Hormonal Changes Research Articles

Advances in the Effects of Heat Stress on Ovarian Granulosa Cells: Unveiling Novel Ferroptosis Pathways.

Heat stress has been one of the key research areas for researchers due to the wide-ranging effects and complex mechanisms of action of its stress product reactive oxygen species (ROS). The aim of this paper is to comprehensively review and summarize the effects of heat stress on ovarian granulosa cells and their mechanism of action. We systematically reviewed the effects of heat stress on ovarian granulosa cells, including intracellular steroid hormone changes, oxidative stress, apoptosis, and mitochondrial function. Meanwhile, this paper discusses in detail several major mechanisms by which heat stress induces apoptosis in ovarian granulosa cells, such as through the activation of apoptosis-related genes, induction of endoplasmic reticulum stress, and the mitochondrial pathway. In addition, we analyzed the mechanism of ferroptosis in ovarian granulosa cells under heat stress conditions, summarized the potential association between heat stress and ferroptosis in light of the existing literature, and explored the key factors in the mechanism of action of heat stress, such as the signaling pathways of Nrf2/Keap1, HSPs, and JNK, and analyzed their possible roles in the process of ferroptosis. Finally, this paper provides an outlook on the future research direction, describing the possible interaction between heat stress and ferroptosis, with a view to providing a theoretical basis for further understanding and revealing the complex mechanism of ferroptosis occurrence in ovarian granulosa cells under heat stress.

Predictive value of neuronal markers for pituitary dysfunction following traumatic brain injury: A preliminary study

Purpose: Traumatic brain injury (TBI), a well-known risk factor for pituitary dysfunction, is associated with increased serum neurofilament light chain (NFL), glial fibrillary acidic protein (GFAP), and total tau (t-tau) levels. We aimed to assess the predictive value of these markers and pituitary dysfunction following TBI in a prospective manner.Methods: Adult patients following TBI were included. Serum levels of NFL, GFAP, t-tau and pituitary and target hormones were analyzed prospectively during first week and one year after TBI.Results: Twenty-two patients (17 males, 5 females; mean age 40±15 years) were included in the study. Basal NFL levels correlated positively with length of hospital stay and basal cortisol (r=0.643, p=0.001 and r=0.558, p=0.007, respectively) and negatively with Glasgow Coma Scale (GCS) score and basal IGF-1 levels (r=-0.429, p=0.046 and r=-0.481, p=0.023, respectively), while there was no significant correlation between GFAP, t-tau and hormone levels. NFL, GFAP, and t-tau levels significantly decreased, and none of the patients developed hormone deficiencies one year after TBI. No correlations were detected between basal markers and first year pituitary hormone levels.Conclusion: Serum NFL levels were correlated with hormonal changes during acute phase of TBI reflecting the physiological response to trauma. Larger studies are needed to analyze the associations during chronic phase.

Insights from triggers and prodromal symptoms on how migraine attacks start: The threshold hypothesis.

The prodrome or premonitory phase is the initial phase of a migraine attack, and it is considered as a symptomatic phase in which prodromal symptoms may occur. There is evidence that attacks start 24-48 hours before the headache phase. Individuals with migraine also report several potential triggers for their attacks, which may be mistaken for premonitory symptoms and hinder migraine research. This review aims to summarize published studies that describe contributions to understanding the fine difference between prodromal/premonitory symptoms and triggers, give insights for research, and propose a way forward to study these phenomena. We finally aim to formulate a theory to unify migraine triggers and prodromal symptoms. For this purpose, a comprehensive narrative review of the published literature on clinical, neurophysiological and imaging evidence on migraine prodromal symptoms and triggers was conducted using the PubMed database. Brain activity and network connectivity changes occur during the prodromal phase. These changes give rise to prodromal/premonitory symptoms in some individuals, which may be falsely interpreted as triggers at the same time as representing the early manifestation of the beginning of the attack. By contrast, certain migraine triggers, such as stress, hormone changes or sleep deprivation, acting as a catalyst in reducing the migraine threshold, might facilitate these changes and increase the chances of a migraine attack. Migraine triggers and prodromal/premonitory symptoms can be confused and have an intertwined relationship with the hypothalamus as the central hub for integrating external and internal body signals. Differentiating migraine triggers and prodromal symptoms is crucial for shedding light on migraine pathophysiology and improve migraine management.

Epigenetic and Immune Mechanisms Linking Breastfeeding to Lower Breast Cancer Rates.

This review shows how mammary stem cells (MaSCs) influence breast development, breastfeeding, and breast cancer risk. MaSCs, which can differentiate into various cell types, are vital for breast tissue health, but also disease development in breast tissue. Research shows that breastfeeding affects MaSCs, offering protection against breast cancer through various mechanisms. Hormonal changes such as increased prolactin concentration, oxytocin secretion, lower progesterone levels, and reduced exposure to estrogen during lactation promote apoptosis in potential cancer cells, boost immune surveillance, and modulate inflammation. Key findings reveal that pregnancy at an earlier age and extended breastfeeding reduce MaSC numbers, lowering cancer risk. Additionally, breastfeeding induces various epigenetic changes, such as DNA methylation and histone modification, which provide long-term protection against the development of cancer. Components of breast milk, like alpha-lactalbumin and lactoferrin, contribute by promoting cancer cell apoptosis and inhibiting tumor growth. The dual benefits of breastfeeding are reduced breast cancer risk for mothers and immunological advantages for infants. Multicenter epidemiology research has focused particular attention on longer breastfeeding duration associated with a reduced risk of triple-negative breast cancer. This review offers comprehensive evidence that breastfeeding protects against breast cancer through various biological, hormonal, and molecular mechanisms, showing the importance of promoting breastfeeding as a natural cancer prevention method. This article reviews the role of mammary stem cells in breast development, lactation, and breast cancer.

Cross-Sectional Examination of Thyroid Hormones and Environmental Exposure to Multiclass Pesticides in Women of Reproductive Age in China.

Some pesticides have been shown to interfere with thyroid functions through changes in thyroid hormone (TH) levels. However, few human studies have explored associations between TH levels and environmental exposure to currently used pesticides, including neonicotinoids, phenylpyrazoles, phenoxy acids, and azoles. Moreover, such studies often measure biomarkers of exposure in urine or blood, and thus reveal only recent exposure. In contrast, hair has been demonstrated to be a suitable matrix for assessing chronic exposure to both persistent and nonpersistent organic pollutants. We investigated 54 biomarkers of pollutant exposure in relation to tetraiodothyronine (T4), 3,3',5-triiodothyronine (T3), 3,3',5'-triiodothyronine (rT3), and 3,3'-diiodothyronine (T2). In a cross-sectional study of 196 healthy Chinese women of reproductive age (25-45 years of age), concentrations of both pollutants and THs were analyzed in the first (starting from the scalp) of the hair matrix, collected in 2016. Associations between pollutants and TH levels were explored using stability-enhanced least absolute shrinkage and selection operator (lasso) by regressing all exposures against each outcome of interest, adjusted for age, body mass index, and city. Each TH was associated with the mixture of at least eight of the examined pesticides. We found associations of -HCH, PCP, DMP, DETP, 3Me4NP, carbofuran, , imidacloprid, 2,4-D, metolachlor, difenoconazole, and tebuconazole with THs. For example, a 2-standard deviation (SD) increase in -transformed hair DMP concentration was associated with lower hair T4 concentration [ (95% CI: , )] and higher hair T3 concentration [8.16% (95% CI: 1.73, 15.0%)] in the adjusted unpenalized regression models. We also found associations of some pesticides with T3/T4, rT3/T4, and rT3/T3 molar ratios, including PCP, DMP, 2,4-D, metolachlor, difenoconazole, and tebuconazole. Our results suggest that exposure to the low levels of pesticides examined here may disrupt thyroid homeostasis in humans. Further studies are needed to confirm our results and to evaluate the long-term consequences of these subtle interferences. https://doi.org/10.1289/EHP14378.

Luteinizing hormone is independently associated with high-sensitive cardiac troponin T elevation in postmenopausal T2DM patients: A cross-sectional study.

It is known that the risk of ischemic heart disease increases in patients with type 2 diabetes mellitus (T2DM). For female patients, the incidence of heart disease can be even greater after menopause, accompanied by dramatic changes in sex hormones. We investigated the correlations between sex hormones and markers of ischemic heart diseases in postmenopausal females with T2DM patients. This cross-sectional study collected data from 324 hospitalized postmenopausal females with T2DM. Multiple linear regression analyses were conducted to determine the correlations between sex hormones and cardiac markers including high-sensitive cardiac troponin T (hs-cTnT) and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels. Multiple linear regression analyses revealed that luteinizing hormone (LH) was positively and independently associated with hs-cTnT concentrations in postmenopausal females with T2DM (β = 0.189, p = 0.002). Postmenopausal females with T2DM and subclinical myocardial injury had higher LH levels than those without subclinical myocardial injury (29.67 vs. 25.08 mIU/mL, p < 0.001). A multivariate logistic regression analysis confirmed an independent and significant association between elevated LH and subclinical myocardial injury in postmenopausal females with T2DM (adjusted odds ratio [OR] = 1.077, 95% confidence interval [CI], 1.033-1.124; p < 0.001). As another gonadotropin, the follicle-stimulating hormone did not show independent correlations with hs-cTnT or NT-proBNP (p > 0.05). Neither estrogen nor testosterone was correlated with cardiac markers. Elevated LH levels were positively and independently associated with increased hs-cTnT levels in postmenopausal women with T2DM. Our findings suggest that LH could serve as a potential marker for assessing the risk of subclinical myocardial injury in postmenopausal females with T2DM.

OS EFEITOS DE EXERCÍCIO DE IMPACTO EM PACIENTES COM OSTEOPOROSE PÓS MENOPAUSA

Introduction: Osteoporosis is a disease characterized by the loss of bone mineral density, which increases the risk of fractures, especially in women. It affects women more due to hormonal changes, and in postmenopause, due to the drop in estrogen levels, which aggravates bone loss. Objective: This was to investigate the effects of impact exercises in patients diagnosed with postmenopausal osteoporosis. Methods: This is an integrative review of the literature, where the PICO strategy was adopted, thus the guiding question of the study was “What are the effects of impact exercises on the bone mineral density of patients with postmenopausal osteoporosis?”. The data search took place between July and August 2024, in the PUBMED, PEDro and LILACS databases, using the descriptors: “impact exercises”, “osteoporosis” and “postmenopause”. A total of 76 articles were found and after applying the eligibility criteria, 8 were used in this review. Results: Impact exercises, such as resistance, aerobic and Pilates exercises, were shown to be effective in improving bone mineral density, muscle strength and balance in postmenopausal women, reducing the risk of fractures and improving quality of life. Conclusion: It is concluded that high-impact exercises offer several benefits for women with osteoporosis in the postmenopausal period, including increased muscle strength, improved balance, lipid profile, calcium absorption, quality of life and bone mineral density.

Sleep Disturbance in Perimenopausal Women

Female sex hormones are involved in various physiological processes including sleep and the circadian cycle. During menopausal transition, various symptoms caused by hormonal changes can occur. Among various perimenopausal symptoms, sleep disturbance is one of the most common and important health issues. More than 40% of perimenopausal women report sleep problems, which not only lower quality of life but also pose substantial health risks including increased cardiovascular risk. Factors contributing to sleep disturbances during perimenopause include direct changes in sleep due to decline of female sex hormones and indirect changes resulting from perimenopausal symptoms. This article will address the influence of female sex hormones on sleep and circadian rhythm, sleep changes in perimenopausal women and their possible mechanisms, prevalent sleep disorders during perimenopause, and their treatments.

РОЛЬ КОНСТИТУЦИОНАЛЬНОЙ ПРИНАДЛЕЖНОСТИ В ГЕНЕЗЕ ОЖИРЕНИЯ У ДЕТЕЙ И ПОДРОСТКОВ 7-17 ЛЕТ

Obesity in children and adolescents is becoming a pressing issue that can be classified as a disease associated with the interaction of genetic and non-genetic factors. There are numerous causes of this disease. The most important ones are hereditary predisposition and the intake of a large number of calories along with reduced physical activity. In children of different somatotypes aged 7-17 years, there is a wave-like change in the growth of the bone, muscle and fat body components. There are periods when growth processes and hormonal changes lead to the maximum increase in the F, M, L components of body weight. Children of the MD, DM, and D body types are at risk of excess fat deposition. The natural age-related increase in the fat component accompanied by negative exogenous and endogenous factors can lead to hormonal failure and a substantial increase in fat mass.

Harmonizing In Vitro Techniques for Anti-Aging Cosmetic Ingredient Assessment: A Comprehensive Review

Skin grows old due to intrinsic factors, such as age and associated hormonal changes, and external factors, like solar radiation and chemical substances to which we are exposed. With age, skin shows thinning, laxity, pallor, increased dryness, and the appearance of wrinkles, attributed to a decrease in collagen and elastin produced by fibroblasts. Several theories explain skin aging, including the free radical formation, neuroendocrine, and mitochondrial decline theories. Based on a scientific understanding of skin behavior, different in vitro methods are used to evaluate the effects of new ingredients in cosmetics. Commonly used methods include anti-collagenase, anti-elastase, and anti-hyaluronidase activity alongside techniques utilizing skin cells or 3D models. Although these methods are recognized and widely used, they lack standardization. In this review, a literature search has been conducted to examine the characteristics and variations of these methods across the laboratories. A key issue identified in this review is that many papers provide insufficient detail regarding their protocols. Moreover, the number of studies using cells is less significant than the ones determining enzyme inhibition. Our findings revealed that, in many cases, there is limited information available, underscoring the urgent need to initiate a comprehensive standardization process for the methodologies used to demonstrate anti-aging activity.

Lung cancer and obesity: A contentious relationship (Review).

The global obesity epidemic, attributed to sedentary lifestyles, unhealthy diets, genetics and environmental factors, has led to over 1.9 billion adults being classified as overweight and 650 million living with obesity. Despite advancements in early detection and treatment, lung cancer prognosis remains poor due to late diagnoses and limited therapies. The obesity paradox challenges conventional thinking by suggesting that individuals with obesity and certain diseases, including cancer, may have an improved prognosis compared with their counterparts of a normal weight. This observation has prompted investigations to understand protective mechanisms, including potentially favorable adipokine secretion and metabolic reserves that contribute to tolerating cancer treatments. However, understanding the association between obesity and lung cancer is complex. While smoking is the primary risk factor of lung cancer, obesity may independently impact lung cancer risk, particularly in non‑smokers. Adipose tissue dysfunction, including low‑grade chronic inflammation, and hormonal changes contribute to lung cancer development and progression. Obesity‑related factors may also influence treatment responses and survival outcomes in patients with lung cancer. The impact of obesity on treatment modalities such as chemotherapy, radiotherapy and surgery is still under investigation. Challenges in managing patients with obesity and cancer include increased surgical complexity, higher rates of postoperative complications and limited treatment options due to comorbidities. Targeted interventions aimed at reducing obesity prevalence and promoting healthy lifestyles are crucial for lung cancer prevention. The impact of obesity on lung cancer is multifaceted and requires further research to elucidate the underlying mechanisms and develop personalized interventions for prevention and treatment.

Managing Menopause: The Evolving Role of Estrogens, Selective Serotonin Reuptake Inhibitors, and Phytoestrogens in Balancing Hormonal Fluctuations.

Menopause is characterized by the cessation of menstruation for 12 consecutive months. In this narrative review, we describe the transitional stages of menopause, clinical presentation, pharmacological management of symptoms, and effects on fluctuating hormone levels. To standardize the stages of menopause, the Stages of Reproductive Aging Workshop + 10 (STRAW+10) system was designed with five distinct categories corresponding to symptom presentation and numerical years. Common clinical presentations consist of vasomotor hot flashes, mood changes, decreased libido, osteoporosis, and genitourinary changes, all of which are associated with changes in hormone levels.Because hormones play a major role in the mechanism of menopause, hormone replacement therapy with estrogen, progesterone, or a combination is explored and shown to demonstrate symptom reduction in a large percentage of women. Nonhormonal treatment and alternative therapies are used to treat vasomotor symptoms if contraindications present to hormone therapy or for those who prefer fewer side effects. Thus, many women experience uncomfortable symptoms during menopause, some of which cause significant changes in quality of life. In this regard, understanding the pathophysiology, symptomatology, and current treatment options with side effect profiles allows for continued research and discovery of advanced therapy for treating symptoms to ameliorate discomfort and pain in menopausal women.

Comparative analysis of reproductive hormones, serum biochemical indexes and ovarian metabolites in Muscovy breeder duck at different laying stages

The hypothalamic-pituitary-gonadal (HPG) axis regulates egg laying through control hormones secretion in poultry. In this study, the serum hormones (12 samples per stage), serum biochemical indexes (12 samples per stage), and ovarian metabolites (8 samples per stage) of Muscovy breeder ducks were detected at prelaying stage (PT), start of laying stage (ST), high laying stage (HT), and the end of laying stage (ET). The serum hormones of Muscovy ducks were measured at 8:00, 13:00, 18:00, 23:00, and 4:00 within 1 d. The TG, TP, ALB, and GLB were significantly increased, while HDL-C was significantly decreased at ST as compared to PT (P < 0.05). Serum Na, Cl, Ca, P, and K showed significant rise at ST as compared to PT. Serum Na, Cl, Ca, and K were significantly declined, while P was significantly increased at ET as compared to HT (P < 0.05). Serum FSH, LH, PRL, E2, P4 levels peaked at ST (P < 0.05) with only FSH and LH fluctuated significantly within 1 ovulation cycle at ST (P < 0.05). Differential metabolites showed continued ovarian aging. The decline of nucleic acid metabolism occured in ST, the decline of sugar metabolism occurred in ET, and the decline of amino acid metabolism continued at all stages. Temporal expression patterns and correlation analyses indicated a high correlation between ovarian cAMP and serum reproductive hormone levels across different reproductive stages. In conclusion, this study revealed the changes in serum hormones, serum biochemical indicators, and ovarian metabolites, as well as the relationship between serum hormones and ovarian metabolites.

The Effects of L-Tartaric Acid on Ovarian Histostereological and Serum Hormonal Analysis in an Animal Model of Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) is the most common endocrine-related reproductive disorder in women of reproductive age, accompanied by both the impairment of female fecundity and a risk of metabolic disorders. PCOS is emphasized as a worldwide concern due to its unknown etiology and lack of specific medications. The current study aimed to evaluate the effects of L-tartaric acid, an abundantly occurring compound in fruits, on the histostereological and hormonal changes caused by PCOS. Forty adult Sprague Dawley rats were randomly divided into four groups including controls (no intervention), Tartaric acid (40mg/Kg/day from day 21 onwards for 39 days), PCOS (21 days letrozole and then normal saline orally for 39 days), and PCOS + Tartaric acid. After treatments, the ovarian histostereological analysis as well as the level of reproductive hormones including luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, progesterone, and testosterone was measured. PCOS caused a significant decrease in the number of unilaminar, multilaminar, antral, and graafian follicles and increased follicular atresia (p-value < 0.001). Moreover, the weight and volume of ovarian tissue and related structures including cortex, medulla, and cysts increased significantly (p-value < 0.0001). However, corpus luteum volume was significantly decreased (p-value < 0.001). Although significant differences were found in some parameters with the control group (p-value < 0.05), the administration of tartaric acid restored the pathological effects of PCOS on the ovarian histostructure. Furthermore, tartaric acid improved the serum levels of LH, estradiol, progesterone, and testosterone (p-value < 0.05). The obtained findings may suggest tartaric acid as a novel strategy for PCOS management, although further studies are necessary.

Time to revisit the enigma of mastalgia management

Mastalgia (breast pain) also known as mastodynia, is one of the most common causes of breast issues for which a female visits a medical practitioner. It is divided into cyclical mastalgia, which is associated with menstruation, or can be noncyclical mastalgia which can present premenopausal or postmenopausal. The incidence of breast cancer associated with mastalgia is extremely low and reassurance plays a major role in the treatment of patients. Hormonal changes have been associated with the pathogenesis of cyclical mastalgia. Outdated treatment modalities are still being followed even though newer and more effective treatment options have been established. Objective assessment of breast pain should be done with the visual analog scale. Non-pharmacological therapy should be encouraged in every patient of mastalgia such as counseling and reassurance, sports bra, yoga, and relaxation therapy. Tamoxifen and ormeloxifene are now the drug of choice in severe mastalgia and care should be taken to counsel the patients about use and common and detrimental side effects. The available treatment modalities and their directions to use are discussed in this review.

Reduced pineal gland volume in patients with obsessive-compulsive disorder.

Patients with obsessive-compulsive disorder (OCD) can have hyperactivity of the hypothalamic-pituitary-adrenal axis and may have increased secretion of adrenocorticotropic hormone and cortisol and reduced secretion of melatonin. Examination of pineal gland volumes in patients with OCD compared to healthy controls, thus, is an important consideration and the focus of this study. A total of 20 patients with OCD and 20 healthy controls were enrolled. Demographic and clinical characteristics of participants were assessed, and structural magnetic resonance imaging was performed. Patients with OCD had a statistically significant smaller pineal gland volumes compared to healthy controls. In this initial small study, patients with OCD exhibited smaller pineal gland volumes compared to healthy control subjects. While this finding suggests a potential link between the pineal gland and OCD pathophysiology, further research with larger sample sizes and measurement of hormonal changes are necessary.

Exploring the far-reaching consequences of malnutrition during pregnancy and beyond: A comprehensive review

In India, maternal and infant malnutrition continues to be a significant contributor to health problems. Fetal malnutrition can result from an inadequate nutrient supply, necessary nutrition services, and ideal practices before, during, and following pregnancy. This comprehensive review delves into the complex relationships among hormone changes, microbial ecosystems, and nutrition, and how these relationships affect the health of mothers and their offspring. The review highlights how important it is to maintain good nutrition during pregnancy and to comprehend the dietary modifications that pregnant people make on their own to create interventions that work. Important minerals like calcium, iron, folic acid, iodine, and vitamin D are covered. Acknowledging the mutualistic association between the eating habits of mothers and the diverse microbiomes found in their gut, vagina, and oral channels, the review explores the influence on hormone levels and their consequences during gestation. Diverse fetal developmental needs are depicted by the table that outlines food requirements for each of the three trimesters. The detrimental effects of poor prenatal nutrition on a mother's health and its repercussions for neonates are examined. The effects of malnutrition after delivery, including difficulties throughout pregnancy, healing periods, and general effects on mental and physical health, are well studied. The study, which adopts a worldwide viewpoint, finds that societal norms, information gaps, and poverty are the main causes of malnutrition. Prevention techniques are discussed, emphasizing the significance of taking a comprehensive approach to addressing this vital issue in both the Indian and global contexts.

Transcriptomic and coexpression network analyses revealed the regulatory mechanism of Cydia pomonella infestation on the synthesis of phytohormones in walnut husks

The codling moth (Cydia pomonella) has a major effect on the quality and yield of walnut fruit. Plant defences respond to insect infestation by activating hormonal signalling and the flavonoid biosynthetic pathway. However, little is known about the role of walnut husk hormones and flavonoid biosynthesis in response to C. pomonella infestation. The phytohormone content assay revealed that the contents of salicylic acid (SA), abscisic acid (ABA), jasmonic acid (JA), jasmonic acid-isoleucine conjugate (JA-ILE), jasmonic acid-valine (JA-Val) and methyl jasmonate (MeJA) increased after feeding at different time points (0, 12, 24, 36, 48, and 72 h) of walnut husk. RNA-seq analysis of walnut husks following C. pomonella feeding revealed a temporal pattern in differentially expressed genes (DEGs), with the number increasing from 3,988 at 12 h to 5,929 at 72 h postfeeding compared with the control at 0 h postfeeding. Walnut husks exhibited significant upregulation of genes involved in various defence pathways, including flavonoid biosynthesis (PAL, CYP73A, 4CL, CHS, CHI, F3H, ANS, and LAR), SA (PAL), ABA (ZEP and ABA2), and JA (AOS, AOC, OPR, JAZ, and MYC2) pathways. Three gene coexpression networks that had a significant positive association with these hormonal changes were constructed based on the basis of weighted gene coexpression network analysis (WGCNA). We identified several hub transcription factors, including the turquoise module (AIL6, MYB4, PRE6, WRKY71, WRKY31, ERF003, and WRKY75), the green module (bHLH79, PCL1, APRR5, ABI5, and ILR3), and the magenta module (ERF27, bHLH35, bHLH18, TIFY5A, WRKY31, and MYB44). Taken together, these findings provide useful genetic resources for exploring the defence response mediated by phytohormones in walnut husks.

Prevalence Of Metabolic Syndrome in Peri and Postmenopausal Women Aged 40- 65 Years in a Tertiary Care Centre

Metabolic syndrome (MetS) is a constellation of interrelated risk factors of metabolic origin— metabolic risk factors—that appear to directly promote the development of atherosclerotic cardio-vascular disease (ASCVD). Menopausal transition with its incidental hormonal changes is considered to contribute to the development of MetS. This was a hospital based cross sectional descriptive study conducted in the Obstetrics and Gynaecology department of Nepal Medical College Teaching Hospital, Attarkhel, Gokarneshwor-8, Kathmandu, from the 1st of September 2023 till the 29th of February 2024 after clearance from the IRC (Ref. No: 56-080/081). Convenience sampling was used among women who fulfilled the inclusion criteria. The aim of the study was to determine the prevalence of MetS among the peri and postmenopausal women and to determine which component of the diagnostic criteria of MetS was more strongly associated with MetS in our population. Women were evaluated to have MetS using both the International Diabetes Federation (IDF) and the National Cholesterol Education Program- Adult Treatment Panel III (NCEP-ATPIII criteria). The prevalence of MetS by the IDF criteria was 54% among the perimenopausal women and 61% among the postmenopausal women. Similarly, the prevalence of MetS according to NCEP-ATPIII was 53.5% among the perimenopausal and 65% among the postmenopausal women. All the MetS diagnostic markers showed a strong correlation with MetS (p&lt;0.001). The prevalence of MetS is high in our population by both the IDF and NCEP-ATP III criteria, being higher in the postmenopausal population, though not statistically significant.

A prediction model for gestational diabetes mellitus based on steroid hormonal changes in early and mid-down syndrome screening: A multicenter longitudinal study

BackgroundSteroid hormones (SH) during pregnancy are associated with the development of gestational diabetes mellitus (GDM). Early and mid-Down syndrome screening is used to assess the risk of Down syndrome in the fetus. It is unclear whether changes in SH during this period can be used as an early predictor of GDM. MethodsThis study was a multicenter, longitudinal cohort study. GDM is diagnosed by an oral glucose tolerance test (OGTT) between 24 and 28 weeks of gestation. We measured SH levels at early and mid-Down syndrome screening, respectively. Based on the SH changes, logistic regression analysis was used to construct a prediction model for GDM. Finally, evaluated the model’s predictive performance by creating a receiver operating characteristic curve (ROC) and performing external validation. ResultsThis study enrolled 193 pregnant women (discovery cohort, n = 157; validation cohort, n = 36). SH changes occur dynamically after pregnancy. At early Down syndrome screening, only cortisol (F) (p < 0.05, 95 % CI 4780.95–46083.68) was elevated in GDM. At mid-Down syndrome screening, free testosterone (FT) (p < 0.01, 95 % CI 0.10–0.55) and estradiol (E2) (p < 0.05, 95 % CI 203.55–1784.78) were also significantly elevated. There were significant differences in the rates of change in E2 (Fold change (FC) = 1.3425, p = 0.0072), albumin (ALB) (FC=1.5759, p = 0.0117), and dihydrotestosterone (DHT) (FC=-2.1234, p = 0.0165) between GDM and no-GDM. Stepwise logistic regression analysis resulted in the best predictive model, including six variables (Δweight, ΔF, Δcortisone (E), ΔE2, Δprogesterone (P), ΔDHT). The area under the curve for this model was 0.791, and for the external validation cohort, it was 0.799. ConclusionsA GDM prediction model can be constructed using SH measures during early and mid-Down syndrome screening.