausal patients with estrogen receptor (ER) positive (&amp;gt;50%), HER-2 negative, locally advanced breast cancer were enrolled. Sequential blood samples (obtained at baseline, after 2 months and 4 months of treatment) were available from 29 patients. All patients were randomized to sequential treatment starting with either letrozole (2.5 mg o.d.) or exemestane (25 mg o.d) for 2 months followed by another 2 months on the alternative compound. The total estrogenic activities in the collected blood samples were determined using AroER tri-screen assay developed by the Chen laboratory. The assay utilizes MCF-7aro ERE cells which contain both aromatase and ER. The samples were assayed in the presence as well as the absence of letrozole, to estimate relative contributions of estrogen and estrogen+androgen to the activities, respectively. Results. Using the highly sensitive AroER tri-screen assay, estrogenic activity were detected at three time points in all blood samples. Importantly, a significantly higher total estrogenic activity was found during therapy with exemestane compared to letrozole in 23 out of 26 patients. Only in three patients, the activity was higher during therapy with letrozole compared to exemestane. When letrozole was included in the assay, the estrogenic activities in most samples collected during exemestane treatment were further reduced, suggesting that low levels of androgen were present in samples from exemestane treatment. Four samples collected after exemestane treatment and three after letrozole treatment had higher activities than baseline samples when assay was carried out with letrozole. Discussion. Our results suggest the AroER tri-screen to be a very sensitive method to estimate the overall estrogen-mediated activity in human samples. Significant higher levels of estrogenic activity in human serum were observed during exemestane than those during letrozole treatment. Our observations, that additional letrozole could reduce further the estrogen activity in the exemestane-treated samples, demonstrate probably residual aromatase activity during therapy with exemestane alone.In addition to distinguish the effects of exemestane and letrozole, our results also demonstrate that the assay can also potentially detect the effects of estrogenic mimics. Citation Format: Bahrami N, Chang G, Kanaya N, Sauer T, Gravdehaug B, Chen S, Geisler J. Total estrogenic activity during neoadjuvant therapy with letrozole and exemestane – An intra-patient cross-over comparison using the AroER tri-screen [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-04-16.

Fat Mass Follows a U-Shaped Distribution Based on Estradiol Levels in Postmenopausal Women.

Estradiol (E2) regulates adipose tissue resulting in increased fat mass (FM) with declining E2. However, increased visceral fat and hyperestrogenemia are features of obese individuals. It is possible that adipocytes in obese individuals are less sensitive to E2 resulting in higher FM. Our objective is to identify the range of serum E2 for which postmenopausal women have the lowest FM and best body composition. Cross-sectional data from 252 community-dwelling postmenopausal women, 42-90 years old. Subjects were stratified into categories of E2 (pg/ml): (1) ≤10.5; (2) 10.6-13.9; (3) 14.0-17.4; and (4) ≥17.5. Body composition by dual-energy X-ray absorptiometry. Serum E2 by radioimmunoassay. Between-group comparisons by analysis of covariance. E2 linearly increased with increasing body weight and body mass index (r = 0.15 and p = 0.01 for both), but not with total FM (kg) or % FM (r = 0.07, p = 0.34 and r = -0.04, p = 0.56, respectively). However, total FM (kg) followed a U-shaped distribution and was significantly lower in group 3 (27.6 ± 10.6), compared with groups 1: (34.6 ± 12.5), 2: (34.0 ± 12.4), and 4: (37.0 ± 10.6), p = 0.005. % FM was also lowest in group 3. While fat-free mass (FFM, kg) increased with increasing E2 (p < 0.001), % FFM was highest in group 3. In our population of postmenopausal women, FM followed a U-shaped distribution according to E2 levels. E2 between 14.0 and 17.4 pg/ml is associated with the best body composition, i.e., lowest total and % FM and highest % FFM. Given the role of E2 in regulating body fat, high FM at the high end of the E2 spectrum may suggest reduced E2 sensitivity in adipocytes among obese postmenopausal women. ClinicalTrials.gov identifier: NCT00146107.

Abstract P2-09-14: Association between BMI and residual estradiol levels in post-menopausal women using adjuvant letrozole: Results of a prospective study

Abstract Background: Adjuvant aromatase inhibitors (AI) are the standard of care for post-menopausal women with early breast cancer (BC). Some studies have suggested that women with high BMI have less benefit from some AIs (anastrozole, but not letrozole) vs. tamoxifen. Of concern, a positive correlation between BMI and residual estradiol in women using letrozole has been reported (ALIQUOT Study; JCO 2012). These findings have created uncertainty about the use of AIs in overweight and obese women. We conducted a prospective study to measure estrogen levels in post-menopausal women using adjuvant letrozole, with the primary objective of evaluating the relationship between residual E2 and BMI. Methods: Post-menopausal women with early BC taking adjuvant letrozole for at least 3 months were recruited at 4 sites in Toronto, Canada. Fasting blood was collected 24 hours after the prior dose at baseline (Day 1, routine use of own letrozole, including generic) and on Day 29, following 28 days of monitored adherence to a provided supply of Femara 2.5 mg/day (Part A). Participants with BMI&amp;gt;25 were treated for a further 28 days (Part B) with a double dose of Femara (5 mg/day). Estradiol and estrone were measured using a high sensitivity liquid chromatography-tandem mass spectrometry assay. Vitamin D and markers of obesity/inflammation were assayed, and symptom/quality of life questionnaires completed at the same time points. Results: 112 eligible patients were enrolled and completed Part A. Median age was 62 and BMI 24.7 kg/m2 (range 19.0 to 42.2 kg/m2). 68% of participants had received adjuvant chemotherapy. Estradiol levels (mean±SD) were 2.81±1.15 pg/mL at baseline (typical use) and 2.69±1.01 pg/mL at Day 29 following monitored Femara use with near-perfect adherence (p=NS). No significant correlation was observed between estradiol and BMI on either Day 1 or Day 29 (r=0.06, p=NS). As previously reported, letrozole 5 mg/day dose did not affect residual estradiol levels at Day 58 for women with BMI&amp;gt;25. Residual estradiol was not correlated with vitamin D or markers of obesity/inflammation (insulin, leptin, CRP). Conclusion: No association was observed between BMI and residual estradiol in women using letrozole (generic or Femara) at standard doses. These results are consistent with the absence of a treatment-by-BMI interaction in the BIG 1-98 trial and they provide reassurance that letrozole is an appropriate treatment in overweight and obese women. Funded by Hold 'Em For Life (Mount Sinai Hospital, Toronto) and Breast Cancer Research Foundation. Citation Format: Cescon DW, Ennis M, Pritchard KI, Townsley C, Warr D, Elser C, Rao L, Stambolic V, Sridhar S, Goodwin PJ. Association between BMI and residual estradiol levels in post-menopausal women using adjuvant letrozole: Results of a prospective study [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-09-14.

Correlation of periodontitis with mandibular radiomorphometric indices, serum calcium and serum estradiol in postmenopausal women: A case-control study.

Osteoporosis and periodontitis have several risk factors in common. The majority of studies evaluating periodontal bone loss and systemic bone mineral density have found that low bone mineral density systemically is significantly associated with an increase in loss of alveolar bone height and periodontal destruction. Hence, the purpose of the study was to determine the effect of periodontitis on mandibular radiomorphometric indices, serum calcium and serum estradiol levels in postmenopausal women. Forty female patients in the age group of 35-55 years were included in the study. The participants were divided into two equal groups, i.e., control group A (twenty - postmenopausal women with healthy periodontium) and study group B (twenty - postmenopausal women with periodontitis). A thorough clinical examination of all the forty patients was carried out to detect the presence of periodontitis on the basis of clinical attachment level. Quantitative indices were measured on digital panoramic radiographs, and serum calcium and estradiol levels were estimated. No statistically significant correlation of periodontitis with any of the radiomorphometric indices, serum calcium and serum estradiol levels was observed in postmenopausal women. There is little evidence of correlation of serum estradiol, serum calcium levels, and morphometric indices with periodontitis and therefore detailed further research about this correlation is required.

Estrone and Estradiol Levels in Breast Cancer Patients Using Anastrozole Are Not Related to Body Mass Index.

Objective Obesity is associated with an increased risk for breast cancer. Recent studies have shown that aromatase inhibitors may be less effective in women with a high body mass index (BMI). The aim of this study was to establish the relationship between the BMI and plasma estrone and estradiol levels in postmenopausal women with hormone receptor-positive breast cancer using anastrozole. Methods In this cohort study, the patients were divided into three groups according to BMI (normal weight, overweight and obese) to compare and correlate plasma hormone levels before starting anastrozole hormone therapy and three months after treatment. Plasma hormone levels were compared for age and use of chemotherapy. Results A statistically significant reduction in estrone and estradiol levels was observed between baseline and three months after starting the anastrozole treatment (p < 0.05). There was no statistically significant difference in plasma estrone and estradiol levels among the BMI groups (p > 0.05), but a significant reduction in plasma estrone levels was observed after three-months' treatment relative to baseline in all groups, as well as a reduction in estradiol in the obese group (p < 0.05). The use of chemotherapy and age > 65 years had no influence on plasma steroid levels. Conclusion Changes in estrone and estradiol levels in the studied groups were not associated with BMI, chemotherapy or age.

Insulin, estradiol levels and body mass index in pre- and post-menopausal women with breast cancer

Breast cancer is the most common cancer among women where it is associated with considerable morbidity and mortality. The aim of this study was to investigate the association between insulin, estradiol levels and body mass index (BMI) as risk factors for breast cancer. Methods: 80 women newly diagnosed with breast cancer stage I–III invasive breast cancer, were selected randomly and divided in two groups: 40 pre-menopausal aged 26–46 years and 40 post-menopausal aged 52–90 years. Radioimmunoassay used for serum insulin levels measurement, ELISA was used for estradiol levels and BMI calculated by weight (kg)/height (m2). Results: Insulin levels in premenopausal (16.6 ± 10.5) and postmenopausal (17.9 ± 8.8); breast cancer patients showed increasing pattern from the normal levels (4.0–16.0 μIU/ml). While, the levels of estradiol in premenopausal (233 ± 173) and postmenopausal, (549 ± 468); estradiol level in postmenopausal was higher than normal level (50–300 ng/ml), its level showed significantly increase in postmenopausal breast cancer (P.Value = 0.001). Conclusion: Insulin levels increased in pre- and post-menopausal breast cancer patients while estradiol levels do not showed association with premenopausal breast cancer. High BMI, high insulin and estradiol levels in post-menopausal women may be considered as risk factors for breast cancer.

Impact of Estradiol on Circulating Markers of Oxidative Stress among Hypertensive Postmenopausal Women with Co-morbidities

Background: Oxidative stress plays a key role in the pathogenesis of several age-associated diseases. The antioxidant properties of estradiol reduce oxidative stress related complications. Menopause is typified by a drop in endogenous estradiol that might subsequently affect women’s wellbeing. Materials and Methods : 100 postmenopausal women were selected and classed into four groups. Estradiol (E2) and enzymatic antioxidant status were assessed among normotensive postmenopausal women (group-1), hypertensive postmenopausal women (group-2), hypertensive postmenopausal women with diabetes (group-3) and hypertensive postmenopausal women with renal insufficiency (group-4). Kruskal-Wallis test and correlation analysis were performed using SPSS16.0 statistical software. Results: Estradiol (E2), catalase (CAT), superoxide dismutase activity (SOD), glutathione peroxidase (GPx) and glutathione-S-transferase (GST) activities were significantly decreased in hypertensive postmenopausal women with diabetes (group-3) and hypertensive postmenopausal women with renal insufficiency (group-4) compared normotensive postmenopausal women (group-1). Catalase, glutathione peroxidise and glutathione-S-transferase activities were significantly reduced in the three experimental groups compared to normotensive control. Estradiol exhibited significant positive correlations with catalase, superoxide dismutase and glutathione peroxidase. Conclusion: Elevated oxidative stress along with drop in estradiol levels in postmenopausal women seems to be aggravated by co-morbid conditions.

Aromatase inhibitors in obese breast cancer patients are not associated with increased plasma estradiol levels

Obesity, in postmenopausal women, has been associated to a higher breast cancer incidence and worst prognosis. Some studies suggested a decrease in aromatase inhibitors (AI) efficacy in obese postmenopausal breast cancer patients, although estradiol levels were not measured. The purpose of the present study was to verify if estradiol levels are measurable in postmenopausal women under AI. If achievable, the goal is to compare the estradiol levels in lean versus obese postmenopausal women under AI treatment for non-metastatic breast cancer. Postmenopausal women were recruited in accordance to one of these four groups: lean [body mass index (BMI) of 18-25 kg/m(2)] under AI (n = 30), obese (BMI ≥ 30 kg/m(2)) under AI (n = 30), lean AI-naïve (n = 10), and obese AI-naïve (n = 10). Lean and obese women were matched according to their age. Estradiol levels were measured in plasma using an ELISA. The Wilcoxon signed-rank test was used to assess the significance of the differences between the groups. Estradiol levels in postmenopausal women under AI varied from 0 to 94.65 pg/ml with a median value of 0.98 pg/ml. Obese AI-naïve women had higher estradiol levels than lean AI-naïve women (p = 0.03). There was no difference in estradiol levels between lean and obese women under AI (p = 0.76). Despite very low plasma levels, it is possible to measure the estradiol levels in postmenopausal women under AI treatment. Our results suggest that the known impact of obesity on recurrence risk in women under AI treatment may not be due to incomplete aromatase inhibition. Further works are needed to examine closely the aromatase-independent pathways that are linking obesity to breast cancer risk and recurrence.

Endogenous Estradiol and The Risk of Incident Fracture in Postmenopausal Women: The OPUS Study

Some, but not all, studies have found that low endogenous estradiol levels in postmenopausal women are predictive of fractures. The aim of this study was to examine the roles of endogenous estradiol (E(2)), sex hormone binding globulin (SHBG), and dehydroepiandrosterone sulfate (DHEAS) in the prediction of incident vertebral and nonvertebral fractures. The study subjects were 797 postmenopausal women from the population-based OPUS (Osteoporosis and Ultrasound Study) study. Spine radiographs and dual-energy X-ray absorptiometry scans were obtained for all subjects at baseline and 6-year follow-up. Nonfasting blood samples were taken at baseline for E(2), SHBG, DHEAS, and bone turnover markers. Incident nonvertebral fractures were self-reported and verified; vertebral fractures were diagnosed at a single center from spinal radiographs. Medical and lifestyle data were obtained by questionnaire at each visit. Thirty-nine subjects had an incident vertebral fracture and 119 a nonvertebral fracture. Estradiol in the lowest quartile predicted vertebral fracture independent of confounders including age, body mass index, bone mineral density, bone turnover, fracture history, and use of antiresorptive therapy, with an OR of 2.97 (95 % confidence interval [CI] 1.52-5.82) by logistic regression. A calculated free estradiol index was not a stronger predictor than total E(2). Higher SHBG predicted vertebral fracture independently of age and body mass index, but not independently of E(2), bone mineral density, or prevalent fracture. Low DHEAS did not predict vertebral fracture. Nonvertebral fractures were not predicted by any of E(2), SHBG, or DHEAS, either in univariate or multivariate analyses. These findings suggest that there may be mechanistic differences in the protective effect of E(2) at vertebral compared with nonvertebral sites.

RE: Infantile and early childhood masturbation: Sex hormones and clinical profile

RE: Infantile and early childhood masturbation: Sex hormones and clinical profile

Tamoxifen, Mammographic Density, and Breast Cancer Prevention

Tamoxifen, Mammographic Density, and Breast Cancer Prevention

Serum concentrations of selected endogenous estrogen and estrogen metabolites in pre- and post-menopausal Chinese women with osteoarthritis

The purpose of this study was to investigate whether serum levels of selected endogenous estrogens and their metabolites are involved in the pathogenesis of osteoarthritis in pre- and post-menopausal women with osteoarthritis. Sixty-four patients with osteoarthritis (OA) of the knee, 48 patients with rheumatoid arthritis (RA) of the knee, and 48 healthy women were included in this study. Serum concentrations of estradiol and estrogen metabolites, such as 2- hydroxyestrone, 2-hydroxyestradiol, and 16α-hydroxyestrone, were measured by high performance liquid chromatography-mass spectrometry. Our results show that the serum concentrations of free estradiol and total 2-hydroxyestrone were significantly lower in pre-menopausal women with OA compared to the levels detected in the control groups (RA and healthy women). While serum concentrations of free and total estradiol in post-menopausal women with OA was significantly decreased compared to those of the control groups, the level of total 2-hydroxyestradiol significantly increased in postmenopausal women. Furthermore, the total 2-hydroxyestrone concentration positively correlated with the total estradiol level in pre-menopausal women with OA. In addition, the total 2- hydroxyestradiol level positively correlated with free and total estradiol levels in post-menopausal women with OA. In conclusion, estradiol and estrogen metabolites, including 2-hydroxyestrone and 2-hydroxyestradiol, were found in the sera of pre- and post-menopausal women with OA. Except for free and total estradiol deficiency, a decreased serum level of total 2- hydroxyestrone in pre-menopausal women and an increased total 2-hydroxyestradiol level in post-menopausal women with OA may also correlate with the pathogenesis of female OA.

Limitations of Direct Immunoassays for Measuring Circulating Estradiol Levels in Postmenopausal Women and Men in Epidemiologic Studies

Serum estradiol (E(2)) serves as an important diagnostic marker in a variety of clinical conditions. In epidemiologic studies, E(2) is commonly used to define the etiologic role of estrogen in hormone-related cancers and chronic conditions. Having an accurate and reliable E(2) assay is of critical importance in these studies, especially when measuring the very low E(2) levels (<30 pg/mL) common in postmenopausal women and men, and for discerning the relatively small (usually <20%) case-control differences in E(2) levels. Because E(2) is metabolized to >100 metabolites in the body, some of which cross-react with E(2) antibodies, direct RIAs without purification steps lack specificity for E(2) and can substantially overestimate E(2) levels. Although direct E(2) RIAs using commercial kits are simpler, less time consuming, and less expensive and require less sample volume than conventional RIAs with preceding purification steps, their lack of sensitivity and specificity makes them invalid for measuring circulating E(2) levels in epidemiologic studies of postmenopausal women or men. Instead, we recommend the use of a well-validated RIA with purification steps to improve sensitivity and specificity and to help achieve the necessary accuracy and reliability needed for epidemiologic studies.

VARIATIONS IN THE DEFICIENCY LEVELS OF ENDOGENOUS ESTRADIOL ON THE RATE OF POSTMENOPAUSAL BONE RESORPTION

Over a period of three years, 257 healthy postmenopausal women (mean age of 51.7 years) and 47 premenopausal women (control group, mean age of 34.23 years) were selected into the study. The postmenopausal women were divided into three estradiol‐deficient (study) groups based on the endogenous estradiol levels such as Group – I (10–25 pg/ml), Group ‐ II (&gt;25–50 pg/ml) and Group ‐ III (&gt;50 pg/ml). Bone formation marker (total alkaline phosphatase), bone resorption markers (tartrate‐resistant acid phosphatase, calcium, free hydroxyproline, free deoxypyridinoline and calcium/creatinine) and intact paratharmone levels were estimated in every subject. The bone formation marker and bone resorption markers were found to be elevated in all the three study groups over controls (P&lt;0.0010) When the study groups compared among one another, the bone resorption markers were found elevated in Group‐I over Group ‐ II and III and in Group ‐ II over Group ‐ III. But, the intact paratharmone levels were found to be normal in all the groups.This study concludes that the degree of bone resorption was high in Group ‐ III (&gt;50 pg/ml, higher in Group – II (&gt; 25–50 pg/ml) and highest in Group ‐ I (10–25 pg m/l) over controls. This view portends that the endogenous estradiol levels are the important determinants of bone resorption risk and also the variations in deficient endogenous estradiol levels in postmenopausal women might contribute to differences in the rate of postmenopausal bone resorption.