Time Points In Women Research Articles

Associations between body height and cardiovascular risk factors in women and men: a population-based longitudinal study based on The Tromsø Study 1979–2016

ObjectivesInvestigate associations between body height and cardiovascular disease risk factors at several time points in women and men across educational levels in Norway.DesignPopulation-based longitudinal study.SettingThe Tromsø Study, a population-based study...

Health-related quality of life among women diagnosed with in situ or invasive breast cancer and age-matched controls: a population-based study

PurposeA breast cancer (BC) diagnosis may negatively affect health-related quality of life (HRQoL). However, there are few comparisons of HRQoL at several time points for women with BC, and particular when subdivided into invasive and in situ tumors. The purpose of this study was to investigate various aspects of HRQoL in women recently diagnosed with invasive BC or ductal carcinoma in situ (in situ) compared to age-matched BC free controls in a population-wide sample recruited through the Cancer Registry of Norway.MethodsThis cross-sectional study utilized HRQoL data collected in 2020–2022 from a digital survey including 4117 cases (3867 women with invasive BC and 430 with in situ) and 2911 controls. HRQoL was assessed ≥ 21 days after diagnosis, using EORTC QLQ-C30. This includes scores assessing global quality of life (gHRQoL) and HRQoL functions and symptoms. Multivariable regression analyses were used to compare HRQoL between cases and controls and to identify factors associated with gHRQoL and fatigue. Additionally, HRQoL 14 months after diagnosis was analyzed in 1989 of the included cases and in 1212 of the controls. Score differences of ≥ 10 points were considered clinically relevant and thus presented in the results.ResultsInvasive BC cases had lower gHRQoL, role- and social functioning in addition to more fatigue than controls. In situ cases had lower role—and social functioning than controls. Invasive BC cases scored worse than in situ on all domains, but the differences were not considered clinically relevant. Physical activity was associated with better gHRQoL and less fatigue in invasive BC, in situ and controls. Both invasive BC and in situ cases improved their role- and social functioning scores from diagnosis to 14 months follow-up, however no improvement was seen for fatigue.ConclusionWomen with invasive BC and in situ reported lower role- and social functioning scores than controls right after diagnosis with improvements 14 months after diagnosis. Physical activity was associated with better gHRQoL and less fatigue and should, whenever possible, play a key role in the care for BC patients.

Factors Associated With Domestic Violence Against Women at Different Stages of Life: Findings From a 19-Year Longitudinal Dataset From the MINIMat Trial in Rural Bangladesh (2001-2020).

Despite the abundance of literature, longitudinal studies evaluating the factors associated with domestic violence (DV) at different stages and over longer periods of women's lives are rare. We evaluated factors associated with physical and sexual DV during pregnancy, at 10-year, and 18-year follow-ups after pregnancy and within a 19-year period of life using a cohort of women (n = 1,126) who participated in the Maternal and Infant Nutrition Interventions, Matlab trial in rural Bangladesh. Data on women's experience of DV, social and economic characteristics, empowerment, and family condition were recorded in a similar manner during pregnancy and at 10- and 18-year follow-ups, using standard questionnaires. Multivariate logistic regression models and generalized estimating equations were used to evaluate factors associated with women's experience of physical and sexual violence at each discrete time point and over a period of 19 years, respectively. During pregnancy, women were more likely to experience violence if they were members of microcredit programs/non-governmental organizations (NGOs), living in an extended family and had lower wealth status. At the 10- and 18-year follow-ups, higher levels of decision-making and higher wealth status were protective against the experience of violence. At the 18-year follow-up, women with larger age differences from their husbands were less likely to experience violence, while membership in microcredit programs/NGOs was associated with higher odds of experiencing violence among women. Within a period of 19 years, a higher level of education, living in an extended family, higher decision-making level and higher wealth index were protective against the experience of violence, while membership in microcredit programs/NGOs was a risk factor. In conclusion, this study showed that correlates of violence might change at different time points in women's life. Thus, policies and programs should consider the stage of women's lives while planning interventions for addressing violence against women.

Gunther Tulip Filter Strut Penetration: Benign Long-Term Follow-up

PurposeTo describe the natural history of Gunther Tulip filter (GTF) strut penetration based on the computed tomography (CT)–documented distance penetrated over time and any clinical manifestations. Materials and MethodsThe records of 203 patients (mean age, 59.1 years; 59.4% men) who had had an infrarenal GTF placed for venous thromboembolism (84.2%) with contraindications to anticoagulation (95.1%) and had CT follow-up were reviewed retrospectively for clinical or imaging evidence of complications. Filter strut penetration was measured on axial images from the outer caval wall to the inner edge of the distal end of each strut. Filter strut behavior over time was modeled using a linear mixed model. ResultsThe extent of penetration correlated positively with filter dwell time (P < .001) but plateaued at 3.3 mm at 10-year follow-up. At median 4.7-year follow-up 79.3% of patients had at least 1 strut that was >0.2 mm and 31% had a strut >3 mm from the inferior vena caval wall. The extent of strut penetration was greater at all time points for women (P = .002). Abutment or entry into an adjacent structure was identified in 183 struts of 105 (52.7%) filters; of the 80 filters with CT follow-up, 47% showed progression and 19% regressed. There were no symptoms referable to filter strut penetration. ConclusionsGTF struts often penetrate the inferior vena cava progressively; however, this tends to plateau by 10 years. The limited long-term progression and a very low incidence of symptomatic complications together support a noninterventional approach to the finding of an asymptomatic GTF strut penetration.

Pain Reduction With an Immersive Digital Therapeutic Tool in Women Living With Endometriosis-Related Pelvic Pain: Randomized Controlled Trial.

BackgroundChronic pelvic pain is a common and disabling condition in women living with endometriosis. Pharmacological and surgical treatments are not always effective at controlling pain and present important restrictions. Digital therapeutics (DTx) are emerging as major nonpharmacological alternatives that aim to extend the analgesic therapeutic arsenal of patients.ObjectiveIn this randomized controlled trial (RCT), we aimed to measure the immediate and 4-hour persisting effects of a single use 20-minute DTx (Endocare) on pain in women experiencing pelvic pain due to endometriosis.MethodsA total of 45 women with endometriosis participated in a randomized controlled study comparing the analgesic effect of a single use of a virtual reality digital treatment named Endocare (n=23, 51%) to a 2D digital control (n=22, 49%). Perceived pain and pain relief were measured before the treatment and 15, 30, 45, 60, and 240 minutes after the end of the treatment.ResultsThe clustered posttreatment pain was significantly reduced compared to the pretreatment for both Endocare and the control group (all P<.01). Endocare was significantly more effective than the control group (all P<.01). Endocare decreased the mean pain intensity from 6.0 (SD 1.31) before the treatment to 4.5 (SD 1.71) posttreatment, while the control only decreased it from 5.7 (SD 1.36) to 5.0 (SD 1.43). When comparing each posttreatment measures to the pretest, Endocare significantly reduced pain perception for all points in time up to 4 hours posttreatment. The differences did not reached significance for the control group. Moreover, Endocare was significantly superior to the control group 15, 30, and 45 minutes after the treatment (all P<.001). The mean perceived pain relief was significantly higher for Endocare at 28% (SD 2%) compared to the control, which was 15% (SD 1%) for all the posttreatment measurements (all P>.05).ConclusionsOur study aimed to test the effects of a single use of a DTx treatment on reported pain at different time points in women diagnosed with endometriosis experiencing moderate-to-severe pelvic pain. Importantly, our results support that Endocare, a virtual reality immersive treatment, significantly reduce pain perception compared to a digital control in women living with endometriosis. Interestingly, we are the first to notice that the effect persisted up to 4 hours posttreatment.Trial RegistrationClinicalTrials.gov NCT04650516; https://tinyurl.com/2a2eu9wv

Food preferences throughout the menstrual cycle – A computer-assisted neuro-endocrino-psychological investigation

BackgroundAs eating behavior changes in relation to the menstrual cycle and weight changes with menopausal transition, ovarian hormones appear to be involved in regulating eating behavior. However, observations are contradictory and are difficult to compare, due to methodological problems related to nutritional epidemiology. To better understand the relationship between ovarian steroid hormones and eating behavior, our study evaluates women's responses to visual food cues at different points in the menstrual cycle with their specific serum estrogen/progesterone levels and women's responses in the case of strong estrogen changes in the context of fertility treatments. MethodsWe collected data from 129 women, 44 of whom received in vitro fertilization (IVF) at the Department of Reproductive Endocrinology, University Hospital Zurich. A total of 85 women with natural cycles were recruited at the University Hospital Zurich (n = 37) and at the Hannover Medical School (n = 48). Our observational study used 4 different measurement time points across the natural cycle and 2 measurement time points in women with supraphysiological estradiol levels during fertility treatments. Using a second cycle, we then tested our results for replication. At these predefined time points, women were shown pictures of 11 categories of food, with 4 items for each category and blood samples for measurement of hormone levels were taken. Food preferences registered at the time of the investigation were indicated on a visual analogue scale (0–100). ResultsWe did not find any statistically significant association between women's serum hormone levels and the rating of visually presented food, either during the menstrual cycle or during fertility treatments after controlling for multiple testing (all p > 0.005). Ratings for fruits, vegetables, and carbohydrates showed a significant linear decline throughout the first menstrual cycle (p < 0.01), which did not replicate in the second cycle (p > 0.05). In contrast, the ratings for sweets showed a significant linear decline in both cycles (both p < 0.01), with a mean rating of 54.2 and 48.8 in the menstrual phase of the first and second cycle, respectively, to a mean rating of 47.7 and 43.4 in the premenstrual phase of the first and second cycle, respectively. During fertility treatments, no food rating showed a significant change (all p > 0.05). Mood such as negative and positive affects did not influence ratings for visual food cues neither throughout the menstrual cycles nor during fertility treatment. ConclusionsSerum levels of estradiol and progesterone do not correlate with food ratings in women, even when estradiol levels are above the physiological level of a natural menstrual cycle. Since, except for sweets, significant changes in food ratings in a first cycle did not replicate in a second menstrual cycle, significant findings from the literature based on animal or human studies focusing on a single-cycle have to be interpreted with caution.

Prenatal and childhood exposure to per- and polyfluoroalkyl substances (PFAS) and child executive function and behavioral problems

Early life exposure to per- and polyfluoroalkyl substances (PFAS) may adversely impact neurodevelopment, but epidemiological findings are inconsistent. In the Project Viva pre-birth cohort, we examined associations of prenatal and childhood PFAS plasma concentrations with parent and teacher assessments of children's behavior problems [Strengths and Difficulties Questionnaire (SDQ)] and executive function abilities [Behavior Rating Inventory of Executive Function (BRIEF)] at age 6–10 years (sample sizes 485–933). PFAS concentrations in pregnant Project Viva mothers (in 1999–2002) and children at ages 6–10 (in 2007–10) were similar to concentrations at similar time points in women and children in the nationally representative U.S. National Health and Nutrition Examination Survey. We observed no consistent associations of prenatal PFAS concentrations with behavior or executive function. Childhood concentrations of perfluorooctanoate (PFOA), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), perfluorononanoate (PFNA) and perfluorodecanoate (PFDA) were associated with higher parent-rated SDQ Total Difficulties scores (mean = 6.7, standard deviation (SD) = 4.9), suggesting greater behavioral problems (top (Q4) versus bottom (Q1) quartile PFOA: 1.5, 95% confidence interval (CI): 0.3, 2.7; PFOS: 1.4, 95% CI: 0.3, 2.5; PFHxS: 1.2, 95% CI: 0.1, 2.3; PFNA: 1.2, 95% CI: 0.1, 2.2; PFDA: 1.1, 95% CI: 0.0, 1.1); teacher-rated SDQ scores did not show associations. Higher childhood PFOS was associated with higher (indicating more problems) parent-rated BRIEF General Executive Composite (GEC) scores (standardized to mean = 50, SD = 10) (Q4 vs. Q1: 2.4, 95% CI: 0.2, 4.6), while teacher BRIEF GEC scores indicated more problems among children with higher PFHxS (Q4 vs. Q1: 3.5, 95% CI: −0.8, 6.3). There were no consistent patterns of sexual dimorphism in associations. In a cohort of U.S. children, we observed cross-sectional associations of childhood PFAS concentrations with greater behavioral and executive function problems, but no consistent associations with prenatal PFAS.

Differential inflammatory response of men and women subjected to an acute resistance exercise

BackgroundThe purpose of this study was to investigate the inflammatory response, lipid peroxidation and muscle damage in men and women athletes subjected to an acute resistance exercise. MethodsTwenty college athletes (10 men and 10 women) performed a half-squat exercise consisting of five incremental intensities: 20%, 40%, 60%, 80% and 100% of the one-repetition maximum. Blood samples were collected at rest, 15 min and 24 h post-test. The concentration of lipid peroxidation markers and the activities of a skeletal muscle damage marker and a cardiac muscle damage marker were determined in serum. Serum α-actin was measured as a marker of sarcomere damage. Serum levels of interleukin-6, interleukin-10, and tumor necrosis factor alpha were determined to assess the inflammatory response. ResultsInterleukin-6 levels were higher at 24 h post-test than at rest and 15 min post-test in men (p < 0.05). Moreover, men showed significantly higher hydroperoxide levels in response to resistance exercise at 24 h post-test than at 15 min post-test (p < 0.05). No differences were found in muscle damage parameters regardless of sex or the time point of the test. No differences regarding the studied variables were found when comparing among different time points in women. ConclusionOur results show a larger influence of half-squat exercises on the release of IL6 and on lipid peroxidation in men than in women at equivalent workloads.

Selection of baseline blood pressure to guide management of hypotension during spinal anaesthesia for caesarean section

IntroductionRecommendations on vasopressor management during caesarean section under spinal anaesthesia suggest maintaining systolic arterial pressure ≥90% of an accurately measured baseline value. The baseline is often taken as the first reading in the operating room. We hypothesise that this reading may not reflect an accurate baseline value. MethodsA retrospective case note review of 300 non-hypertensive women undergoing caesarean section with neuraxial anaesthesia, including spinal anaesthesia for elective delivery (n=100), and spinal (n=100) and epidural top-up anaesthesia (n=100) for emergency delivery. Systolic arterial pressure values recorded at various time points between the last antenatal visit and the first blood pressure value recorded in the operating room were compared. ResultsThere was a stepwise and significant increase in systolic arterial pressure over three time points (last antenatal clinic, morning of surgery, operating room) before elective caesarean section (all P <0.001). In women having emergency caesarean under spinal anaesthesia, a stepwise increase over four time points (last antenatal clinic, first reading in labour, final reading in labour, operating room) was observed. A similar trend was seen over these time points for women having emergency caesarean under epidural top-up, although the systolic blood pressure did not rise during labour. ConclusionsUsing the initial blood pressure reading in the operating room as the baseline value may lead to unnecessary vasopressor use and hypertension. Prospective research is required to clarify which reading represents the most accurate baseline to maintain homeostasis and reduce the hypotensive sequelae of neuraxial anaesthesia for both the mother and fetus.

Temporal changes in the vaginal microbiota in self-samples and its association with persistent HPV16 infection and CIN2+

BackgroundThe vaginal microbiota has been reported to be associated with HPV infection and cervical cancer. This study was performed to compare the vaginal microbiota at two timepoints in women performing self-sampling and had a persistent or transient HPV16 infection. The women were tested for 12 high-risk HPV (hrHPV) types but only women with single type (HPV16) were included to reduce confounding variables.MethodsIn total 96 women were included in this study. Of these, 26 were single positive for HPV16 in the baseline test and HPV negative in the follow-up test and 38 were single positive for HPV16 in both tests and diagnosed with CIN2+ in histology. In addition, 32 women that were negative for all 12 HPV tested were included. The samples of vaginal fluid were analyzed with the Ion 16S™ Metagenomics Kit and Ion 16S™ metagenomics module within the Ion Reporter™ software.ResultsK-means clustering resulted in two Lactobacillus-dominated groups, one with Lactobacillus sp. and the other specifically with Lactobacillus iners. The two remaining clusters were dominated by a mixed non-Lactobacillus microbiota. HPV negative women had lower prevalence (28%) of the non-Lactobacill dominant cluster in the baseline test, as compared to women with HPV16 infection (42%) (p value = 0.0173). Transition between clusters were more frequent in women with persistent HPV16 infection (34%) as compared in women who cleared the HPV16 infection (19%) (p value = 0.036).ConclusionsThe vaginal microbiota showed a higher rate of transitioning between bacterial profiles in women with persistent HPV16 infection as compared to women with transient infection. This indicate an instability in the microenvironment in women with persistent HPV infection and development of CIN2+.

Longitudinal Evaluation of Syndemic Risk Dyads in a Cohort of Young Pregnant Couples

PurposeThe burden of syndemics—which are clusters of overlapping risk factors that adversely impact health—has been previously evaluated among high-risk individuals, yet little is known regarding syndemics within the relationship context. MethodsWe evaluated concordant and discordant syndemic profiles among 296 pregnant couples and their actor–partner effects longitudinally from pregnancy to 1-year postpartum. ResultsSyndemic score and severity were correlated across all time points for men and women. There was a significant difference in syndemic score (βMen–Women = .2736, p = <.0001) and severity (βMen–Women = .4282, p = <.0001) during pregnancy. For actor effects, we found score (βT1–T2 = .273, p = .002; βT2–T3 = .300, p = .005) and severity (βT1–T2 = .253, p = .004; βT2–T3 = .418, p = .001) were significantly associated across all time points for women. For men, only syndemic score predicted subsequent score at later time points (βT1–T2 = .393, p = <.001; βT2–T3 = .421, p = <.001). Severity was not significantly associated across time (βT1–T2 = .043, p = .566; βT2–T3 = .172, p = .066). For partner effects, we found women's syndemic risk to influence men's syndemic risk, while men had no significant effect on women's syndemic risk. ConclusionsPregnancy provides an opportunity to reduce syndemic burden among men and women. Couples-based prevention programs may serve to reduce syndemic risk for both partners, particularly during the postpartum period.

Mid-gestational changes in cervicovaginal fluid cytokine levels in asymptomatic pregnant women are predictive markers of inflammation-associated spontaneous preterm birth

ObjectivesPerturbation of the choriodecidual space before the onset of spontaneous preterm birth (sPTB) could lead to a concomitant rise in both cervicovaginal fluid (CVF) cytokine and fetal fibronectin (FFN), and assessing the concentrations of both markers could improve the prediction of sPTB (delivery before 37 completed weeks of gestation). Therefore, we prospectively determined mid-trimester changes in CVF cytokine and FFN concentrations, and their predictive capacity for sPTB in asymptomatic pregnant women. Study designCVF collected at 20+0–22+6 weeks (n = 47: Preterm-delivered = 22, Term-delivered = 25) and 26+0–28+6 weeks (n = 50: Preterm-delivered = 17, Term-delivered = 33) from 63 asymptomatic pregnant women at risk of sPTB were examined. Cytokine and FFN concentrations were determined by multiplexed bead-based immunoassay and 10Q Rapid analysis (Hologic, MA, USA) respectively. The 20+0–22+6/26+0–28+6 weeks ratios of cytokines and FFN concentrations were compared between preterm- and term-delivered women using Receiver Operating Characteristics curves to predict sPTB. Also, bacterial 16S rDNA from 64 samples (20+0–22+6 weeks n = 36, 26+0–28+6 weeks n = 28) was amplified by polymerase chain reaction to determine associations between vaginal microflora, cytokine and FFN concentrations. ResultsChanges in RANTES and IL-1β concentrations between 20+0–22+6 and 26+0–28+6 weeks, expressed as a ratios, were predictive of sPTB, RANTES (AUC = 0.82, CI = 0.62–0.94) more so than IL-1β (AUC = 0.71, CI = 0.53–0.85) and FFN (not predictive). Combining these markers (AUC = 0.83, CI = 0.63–0.95) showed similar predictive capacity as RANTES alone. FFN concentrations at 26+0–28+6 weeks correlated with IL-1β (r = 0.4, P = 0.002) and RANTES (r = 0.3, P = 0.03). In addition, there was increased prevalence of vaginal anaerobes including Bacteroides, Fusobacterium and Mobiluncus between gestational time points in women who experienced sPTB compared to the term women (P = 0.0006). ConclusionsCVF RANTES and IL-1β in mid-trimester of pregnancy correlate with quantitative FFN. The levels of CVF RANTES and IL-1β decline significantly in women who deliver at term unlike women who deliver preterm. This observation suggests that sPTB may be characterised by sustained choriodecidual inflammation and may have clinical value in serial screening for sPTB if confirmed by larger studies.

44 Predictive value of repetitive measurement of sFlt-1:PLGF ratio in women with (suspected) preeclampsia

Introduction The ratio of the maternal plasma angiogenic factors soluble Fms-kinase 1 (sFlt-1) and placental growth factor (PlGF) is a novel diagnostic tool for preeclampsia (PE), with a value ⩽ 38 predicting short-term absence of PE in women in whom the syndrome is suspected clinically. The clinical implication of a single determination below the sFlt-1/PlGF ratio of 38 beyond 1 week remains to be established. Objective To assess the evolution of the sFlt-1/PlGF ratio in patients with (suspected) PE on clinical grounds. Methods In this ongoing observational study, the sFlt-1/PlGF ratio was determined (Elecsys assay, Roche Diagnostics) at ⩾ 2 time points in women with (suspected) PE based on the presence of ⩾ 1 of the following symptoms: new onset or aggravation of hypertension or proteinuria; renal insufficiency (serum creatinine > 100 μ mol/l); neurological complications (severe headache, hyperreflexia, persistent visual scotoma, blindness, stroke, seizures); severe edema or HELLP symptoms (right upper quadrant/epigastric abdominal pain; elevated transaminases; thrombocytopenia; hemolysis). Results We included 49 women (singleton pregnancies), aged 18-47 years and with a median pregnancy duration of 35 weeks (range 20-41 weeks). In those with a ratio ⩽ 38 (median 8 (range 2-37); n=30) at baseline, the ratio remained constant for up to 70 (range 26-107) days despite the fact that their protein-to-creatinine ratio and blood pressure often rose. In contrast, in those with a ratio > 38 (97 (range 42–991); n = 19) at inclusion, the ratio rapidly increased further, often doubling every week. Conclusions A sFlt-1/PlGF ratio at inclusion ⩽ 38, does not result in a further rise, while a steep rise occurs in those with an inclusion ratio > 38.

Insulin action in women with polycystic ovary syndrome and its relation to gestational diabetes.

How does insulin action change during pregnancy in women with polycystic ovary syndrome (PCOS) who develop gestational diabetes (GDM) compared with women with PCOS who do not? Women with PCOS who develop GDM already show disturbed insulin action early in pregnancy. Pregnant women with PCOS are at increased risk of developing GDM compared with women without PCOS. This study represents a post hoc analysis of a subgroup of pregnant women with PCOS participating in a multicentre prospective cohort study. A total of 72 women were included. Women with PCOS and a wish to conceive were included before conception and followed during pregnancy. Insulin, glucose, homeostasis model assessment of insulin resistance (HOMA-IR), sex hormone-binding globulin (SHBG) and testosterone were analysed at three different time points in women who developed GDM and women who did not. Seventy-two pregnant women with PCOS were included of which 22 (31%) women developed GDM. Both insulin levels and HOMA-IR were significantly higher at each sampling point in women with PCOS who developed GDM. SHBG levels were significantly lower before conception and in the second trimester compared with women who did not develop GDM. Testosterone concentrations were significantly lower before conception in women who developed GDM. After adjusting for BMI, waist circumference and waist/hip ratio, the differences in insulin, HOMA-IR, SHBG and testosterone levels remained largely the same. Selection bias cannot be excluded since only women from one centre with a complete blood sampling set were included in this study. The knowledge that women with PCOS who develop GDM already have a disturbed insulin action early in pregnancy is likely to be useful in considering the pathophysiology processes underlying this disorder in this specific group of women. This study was funded by the Child Health research programme of the University Medical Centre Utrecht. M.A.d.W., A.J.G., S.M.V.-V., A.F. and M.P.H.K. have no conflicts of interest to disclose. M.J.C.E. has received grant support from the following companies (in alphabetic order): Illumina and MSD. B.C.J.M.F. has received fees and grant support from the following companies (in alphabetic order): Ferring, Ova-Science, PregLem SA, Roche and Watson Laboratories. The authors declare complete independence from funders. Clinicaltrials.gov, number NCT00821379.

Leukocyte subpopulation responses to resistance exercise are different in men and women and affected by protein supplementation (LB800)

Immune cells are integral to the recovery from exercise, but little is known about the effects of supplementation and sex on the immune response. Untrained men (M) (N=88) and women (W) (N=54) performed a squat exercise protocol (6 sets, 10 repetitions, 2 minutes rest between sets at 65% of 1 RM) and randomly received a supplement immediately post exercise of carbohydrate (CHO) (M=27, W=16), whey (WHY) (M=25, W=18) or soy (SOY) (M=27, W=19). Immunophenotypic analysis of leukocytes was performed before (Pre) and 15 and 60 min post exercise (PE). Comparison of sexes disregarding supplementation indicated lower CD4 T cell counts at all time points in women. CD4 T cells continuously declined in men at 15 and 60 min PE while women only decreased below Pre at 60 min PE. Monocytes increased significantly at 15 min PE in women only (M=+11%, W=+17%) but decreased significantly in both sexes at 60 min PE (M=‐21%, W=‐11%). After division by sex and supplement, monocytes were not different from Pre to 60 min PE in women in all groups, but in men monocytes decreased below Pre at 60 min PE in both CHO and SOY. B cells decreased below Pre at 60 min PE in men in all groups, but only decreased below Pre at 60 min PE in women in SOY. Granulocytes continuously increased PE in men in WHY and CHO, and in women in CHO and SOY. Sex and supplementation differentially affect leukocyte compartmentalization with the most apparent effects on monocytes.Grant Funding Source: Supported by the Dairy Research Institute

Change in Peripheral Blood Leukocyte Telomere Length and Mortality in Breast Cancer Survivors

Progressive telomere shortening with cell division is a hallmark of aging. Short telomeres are associated with increased cancer risk, but there are conflicting reports about telomere length and mortality in breast cancer survivors. We measured peripheral blood leukocyte telomere length at two time points in women enrolled in a multiethnic, prospective cohort of stage I to stage IIIA breast cancer survivors diagnosed between 1995 and 1999 with a median follow-up of 11.2 years. We evaluated associations between telomere length measured at mean 6 (baseline; LTL0; n = 611) and 30 months (LTL30; n = 478) after diagnosis and the change between those time points (n = 478), with breast cancer-specific and all-cause mortality using Cox proportional hazards models adjusted for possible confounders. Statistical tests were two-sided. There were 135 deaths, of which 74 were due to breast cancer. Neither baseline nor 30-month telomere length was associated with either all-cause or breast cancer-specific mortality (LTL0: hazard ratio [HR] = 0.83, 95% confidence interval [CI] = 0.67 to 1.02; HR = 0.88; 95% CI = 0.67 to 1.15; LTL30: HR = 0.78, 95% CI = 0.59 to 1.05; HR = 0.86; 95% = CI = 0.58 to 1.26, respectively). However, participants whose telomeres shortened between baseline and 30 months were at a statistically significantly increased risk of breast cancer-specific (HR = 3.03; 95% CI = 1.11 to 8.18) and all-cause mortality (HR = 2.38; 95% CI = 1.28 to 4.39) compared with participants whose telomeres lengthened. When follow-up was censored at 5-years after diagnosis, LTL0 (HR = 0.66; 95% CI = 0.45 to 0.96), LTL30 (HR = 0.51; 95% CI = 0.29 to 0.92), and change in telomere length (HR = 3.45; 95% CI = 1.11 to 10.75) were statistically significantly associated with all-cause mortality. Telomere shortening was associated with increased risk of breast cancer-specific and all-cause mortality, suggesting that change in blood telomere length over time could be a biomarker of prognosis. Research on determinants of telomere length and change is needed.

The Association Between 2D:4D Ratios and Sociosexuality: A Failure to Replicate

Researchers investigating the role of biological factors in the development and maintenance of interest in uncommitted sexual activity (i.e., sociosexuality) have reported that greater prenatal androgen action in women, as inferred by the ratio of the 2nd to 4th digit, is associated with greater interest in uncommitted sexual relationships, as measured by scores on the Sociosexuality Orientation Inventory (SOI) (Clark, 2004). This evidence suggesting a rather extensive role for prenatal factors in human mating behavior has been cited over 20 times in the literature. However, despite this indication of the impact of the research results on theories of human sex differences, there are no published replications of the original finding. For that reason, the association between 2D:4D ratios and sociosexuality was evaluated in two studies. In the first study, using methodology similar to the original report, no significant association between 2D:4D ratios and SOI scores was found either in women (n = 25) or men (n = 25). Next, to test the possibility that moderating factors, such as menstrual cycle phase and circulating testosterone levels, influence the strength of the association between 2D:4D ratios and sociosexuality, salivary hormone levels and behaviors were measured during the early follicular and mid-luteal phase of the menstrual cycle in women not using hormonal contraceptives (n = 40) and at two time points in women using oral contraceptives (n = 44) and in men (n = 42). Women and men in this study showed the expected sex differences in hormone levels and behavior. However, circulating hormones and 2D:4D ratios were unrelated to measures of sociosexuality obtained at the two test sessions. In sum, these data suggest that factors other than prenatal and circulating hormones explain the sex differences in self-reports of sociosexuality.

Skeletal effects of exemestane on bone-mineral density, bone biomarkers, and fracture incidence in postmenopausal women with early breast cancer participating in the Intergroup Exemestane Study (IES): a randomised controlled study

Tamoxifen preserves bone in postmenopausal women, but non-steroidal aromatase inhibitors accelerate bone loss and increase fracture risk. We aimed to study the effect on bone health in a subgroup of women included in the Intergroup Exemestane Study (IES), a large randomised trial that compared the switch to the steroidal aromatase inhibitor exemestane with continuation of tamoxifen in the adjuvant treatment of postmenopausal breast cancer. Results were analysed from 206 evaluable patients from the IES, in which postmenopausal women with histologically confirmed and completely resected unilateral breast cancer (that was oestrogen-receptor positive or of unknown status), who were disease-free after 2-3 years of treatment with tamoxifen were randomised to continue oral tamoxifen 20 mg/day or switch to oral exemestane 25 mg/day to complete a total of 5 years of adjuvant endocrine therapy. The primary endpoint was change in bone-mineral density (BMD) assessed by dual energy X-ray absorptiometry. Changes in biochemical markers of bone turnover were also analysed in this substudy, and the incidence of fractures in the entire study reported. The IES is registered on the Current Controlled Trials website . Within 6 months of switching to exemestane, BMD was lowered by 0.051 g/cm(3) (2.7%; 95% CI 2.0-3.4; p<0.0001) at the lumbar spine and 0.025 g/cm(3) (1.4%; 0.8-1.9; p<0.0001) at the hip compared with baseline. BMD decreases were only 1.0% (0.4-1.7; p=0.002) and 0.8% (0.3-1.4; p=0.003) in year 2 at the lumbar spine and hip, respectively. No patient with BMD in the normal range at trial entry developed osteoporosis. Bone resorption and formation markers increased at all time points in women receiving exemestane (p<0.001). With a median follow-up in all IES participants (n=4274) of 58 months, 162 (7%) and 115 (5%) patients in the exemestane and tamoxifen groups, respectively, had fractures (odds ratio 1.45 [1.13-1.87]; p=0.003). These results indicate that the increase in survival shown previously with the IES switch strategy is achieved at the expense of some detriment to skeletal health, so the risk-benefit ratio to women needs to be individually assessed.