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Perimenopausal Women (perimenopausal + woman)
Selected AbstractsPremenopausal Smoking and Bone Density in 2015 Perimenopausal WomenJOURNAL OF BONE AND MINERAL RESEARCH, Issue 4 2000Dr. A. P. Hermann Abstract The importance of cigarette smoking in relation to bone mass remains uncertain, especially in younger women. In a recent meta-analysis including 10 studies in premenopausal women no effect was seen in this age group. We used baseline data from a large national cohort study (Danish Osteoporosis Prevention Study [DOPS]) to study the cumulated effect of pre- and perimenopausal smoking on bone mineral density (BMD) measured shortly after the cessation of cyclic bleedings. Baseline observations on 2015 recently menopausal women were available. Eight hundred thirty-two women were current smokers and 285 were exsmokers. Significant negative associations of cigarette smoking coded as current, ex-, or never smoking were seen on bone mass in the lumbar spine (P = 0.012), femoral neck (P < 0.001), and total body (P < 0.001). Quantitatively, the differences between current smokers and never smokers were limited to 1.6, 2.9, and 1.9%, respectively. A statistical interaction was found between smoking and fat mass, indicating that women in the highest tertile of fat mass were unaffected by cigarette smoking. Serum vitamin D levels and osteocalcin were inversely related to the number of cigarettes smoked per day (r = 0.11 and P < 0.001; r = 0.17 and P = 0.04), respectively. Bone alkaline phosphatase (BALP) and urinary hydroxyproline (U-OHP) were unaffected by current smoking. The average cumulated effect of premenopausal smoking on bone is small but biologically significant. Reduced body mass in smokers explains part of the negative effect on the skeleton and a complex interaction between smoking and fat mass on the skeleton is indicated. Serum levels of 25-hydroxyvitamin D (25-OHD) and osteocalcin are lower in smokers, which may effect rate of bone loss. [source] Follicle-stimulating hormone and oestradiol levels during perimenopause in a cohort of Japanese womenINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 10 2008M. Yamada Summary Context:, There had been a lack of longitudinal studies regarding follicle-stimulating hormone (FSH) and oestradiol (E2) during perimenopause for non-Caucasian populations. Objective:, To investigate FSH and E2 levels during perimenopause in a Japanese cohort. Design and setting:, The Adult Health Study is a longitudinal population-based study. Perimenopausal women from this study cohort were followed between 1993 and 2003. Participants and main outcome measures:, Non-menopausal women, aged 47,54 years, were measured in terms of FSH and E2 levels every 6 months. For 89 women whose FSH and E2 levels were measured within 3 months from their final menstrual period (FMP), trends of FSH and E2 within 21 months of FMP were investigated at 6-month intervals. Results:, Follicle-stimulating hormone and E2 levels within 3 months from FMP showed wide ranges. Neither FSH nor E2 levels differed by age, weight or duration of amenorrhoea. Although FSH increased and E2 decreased during perimenopause, FSH and E2 levels at a single time point were found to not be a reliable marker of biological menopause, as hormone levels in and between the subjects showed wide variation and any trend in one individual was not necessarily one directional. Conclusions:, Among Japanese women who had natural menopause around the age of 50, hormone levels in and between individuals showed wide variation throughout perimenopause with a converged biochemical menopausal pattern characterised by high FSH and low E2 at about 2 years after FMP. [source] Female Premenopausal Fracture Risk Is Associated With Gc Phenotype,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 6 2004Anna Lis Lauridsen Abstract The phenotype of the vitamin D binding and macrophage activating protein, Gc, is a predictor of premenopausal bone fracture risk, possibly mediated through activation of osteoclasts. This was concluded from a study on 595 Danish perimenopausal women 45-58 years of age (30,040 person years). Introduction: The multifunctional plasma protein Gc, also known as group-specific component, Gc globulin, or vitamin D binding protein (DBP), has two functions with relation to bone tissue: it is the major carrier protein of vitamin D in the circulation, and deglycosylation converts it into a very potent macrophage- and osteoclast-activating factor (Gc-MAF). There are several phenotypes of Gc, and in this study, we examined the relation between Gc phenotype and bone fragility. Materials and Methods: By isoelectric focusing we identified the Gc phenotype of 595 white recent postmenopausal women enrolled into the Danish Osteoporosis Prevention Study (DOPS) and identified three groups: Gc1-1 (n = 323), Gc1-2 (n = 230), and Gc2-2 (n = 42). Differences between the three groups were examined with respect to number of fractures before enrollment, BMC and BMD, and various biochemical and clinical parameters, including the concentration of Gc measured by immunonephelometry and the concentration of the macrophage marker soluble CD163 measured by ELISA. Results and Conclusions: The risk of having at least one premenopausal bone fracture (total number of women with fracture = 179) differed significantly (p = 0.017) in women with phenotype Gc1-1 (110/323 = 0.34), Gc1-2 (63/230 = 0.27), and Gc2-2 (6/42 = 0.14). The differences were even more striking (p = 0.005) for fractures caused by low-energy traumas. Using logistic regression, we found the relative risk of premenopausal fracture to be 0.32 (0.13-0.80) in Gc2-2 compared with Gc1-1. We propose that the Gc phenotypes cause differences in osteoclast activity, a theory supported by our finding of lower levels of Gc and of soluble CD163 in women with Gc2-2 compared with Gc1-1. [source] Sleep disturbance experiences among perimenopausal women in TaiwanJOURNAL OF CLINICAL NURSING, Issue 15 2009Hsiu-Chin Hsu Aim., To generate a descriptive theory framework regarding the experiences of sleep disturbances among perimenopausal women in Taiwan. Background., Although studies show that some perimenopausal women are troubled by sleep problems, little information was found about the subjective experiences of sleep disturbances among these women. Research is required to explore women's feelings or perceptions in dealing with their sleep problems. These understandings will be important to help alleviate perimenopausal women's sleep problems. Design., A grounded theory research design was applied. Method., Twenty-one Taiwanese sleep disturbed women, aged 46,57 years, participated in in-depth interviews. Results., ,Getting back a good night's sleep' was the core theme for describing and guiding the process of the women's sleep disturbance experiences. During the process, ,disturbed sleep' was identified as the antecedent condition that included subcategories: easy awakening, difficulty falling asleep, inner worries, physical discomfort and genetic and bodily constitution. Analyses showed five categories (some with subcategories) of the sleep disturbed women: (i) worsening health status , physical exhaustion, impaired social interactions, emotional swings and decreased work performance; (ii) living with lonely nights , self-help and endurance; (iii) a search for resources to relieve sleep difficulties , doctor shopping, trying alternative therapies, exercising and seeking support; (iv) vicious cycle and (v) acceptance of insomnia. Conclusions., Women expected to relieve their sleep disturbance by finding comprehensive counselling or by their body constitution responding to treatment. Healthcare providers need to value women's individual concerns and subjective voices. Providers must seek out sleep counselling instead of simply prescribing drugs for their sleep difficulties. Relevance to clinical practice., It is crucial to integrate perimenopausal sleep care by implementing a multidimensional approach such as sleep assessment laboratories, sleep counselling, complementary alternative medicine, sleep strategies and support groups. [source] Hormone therapy and mortality during a 14-year follow-up of 14 324 Norwegian womenJOURNAL OF INTERNAL MEDICINE, Issue 5 2004S. Graff-Iversen Abstract. Objectives., We evaluated mortality from cardiovascular disease (CVD), coronary heart disease (CHD) and all causes in relation to use of any hormone therapy (HT) and HT with oestradiol and norethisterone or levonorgestrel. Design., Population-based cohort study. Setting and subjects., Women in three Norwegian counties were invited to a health survey in 1985,88 and 82.8% participated. In all 14 324 post- or perimenopausal women aged 35,62 years, including 702 HT users with a mean age of 48.8 years, were followed for 14 years. Results., Women using HT had mortality from all causes and CVD comparable with that of nonusers. The relative risk (RRs) for CVD mortality amongst all women were 0.69 (95% CI: 0.35,1.33) for users of HT, and 0.96 (95% CI: 0.43,2.17) for users of HT with norethisterone or levonorgestrel. Amongst women free of self-reported cardiovascular health problems at baseline all-cause, CVD and CHD mortality tended to be lower amongst users of HT whilst HT use was linked with increased mortality amongst women with cardiovascular health problems. Conclusions., In this cohort of women around the usual age of menopause all-cause or CVD mortality amongst users of HT, most often oestradiol combined with norethisterone or levonorgestrel, was not markedly different from that of nonusers. Early CHD events amongst HT users prior to the baseline survey, together with selective inclusion of healthy subjects, may in part explain protective effects of HT on CHD reported from previous observational studies. [source] An Earlier Menopause as Clinical Manifestation of Granulosa-Cell Tumor: A Case ReportJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 1 2000Dr. Hisahiko Hiroi Abstract We present a case of a granulosa-cell tumor, which can cause menopause at an earlier than normal age. The hormonal profiles were characterized by undetectable FSH levels associated with an estradiol level compatible with the level seen in perimenopausal women and by a significant increase in the inhibin level. [source] Mixed epithelial and stromal tumor of the kidney in a 12-year-old girlPATHOLOGY INTERNATIONAL, Issue 10 2005Noboru Hara Mixed epithelial and stromal tumor of the kidney (MESTK) is a rare kidney neoplasm that almost exclusively occurs in perimenopausal women, and long-term estrogen replacement is relevant to its pathogenesis. Herein is described an atypical case of MESTK uncovered in a 12-year-old premenarcheal girl without a history of prior estrogen use. On surgical specimen it was found that the well-circumscribed tumor measuring 14 cm arose from the lower pole of the right kidney, showing solid and fibrous-cystic areas. Microscopically, it was composed both of epithelial structures similar to renal tubules and stroma comprising non-specific spindle cells. Some intratumoral tubules showed affinities to distal-nephron-specific lectins, and those immunoreactive for proximal-tubule-specific CD15 were also present. In addition, primitive ductal structures were reactive both for CD15 and lectins, but immature epithelial elements typical of nephroblastoma were absent. Spindle cells were positive for actin, desmin and vimentin, and expressed progesterone and estrogen receptors. The tumor was comparable with MESTK, although some epithelia were associated with the immunophenotype of proximal tubules. The patient was free of disease postoperatively for 40 months. In the present case, remnants of the primitive periductal mesenchyme might be promoted to neoplastic cells by a sex-steroid surge during puberty. [source] Latent-Model Robustness in Joint Models for a Primary Endpoint and a Longitudinal ProcessBIOMETRICS, Issue 3 2009Xianzheng Huang Summary Joint modeling of a primary response and a longitudinal process via shared random effects is widely used in many areas of application. Likelihood-based inference on joint models requires model specification of the random effects. Inappropriate model specification of random effects can compromise inference. We present methods to diagnose random effect model misspecification of the type that leads to biased inference on joint models. The methods are illustrated via application to simulated data, and by application to data from a study of bone mineral density in perimenopausal women and data from an HIV clinical trial. [source] | ||||||||||