Population Of Postmenopausal Women Research Articles

Telomere length and chronotype among women in the California Teachers Study (CTS)

ABSTRACT While links between certain chronotypes and poorer health outcomes have been well established in previous studies, few studies have examined the relationship between chronotype and cellular aging. Using data from the California Teachers Study (CTS), the present study evaluates the relationship between cellular aging and chronobiology through an analysis of leukocyte telomere length (LTL) and chronotype among 817 predominantly postmenopausal women with no history of cancer and occupations not associated with night-shift work. Unconditional logistic regression models were run to estimate odds ratios (ORs) for each chronotype category, adjusted for age, ethnicity, and smoking status. Analyses were then stratified by potential modifiers to assess whether results varied among specific subgroups within the sample. Women who reported being current evening types and evening types from teen years to now were significantly less likely to have short LTL compared to women who reported being current morning types or morning types from teen years to now (OR = 0.72; 95% CI = 0.53-0.98; OR = 0.57; 95% CI = 0.39-0.84). Our results suggest that women with no history of cancer who identify as evening chronotypes may undergo decreased cellular aging compared to women in the same population who identify as morning types. Further studies on populations of postmenopausal women are warranted.

The relationship between the vaginal and vulvar microbiomes and lichen sclerosus symptoms in post-menopausal women

Lichen sclerosus is a chronic inflammatory condition of unknown etiology that affects the genital and extragenital skin, which can lead to sexual dysfunction and has been associated with vulvar cancer. The vaginal microbiome has a critical role in gynecologic health, but little is known about the microbiome in lichen sclerosus. This study investigated the vaginal and vulvar microbiomes of 27 post-menopausal women with lichen sclerosus. The most abundant genera detected in the vaginal microbiome were Lactobacillus, Gardnerella, and Anaerococcus, while Lactobacillus, Anaerococcus, and Staphylococcus were the most abundant in the vulvar microbiome. The vaginal samples clustered into two main groups, Lactobacillus dominant (n = 6, > 50% microbiome Lactobacillus) and polymicrobial (n = 21) with no dominant genus. The vulvar samples were mainly polymicrobial (n = 25). Actinomyces, Anaerococcus, and Ezakiella in the vaginal microbiome and Actinomyces and Ezakiella in the vulvar microbiome were significantly associated with lichen sclerosus symptoms (adjusted p < 0.05). In this population of post-menopausal women with lichen sclerosus the majority have diverse, non-Lactobacillus dominant microbiomes, which is considered less optimal for gynecologic health based on studies of pre-menopausal women. Actinomyces, Ezakiella, and Anaerococcus were associated with lichen sclerosus symptoms. Understanding the role of these bacteria in lichen sclerosus pathogenesis will be an essential future investigation.

Health Problems and Disabilities Among the Postmenopausal Saudi Women in Bisha City Receiving Home Care: A Descriptive Cross-Sectional Study.

Postmenopausal women experience physical and psychological changes that may affect their health status. In Saudi Arabia, where the population of postmenopausal women is increasing, there is a need to examine the health problems and disabilities experienced by this group, particularly those who receive home care. This study aims to identify the common health problems and disabilities experienced by postmenopausal Saudi women in Bisha city who receive home care services. A cross-sectional study in Bisha city, Saudi Arabia, involved 155 postmenopausal women (age 60 years and above) receiving home care services. Data were collected using structured interviews and medical records. The study found that the most common health problems among postmenopausal women receiving home care were cardiovascular diseases in 85 women (54.84%), diabetes in 85 women (54.84%), and musculoskeletal disorders in 56 women (36.13%). There was a significant association between the number of health problems and disabilities, indicating that women with more health problems were more likely to experience disabilities (p-value ≤ 0.05). The results showed that age (OR=1.56, 95% CI 1.23-1.99, p=0.001), chronic diseases (OR=2.34, 95% CI 1.43-3.84, p=0.001), and lower education level (OR=1.45, 95% CI 1.01-2.08, p=0.045) were significantly associated with the presence of health problems and disabilities among postmenopausal Saudi women receiving home care in Bisha city. However, marital status and employment status were not found to be significant predictors. Postmenopausal women in Bisha city who receive home care services experience a range of health problems and disabilities, particularly related to hypertension, diabetes, and musculoskeletal disorders. The findings of this study can help healthcare providers develop effective interventions and strategies to improve the health outcomes of this population.

Limited utility of salivary mineral content in prediction of fragility fractures among postmenopausal women.

Osteoporosis is a metabolic disease characterized by increased bone fragility. As it is characterized as a general skeletal disease, changes can also be seen in the stomatognathic system (edentulism, wrong fitting of dentures, etc.). The question is whether early changes in the salivary mineral content and acid-base balance may reflect skeletal status and risk of bone fracture. The objective of the study was to evaluate whether minerals in the saliva were associated with skeletal fractures in a population of postmenopausal women. In this observational study, dental examinations along with the collection of saliva were conducted in 117 randomly recruited women (mean age 64.6 ±5.9 years). The study group included 23 study participants with fractures, of which 10 had a history of osteoporotic fractures. Saliva samples for mineral content including copper (Cu), zinc (Zn), calcium (Ca), and phosphorus (P), as well as salivary pH were collected and analyzed to determine associations between salivary mineral content and fracture risk. As a result, the median pH value was 6.8, and the median levels for Cu (0.35 μmol/L), Zn (0.61 μmol/L), Ca (0.7 mmol/L), and P (6.64 mmol/L) were observed. No differences were noted in salivary mineral content and acid-basic balance between the fractured and non-fractured participants. The results of our study suggest that salivary mineral content has limited usability in predicting skeletal fragility in postmenopausal women when used alone.

The benefits and risks of menopause hormone therapy for the cardiovascular system in postmenopausal women: a systematic review and meta-analysis

BackgroundMenopause hormone therapy (MHT), as an effective method to alleviate the menopause-related symptoms of women, its benefits, risks, and potential influencing factors for the cardiovascular system of postmenopausal women are not very clear.ObjectivesTo evaluate cardiovascular benefits and risks of MHT in postmenopausal women, and analyze the underlying factors that affect both.Search strategyThe EMBASE, MEDLINE, and CENTRAL databases were searched from 1975 to July 2022.Selection criteriaRandomized Clinical Trials (RCTs) that met pre-specified inclusion criteria were included.Data collection and analysisTwo reviewers extracted data independently. A meta-analysis of random effects was used to analyze data.Main resultsThis systematic review identified 33 RCTs using MHT involving 44,639 postmenopausal women with a mean age of 60.3 (range 48 to 72 years). There was no significant difference between MHT and placebo (or no treatment) in all-cause death (RR = 0.96, 95%CI 0.85 to 1.09, I2 = 14%) and cardiovascular events (RR = 0.97, 95%CI 0.82 to 1.14, I2 = 38%) in the overall population of postmenopausal women. However, MHT would increase the risk of stroke (RR = 1.23, 95%CI 1.08 to 1.41,I2 = 0%) and venous thromboembolism (RR = 1.86, 95%CI 1.39 to 2.50, I2 = 24%). Compared with placebo, MHT could improve flow-mediated arterial dilation (FMD) (SMD = 1.46, 95%CI 0.86 to 2.07, I2 = 90%), but it did not improve nitroglycerin-mediated arterial dilation (NMD) (SMD = 0.27, 95%CI − 0.08 to 0.62, I2 = 76%). Compared with women started MHT more than 10 years after menopause, women started MHT within 10 years after menopause had lower frequency of all-cause death (P = 0.02) and cardiovascular events (P = 0.002), and more significant improvement in FMD (P = 0.0003). Compared to mono-estrogen therapy, the combination therapy of estrogen and progesterone would not alter the outcomes of endpoint event. (all-cause death P = 0.52, cardiovascular events P = 0.90, stroke P = 0.85, venous thromboembolism P = 0.33, FMD P = 0.46, NMD P = 0.27).ConclusionsMHT improves flow-mediated arterial dilation (FMD) but fails to lower the risk of all-cause death and cardiovascular events, and increases the risk of stroke and venous thrombosis in postmenopausal women. Early acceptance of MHT not only reduces the risk of all-cause death and cardiovascular events but also further improves FMD, although the risk of stroke and venous thrombosis is not reduced. There is no difference in the outcome of cardiovascular system endpoints between mono-estrogen therapy and combination therapy of estrogen and progesterone.

THU409 Relationship Between Bone Loss And Oral Health Among Post-menopausal Women With And Without Diabetes

Abstract Disclosure: S. Ahmad: None. R. Nauman: None. K. Batra: None. A. Gupta: None. K.E. Izuora: Research Investigator; Self; Novo Nordisk. Background: There is a high prevalence of periodontal disease (PD) and bone loss (osteopenia and osteoporosis) among patients with diabetes. Understanding the relationship between these conditions in the context of type 2 diabetes (T2DM) as a risk factor will help better understand their pathophysiology and provide guidance for more appropriate care. Methods: This was a cross-sectional study that enrolled post-menopausal women presenting for routine bone density evaluation. Following informed consent, we obtained information about their demographics, diabetes status, and dental history using an investigator-administered questionnaire. We measured their height and weight with a stadiometer and inspected their oral cavity for teeth loss and PD. We then obtained their bone density assessment after interpretation by the radiologist. Data were analyzed using chi-square and logistic regression tests with the significance level set at 5%. Results: Among 66 eligible participants, the mean age and body mass index (BMI) were 67.67 ± 8.1 years and 29.76 ± 5.45 kg/m2 respectively. Twelve participants (18.2%) had T2DM, 19 (28.8%) had &amp;lt; 20 natural teeth and 17 (25.8%) had normal bone mineral density. Using a binary logistic regression, significant predictors of bone loss included age (OR 1.217, p=0.008), BMI (OR 0.827, p=0.04), and a diagnosis of T2DM (OR 0.056, p=0.033). The number of natural teeth, number of broken or decayed teeth, and presence of periodontal disease were not associated with bone loss. Conclusion: Among our population of post-menopausal women, clinical variables associated with bone loss included older age and lower BMI. Having T2DM was associated with a higher bone mineral density which does not translate to stronger bones according to previous reports. Oral health outcomes were not associated with bone loss and may reflect the similarity in the risk factors for the two conditions. Presentation: Thursday, June 15, 2023

Correlation of Social Support through the Quality of Life of Menopausal Women at Puskesmas Kelurahan Pondok Bambu II, Duren Sawit District, East Jakarta in 2021

The increase in life expectancy in Indonesia has implications for the increase in the population of postmenopausal women. Menopausal women experience hormone deficiencies that cause complaints of vaginal atrophy, hot fluses, weight gain, bone pain, depression and others, which affect women's quality of life. This is supported by the results of research by Ruri Yuni, et al (2014) which states that 69.6% of menopausal women's quality of life is affected by menopausal syndrome. The purpose of the research: to determine the correlation of social support to the quality of life of women in dealing with menopausal life in the Puskesmas Pondok Bambu II Village. Research method: quantitative, with a cross sectional analytic design. The sample of this study was 45-55 years old postmenopausal women who had a family/husband in Puskesmas Kelurahan Pondok Bambu II area are 47 people. This research uses Purposive Sampling Technique. The results: from 47 respondents, menopausal women with social support with good quality of life were 20 respondents (76.9%), compared to menopausal women who received social support but had poor quality of life by 6 respondents (23.1%). The results of the Chi-Square test obtained p value of 0.003 which means that there is a relationship between social support and the quality of postmenopausal women.Conclusion Our study confirms the differences Quality of life of postmenopausal women between social support and non-social support. The impact of educational level, occupation and income and knowledge about menopause as predictors of a better quality of life in postmenopausal women.

Clinical Profile of Postmenopause Women with Genetic Predisposition of Metabolic Syndrome in Batam, Makassar, and Surabaya

Background: Menopause is defined as the cessation of menstruation for 12 months or more. Women who experienced menopause often present with some symptoms associated with menopause. Menopausal symptoms are a serious problem in menopausal women as menopausal symptoms suffered by some women can interfere with their quality of life. Metabolic syndrome consists of a collection of metabolic disorders that increase the risk of cardiovascular disease and diabetes mellitus. Both genetic and environmental factors play an important role in the development of metabolic syndrome. Objective: The purpose of this study was to determine the clinical profile of postmenopausal women with a genetic predisposition to metabolic syndrome. Materials and Methods: This is a cross-sectional study using the total sampling method in a population of postmenopausal women from 3 communities in Batam, Makassar, and Surabaya. The research was conducted online using a questionnaire. Result: Researchers selected 70 postmenopausal women. Of the 70 respondents, the average age of the respondents was 55.66 ± 4.24 (SD) years. The mean age of the respondents at menopause was 50.01 ± 3.57 (SD) years. The majority of respondents in this study had menopause for 1 – 5 years. The job that most respondents had was as a civil servant. The majority of respondents have a university level of education. The number of respondents who are in income group 3 and group 4 is the same. Most of the menopausal symptoms experienced by respondents were physical and mental exhaustion followed by joint and muscular discomfort. The most common genetic predisposition of the metabolic syndrome component suffered by respondents in this study was central obesity, followed by hypertension. The highest prevalence of metabolic syndrome components suffered by respondents is central obesity, then hypertension. Based on the hypothesis test using chi-square on the genetic predisposition of the metabolic syndrome component and the metabolic syndrome component on menopausal symptoms, there was no significant correlation between the variables tested (P value > 0.05) Conclusion: There was no significant correlation between the genetic predisposition of the metabolic syndrome component variable and the metabolic syndrome component variable on the menopausal symptoms variable.

Effect of zinc supplementation on circulating concentrations of homocysteine, vitamin B12, and folate in a postmenopausal population

IntroductionThe decrease in estrogen levels associated with menopause increases the risk of deficiencies of key micronutrients such as zinc and of disturbances in methylation cycle-related markers. The present study assesses the effect of 8-week Zn supplementation upon circulating concentrations of Hcy, B12, and Fol levels in a population of postmenopausal women. MethodsFifty-one postmenopausal women aged between 44 and 76 years took part in the study. Two randomized groups (placebo and zinc [50 mg/day]) were treated during 8 weeks. Nutrient intake was assessed based on the 72-hour recall method. Zinc was analyzed by flame atomic absorption spectrophotometry. Clinical-nutritional parameters were determined by enzyme immunoassay techniques. ResultsFolate levels increased significantly (p < 0.05) in the zinc group on comparing the baseline versus follow-up values. Homocysteine decreased in the inter-group analysis (p < 0.05) after the intervention. Furthermore, higher folate (r = −0.632; p = 0.005) and vitamin B12 (r = −0.512; p = 0.030) levels were correlated to low homocysteine levels in the zinc group after the intervention, although the zinc intervention had the same effect on B12 levels in both groups. ConclusionZinc supplementation enhanced circulating folate and homocysteine by improving the folate values in the zinc-supplemented group and decreasing homocysteine levels inter-groups. Further studies involving larger samples and optimizing the doses and intervention period are needed to reinforce our main findings.

5 Early diagnosis of coronary artery disease in postmenopausal women by arterial stiffness assessment

Abstract Aims Arterial stiffness is a marker of cardiovascular disease useful to identify, at an early stage, subjects with increased risk of cardiovascular artery diseases (CADs). Nevertheless, studies on gender-specific interactions of PWV and CAD are lacking. Therefore, the aim of this study is to investigate, in a population of postmenopausal women, the role of PWV in relation to CAD. The goal of our study was to assess the prevalence of CAD, among postmenopausal women affected by increased arterial stiffness, assessed by global pulse wave velocity (gPWV), and with diabetes and/or hypertension on target, distinguishing the different phenotypes. Methods and results We enrolled 632 consecutive women with an increased gPWV, 300 consecutive postmenopausal women with normal gPWV were included as control group (CG). We assessed arterial stiffness by gPWV, performed by pulsed Doppler (3.5 MHz probe) using two-dimensional guidance and ECG trigger. Philips Epiq 7 was used which is an echo-Doppler system equipped with a multifrequency transducer. The gPWV was assessed as normal for a velocity equal or lower than 7.1 m/s. CAD diagnosis was accepted when confirmed by exercise or nuclear stress test, cardiac catheterization, and angiogram or cardiac CT scan. All women were on therapy, with blood pressure &amp;lt; 130/80 mmHg and HbA1c &amp;lt; 7%. 55 (8.8%) women were affected by CAD among 632 with increased gPMW, and 15 (5%) among 300 women of CG, P &amp;lt; 0.04. There was no difference for mean age between the two groups: 58 ± 11 and 56 ± 8, respectively, P = 0.2. 29 (4.5%) women were affected by CAD and hypertensive cardiomyopathy among 632 with increased gPMW, and 6 (2%) among 300 women of CG, P &amp;lt; 0.05. 16 (2.6%) women were affected by CAD and metabolic cardiomyopathy among 632 with increased gPMW, and 2 (0.7%) among 300 women of CG, P &amp;lt; 0.05. Seventeen (2.7%) women were affected by CAD alone among 632 with increased gPMW, and 2 (0.7%) among 300 women of CG, P &amp;lt; 0.04. Conclusions We found a higher prevalence of CAD among postmenopausal women with increased gPWV when affected by hypertension and/or diabetes, also if on target therapy; the statistically significant correlation is confirmed also when women are affected by hypertensive or metabolic cardiomyopathy. We conclude that early detection increased gPWV may identify women with higher risk to develop CAD also before they become symptomatic.

ASSESSMENT OF RISK FACTORS OF OSTEOPOROSIS IN POSTMENOPAUSAL WOMAN

Background: To determine the usefulness of risk assessment and screening for osteoporosis in a hospital based population of postmenopausal women.&#x0D; Methods: 100 women with post-menopausal women, age more than 40 yrs, cessation of period more than 1yr were included in the study.&#x0D; Result: 17 (17.0%) were more than 65 years of age. Low body weight, inadequate dietary intake of calcium and decreased physical activity were most commonly associated risk factor. 4 (4.0%) women were smokers, women had history of oral steroid intake for &gt;3 months for various medical illnesses.&#x0D; Conclusion: Evaluation of postmenopausal women by screening for risk factors was found to be a powerful tool to define the risk status for osteoporosis. Low body weight and poor dietary calcium are modifiable risk factors for developing osteoporosis.&#x0D; Keywords: Osteoporosis, Post-Menopausal, Prevalence&#x0D;

FACTORS AFFECTING SEXUAL LIFE OF MENOPAUSAL WOMEN: SCOPING REVIEW

Background: WHO predicts that there will be a menopause explosion in 2030 with around 1.2 billion women aged over 50 years. Most of them (about 80%) live in developing countries. The population of postmenopausal women is increasing by about three percent every year. Although menopause is a normal condition, it turns out that not all women can accept this well, one of which is related to sexual problems. Objective: To determine the factors that influence the sexual life of menopausal women in various countries based on the results of past studies. Method: Scoping Review which adapts the Arskey and O'Malley framework. This study took databases from PubMed, EbscoHost, and ProQuest. Results: There were 20 articles out of 2,415 selected based on inclusion and exclusion criteria. This research has 2 main themes, consisting of physical aspects and psycho-social aspects. Physical aspects that affect the sexual life of menopausal women are hot flushes, vaginal dryness, changes in body shape, insomnia, fatigue, and body image. Meanwhile, psycho-social aspects, in this case, include stress, depression, socio-culture, intimacy with partners, lack of social support, and lack of information and health services for menopausal women. Conclusion: The factors that affect the sexual life of menopausal women are a description of physical and psychological discomfort. The most dominant factors affecting the sexual life of menopausal women are hot flushes, vaginal dryness, body image, depression, lack of social support, and lack of information and health services for women during menopause. There is a need for further research on the factors that influence the sexual life of menopausal women in Indonesia to be more relevant to describe conditions in Indonesia.&#x0D; &#x0D; &lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/edu_01/0888/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

Postmenopausal Symptoms and Management by Women in Delhi–NCR

Menopause is defined as the complete cessation of the menstrual cycle in women for twelve consecutive months. Although menopause is an important aspect of the female reproductive health cycle, it is often ignored. Women may experience different menopausal and postmenopausal symptoms ranging from mild to severe. In the present study, a cross-sectional survey of 200 women in their postmenopausal years was conducted across Delhi and the National Capital Region (NCR). A pretested questionnaire was given to a random population of postmenopausal women to record various postmenopausal symptoms and the coping strategies adopted by them. The mean age of menopause of the sample population was 47.48 years, and body mass index seemed to affect the age of onset of menopause. The majority of women experienced postmenopausal symptoms, with 95.28% experiencing more than one symptom, ranging from fatigue and sleep disturbances to severe symptoms such as anxiety attacks, palpitations and joint pains. Many women used different coping strategies, such as changes in lifestyle and social interaction with other women experiencing menopause. Very few women used hormone replacement therapy as a coping mechanism and most of them were ignorant about the same. Interestingly, both education and working status were observed to affect the adoption of coping strategies by women in Delhi–NCR. The results of the study emphasize the need of addressing the problems of the postmenopausal population and incorporating the same in the national healthcare programme.

AN AYURVEDIC APPROACH TOWARDS POSTMENOPAUSAL OSTEOPOROSIS - A REVIEW

India is the second largest country in the world regarding population. As the life expectancy has increased, the population of postmenopausal women is also increased. Hence the problems associated with increasing age are increased. The studies of last two decades suggest that women in menopausal age report more phys-iological and psychological problems. Osteoporosis is one among them. Osteoporosis or porous bone is a worldwide problem, characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased risk of fractures. In modern science treatment available for menopausal symptoms is mainly symptomatic and has some adverse effects too. In Ayurveda we cannot find the name of this disease, but signs and symptoms of Asthi- Kshaya are found quite similar to osteoporosis. The func-tion of dhatu is dharaṇa (To maintain the structure) of the body. Among all dhatus, asthidhatu is responsi-ble for maintenance of structural framework of the body. It shapes the body and protects the vital organs. Acharya Charaka in Sutra Sthan has explained the concept of osteoporosis. Aggravation of Vata is a main cause of Asthi- Kshaya and so it is mentioned as a Vata related disorder in Samhitas. Principle of treatment mentioned in Charak Samhita is as, “Samanagunabhyaso Hi Dhatunaam Vruddhi Karanam”. According to it, things, which contain similar properties to a particular Dhatu of body, can be helpful to increase that one Dhatu. So Vatashamak medicines, diet, exercise having similar properties to Asthi Dhatu, Panchakarma, Rasayana can be very effective to promote bone cells in body. This study is an attempt to understand Ni-dana panchaka of this disease, and its holistic management in context of Ayurveda. Keywords: Menopause, Rajonivrutti, Osteoporosis, Asthikshaya

Effectiveness of eight-week zinc supplementation on vitamin D3 status and leptin levels in a population of postmenopausal women: a double-blind randomized trial

BackgroundThe menopausal period is characterized by hormonal imbalance related to the alteration of parameters involved in lipid metabolism. In addition, menopause increases the risk of deficiencies of key vitamins and minerals such as vitamin D and zinc in such women. The present study investigates the influence of zinc supplementation on the status of vitamin D3 and other lipid parameters in postmenopausal women. MethodsFifty-one healthy postmenopausal women aged 44–76 years from the province of Granada (Spain) were divided into two groups (placebo and zinc) of 25 and 26 women, respectively. The zinc group was supplemented with 50 mg/day of zinc for 8 weeks. Nutrient intake assessment was performed by means of a 24 -h reminder. Zinc was determined by flame atomic absorption spectrophotometry. Vitamin D was analyzed by liquid chromatography - tandem mass spectrometry. Leptin was determined by enzyme immunoassay. ResultsZinc supplementation improved the initial vitamin D3 status of the postmenopausal population (p = 0.049). Plasma levels of 25−OH-D3 increased significantly after Zn supplementation in women with lower age at menopause (p = 0.045). Both intake and plasma zinc levels were inversely correlated to serum leptin levels (p = 0.044 and p = 0.033, respectively), being significantly lower in lower age at menopause (p < 0.001). ConclusionZinc supplementation improved vitamin D3 status and was associated to low leptin levels in the postmenopausal women of the study.

Lack of periosteal apposition in the head and neck of femur after menopause in Chinese women with high risk for hip fractures - A cross-sectional study with QCT.

In elderly subjects and in particular in those with osteoporosis the evidence on age related volume changes of the hip is still very limited. Even less is known about bone changes of the femoral head. The aim of this study is to explore associations of bone size of the femoral head and neck with age in postmenopausal women with very high risk of hip fracture and to investigate associations of femoral head and neck bone mineral density. MIAF (medical image analysis framework)-Femur was used for the analysis of CT datasets from 319 females with acute hip fractures age 50 to 98. Integral BMD and volume of the head and neck were assessed. The femoral head was divided into four quadrants to address differential vBMD and volume responses of its superior, inferior, posterior and anterior parts. Areal BMD (aBMD) of femoral neck was also obtained. In this population of postmenopausal women we did not observe age-related changes in bone volume of the femoral head or neck between ages 50 and 98years. Integral vBMD in the head in the 90-98year group was 48.0mg/cm3 lower than that in 50-59year group, which accounts for nearly 30% decrease in vBMD with 40years increase. Age-related vBMD changes in the head quadrants were similar to that in total. With age, the trend line correlation coefficients for vBMD in quadrants were relatively small, but significant (p<0.001) for all. The femoral head integral vBMD correlates well with neck vBMD and FN aBMD. FN aBMD explained 45% of head integral vBMD variance (p<0.0001). Elderly women had relative preservation of femoral head and neck bone volume from 50yrs. over four decades but markedly lower integral vBMD of proximal femur. The findings of our study call in question about the concept of bone expansion with aging even in elderly age.

Abstract P451: Aircraft Noise Exposure As A Novel Risk Factor For Clonal Hematopoiesis Of Indeterminate Potential

Background: Although the etiology of clonal hematopoiesis of indeterminate potential (CHIP) remains unclear, CHIP-defining somatic mutations within hematopoietic stem cells appear to expand peripheral blood leukocyte populations, promote inflammation, and thereby increase cardiovascular disease (CVD) risk. Moreover, high noise exposures have been linked to chromosomal aberrations in bone marrow and DNA repair in peripheral blood leukocytes. We therefore examined the potential of aircraft noise exposure as a novel risk factor for CHIP. Methods: We leveraged cross-sectional data on 10,050 postmenopausal women without prior hematologic malignancy in a Women’s Health Initiative (WHI) ancillary study of 5,309 women with stroke and/or venous thromboembolic disease and 4,741 controls. We ascertained CHIP using Trans-Omics for Precision Medicine (TOPMed) whole-genome sequencing data, the GATK Mu TECT2 somatic variant caller, a pre-specified list of leukemogenic driver mutations in 74 genes, and a threshold variant allele frequency of &gt; 0.02. In cooperation with the Federal Aviation Administration, we generated day-night-level (DNL) noise contours around 90 major U.S. airports using the Aviation Environmental Design Tool noise modelling software. The DNL imposes a penalty for nighttime noise exposure and is the primary means for assessing and regulating noise exposure in the U.S. We estimated geocoded participant address-specific, annual average DNL aircraft noise exposures in decibels (dB) from the contours on the day of blood draw and categorized individuals as exposed or non-exposed (DNL ≥ or &lt; 45dB). We estimated the noise-related risk of CHIP as an odds ratio, 95% confidence interval (OR, 95% CI) using logistic regression before and after adjustment for age, race / ethnicity, case-control status, smoking, alcohol use, body mass index, physical activity, hearing loss, education, and neighborhood socioeconomic status. Results: Among this population of postmenopausal women (Mean age: 68.7 years; White: 82.1%; African American: 12.3%), 19.4% were exposed to aircraft noise, and 8.4% had CHIP. The age-adjusted CHIP proportion was higher among whites (8.1%) than African Americans (7.3%) and other racial/ethnic groups (6.4%). CHIP was also more common among women aged ≥ 70 years (11.5%) than those aged 60-69 years (7.5%) or 50-59 years (3.8%). Compared to non-exposed women, those exposed to aircraft noise were not at increased risk of CHIP: OR unadjusted (95% CI) = 0.95 (0.80, 1.14) and OR adjusted (95% CI) = 0.97 (0.81, 1.16). Results were insensitive to dichotomization of noise exposure at 55 dB and further exclusion of women with hearing loss. Conclusion: Our study found no evidence of an association between aircraft noise and CHIP suggesting that aircraft noise may not be a factor contributing to CHIP-defining somatic mutations linked to CVD.

Abstract P3-08-17: Clinical factors of late recurrence of HR+ early breast cancer after completion of 5 years of aromatase inhibitor and development of a prognostic tool. A study of 1496 women of the ICO database

Abstract INTRODUCTION: Post-menopausal women with hormone receptor positive (HR+) early breast cancer receive generally 5 years of adjuvant aromatase inhibitor (AI). However, more than half of recurrences occur after that period and the identification of patients who could derive benefit from the prolongation of AI above 5 years is a critical task. We aimed to develop a simple prognostic tool to estimate the risk of late recurrence of patients with HR+ EBC who had completed 5 years of AI, in order to help the decision making process of extending AI. METHODS: We conducted a monocentric, retrospective study based on a local database (BERENIS), which included all patients treated for EBC at the Institut de Cancerologie de L’Ouest (ICO). We identified all post-menopausal women diagnosed with HR+ EBC and who had completed at least 54 months of adjuvant AI. We analysed the outcome after stopping AI, including HR+ metastatic, contralateral and ipsilateral relapses. RESULTS: Between January 2003 and December 2011, 1107 post-menopausal women were retrieved. Median follow-up after completion of 5y AI was 32.6 months [1-132]. The recurrence rate of HR+ disease was 8% (n=89) including 60 metastatic relapses, and 8 and 21 ipsilateral and contralateral local relapses respectively. Multivariate analysis showed that the pathological tumour size (continuous variable) (HR = 1.02; p = 0.035), the number of macro-metastases (continuous variable) (HR = 1.17; p = 0.001) and age (HR = 1.04; p = 0.012) were independent factors of HR+ invasive disease free survival. We then designed a score estimating the risk of late relapse. This was designed as follow: 10*(tumour size (mm)) +79*(number of macro metastases) +14*(years old). Patients were classified as low risk (78.8% of patients) or high risk (21.2%) with a threshold at 1200 points. Low risk patients had a mean 5- to 10-year risk of invasive HR+ local or distant recurrence of 9.8% (95% CI, 7.1% to 13.5%) as compared with 38.3% (95% CI, 27.6% to 50.9%) for high-risk groups. CONCLUSION: Our study is one of the first estimating the risk of late relapse in a population of post-menopausal women who have completed 5y of adjuvant AI for EBC. Our simple score identify accurately patients at high risk of relapse despite 5 years of treatment. This tool may help oncologist to select patients who could derive the most benefit of extending adjuvant AI above 5 years. A validation of this score in an independent population is necessary. Citation Format: Jean-Sebastien Frenel, Loïc Campion, Marie Robert, Classe Jean-Marc, Campone Mario, Camille Moreau-Bachelard. Clinical factors of late recurrence of HR+ early breast cancer after completion of 5 years of aromatase inhibitor and development of a prognostic tool. A study of 1496 women of the ICO database [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P3-08-17.

Abstract PD3-09: Sulindac reduces breast density and alters collagen alignment in patients on aromatase inhibitors

Abstract Background. Preclinical and observational evidence supports cancer prevention activity of non-steroidal anti-inflammatory drugs (NSAIDs) in the breast via suppression of prostaglandin E2 (PGE2) synthesis by cyclooxygenase-2 (COX2). Evidence includes linking of PGE2 to aromatase activity and estrogen synthesis in breast adipose tissue, as well as effects on collagen and breast density (BD). Methods. In an open-label trial, we evaluated the effect of the non-selective NSAID sulindac at 150 mg bid for 12 months on BD in 52 postmenopausal women taking adjuvant aromatase inhibitors (AIs) for breast cancer. BD was measured using a fat-water decomposition MRI based BD measure (MRD) previously shown to be more quantitative than mammographic density. A non-randomized observation cohort of 46 postmenopausal women on AI without NSAID use was conducted in parallel to assess the effect of AI on MRD over 12 months. Eligible participants were recruited at two study sites and included women with an intact, unaffected contralateral breast and BI-RADS ≥ 2. Each subject’s MRI_BD measures at baseline and at 6 and 12 months were included in linear mixed models for longitudinal data. Log-transformation was applied to the outcome of BD. Covariates included log-transformed baseline BD, time on AI, and baseline body mass index (BMI) and change in BMI. Breast tissue collagen fiber alignment for 30 women with paired breast biopsies, before and after 6 months on sulindac, was examined using Second-Harmonic Generation (SHG) microscopy and analysis of the distribution (histogram) of ‘straight’ fibers in three randomly selected areas of breast tissue. Straightness of individual fibers was calculated as the linear length of a fiber divided by the distance along the fiber. Results. Participants on sulindac intervention had a significant change in BD relative to baseline BD at 6 (p=0.05) and 12 months (p&amp;lt;0.001). After adjusting for time on AI, baseline BMI and BMI change, the relative change in BD at 12 months from baseline BD was 10% lower (95% CI; -14.4, -5.4%) for women on sulindac. For the AI only group, no significant change from baseline BD was observed at 6 (p=0.50) or 12 months (p=0.17). The relative change in BD for the AI only group at 12 months was -3.5% (95% CI; -8.3, +1.6%). For women with baseline MRD_BD of ≥ 25%, the relative decrease in BD from baseline in the sulindac group was greater, at -16.3% (95% CI, -25.4, -6.2%). In contrast, there was no evidence for baseline BD effect on change in BD at 12 months in the AI only group whose baseline BD was ≥25% [-3.3% change at 12 mo (95% CI; -12.7, +7.1%)]. Exploratory analyses of collagen fiber alignment in the sulindac group at 6 months showed a significant decrease in straight collagen fibers (p=0.01). The decrease in collagen straightness correlated with a decrease in BD (rho=0.66, p=0.01). Conclusions. Twice daily 150 mg sulindac for 12 months in postmenopausal women on AIs was associated with a significant decrease in BD using MRD that was slightly higher for women with higher baseline BD. At the tissue level, the decrease in BD was associated with change in collagen straightness. No decrease in BD was observed in a non-randomized population of postmenopausal women on AI only therapy. These results suggest that sulindac decreases BD and may do so through effects on collagen alignment. Further investigation of sulindac for effects on BD, including synergy with AIs, for breast cancer prevention is indicated. Citation Format: Patricia Thompson, Chuan Huang, Betsy Wertheim, Christina Preece, Jie Yang, Jessica Martinez, Denise Roe, Pavani Chalasani, Alison Stopeck. Sulindac reduces breast density and alters collagen alignment in patients on aromatase inhibitors [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr PD3-09.

Abstract 182: Adverse Pregnancy Outcomes and Cardiovascular Disease in the Mother: The Women’s Health Initiative (WHI)

Background: Adverse pregnancy outcomes (APOs) occur in up to 15% of all pregnancies, and are associated with an increased risk of long-term atherosclerotic cardiovascular disease (ASCVD) in the mother. However, it is unclear if this association is independent of standard ASCVD risk factors or is present in multiethnic populations with adjudicated CVD events. Methods: Participants in the Women’s Health Initiative were asked to complete a retrospective survey in 2017 about APOs, [gestational diabetes, birthweight &lt; 5 pounds, birth weight &gt; 9 pounds, delivery &gt; 3 weeks pre-term, and hypertensive disorder of pregnancy (gestational hypertension or preeclampsia)]. Cox models were used to assess the hazard for developing incident ASCVD (defined as adjudicated stroke, myocardial infarction, peripheral artery disease, coronary revascularization). Follow up began at the baseline study exam. Hazard ratios were assessed using the Cox model. Two primary models were employed for each individual APO: 1) univariate, and 2) adjusted for the baseline ASCVD risk factors of age, smoking, use of cholesterol lowering drugs, hypertension and diabetes. Results: The 50,679 respondents were 89.1% White, 5.2% Black, 2.4% Hispanic, 2.1% Asian-Pacific Islander, and 1.2% Other race. There were 12,499 (25%) women who reported an APO: 1041 (2.1%) had gestational diabetes, 6282 (12.4%) had low birth weight, 2970 (5.9%) had high birth weight, 7365 (14.5%) had a premature birth, and 3238 (6.4%) had preeclampsia or gestational hypertension. Over 1,020,899 person-years of follow up, 3569 (7.0%) adjudicated CVD events occurred. In univariate models, each APO was associated with ASCVD (Figure). In multivariable models adjusting for standard risk factors, all APOs were associated with a significantly increased risk of CVD (Figure), with the exception of high birth weight. There was no significant effect modification by race on these associations. Conclusion: Adverse pregnancy outcomes were associated with increased risk of late ASCVD in a multiethnic population of post-menopausal women, independent of ASCVD risk factors. Associations between APO and ASCVD were consistent across racial groups. APOs should be considered in CVD risk assessment in women.