Postmenopausal Controls Research Articles

12565 Expression Of Sex Hormone Receptors In Levator Ani Muscle Tissue From Patients With Pelvic Organ Prolapse

Abstract Disclosure: T. You: None. A. Halle: None. W. Xu: None. T. Potluri: None. H. Nguyen: None. S.E. Bulun: None. J. Julia Geynisman-Tan: None. H. Zhao: None. Introduction: Women with pelvic floor disorders usually have weakened pelvic floor muscles, which may cause urinary incontinence, fecal incontinence, and pelvic organ prolapse (POP). Histologically, the pelvic floor musculature in POP patients displays increased fibrosis and muscle atrophy. However, the underlying molecular mechanism for POP has not been fully investigated. We and others found that estrogen causes pelvic skeletal muscle fibrosis and inguinal hernias in male animal models. Additionally, clinical trials from the Women's Health Initiative showed women receiving estrogen-only or estrogen plus progestin treatment had statistically significant increases in the risk for urinary incontinence. However, the role of estrogen, progesterone, androgen, and their receptor expression in pelvic floor muscle is not well studied. Methods: TruCut biopsy needles were used to obtain levator ani (LA, the major pelvic floor muscle) biopsies from four groups of patients undergoing surgery: (i) 5 premenopausal women with stage II/III POP (age 38-52 years), (ii) 5 postmenopausal women with stage III POP (59-75 years), (iii) 5 age and parity matched premenopausal controls, and (iv) 5 age and parity matched postmenopausal controls. The control patients did not have any POP (stage 0) or only had sole stress urinary incontinence. H&E staining, Masson’s trichrome staining, and immunohistochemistry (IHC) staining for estrogen receptor α (ERα), progesterone receptor (PGR), and androgen receptor (AR) were performed in LA muscle tissue. Standard patient demographics (age, parity, and diagnosis) were collected. Results: We used H&E staining to morphologically assess stromal cells and myofibers obtained from LA muscle biopsies. Masson’s trichrome staining showed extracellular matrix deposition in the LA muscle from women with or without POP. In addition, we found ERα was present in the stromal cells from nearly every LA biopsy using IHC staining. ERα expression (H-Score) was similar in four groups of patients. ERα IHC staining was absent in LA myofibers. AR was highly expressed in stromal cells in all LA muscles and weakly expressed in myofibers in ∼70% of LA tissues. AR expression (H-Score) was significantly decreased in postmenopausal women with stage III pelvic organ prolapse. PGR was only expressed in a small portion of the LA sample (30%), with PGR exclusively expressed in the stroma of the LA muscle. Conclusion: Our findings indicate that sex hormone receptors (ERα, AR, and PGR) are present in LA muscle stroma, providing the foundation to further define the roles of sex steroid hormones in pelvic organ prolapse. Presentation: 6/3/2024

Burden of postmenopausal breast cancer attributable to excess body weight: comparative study of body mass index and CUN-BAE in MCC-Spain study

Background10% of postmenopausal breast cancer cases are attributed to a high body mass index (BMI). BMI underestimates body fat, particularly in older women, and therefore the cancer burden attributable to...

Prevalence and Factors Associated with Sarcopenia in Post-Menopausal Women with Rheumatoid Arthritis.

To estimate the prevalence of sarcopenia in post-menopausal women with rheumatoid arthritis (RA) and to investigate possible correlation with disease parameters. Eighty post-menopausal women with RA and thirty post-menopausal controls were enrolled in this cross-sectional study. RA patients were further divided in two groups according to the existence of sarcopenia. Sarcopenia was defined according to EWGSOP-II recommendations and osteoporosis as a T-score≤-2.5 in femoral neck bone mineral density. Biomarkers of bone turnover were determined. RA disease activity was calculated using the DAS28-ESR score and inflammatory markers (ESR, CRP). Functionality was calculated with the HAQ-DI score and seropositivity was determined according to RF and anti-CCP antibodies. Thirty-two post-menopausal women with RA (39%) met the EWGSOP-II criteria for sarcopenia. None of the control subjects was detected with sarcopenia (p<0.0001). All parameters that define sarcopenia were significantly lower in the RA group. Sarcopenic RA patients had significantly lower mean BMI (27.1 kg/m2 vs. 30.5 kg/m2, p=0.008), daily physical activity (IPAQ score) (1213 vs 2867, p<0.0001), mean skeletal muscle mass (ASMI) (5.2 kg/m2 vs 6.6 kg/m2, p<0.0001) and handgrip strength (13.7 kg vs 20.1 kg, p<0.0001). No differences were observed in disease parameters or in biomarkers of bone turnover. IGF-1 was the only parameter that differed between the sarcopenic and non-sarcopenic RA patients (90.1 ng/ml vs 112.8 ng/ml, p=0.024). Sarcopenia is more common in RA patients. Sarcopenic RA patients had lower BMI, IPAQ, ASMI and handgrip strength. IGF-1 was the only parameter that was significantly lower in sarcopenic RA patients.

Assessing the Factor Structure and Measurement Invariance of the Pittsburgh Sleep Quality Index Between Postmenopausal Breast Cancer Survivors and Controls.

Background and Purpose: This study evaluates the Pittsburgh Sleep Quality Index (PSQI) in terms of factor structure and measurement invariance (MI). The sample included postmenopausal breast cancer (BC) survivors (n = 101) and matched healthy controls (n = 60). Methods: Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed on PSQI's seven component scores. MI was tested between groups and across time using Bayes factor (BF). Results: Two factors were identified: sleep efficiency and perceived sleep quality. MI is evidenced between groups (BF < 0.007) and over time (BF > 150). Conclusions: PSQI scores with two subscales are comparable between postmenopausal BC survivors and controls over a 1-year period, providing some validation of PSQI for researching sleep quality in this population.

Spatial heterogeneity of peri-tumoural lipid composition in postmenopausal patients with oestrogen receptor positive breast cancer

Deregulation of lipid composition in adipose tissue adjacent to breast tumour is observed in ex vivo and animal models. Novel non-invasive magnetic resonance imaging (MRI) allows rapid lipid mapping of the human whole breast. We set out to elucidate the spatial heterogeneity of peri-tumoural lipid composition in postmenopausal patients with oestrogen receptor positive (ER +) breast cancer. Thirteen participants (mean age, 62 ± [SD] 6 years) with ER + breast cancer and 13 age-matched postmenopausal healthy controls were scanned on MRI. The number of double bonds in triglycerides was computed from MRI images to derive lipid composition maps of monounsaturated, polyunsaturated, and saturated fatty acids (MUFA, PUFA, SFA). The spatial heterogeneity measures (mean, median, skewness, entropy and kurtosis) of lipid composition in the peri-tumoural region and the whole breast of participants and in the whole breast of controls were computed. The Ki-67 proliferative activity marker and CD163 antibody on tumour-associated macrophages were assessed histologically. Mann Whitney U or Wilcoxon tests and Spearman’s coefficients were used to assess group differences and correlations, respectively. For comparison against the whole breast in participants, peri-tumoural MUFA had a lower mean (median (IQR), 0.40 (0.02), p < .001), lower median (0.42 (0.02), p < .001), a negative skewness with lower magnitude (− 1.65 (0.77), p = .001), higher entropy (4.35 (0.64), p = .007) and lower kurtosis (5.13 (3.99), p = .001). Peri-tumoural PUFA had a lower mean (p < .001), lower median (p < .001), a positive skewness with higher magnitude (p = .005) and lower entropy (p = .002). Peri-tumoural SFA had a higher mean (p < .001), higher median (p < .001), a positive skewness with lower magnitude (p < .001) and lower entropy (p = .012). For comparison against the whole breast in controls, peri-tumoural MUFA had a negative skewness with lower magnitude (p = .01) and lower kurtosis (p = .009), however there was no difference in PUFA or SFA. CD163 moderately correlated with peri-tumoural MUFA skewness (rs = − .64), PUFA entropy (rs = .63) and SFA skewness (rs = .59). There was a lower MUFA and PUFA while a higher SFA, and a higher heterogeneity of MUFA while a lower heterogeneity of PUFA and SFA, in the peri-tumoural region in comparison with the whole breast tissue. The degree of lipid deregulation was associated with inflammation as indicated by CD163 antibody on macrophages, serving as potential marker for early diagnosis and response to therapy.

Breast cancer but not the menopausal status is associated with small changes of the gut microbiota.

Possible relationships between gut dysbiosis and breast cancer (BC) development and progression have been previously reported. However, the results of these metagenomics studies are inconsistent. Our study involved 88 patients diagnosed with breast cancer and 86 cancer-free control women. Participants were divided into groups based on their menopausal status. Fecal samples were collected from 47 and 41 pre- and postmenopausal newly diagnosed breast cancer patients and 51 and 35 pre- and postmenopausal controls, respectively. In this study, we performed shotgun metagenomic analyses to compare the gut microbial community between pre- and postmenopausal BC patients and the corresponding controls. Firstly, we identified 12, 64, 158, and 455 bacterial taxa on the taxonomy level of phyla, families, genera, and species, respectively. Insignificant differences of the Shannon index and β-diversity were found at the genus and species levels between pre- and postmenopausal controls; the differences concerned only the Chao index at the species level. No differences in α-diversity indexes were found between pre- and postmenopausal BC patients, although β-diversity differed these subgroups at the genus and species levels. Consistently, only the abundance of single taxa differed between pre- and postmenopausal controls and cases, while the abundances of 14 and 23 taxa differed or tended to differ between premenopausal cases and controls, and between postmenopausal cases and controls, respectively. There were similar differences in the distribution of enterotypes. Of 460 bacterial MetaCyc pathways discovered, no pathways differentiated pre- and postmenopausal controls or BC patients, while two and one pathways differentiated cases from controls in the pre- and postmenopausal subgroups, respectively. While our findings did not reveal an association of changes in the overall microbiota composition and selected taxa with the menopausal status in cases and controls, they confirmed differences of the gut microbiota between pre- and postmenopausal BC patients and the corresponding controls. However, these differences were less extensive than those described previously.

Acute iv CRH administration significantly increases serum active ghrelin in postmenopausal PCOS women compared to postmenopausal controls.

In women with Polycystic Ovarian Syndrome (PCOS), an increased risk of disordered eating has been described. There is growing interest regarding a possible interconnection between psychological states and increased appetite in women with PCOS. Acute stress is characterized by increased Corticotropin Releasing Hormone (CRH) secretion. The aim was to estimate the ghrelin concentrations during CRH test. Twenty postmenopausal women with PCOS and twenty age- and BMI- matched postmenopausal control women were recruited at Aretaieion University Hospital. In the morning (9 am) all subjects had anthropometric measurements (weight, height, waist circumference) and a fasting sample for hormonal measurements. An intravenous (iv) CRH stimulation test conducted over 1 min. Serum active ghrelin levels were measured at 0, 15, 30, 60, 90, 120 min after iv CRH administration. The postmenopausal PCOS group had a higher waist circumference compared to postmenopausal controls. Active ghrelin concentrations increased significantly from 0 to 15 min, to 30 min, to 60 min, to 90 min and then decreased to 120 min. However, within the postmenopausal control group there were no significant changes in serum active ghrelin levels. Serum active ghrelin concentrations were significantly greater in the postmenopausal control group at 0, 15 and 120 min compared to the postmenopausal PCOS group. At 90 min active ghrelin concentrations were significantly greater in the postmenopausal PCOS group. Delta Area Under the Curve of active ghrelin (ΔAUCghr) was significantly greater in the postmenopausal PCOS group compared to controls. In postmenopausal PCOS, but not in postmenopausal controls, iv CRH administration induces increased serum active ghrelin secretion, suggesting a possible anti-stress adaptive mechanism. An increase in serum active ghrelin may induce hunger as a side-effect of this presumed adaptive mechanism.

Alterations of Serum Calcium, Phosphorus and AlkalinePhosphatase in Postmenopausal Women

In the present study 3 biochemical parameters ( Calciun1i Phosphorus and Alkaline phosphatase) has been measured in blood of 111 apparently healthy volunteers women, including 41 apparently healthy premenopausal women aged between ( 21- 42 ) years as a .control group and 70 apparently healthy postmenopausal women ( tbe menopause occur normally ) aged between ( 50- 69 ) years which divided into two age groups. From the results it is found that there were a significant difference of serum calcium, phosphorus and alkaline phosphatase between postmenopausal women group and control group also the current study showed that lhe serum calcium and phosphorus declines with age with in postmenopausal women group. while the mean value of alkaline phosphatase activity showed a significant increase with increasing age in postrnenopausal women group.

Activins, follistatins and inhibins in postmenopausal osteoporosis: A proof of concept, case-control study

BackgroundBone metabolism has been proposed to be affected by the activins-follistatins-inhibins (AFI) hormonal system. We aimed to evaluate AFI in patients with osteoporosis and osteopenia compared with postmenopausal and premenopausal controls. MethodsIn this case-control study, circulating levels of the AFI system were evaluated, individually and jointly, between postmenopausal women with osteoporosis (BMD T-score ≤−2.5; n = 25) or osteopenia (BMD T-score >−2.5 and ≤−1; n = 25) and postmenopausal women with normal BMD (T-score >−1.0; n = 25) or premenopausal women with normal BMD (Z-score >−1.0; n = 25), with and without adjustment for potential confounders. ResultsIn the sum of participants, AFI molecules and their ratios followed an opposite pattern of correlations for age and BMI vs. BMD. In unadjusted models, FSTL3 concentrations were higher, whereas activin B, inhibin A and inhibin B and the ratios of activin B/follistatin and activin B/FSTL3 were lower in the three postmenopausal groups compared with the premenopausal group. Activin A/follistatin and activin AB/follistatin ratios were lower in the osteoporosis group than the other three groups. After adjustment for BMI and age, inhibin B (p = 0.005), and the ratios of activin A/follistatin (p = 0.009), activin B/follistatin (p = 0.040) and activin AB/follistatin (p = 0.003) were lower in the osteoporotic group compared with the other groups. In fully adjusted logistic regression analysis log(inhibin B) (p = 0.041), log(activinA/follistatin) (p = 0.014), log(activinB/follistatin) (p = 0.025) and log(activinAB/follistatin) (p = 0.021), but not FSTL3, remained independently associated with the presence of osteoporosis. ConclusionsLower inhibin B and higher ratios of activins A, B, and AB to follistatin are associated with lumbar spine BMD and the presence of osteoporosis independently from age or BMI.

Updating of PD-1, PDL-1 and CD8+ in Benign and Malignant Breast Cancer in Iraqi Women

The study conducted at Center for the Early Detection of Breast Tumors at Medical City’s oncology teaching hospital carried 90 patients who participated in this study. The research was carried out between February 15, 2021, and July 20, 2021. The diagnosis was made by the consultant medical team using the triple assessment technique, which includes physical breast examination, ultrasonography, mammography, and fine needle aspiration cytology. Women patients clasified into 3 groups (benign tumor, control and malignant tumor) benign B (34 women) divided in/to two sub groups such as (benign premenopausal age B1 (17) and benign postmenopausal age B2 (17) and malignant M (34), malignant premenopausal age M1 (17) and malignant postmenopausal age M2 (17), and control group C includes (11) premenopausal age C1 and (11) C2. An ELISA approach was used to measure the level of soluble PDL, PD L1, and CD8 expression in serum. PD1 shows significant increase (p ≤ 0.05) in pre- and post-menopausal malignant groups M5, M6 when compared with C1, C2, B1, B2. PDL-1 levels were non-significant (p ≥ 0.05) in pre and postmenopausal control and benign groups (C1, C2, B1 and B2) while they were increased significantly (p ≤ 0.05) in M1, M2 in comparison with B2,C1,C2, B1. CD8 in the M1 increased significantly (p ≤ 0.05) when compere with group1, group 2, group bening1, group benign 2 and malignant 2. Conclusions from the current study that the values of PD1and PDL1in pre and postmenopausal malignant women breast cancer showed an increase compere with the other groups, the levels of CD8+ increase in the premenopausal malignant breast cancer women in comparison with other groups.

254 (PB-078) Poster - Bacterial β-glucuronidase activity in postmenopausal breast cancer patients: a pilot study

Background: Long lifetime exposure to elevated estrogen levels is associated with a higher risk for developing estrogen receptor-positive (ER+) breast cancer in postmenopausal women. A factor that can influence estrogen levels is the intestinal bacterial enzyme β-glucuronidase (GUS), which can de-conjugate estrogens, leading to their reabsorption into the circulation. In this pilot study, we aimed to investigate if there was a significant difference in fecal GUS activity between postmenopausal ER+ breast cancer patients and postmenopausal controls.

Association of 2-methoxyestradiol levels with the occurrence and development of endometrial cancer in humans*

Abstract Objective The aim of the study was to determine the association of urinary levels of estradiol (E2) and 2-methoxyestradiol (2-MeOE2) with the occurrence and development of endometrial cancer. Methods In this case-control study, 24-h urine specimens were collected from 28 postmenopausal patients with endometrial cancer and 28 postmenopausal healthy female controls. The concentration of 2-MeOE2 was determined using liquid chromatography-mass spectrometry with hollow fiber liquid-phase microextraction. The concentration of E2 was determined using an enzyme-linked immunosorbent assay. Results Estrogen levels were different between the patients with endometrial cancer and controls. The relative quantity of E2 in the case group was higher than that in the control group (P &lt; 0.05), whereas that of 2-MeOE2 was lower in the case group than that in the control group (P &lt; 0.05). The ratio of E2-to-2-MeOE2 in the case group was significantly higher than that in the control group (P &lt; 0.05). Conclusion The results of this study indicate an imbalance of estrogen metabolites in endometrial carcinogenesis. Reduced 2-MeOE2 levels and elevated E2-to-2-MeOE2 ratio may be used as potential biomarkers for the risk assessment of estrogen-induced endometrial cancer.

The effect of vitamin D on the lipid profile as a risk factor for coronary heart disease in postmenopausal women: a meta-analysis and systematic review of randomized controlled trials

The exact effect of vitamin D administration on the lipid profile in postmenopausal women is unknown. However, as dyslipidemia is a recognized risk factor for coronary heart disease (CHD) in this population, the lipid-lowering effects of vitamin D need to be explored Thus, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) that evaluated the impact of vitamin D use on triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) as a risk factor for coronary heart disease (CHD) in postmenopausal women. We developed a search strategy for multiple databases (PubMed/Medline, Scopus, Embase, and Web of Science) to identify relevant RCTs whose results were published until June 1st, 2021. We combined the results using a random effects model (the DerSimonian and Laird random effects model). Lipid profile outcomes were expressed as weighted mean difference (WMD) and 95% confidence intervals (CIs) between intervention and comparator groups. Supplementation with vitamin D decreased TG (WMD: -3.55mg/dL, 95% CI: -5.34 to -1.76, P<0.001) in postmenopausal females versus controls. In the subgroup analyses, vitamin D increased TC when the treatment duration was ˂26weeks (WMD: 6.56mg/dL, 95% CI: 0.78 to 12.35, P=0.02) as compared to ≥26weeks (WMD: -2.06mg/dL, 95% CI: -5.49, 1.36, P=0.23) and in the participants with a BMI ≥30kg/m2 (WMD: 3.65mg/dL, 95% CI: 0.09, 7.22, P=0.044). Moreover, vitamin D increased HDL-C when the treatment duration was ˂26weeks (WMD: 2.67mg/dL, 95% CI: 0.66 to 4.68, P=0.009). In addition, vitamin D decreased LDL-C when the vitamin D dose was ˃400IU/day (WMD: -1.89mg/dL, 95% CI: -2.47 to -1.31, P<0.001) as compared to ≤400IU/day (WMD: 2.50mg/dL, 95% CI: -2.50, 7.52, P=0.327). Vitamin D administration on the lipid profile as a risk factor for CHD in postmenopausal women reduces TG. Its effects to lower LDL-C and increase HDL-C and TC levels are clinically negligible but should be investigated in future research. In addition, supplementation with vitamin D results in a clinically significant reduction in TG, particularly in postmenopausal females with hypertriglyceridemia at baseline.

Urine and vaginal microbiota compositions of postmenopausal and premenopausal women differ regardless of recurrent urinary tract infection and renal transplant status

Postmenopausal women and renal transplant recipients are at increased risk of recurrent urinary tract infections (RUTI). Urine and vaginal microbiota of premenopausal controls (N = 18) and RUTI cases (18), and of postmenopausal controls (30) and RUTI cases (20) with and without a renal transplant, were characterized using 16S rRNA sequencing. Participants did not have UTI symptoms at the time of sampling. Gram-negative uropathobionts (predominantly Escherichia/Shigella, Pseudomonas, Klebsiella, and Acinetobacter) had a much higher mean relative abundance in urine than vaginal samples, especially in premenopausal women. No statistically significant differences in mean relative abundances of bacterial groups were found within the premenopausal group or within the postmenopausal group by RUTI or renal transplant status without chronic antibiotic use. Comparing postmenopausal to premenopausal women, mean relative abundances of lactobacilli (especially L. crispatus) in urine and vaginal samples and of Gram-negative uropathobionts in urine were lower, and of BV-anaerobes and Gram-positive uropathobionts in urine and vaginal samples were higher. While RUTI in premenopausal women is predominantly caused by Escherichia, the causative organisms in postmenopausal women are likely more diverse. The relative importance of individual organisms is currently unknown. We recommend that future studies, including intervention studies, include longitudinal microbiota assessments.

Effect of thyrotropin suppressive therapy on lumbar bone mineral density in patients with differentiated thyroid cancer: a retrospective cohort study

To investigate the effect of thyrotropin (TSH) suppressive therapy on lumbar bone mineral density (BMD) in patients with differentiated thyroid cancer (DTC) after operation. We retrospectively analyzed 70 DTC patients at intermediate or high risk of recurrence, including 17 males, 30 premenopausal females, and 23 postmenopausal females. All patients were treated with oral 131I to clear any residual thyroid and L-thyroxine tablets to suppress TSH after surgery. The baseline and follow-up lumbar BMD were measured. The anthropometric and biochemical parameters, the doses of calcium supplement, and levothyroxine were collected. Lumbar BMD in the postmenopausal female group was markedly decreased (regression coefficient: -0.201; P<0.001) compared to the male group and premenopausal female group (both: P>0.05). Further comparisons between groups found that premenopausal women had a monthly lumbar BMD reduction of 0.001 g/cm2 more than men, but the difference was not statistically significant (P=0.515). In contrast, postmenopausal women had a monthly lumbar BMD reduction of 0.004 g/cm2 more than men and 0.003 g/cm2 more than postmenopausal controls (P=0.017 and P<0.001, respectively). Lumbar BMD decreased significantly with the increasing duration of TSH suppression in both the calcium supplement group and the non-calcium supplement group (both: P<0.05), but there was no statistical difference between the two groups (P=0.534). The longer the duration of TSH suppression in DTC patients after operation, the more significant the decrease of BMD, especially in postmenopausal women. Furthermore, calcium supplementation did not significantly improve lumbar BMD.

Altered cervicovaginal microbiota in premenopausal ovarian cancer patients.

Nearly three hundred thousand female patients are diagnosed with ovarian cancer in the world annually, and this number shows an increasing trend. However, characteristic symptoms caused by ovarian cancer are so few that early diagnosis remains challenging, and an effective screening method has not yet been established. Here, we conducted a case-control study in Japan to analyze the association between cervicovaginal microbiome and ovarian cancer, using 16S rRNA amplicon sequencing. Analysis of DNA extracted from cervical smear samples revealed Lactobacillus-dominant and Lactobacillus-deficient, highly-diversified bacterial communities in premenopausal and postmenopausal healthy controls, respectively, as reported for vaginal microbiota previously. We found that cervicovaginal microbiota in ovarian cancer patients, regardless of their menopausal status, were frequently a diversified community and similar to those in healthy subjects at postmenopausal ages. The diverse microbiota was associated with the major histotypes of epithelial ovarian cancer, including serous ovarian cancer and ovarian clear cell cancer. The present study implies the potential of a cervicovaginal microbiome biomarker in screening ovarian cancer in premenopausal women.

SERUM IRON PARAMETERS AS PROGNOSTIC MARKERS IN BREAST CANCER PATIENTS

BACKGROUND AND OBJECTIVE: Breasts are an important aspect of a woman's femininity and all aberrations in their functional and cosmetic attributes are essential for scientic evaluation as breast cancer has become the most common cancer among women worldwide. Its risk increases with age and menopausal status. Serum parameters like Ferritin and TIBC concentration is altered in sera of these patients. Iron homeostasis is inuenced by estrogen and overload impacts cellular proliferation and physiological dysfunction in electron and oxygen transport, energy production and DNA synthesis. A vicious cycle between breast cancer, iron homeostasis deregulation, menopausal status and serum parameters derangement enables us to prognosticate such patients. METHOD: Histopathologically conrmed, 50 newly diagnosed cases were analyzed with age matched 50 clinically healthy controls with no family history. Level of serum ferritin was estimated by Sandwich Elisa using Ferritin SAElisa kit and serum TIBC level measured with CL-1000i Chemiluminescence immunoassay analyzer. RESULT: Serum ferritin level in breast cancer cases (300.73±25.33ng/ml) was statistically higher than in controls (85.22±41.80ng/ml). In breast cancer, ferritin level was higher in postmenopausal (300.73±25.33ng/ml) compared to premenopausal (228.059±11.24ng/ml) patients and even in their healthy counterparts.Serum TIBC level in breast cancer (772.99±127.93) was higher than in controls (329.41± 69.40).In postmenopausal breast cancer female TIBC level was higher (815.39±104.32) compared to premenopausal females (652.31±110.86) and similarly it was higher in postmenopausal healthy controls than in premenopausal controls and signicant statistically. CONCLUSION: Serum ferritin and TIBC parameters can be used as prognostic markers for breast cancer and their levels are elevated in postmenopausal females of both breast cancer patients and healthy cases.

Measured body size and serum estrogen metabolism in postmenopausal women: the Ghana Breast Health Study

BackgroundSeveral anthropometric measures have been associated with hormone-related cancers, and it has been shown that estrogen metabolism in postmenopausal women plays an important role in these relationships. However, little is known about circulating estrogen levels in African women, and the relevance to breast cancer or breast cancer risk factors. To shed further light on the relationship of anthropometric factors and estrogen levels in African women, we examined whether measured body mass index (BMI), waist-to-hip ratio (WHR), height, and self-reported body size were associated with serum estrogens/estrogen metabolites in a cross-sectional analysis among postmenopausal population-based controls of the Ghana Breast Health Study.MethodsFifteen estrogens/estrogen metabolites were quantified using liquid chromatography-tandem mass spectrometry in serum samples collected from postmenopausal female controls enrolled in the Ghana Breast Health Study, a population-based case–control study conducted in Accra and Kumasi. Geometric means (GMs) of estrogens/estrogen metabolites were estimated using linear regression, adjusting for potential confounders.ResultsMeasured BMI (≥ 30 vs. 18.5–24.9 kg/m2) was positively associated with parent estrogens (multivariable adjusted GM for unconjugated estrone: 78.90 (66.57–93.53) vs. 50.89 (43.47–59.59), p-value < 0.0001; and unconjugated estradiol: 27.83 (21.47–36.07) vs. 13.26 (10.37–16.95), p-value < 0.0001). Independent of unconjugated estradiol, measured BMI was associated with lower levels of 2-pathway metabolites and higher levels of 16-ketoestradriol. Similar patterns of association were found with WHR; however, the associations were not entirely independent of BMI. Height was not associated with postmenopausal estrogens/estrogen metabolite levels in African women.ConclusionsWe observed strong associations between measured BMI and parent estrogens and estrogen metabolite patterns that largely mirrored relations that have previously been associated with higher breast cancer risk in postmenopausal White women. The consistency of the BMI-estrogen metabolism associations in our study with those previously noted among White women suggests that estrogens likely explain part of the BMI-postmenopausal breast cancer risk in both groups. These findings merit evaluation in Black women, including prospective studies.

Relation of circulating estrogens with hair relaxer and skin lightener use among postmenopausal women in Ghana.

Hair relaxers and skin lighteners have been commonly used by African women, with suggestions that they may have hormonal activity. To investigate the relationship of hair relaxer and skin lightener use to serum estrogen/estrogen metabolite levels. We utilized the postmenopausal population-based controls of the Ghana Breast Health Study to estimate adjusted geometric means (GM) and 95% confidence intervals of individual circulating estrogen levels by hair relaxer/skin lightener exposure categories. Of the 585 postmenopausal women included in our analysis, 80.2% reported hair relaxer use and 29.4% skin lightener use. Ever hair relaxer use was positively associated with estriol (adjusted GM 95.4 pmol/L vs. never 74.5, p value = 0.02) and 16-epiestriol (20.4 vs. 16.8, p value = 0.05) particularly among users of lye-based hair relaxers. Positive associations between scalp burns and unconjugated estrogens were observed (e.g., unconjugated estrone: 5+ scalp burns 76.9 [59.6-99.2] vs. no burns 64.0 [53.7-76.3], p-trend = 0.03). No association was observed between use of skin lighteners and circulating estrogens. This study presents evidence that circulating 16-pathway estrogens (i.e., estriol and 16-epiestriol) may be increased in users of lye-based hair relaxer products. Among hair relaxer users, unconjugated estrogen levels were elevated in women with a greater number of scalp burns. In this population-based study of hair relaxer and skin lightener use among postmenopausal women in Ghana, altered estrogen metabolism was observed with hair relaxer use, particularly among women using lye-based products or with a greater number of scalp burns. In contrast, skin lightener use was not associated with differences in estrogen metabolism in this population. Continued investigation of the potential biological impact on breast cancer risk of hair relaxer use is warranted.

The Effect of Postmenopausal Osteoporosis on Middle Ear Resonance Frequency.

Background: The effect of postmenopausal osteoporosis on the middle ear mechano-acoustic system is unknown. The aim of this study is to investigate whether or not middle ear resonance frequency is affected in females with postmenopausal osteoporosis.Methods:The study included postmenopausal women aged 45-60 years, separated into 2 groups as females with postmenopausal osteoporosis and healthy postmenopausal females (control group). A detailed anamnesis was taken from all subjects and then the ear, nose, and throat examinations were done followed by pure tone audiometry, tympanometry, and multifrequency tympanometry tests. The groups were compared in respect of pure tone average, bone conduction threshold, RF, static admittance, and tympanometric peak pressure values.Results: The mean age of the patients was 59.2 ± 4.53 years (range, 48-65 years) in the postmenopausal osteoporosis group and 57.11 ± 4.27 years (range, 48-65 years) in the control group (P > .05). The mean resonance frequency values for the postmenopausal osteoporosis and control group were 954.41 ± 127.47 and 935.29 ± 126.39 Hz (P > .05 ). The mean static admittance values for the postmenopausal osteoporosis and control group were 0.82 ± 0.33 and 0.85 ± 0.3 mmho, and mean tympanometric peak pressure values were −7.35 ± 18.52 and −6.94 ± 19.52 daPa (P > .05 for both static admittance and tympanometric peak pressure). The mean pure tone averagevalues for the postmenopausal osteoporosis and control group were 20.96 ± 6.82 and 15.60 ± 7.81 dB, and mean bone conduction threshold values were 17.57 ± 6.03 and 12.10 ± 6.52 dB (P < .05 for both pure tone average and bone conduction threshold).Conclusions: The results showed that the middle ear resonance frequency values were not affected in postmenopausal osteoporosis patients, but there was seen to be greater sensorineural hearing loss in females with postmenopausal osteoporosis compared to healthy postmenopausal females.