Relationship Between Poly (A) Microsatellite in Vitamin D Receptor Gene, and Bone Mineral Density in Postmenopausal Korean Women / 대한산부인과학회잡지

OBJECTIVE: To investigate a poly (A) microsatellite in vitamin D receptor (VDR) gene and to evaluate its relationship with bone mineral density (BMD) in postmenopausal Korean women. METHODS: The poly (A) polymorphism was analyzed in 417 postmenopausal Korean women. Serum CrossLaps (CTX), bone alkaline phosphatase (BAP), osteocalcin and 1,25 (OH)2 vitamin D3 levels were measured by enzyme linked immunosorbent assay and immmunoassay and BMD at the lumbar spine and proximal femur by dual energy X-ray absorptiometry. RESULTS: When alleles of poly (A) microsatellite were classified into two groups, long (L: A18-22) and short (S: A12-17), based upon the length of the repeat, the prevalence of SS was 1.4%, LS 10.1%, and LL 88.5%. There was a significant correlation between BMD and poly (A) polymorphism. BMD at the femoral neck and trochanter in LS genotype was significantly lower than that in LL genotype. LL genotype was more prevalent in women with normal BMD compared with women with low bone mass while LS genotype was more prevalent in the latter group. There were no significant associations between the adjusted levels of the bone markers, 1,25 (OH)2 vitamin D3 and poly (A) genotypes. CONCLUSION: The VDR gene poly (A) polymorphism is one of genetic factors which may affect BMD in Korean women.

Relationship between vitamin D receptor gene polymorphism, and bone mineral density in postmenopausal Korean women / 대한산부인과학회잡지

OBJECTIVE: To investigate the relationship between vitamin D receptor (VDR) gene polymorphisms and bone mineral density (BMD) in postmenopausal Korean women, and to evaluate if VDR gene polymorphisms are associated with serum levels of 1,25 (OH)2 vitamin D3 and bone turnover markers METHODS: The BsmI, TaqI, ApaI, and FokI polymorphisms were analyzed by restriction fragment length polymorphism in 443 postmenopausal Korean women. Serum CrossLaps (CTX), bone alkaline phosphatase (BAP), osteocalcin and 1,25 (OH)2 vitamin D3 levels were measured by enzyme linked immunosorbent assay and immmunoassay and BMD at the lumbar spine and proximal femur by dual energy X-ray absorptiometry. RESULTS: BMD at the femoral neck and Ward' triangle in women with the Bb, and Tt genotype (uppercase letters signifying the absence and lowercase letters the presence of the restriction site) was lower than that in women with the bb, and tt genotype respectively. Haplotype analysis showed that BbTt genotype had lower BMD at all skeletal sites than bbtt genotype. No significant association between adjusted BMD at any skeletal site and the FokI or ApaI genotypes was observed. There were no significant associations between the adjusted levels of the bone markers and 1,25 (OH)2 vitamin D3 and single or combined genotypes. CONCLUSION: The VDR gene BsmI, and TaqI polymorphisms are genetic factors which may affect BMD at the lumbar spine and proximal femur in postmenopausal Korean women, but does not affect serum levels of 1,25 (OH)2 vitamin D3 and bone turnover markers.

The bone mineral densities in Korean postmenopausal women: a comparison between natural and surgically induced menopause / 대한산부인과학회잡지

OBJECTIVE: To investigate the bone mineral density(BMD) in Korean postmenopausal women. METHODS: We performed the retrospective study for 1,508 postmenopausal women who had menopause after 40 years of age and didn't take any hormonal agent before measuring bone mineral density. Spinal and femur neck BMD were measured using dual energy X-ray absorptiometry(DXA, Lunar Co.). RESULTS: The mean age of the study subjects was 53.7+/-5.7 years and the average BMD of the lumbar spine(L2-L4; L24) and femur neck(FN) were 0.996+/-0.173 g/cm(2) and 0.821+/-0.133 g/cm(2), respectively. Of all subjects, 44.1%(665/1,508) had osteopenia and 14.7%(222/1,508) were already osteoporotic. The prevalence of osteoporosis increased with age; 5.2% in 41-50 years of age, 15.6% in fifties, 32.5% in sixties, and 45.5% in over 70 years of age. There was no significant difference in the age-adjusted BMD between naturally menopausal women(n=828) and surgically menopausal women(n=78). The mean age at menopause of surgically menopausal women was significantly younger than that of naturally menopausal women(47.6+/-3.6 vs 49.2+/-3.5). Duration of menopause, body weight, and height were revealed to be the significant risk factors for osteoporosis. The annual bone loss rates in lumbar spine and femur neck were 1.2% and 1.1% respectively in naturally menopausal women, and 1.5% and 1.2% in surgically menopausal women. CONCLUSIONS: This study established the BMD curve and regression equation in Korean postmenopausal women according to the causes of menopause. There was no significant difference in the mean BMD and the prevalence of osteoporosis between naturally and surgically menopausal women. Duration of menopause, body weight, and height were found to be the risk factors which influence the development of the osteoporosis. So the postmenopausal women who are at increased risks of developing osteoporosis need more active interventions for preventing the osteoporotic fracture.

Transvaginal Doppler Ultrasonography of Uterine Intraendometrial and Intramyometrial Arteries as a Predictor of Pregnancy after In Vitro Fertilization and Embryo Transfer / 대한산부인과학회잡지

OBJECTIVE: This study was performed to assess whether uterine intraendometrial or intramyometrial arterial blood flow impedance in Doppler sonography is related to the outcomes of IVF-ET cycles. METHODS: A total of 24 patients undergoing IVF-ET was recruited for the study. All patients received controlled ovarian hyperstimulation(COH) with GnRH agonist and gonadotropins. Doppler sonographic examinations were performed by using Combison 530(Medison) with 5.5 MHz transvaginal probe. Pulsatility index(PI) was evaluated for uterine, radial, and spiral arteries on the days of hCG administration, oocyte retrieval, and embryo transfer(ET). Serum E2 level was assayed on the hCG day. RESULTS: The overall pregnancy rate after IVF-ET was 29.2%(7/24). There was no significant difference in PI of uterine artery between pregnant and nonpregnant groups, No pregnancy occurred in 4(16.7%) patients without intraendometrial or subendometrial blood flow. Compared with nonpregnant group, PI of radial artery on the hCG day and PI of spiral artery on the hCG and oocyte retrieval days were significantly lower in pregnant group. There were no significant correlations between Serum E level on the hCG day and Pl of any three arteries. CONCLUSION: This study suggests that the Doppler sonographic parameter, PI, of intraendometrial and intramyometrial arteries are more useful than that of uterine artery not only in predicting the success of IVF-ET, but also in assessing the endometrial receptivity.

Analysis of Strict Morphology of Human Spermatozoa / 대한산부인과학회잡지

The proportion of male factor infertility due to quantitative and qualitative sperm disorders is approximately 50-60% in infertile couples. In IVF-ET, lower or failed fertilization of oocytes usually results from subnormal count of total motile sperms, but this may occur in infertile couples even with normal sperm count. It has been suggested that some functional defects in sperms are responsible for lower or failed fertilization. Routine semen analysis based on numerical background has limits for the assessment of fertilization capacity of sperm in infertile males, and the andrologic test for the prediction of fertilization capacity must be objective, repeatable, quick, economic, and easily applicable for the clinical settings. The purposes of this study were to develop the analysis method of strict morphology of sperm using the strict criteria as a simple, inexpensive and useful test of sperm fertilization capacity, to establish the normal fertile range and the cut-off value of strict morphology, and to evaluate the validity of strict morphology as a prognostic indicator of fertilization capacity in IVF-ET. In establishing the effectiveness of strict morphology of sperm, ROC curve was used. Among the various thresholds for the prediction of fertilizing ability, normal morphologic value 10.0 corresponding to the value with higher sensitivity and lesser false positive rates was determined as a cut-off value. Using this cut-off point, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of strict morphology for the prediction of fertilization capacity was 73.9%, 81.0%, 80.6%, and 72.7%, respectively. To evaluate the clinical validity of strict morphology as a prognostic indicator of fertilization capacity, this cut-off point was applied to 133 patients undergoing IVF-ET. For the prediction of fertilization rate >30% in IVF-ET, the sensitivity, specificity, PPV, and NPV was 77.3%, 77.8%, 87.2%, and 63.6%, respectively. In conclusion, the strict morphology of sperm is one of the most simple and useful test for the assessment of fertilization capacity of sperm and the prediction of IVF-ET outcomes in infertile couples.

Perinatal Outcome, Prevalence and Clinical Significance of Pregnancies with Single Umbilical Artery / 대한산부인과학회잡지

No abstract available.