Pre-M Group Research Articles

The impact of menopausal status on auditory brainstem responses

ObjectiveTo determine the effect of decreased estrogen levels due to menopause on auditory brainstem response measurements (ABR). Study designRetrospective chart review. SettingAcademic. PatientsPre- and post-menopausal females (pre-M, post-M) and age-matched males. MethodsABR measurements of wave I, III, and V latencies, and interpeak latencies; amplitudes of waves I, III, V, and V/I ratio. Outcome measureDifferences in ABR measurements between pre-M and post-M. Results164 subjects (101 female and 64 male) were included. Post-M had significantly greater latencies (msec) than pre-M of wave V. Post-M had a significantly smaller wave I amplitude (uV) than pre-M. Post-M had a significantly higher wave V/I amplitude ratio than pre-M. Pre-M had significantly shorter latencies than young males for wave III, and wave V. Post-M had significantly shorter latencies than older males at wave III, and wave V. A two-way ANOVA revealed a significant interaction between the effects of age category and gender on V/I amplitude. ConclusionPost-M group showed a significant drop in wave I amplitude compared with pre-M group, even in the absence of hearing loss, suggesting that the gender differences in hearing are related to estrogen signaling along the auditory pathway. If wave I amplitude changes between older and younger groups resulted from decreased peripheral hearing sensitivity, we would expect larger drops in amplitude in males since rates of presbycusis are higher. We observed much larger drops in wave I amplitude in females, which cannot be attributed to peripheral hearing loss. These results may assist in understanding gender differences in presbycusis and a possible protective effect of estrogen on the auditory system. Knowledge of gender differences in wave I may be important when ABR is used to assess possible synaptopathy.

Differences in the Presentation and Outcome between Premenopausal and Postmenopausal Primary Hyperparathyroidism Indian Women: A Single-Center Experience.

Primary hyperparathyroidism (PHPT) is an endocrine disorder wherein enlargement of one or more of the parathyroid glands causes autonomous overproduction of the parathyroid hormone (PTH), which leads to high serum calcium levels. The objective of this study was to compare the clinical, laboratory, and operative variables between premenopausal (pre-M) and postmenopausal (post-M) women with PHPT. A retrospective analysis of the data of female patients who underwent surgery for PHPT at a single center, from January 2011 to December 2020, was done. Patients with familial PHPT and secondary hyperparathyroidism were not included. Of the 130 women with PHPT, 44.6% were pre-M and 55.4% were post-M. A significantly higher number of pre-M females were symptomatic compared to post-M females (pre-M vs. post-M, 84.5% vs. 68.1%, P = 0.031). Renal calculi were more common in pre-M women (34.5% vs. 18.1%, P = 0.032), while the rest of the clinical features were comparable between the two groups. The proportion of women with osteoporosis (6.7% vs. 19.4%, P = 0.071), hypertension (13.8% vs. 34.7%, P = 0.012), and diabetes mellitus (3.5% vs. 16.7%, P = 0.033) was lesser in the pre-M group. Elevated serum alkaline phosphatase levels were significantly more prevalent in the pre-M group (37.9% vs. 20.8%, P = 0.032). The mean serum calcium (12.35 ± 1.28 vs. 11.96 ± 1.22 mg/dL, P = 0.079), median serum PTH (334 vs. 239 pg/mL, P = 0.051), and median weight of the operated adenomas (1.75 vs. 1.45 g, P = 0.075) were also higher in pre-M females. The proportion of ectopic adenomas and multiple adenomas, presurgery adenoma localization rates, and disease cure rates did not differ according to the menopausal status. The occurrence of postoperative hungry bone syndrome was higher in the pre-M women (15.5% vs. 1.4%, P = 0.008). The majority of women with PHPT are post-M, but symptomatic presentation is more common in pre-M females. The severity of the disease appears to be more in pre-M women; however, imaging and operative variables generally did not significantly differ between the two groups.

Plasma Adipokines Profile in Prepubertal Children with a History of Prematurity or Extrauterine Growth Restriction.

Adipose tissue programming could be developed in very preterm infants with extrauterine growth restriction (EUGR), with an adverse impact on long-term metabolic status, as was studied in intrauterine growth restriction patterns. The aim of this cohort study was to evaluate the difference in levels of plasma adipokines in children with a history of EUGR. A total of 211 school age prepubertal children were examined: 38 with a history of prematurity and EUGR (EUGR), 50 with a history of prematurity with adequate growth (PREM), and 123 healthy children born at term. Anthropometric parameters, blood pressure, metabolic markers and adipokines (adiponectin, resistin, leptin) were measured. Children with a history of EUGR showed lower values of adiponectin (μg/mL) compared with the other two groups: (EUGR: 10.6 vs. PREM: 17.7, p < 0.001; vs. CONTROL: 25.7, p = 0.004) and higher levels of resistin (ng/mL) (EUGR: 19.2 vs. PREM: 16.3, p =0.007; vs. CONTROL: 7.1, p < 0.001. The PREM group showed the highest values of leptin (ng/mL), compared with the others: PREM: 4.9 vs. EUGR: 2.1, p = 0.048; vs. CONTROL: 3.2, p = 0.029). In conclusion, EUGR in premature children could lead to a distinctive adipokines profile, likely associated with an early programming of the adipose tissue, and likely to increase the risk of adverse health outcomes later in life.

Prematurity With Extrauterine Growth Restriction Increases the Risk of Higher Levels of Glucose, Low-Grade of Inflammation and Hypertension in Prepubertal Children

Introduction: An adipose tissue programming mechanism could be implicated in the extrauterine growth restriction (EUGR) of very preterm infants with morbidity in the cardiometabolic status later in life, as has been reported in intrauterine growth restriction. The aim of this study was to assess whether children with a history of prematurity and EUGR, but also with an adequate growth, showed alterations in the metabolic and inflammatory status.Methods: This was a case–control study. A total of 88 prepubertal children with prematurity antecedents were selected: 38 with EUGR and 50 with an adequate growth pattern (PREM group). They were compared with 123 healthy children born at term. Anthropometry, metabolic parameters, blood pressure (BP), C-reactive protein, hepatocyte growth factor (HGF), interleukin-6 (IL-6), IL-8, monocyte chemotactic protein type 1 (MCP-1), neural growth factor, tumour necrosis factor-alpha (TNF-α) and plasminogen activator inhibitor type-1 were analysed at the prepubertal age.Results: EUGR children exhibited higher BP levels and a higher prevalence of hypertension (46%) compared with both PREM (10%) and control (2.5%) groups. Moreover, there was a positive relationship between BP levels and values for glucose, insulin and HOMA-IR only in children with a EUGR history. The EUGR group showed higher concentrations of most of the cytokines analysed, markedly higher TNF-α, HGF and MCP-1 levels compared with the other two groups.Conclusion: EUGR status leads to cardiometabolic changes and a low-grade inflammatory status in children with a history of prematurity, and that could be related with cardiovascular risk later in life.

EP31.08: Does hormonal status influence uterine venous diameter?

Pelvic venous congestion (PVC) primarily affects premenopausal (Pre-M) women and is characterised by evidence of pelvic varicosities on transvaginal ultrasound (TVS). Postmenopausal (Po-M) women rarely exhibit these symptoms suggesting that hormonal influence is a definite factor. The aim of this study was to examine the affect hormonal status has on vein diameter. This was a single-centre, prospective cross-sectional study of women attending our general gynecology clinic during a 16-month period. Demographic data and a full medical/surgical history were recorded. Exclusion criteria included age<18 years, previous hysterectomy, contraindication to/declining TVS and evidence of pelvic pathology on TVS. All women underwent TVS assessment of the pelvic organs and pelvic veins. The Mann Whitney U-test was used to compare the diameters between Pre-M and Po-M women. Linear regression was performed to examine whether exogenous hormone use influenced venous diameter. 486 women had normal pelvic organs out of 1500 women examined. Of these, 375 were Pre-M and 111 were Po-M. Overall, the pelvic vessel diameters were smaller in Po-M women, with statistical significance observed in the right vein and both sides combined. Exogenous hormone use in the Pre-M group was associated with smaller vessel diameters, with statistical significance in the left vein (p = 0.001). There was no association between vein diameter and HRT use in the Po-M group (p = 0.98 left vein; p = 0.64 right vein). Our findings showed that Pre-M women have larger pelvic veins than Po-M women. These findings provide further insight into the biomechanics of veins and hence suggest that they are sensitive to hormonal fluctuations. This is further supported by our findings revealing that suppression of ovarian activity with hormones in Pre-M women leads to a reduction in vein diameter, which is often treatment for PVC. EP31.08: Table 1. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Age and leptinemia association with anxiety and depression symptoms in overweight middle-aged women.

The aim of the study was to investigate the effect of menopause and of postmenopausal stages on depression and anxiety symptoms, and whether these symptoms associate with anthropometric, metabolic, and hormonal parameters in midlife women. Postmenopausal women (age 50-65), either at early (EPM, n=33) or late (LPM, n = 23) postmenopause, and 23 premenopausal controls (PreM, age 40-50), matched for BMI with the PM groups, were studied. Blood biochemical and hormonal determinations, bioimpedance anthropometry, and depression and anxiety symptoms (Beck's depression [BDI] and anxiety [BAI] inventories) were conducted. The BAI score was higher in both PM groups than in the PreM group. In contrast, only the LPM group showed a significantly elevated BDI score. All groups presented overweight and abdominal obesity, having similar BMI and waist/hip ratio values. Both PM groups showed insulin resistance, whereas only the LPM group presented decreased skeletal muscle mass and basal metabolic rate. Correlation analysis, including all 79 middle-aged women, showed age, percentage body fat, waist/hip ratio, and leptinemia to correlate positively with the anxiety and depression scores. Multivariate regression showed leptin and age to associate positively with depressive- and anxious-like symptoms. Postmenopausal women presented impaired body composition, energy expenditure, insulin sensitivity, and mental symptoms, in comparison to similarly overweight premenopausal women. Among all the overweight midlife women, these symptoms were more strongly associated with age and leptin levels than with reproductive aging itself. The data indicate that, among overweight middle-aged women with abdominal obesity, the aging process and the development of leptin resistance are associated with impairment of mental health.

Abstract P3-08-10: A unique coding and non-coding benign breast transcriptome in post-menopausal ER+ breast cancer

Abstract Background: Differences in ER+ and ER- breast cancer tumor biology are well-documented, but little is known about the field of background benign breast in which those cancers arise. We evaluated the transcriptome of benign breast tissues from women with concurrent ipsilateral ER+ and ER- breast cancers (BC) to characterize coding and non-coding RNA profiles. This pilot study provides insight into the transcriptomic landscapes of benign breast tissues in patients with BC, and the microenvironment of the at-risk benign tissue. Methods: With institutional approval, cryobanked breast tissues from patients with concurrent ipsilateral ER+ BC (benign ER+BC, N=14) or ER- BC (benign ER-BC, N=10), were selected for benign tissues with similar epithelial:stromal ratios and grouped into pre (preM) and post-menopausal (PM) groups. Following RNA sequencing (Illumina TruSeq Stranded mRNA kit &amp; Illumina HiSeq 4000), reads were processed (MAP-RSeq v3.0.0) and aligned (STAR aligner; hg38). Differential expression (DE) analysis (edgeR 2.6.2) identified DE genes from normalized RPKM reads (absolute log2 fold change (FC) &amp;gt; 1 and false discovery rate (FDR) &amp;lt; 0.10), corrected for intra-group biases. Over-representation analysis [Ingenuity pathway analysis (IPA), Ingenuity® Systems] and gene set enrichment analysis [(GSEA), GeneTrail 2.0] identified significantly-enriched pathways. Results: In the PM group, there were 144 DE transcripts between benign ER+BC and benign ER-BC, including coding RNAs (40%), antisense RNAs (35%) and lncRNAs (7%). In contrast, the preM group had no significantly DE genes between benign ER+BC and benign ER-BC. In the PM DE coding gene set, the top DE transcripts in benign ER+BC included many genes implicated in BC development# or ER+ BC progression (*) (e.g. up-regulated: KAAG1*, DNAJB7/HSP40*, TMEM151B, ZBTB32# p &amp;lt; 0.001 ; down-regulated: CPB1*, FOS, TPPP3#, CLEC3B#p &amp;lt; 0.001). Top canonical pathways altered in benign ER+BC included MAPK, PI3K, and acute phase response pathways (p&amp;lt;0.05). GSEA of the entire gene set (N=15,223; ranked in order of 144 DE genes) identified 72 altered pathways (P &amp;lt; 0.005); those with the highest normalization enrichment scores (NES) (&amp;gt; 0.4) functionally grouped as immune function-related (T cell function and antigen presentation). Depleted pathways with NES &amp;gt; 0.4, (N=6) functionally grouped into proteasome-related, fatty acid biosynthesis and mitochondrial energy metabolism. Among the non-coding DE gene set, notably, the entire DE antisense RNA gene set (N=51 transcripts) was up-regulated in benign ER+ BC compared to benign ER-BC (P&amp;lt; 0.001) with a subset (N=11) showing marked up-regulation (&amp;gt; 4 log2FC). Among the DE antisense RNAs, 70% have reported roles in carcinogenesis or BC progression (e.g. KRT7-AS, NAV2-AS2, CCDC144NL-AS1, RP11-66B24.4, HSA-MIR4454). Conclusion: The benign breast transcriptome differs between postmenopausal women with ER+ vs ER- BC, with distinctive coding and non-coding RNA signatures. In postmenopausal women with ER+ BC, benign breast expresses a unique antisense RNA set and is enriched in genes implicated in BC development or progression. These data provide insight into at-risk benign breast and facilitate identification of potential biomarkers of carcinogenesis. Citation Format: Carter JM, Nair AA, Davila JI, Heinzen EP, Hoskin TL, Winham SJ, Radisky DC, Visscher DW, Degnim AC. A unique coding and non-coding benign breast transcriptome in post-menopausal ER+ breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-08-10.

The influence of the expression of steroid receptors on angiogenesis, proliferation and apoptosis in myomas of pre- and postmenopausal women

Introduction/Objective. The aim of this study was to determine the effects of the estrogen and progesterone receptor status on angiogenesis, proliferation, and apoptosis of myoma cells in premenopausal (PreM) and postmenopausal (PostM) women. Methods. This was a cross section; clinical-experimental, retrospective, non-interventional study in the field of the study of fundamental pathogenesis mechanisms of disease using pathohistological materials from the existing archive. The research included 76 patients diagnosed with uterine leiomyomas, operatively treated in the Clinic for Gynecology and Obstetrics, Clinical Centre Kragujevac, Serbia. According to the menstrual status, we formed two experimental subgroups. The first group was PreM women (n = 35; 46.2 ? 5.02 years old), and the second group was PostM women (n = 41; 60.25 ? 5.41 years old). Hematoxylin-eosin staining for myoma and myometrium was conducted, as well as immunohistochemistry for ER?, ER?, PR?, vascular endothelial growth factor, endoglin, Ki67, and caspase-3. Results. Progesterone receptor was overexpressed in myoma and myometrium of PreM compared to myoma and myometrium of PostM women. Expression of caspase-3 was a statistically significant increase in PostM women compared to PreM group. ER? and ER? were not changed among groups neither in myoma nor in myometrium samples. Conclusion. According to our data, PR? had higher influence on apoptosis and cell growth than estrogen receptors. Since PR? was increased in PreM in both myoma and myometrium, probably this expression led further to lower expression of apoptotic marker in PreM women.

Menopausal Status and Outcomes of BRCA Mutation Carriers with Breast Cancer

Outcomes based on menopausal status of breast cancer (BC) patients who are BRCA mutations carriers (BRCAm) are not well known. A prospective database identified 88 BRCAm with BC from 2005 to 2015. Of the 88 patients, 68 (77.3%) women were premenopausal (Pre-M) and 20 (22.7%) were postmenopausal (Post-M). In the Pre-M group, 52.9 per cent of patients had triple-negative (TN) BC, whereas in the Post-M group, there were more estrogen receptor +(65%; P = 0.129) and less TN (25%; P = 0.041) tumors. Median tumor size was significantly larger in the Pre-M group compared with the Post-M group (P <0.001). Pre-M women were more likely to present with stage III cancers (14.7% vs 0%, respectively, P = 0.082). Ten-year overall survival was 87.9 per cent in the Pre-M group and 93.8 per cent in the Post-M group (P = 0.44), and 25.3 per cent of Pre-M women had recurrences compared with 11.5 per cent of Post-M women (P = 0.24). Premenopausal BRCAm with BC are more likely to have TN, higher stage disease, and twice the number of recurrences at 10 years than Post-M BRCAm. Our study is the first to show worse BC outcomes for Pre-M BRCAm compared with Post-M BRCAm women.

Genetically Obese Human Gut Microbiota Induces Liver Steatosis in Germ-Free Mice Fed on Normal Diet.

Dysbiotic gut microbiota contributes to genetically obese phenotype in human. However, the effect of genetic obesity-associated gut microbiota on host hepatic metabolic deteriorations remains largely unknown. Gut microbiota from a genetically obese human donor before and after a dietary weight loss program was transplanted into germ-free C57BL/6J male mice, grouped as PreM and PostM groups, respectively. The gut microbiome, liver pathology and transcriptome response in the gnotobiotic mice were evaluated. After being fed on normal chow diet for 4 weeks, PreM group developed liver macrovesicular steatosis accompanied with higher concentrations of hepatic triglyceride and cholesterol, while PostM group exhibited normal hepatic physiology. The gut microbiota in PreM and PostM groups was significantly different from each other and was more resembling with their respective donor. RNA-sequencing revealed that, in comparison with PostM group, PreM group showed a foregoing pro-steatotic transcriptional response in liver featuring by the repression of lipid beta-oxidation and the activation of lipid absorption and cholesterol uptake before the pathology of liver steatosis. Moreover, peroxisome proliferator-activated receptor alpha (PPARα), which was repressed in PreM group, may act as crucial regulator of the hepatic transcriptional profile of lipid metabolism between two groups. Our results show that gut microbiota from a genetically obese human promotes the onset of liver steatosis by impacting hepatic transcriptional profile of lipid metabolism in mice. This adds new evidence that gut microbiota may play a causative role in the development of non-alcoholic fatty liver disease.

Visible-Near Infrared Spectroscopic Assessment of Urogenital Tissue in Premenopausal and Postmenopausal Women.

Background:A clinical study was conducted to evaluate the feasibility of using visible and near-infrared (NIR) spectroscopy as a potential noninvasive measure of genital skin health in premenopausal and postmenopausal women.Methods:A total of 45 female subjects (aged 21-70 years), all of whom gave fully informed consent to participate, were enrolled in the study and assigned to 1 of 3 groups: 15 premenopausal (Pre-M), 15 postmenopausal receiving hormone replacement therapy (Post-M HRT), and 15 postmenopausal receiving no form of hormone replacement therapy (Post-M non-HRT). Spectral measurements were taken at the vaginal mucosa, and spectral data were evaluated for the erythema index (EI), hemoglobin index (HI), bilirubin/β-carotene, and melanin. The color index (CI; calculated as the ratio of absorbance at 480 nm/540 nm) was also determined. Results were compared with previously published results on biomarkers and physical characteristic of genital tissue measured on the same groups of women.Results:Spectral measurements from the Post-M Non-HRT subjects indicated a significant reduction in HI compared with the Pre-M group (P = .0003) and to the Post-M HRT group (P < .0001). Similarly, EI was reduced in the Post-M Non-HRT (P < .0001 and P = .0041 for the Pre-M and Post-M HRT groups, respectively). In contrast, the Post-M Non-HRT subjects exhibited a significant increase in β-carotene compared with the Pre-M subjects (P = .0098). Bilirubin and melanin were not significantly affected. The Post-M Non-HRT group exhibited a significant increase in CI, indicating a shift away from the hemoglobin absorption region (510-620 nm wavelength) and toward the bilirubin/β-carotene absorption region (450-490 nm wavelength). This change was significant when compared with both the Pre-M group (P < .0001) and the Post-M HRT group (P = .0048). The changes in spectral measurements were consistent with previously reported changes in physical parameters (vaginal atrophy, increased pH, decreased skin temperature) and with decreased concentrations of the biomarkers histamine and histidine.Conclusions:Hemodynamic spectral characteristics differ in postmenopausal vaginal tissue compared with tissue in premenopausal women, with decreased absorbance in the hemoglobin absorption region (510-620 nm wavelength) and an increased absorbance in the bilirubin/β-carotene absorption region (450-490 nm wavelength). A change in absorbance in the visible and NIR wavelengths is a promising, additional measure of genital skin health related to menopause and vulvovaginal atrophy.

Urogenital Biomolecular and Physical Measures in Pre- and Post-Menopausal Women

Background: A clinical study was conducted to evaluate biomolecules and physical measures in the urogenital skin of pre-menopausal and post-menopausal women. Methods: A total of 45 female subjects (aged 21 - 70 years) were enrolled in the study and assigned to one of three groups: 15 pre-menopausal (pre-M), 15 post-menopausal receiving no form of hormone replacement therapy (post-M non-HRT), and 15 post-menopausal receiving HRT (post-M HRT). Self-assessed symptoms were recorded from each group (i.e. dryness, itch and difficulty with intercourse). Skin temperature and pH, and quantification of biomolecules (via tape strip samples) were obtained from the labia majora, labia minora and introitus. Vaginal pH was also collected. Results: More post-menopausal subjects (HRT and non-HRT) reported genital symptoms of external and vaginal dryness, and difficulties with intercourse. External genital skin itch was reported more frequently in the post-M non-HRT group. Skin temperature was lower in both post-M groups indicating reduced blood perfusion. The pH was significantly higher for the post-M non-HRT group at the vagina, introitus and labia minora compared to the pre-M group. Histamine was significantly reduced in both post-M groups; however, histamine levels did not correlate with complaints of itching. The concentration of natural moisturizing factors (NMFs) did not differ consistently between groups. Concentrations of IL-1α tended to be lower in the pre-M group at all three body sites. Conclusions: This is the first report of non-invasive measures of temperature, pH, biomolecules of vulvar tissue in post- and pre-menopausal women. Based on results of histamine analyses, we propose that reduced histamine levels in post-menopausal women are related to sexual and lubrication difficulties, and reduced blood perfusion. J Clin Gynecol Obstet. 2015;4(3):237-250 doi: http://dx.doi.org/10.14740/jcgo347e

Long-term results of single-procedure catheter ablation for atrial fibrillationin pre- and post-menopausal women.

ObjectivesTo address whether menopause affects outcome of catheter ablation (CA) for atrial fibrillation (AF) by comparing the safety and long-term outcome of a single-procedure in pre- and post-menopausal women.MethodsA total of 743 female patients who underwent a single CA procedure of drug-refractory AF were retrospectively analyzed. The differences in clinical presentation and outcomes of CA for AF between the pre-menopausal women (PreM group, 94 patients, 12.7%) and the post-menopausal women (PostM group, 649 patients, 87.3%) were assessed.ResultsThe patients in the PreM group were younger (P < 0.001) and less likely to have hypertension (P < 0.001) and diabetes (P = 0.005) than those in the PostM group. The two groups were similar with regards to the proportion of concomitant mitral valve regurgitation coronary artery disease, left atrium dimensions, and left ventricular ejection fraction. The overall rate of complications related to AF ablation was similar in both groups (P = 0.385). After 43 (16–108) months of follow-up, the success rate of ablation was 54.3% in the PreM group and 54.2% in the PostM group (P = 0.842). The overall freedom from atrial tachyarrhythmia recurrence was similar in both groups. Menopause was not found to be an independent predictive factor of the recurrence of atrial tachyarrhythmia.ConclusionsThe long-term outcomes of single-procedure CA for AF are similar in pre- and post-menopausal women. Results indicated that CA of AF appears to be as safe and effective in pre-menopausal women as in post-menopausal women.

Mediterranean diet and bone mineral density in two age groups of women

We hypothesized that adherence to the Mediterranean diet measured as a Mediterranean diet score (MDS) has a beneficial effect on bone mineral density (BMD). For the purposes of this study, a sample of healthy women from Southern Spain was chosen. Subjects were grouped into two major groups: a first group consisted of women of reproductive age (premenopausal, pre-M) and a second group consisted of postmenopausal women (pos-M). The consumption of vegetables and fruit was found to be significantly related to BMD in both groups of subjects studied. In the pre-M group, the lipid ratio was positively associated with BMD and in pos-M women nuts intake was also associated with BMD. After implementing the analysis of covariance analysis, significant linear trends between the MDS and BMD were observed in all subjects studied. Our results indicate that a varied diet based on Mediterranean diet patterns may be beneficial in the prevention of osteoporosis.

Menopause alters temperature sensitivity of muscle force in humans

Isometric maximum voluntary force (MVF) of the adductor pollicis and first dorsal interosseous muscles was measured in 11 pre- and 11 post-menopausal (Pre-M and Post-M) human subjects. The temperature of the hand varied in the range 18°-38°C by water immersion and skin temperature was recorded. MVF at each temperature was expressed relative to the value at skin temperature above 35°C to give MVF(REL). The form of the relation between MVF(REL) and temperature was different in the Pre-M and Post-M groups (p < 0.01). In the Pre-M group the maximum value of MVF(REL) occurred near 30°C and force fell at both higher and lower temperatures. In the Post-M group MVF(REL) showed an approximately linear decline with cooling across the whole temperature range. The maximum value of MVF(REL) for the Post-M group was near 35°C. The values of MVF(REL) for the Post-M group were significantly lower than for the Pre-M group at temperatures between 18° and 30°C.

Pesticide exposure of two age groups of women and its relationship with their diet

The widespread presence of organochlorine (OC) pesticides in human samples may be explained by the environmental exposure of the population. Foods are considered a constant source of exposure, despite compliance with maximum permitted residue levels. This study aimed to examine the relationship between nutritional habits of women in Southeast Spain and their serum concentrations of OCs. A semi-quantitative questionnaire was used to estimate the frequency of consumption of foods by two age groups of women, pre-menopausal (Pre-M) and post-menopausal (Post-M), and their serum pesticide levels were measured by gas chromatography (GC) with electron capture detector and confirmed by GC and mass spectrometry. The Pre-M group showed significantly higher serum concentrations of all OCs studied with the exception of DDE. The groups significantly differed in consumption of all food groups with the exception of fruit. In the Pre-M group, the mean serum p,p-DDT concentration was significantly associated with milk/yoghurt (p<0.045) and red meat (p<0.023), serum o,p-DDT with red meat (p<0.049), serum aldrin with eggs (p<0.038) and poultry (p<0.024), and serum DDE with eggs (p<0.025). In the Post-M group, serum lindane was associated with fresh and cured cheese (p<0.001), red meat (p<0.001) and white and oily fish (p<0.001), and both serum DDE and dieldrin were associated with fresh cheese, cured cheese, red meat, and white and oily fish (p<0.001). These results confirm foods as a source of human exposure to persistent organic molecules. Consideration should be given to the reduction of permitted residue levels to minimize this threat to human and animal health.

Cutoff Values of Intra-Abdominal Fat Area for the Prevention of Metabolic Disorders in Women

0087 Japan Society for the Study of Obesity has originally proposed a cutoff value for intra-abdominal fat area (IFA) as “visceral fat obesity” (IFA > = 100 cm2) for Japanese adults. However, there are no studies on the effects of menopause and weight reduction on the cutoff value. PURPOSE: The purpose of this study was to determine a new cutoff value of IFA for pre- and post-menopausal groups before and after they reduce weights. METHODS: One hundred and forty-nine pre-menopausal women (PreM group, 43.3 y, 27.3 kg/m2) and 58 post-menopausal women (PostM group, 53.9 y, 27.7 kg/m2) participated in a 14-wk weight reduction program (diet and exercise). IFA was measured by computed tomography. The receiver operating characteristics (ROC) curve analysis was applied for the data of each group before and after the program in order to determine the cutoff value. RESULTS: The program induced significant reductions in body weight of 8.6 kg in PreM and 7.8 kg in PostM. The numbers of metabolic disorder (hyperglycemia, dyslipidemia, or hypertension) were significantly decreased from 1.10 ± 1.13 to 0.50 ± 0.78 in PreM and from 1.64 ± 1.22 to 0.84 ± 0.91 in PostM. The ROC curve analyses revealed that the appropriate cutoff values were 80 cm2 in PreM and 110 cm2 in PostM before the weight reduction program, while the appropriate cutoff values after weight reduction were determined as 40 and 80 cm2, respectively. CONCLUSIONS: It would appear that the cutoff value (100 cm2) for metabolic disorder should be lower for those who were pre-menopausal or reduced their weights.

Effects of estrogen on gender-related autonomic differences in humans.

Our previous studies demonstrated that premenopausal women have dominant vagal and subordinate sympathetic activity compared with age-matched men. This study was designed to investigate the role of estrogen in gender-related autonomic differences. We evaluated the heart rate variability of four healthy groups: age-matched postmenopausal women without hormone replacement therapy (PM), postmenopausal women on conjugated estrogen replacement therapy (PME), men, and non-age-matched premenopausal women (PreM). Frequency-domain analysis of short-term and stationary R-R intervals was performed to evaluate low-frequency power (LF; 0.04-0.15 Hz), high-frequency power (HF; 0.15-0.40 Hz), the ratio of LF to HF (LF/HF), and LF in normalized units (LF%). No gender-related autonomic differences existed between the PM and men groups, but they did exist between the PME and men group. Compared with the PreM group, the PM group had a lower HF and higher LF% and LF/HF. Compared with the PM group, the PME group had a higher HF but lower LF% and LF/HF. These results suggest that conjugated estrogen replacement therapy may facilitate vagal and attenuate sympathetic regulation of heart rate in postmenopausal women. In addition, estrogen may play an important role in gender-related autonomic differences.

Menopause, coronary artery disease and antioxidants.

The aim of this study was to examine the influence of menopause on the activity of primary intracellular antioxidant enzymes, superoxide dismutase (SOD), glutathione peroxidase (GPx) as well as on the level of total antioxidant status (TAS) in healthy women and women with coronary artery disease (CAD). We studied 140 women divided into two groups. The first group (controls) consisted of 99 healthy women aged between 18 and 55 years) classified into three subgroups: pre-menopausal women (Pre-M; n=48), peri-menopausal women (Peri-M; n=22) and post-menopausal women (Post-M; n=29). The second group consisted of 41 women with CAD aged between 48-68 years, classified into two subgroups: Peri-M (n=20) and Post-M (n=21). The activity of GPx and the level of TAS were significantly decreased in Peri-M (p<0.005) and Post-M groups (p<0.001) in comparison with the Pre-M group. SOD was decreased in Peri-M and Post-M groups compared with the Pre-M group, but this was statistically not significant. The activity of SOD and GPx as well as TAS were significantly decreased in the Post-M group compared with the Peri-M group with CAD (p<0.001). The activity of the antioxidant enzymes in Peri-M and Post-M groups was significantly decreased (p<0.02) in comparison with the control group. TAS was not changed in women with CAD in comparison with controls. In conclusion, menopause leads to the reduction of the level of antioxidants, especially in women with CAD.

Hormone replacement therapy and urinary prostaglandins in postmenopausal women

The objective of the study was to observe the effects of hormone replacement therapy upon urinary prostaglandin E 2 and prostaglandin F 2 α levels in postmenopausal patients. A total number of 55 women were enrolled in this study and 15 premenopausal (PreM) healthy subjects constitute the control group. A total of 40 patients at least 12 months after their natural menopause were divided into two groups: 15 of them was not medicated hormone replacement therapy (which composed NRHRT group) while 25 of the rest, received conjugated estrogen (Premarin) 0.625 mg/day orally plus medroxyprogesterone acetate (Farlutal) 10 mg/day orally built up the RHRT group. PGE 2 and PGF 2 α levels were measured with PGE 2 [ 125I] and PGF 2 α [ 3H] RIA kits. Statistical significance was analyzed by Student’s t-test for impaired data. NRHRT and RHRT patients had had increased urinary PGE 2 levels when compared with PreM ( P<0.001). HRT caused a significant decrease in PGE 2 levels in menopausal women ( P<0.001). Urinary PGF 2 α values of NRHRT and RHRT were significantly lower ( P<0.001) in comparison with PreM group. There was no difference in PGF 2 α values between two postmenopausal groups. HRT given to postmenopausal patients might have a positive impact on prostaglandins and therefore on bone turnover in a series of various mechanisms.