Assessment of Knowledge Regarding Osteoporosis among Pre-Menopausal Women residing in Selected Rural Communities

Background: As a woman approaches menopause there are gradual changes in the physiology of her body. One of the prominent changes is an increase in the fragility of bone due to calcium variation causing Osteoporosis. A low level of estrogen, which occurs around the time of menopause leads to increased bone loss. A woman can undergo either primary or secondary osteoporosis. In most cases, the first 'symptom' of osteoporosis is broken bone. As osteoporosis is an emerging health problem, that creates an economic burden, it needs a special focus to promote healthy ageing. Knowledge is the best contributor to reducing the risk of premenopausal women getting osteoporosis. Methods: Total 70 pre-menopausal women living in chosen rural communities in Bagalkot were chosen with a convenient sampling technique. A structured questionnaire developed by the researcher was used to gather information concerning knowledge about osteoporosis. Chi-square analysis was used to uncover the relationship between knowledge about osteoporosis with socio-demographic factors. Results: Total 24.28% of women were having good knowledge, 54.28% were having average knowledge, and 21.42% of women were having poor knowledge about osteoporosis. A significant relationship was attained between knowledge regarding osteoporosis and occupation (?2=14.20, p<0.007) and formal education (?2=16.22, p<0.039) at the position of the significance of 0.05. Conclusion: After evaluation of knowledge on the subject of osteoporosis among pre-menopausal women, it was found that most women had average knowledge regarding osteoporosis.

A cross-sectional comparative study of some cardiovascular risk factors in premenopausal and postmenopausal apparently healthy women of Ranchi

Background: Loss of estrogenic support may put postmenopausal women at higher risk of cardiovascular diseases. Aims and Objectives: This study aimed to examine premenopausal and postmenopausal woman to provide pertinent data on some of the cardiovascular risk factors and to know approximately the period which is under protection of estrogen and the period from which a woman is affected by changes in cardiovascular risk factors. Materials and Methods: This cross-sectional study was conducted in RIMS Ranchi from February 2018 to August 2019. A total of 262 apparently healthy women in the age group of 35–60 years were assessed for cardiovascular risk factors. Parameters assessed in premenopausal and postmenopausal women were heart rate, blood pressure (Systolic and Diastolic Blood Pressure), body mass index (BMI), waist circumference, hip circumference, blood sugar level, and lipid profile of the subjects. Results: Out of 262 participants, 132 were in the premenopausal group with mean age of 39.76 years and 130 were in the postmenopausal group with mean age of 50.8. Except BMI, all other cardiovascular risk parameters showed significant difference between premenopausal and postmenopausal women. Conclusion: We concluded that adverse changes in lipid profile and blood sugar along with significant increase in other cardiac risk factors in postmenopausal women as compared to premenopausal group of the study predisposed this group of women at increased risk of having cardiovascular disease in near future. Hence, preventive measures against cardiovascular disease risk should be started in premenopausal period only.

Clinical characteristics of hospitalized premenopausal patients with hyperuricemia / 中华全科医师杂志

Objective:To analyze the clinical characteristics of hospitalized premenopausal patients with hyperuricemia.Methods:The medical records of premenopausal women with hyperuricemia (serum uric acid ≥360 μmol/L during hospitalization) admitted in Peking Union Medical College Hospital from 2013 to 2018 were reviewed and the clinical data were analyzed.Results:A total of 2 099 patients were enrolled. Only 14.01% (294 cases) of the patients were concerned about hyperuricemia by physicians. Autoimmune diseases (32.11%, 674 cases), nephrotic disease (19.29%, 405 cases) and endocrine system diseases (9.72%, 204 cases) are the main reasons for hospitalization, while 6.34%(133 cases) of patients were in gestation. In terms of the etiology, renal diseases (49.35%, 1 035 cases), specific drug use (49.26%, 1 034 cases) were the main causes of secondary hyperuricemia in premenopausal women, followed by metabolic diseases (10.62%, 233 cases). There was no significant difference in serum uric acid level among premenopausal women of different ages ( H=4.47, P=0.107), but the etiology of hyperuricemia among patients of different ages had significant differences. The proportion of hyperuricemia in patients with cancer and metabolic syndrome,secondary to use of diuretics and anti-tuberculosis drugs had differences among different age groups ( χ2=90.96,52.89,19.26 and 6.41, P<0.05). Conclusion:Hyperuricemia is not uncommon in premenopausal women. There are many secondary factors leading to hyperuricemia in premenopausal women, among which drugs and renal lesions are the main causes. In addition, the secondary factors in women with hyperuricemia has differences among different age groups.

A study to compare thyroid profile between premenopausal and postmenopausal women

Background: The most abundant disorders worldwide are the thyroid disorders next to diabetes. Normal levels of thyroid hormones are essential for normal reproductive behavior. The onset of thyroid disorder increases with age. Thyroid disorders are more common in women than men. It is common that women develop menstrual cycle-related symptoms and are usually prone to thyroid dysfunction. Aim and Objectives: The objectives of this study were as follows: (i) To assess the thyroid profile in premenopausal women; (ii) to assess the thyroid profile in postmenopausal women; and (iii) to compare the thyroid profile between premenopausal and postmenopausal women. Materials and Methods: Subjects were selected according to premenopausal and postmenopausal status. Seventy premenopausal women more than 40 years of age and 70 postmenopausal women with menopause duration not more than 5 years. Thyroid profile was done in the central laboratory of Amala institute of Medical sciences, Thrissur. The tests were done basal-fasting state. Results: The mean thyroid-stimulating hormone levels in the postmenopausal group (3.33 ± 3.88) were higher than premenopausal group (2.65 ± 2.36 MIU/L). The mean FT3 level in postmenopausal group (5.39 ± 0.64 pmol/L) was higher than in premenopausal group (5.19 ± 0.66 pmol/L) and the mean FT4 level was also higher in postmenopausal group (12.01 ± 2.99 pmol/L) than in premenopausal group (11.22 ± 2.13 pmol/L). There was no statistically significant difference in the thyroid hormone profile in premenopausal and postmenopausal status. Conclusion: This study, the difference of thyroid parameters between premenopausal and postmenopausal women, does not show statistical significance. Further study with larger sample size in Indian population is required to evaluate association between thyroid status with pre- and postmenopausal status.

Factores de riesgo de baja masa ósea en mujeres premenopáusicas con lupus eritematoso sistémico / Risk factors for low bone mass in premenopausal women with systemic lupus erythematosus

RESUMEN Introducción: los pacientes con lupus eritematoso sistémico tienen un riesgo elevado de presentar baja masa ósea. La etiología es multifactorial (factores de riesgo tradicionales, propios de la enfermedad, laboratoriales, serológicos, metabólicos y los relacionados al tratamiento). Objetivo: determinar los factores de riesgo de baja masa ósea tradicionales (sedentarismo, tabaquismo, alcohol, baja ingesta láctea, bajo índice de masa corporal), los relacionados con la enfermedad (presentación clínica, laboratoriales), metabólicos y el tratamiento, con la disminución de la densidad mineral ósea en mujeres premenopáusicas con lupus eritematoso sistémico Metodología: estudio observacional de corte transverso prospectivo analítico de mujeres premenopáusicas con lupus eritematoso sistémico, que acudieron al Hospital Nacional en el periodo octubre 2017 - octubre 2019. La densidad mineral ósea se evaluó por densitometría DEXA, y se utilizó el Z score, valores iguales o inferiores a -2,0 DS se consideró como baja masa ósea. Las variables analizadas fueron: factores de riesgo de baja masa ósea tradicionales, relacionados con el lupus, laboratoriales, serológicos, metabólicos y el tratamiento. Análisis estadístico: para la descripción de las variables se utilizaron media y desviación estándar para las variables continuas; y proporciones para las cualitativas. Se establecieron los factores de riesgo para baja masa ósea por la prueba de Chi cuadrado considerándose significativa un valor p ˂0,05, para la comparación de medias se utilizó la prueba t de Student. Resultado: fueron estudiadas 61 mujeres premenopáusicas, con una edad media 25,6 ± 7 años, siendo del interior de país 50,8 % y Central 49,18 %. Tenían estudios secundarios 54,10 %, terciarios 34,43 %, primarios 11,48 %. Eran sedentarias 40,98 %. Presentaron una baja ingesta láctea el 21,31 % y una era fumadora activa 1,64 %. Tenían peso normal 66,2 %, sobrepeso 15,25 %, obesidad 18,33 %, bajo peso 1,64 %. El tiempo de enfermedad, la media fue 50,5 ± 56,4 meses. El índice de actividad de la enfermedad (SLEDAI) fue 6,5 ± 6,5. Presentaron una duración de la enfermedad mayor de 5 años el 31,5 %. Tenían nefritis lúpica 52,54 %, actividad severa 24,5 %, hipocomplementemia 45 %. ANA media 995,5 ± 1164, anti DNA media 274,2 ± 830,8, anti Ro positivo 54,7 %, anti Sm positivo 24,5 %. Vitamina D valor normal 18,5 %, insuficiente 50,9 %, deficiente 32,6 %. Presentaron baja masa ósea 7 pacientes 11,4 %. No se encontró una asociación entre los factores de riesgo tradicionales, los relacionados con la enfermedad (inflamación sistémica, laboratoriales), metabólicos y el tratamiento con una baja masa ósea, (p ≥ 0,05). Conclusión: presentaron una baja masa ósea 11,4 %. Los factores de riesgo tradicionales, los relacionados con la enfermedad, laboratoriales, metabólicos y el tratamiento no presentaron una asociación estadísticamente significativa con la baja masa ósea.

ABSTRACT Introduction: patients with systemic lupus erythematosus have a high risk of presenting low bone mass. The etiology is multifactorial (traditional risk factors, characteristic of the disease, laboratory, serological, metabolic and those related to treatment). Objective: to determine the traditional risk factors for low bone mass (sedentary lifestyle, smoking, alcohol, low milk intake, low body mass index), those related to the disease (clinical presentation, laboratory), metabolic and treatment, with the decrease of bone mineral density in premenopausal women with systemic lupus erythematosus. Methodology: prospective analytical cross-sectional observational study of premenopausal women with systemic lupus erythematosus, who attended the National Hospital in the period October 2017 - October 2019. Bone mineral density was evaluated by DEXA densitometry, and the Z score was used, equal values or lower than -2,0 SD was considered low bone mass. The variables analyzed were: traditional risk factors for low bone mass, related to lupus, laboratory, serological, metabolic and treatment. Statistical analysis: mean and standard deviation for continuous variables were used to describe the variables; and proportions for qualitative ones. The risk factors for low bone mass were established by the Chi square test, considering a p value of ˂0,05 as significant; the Student's t test was used to compare means. Result: 61 premenopausal women were studied, with a mean age 25,6 ± 7 years, being from the interior of the country 50,8 % and Central 49,18 %. They had secondary studies 54,10 %, tertiary 34,43 %, primary 11,48 %. 40,98 % were sedentary. 21,31 % had a low milk intake and 1,64 % was an active smoker. They were 66,2 % normal weight, 15,25 % overweight, 18,33 % obese, 1,64 % underweight. The mean time of illness was 50,5 ± 56,4 months. The disease activity index (SLEDAI) was 6,5 ± 6,5. 31,5 % had a duration of the disease greater than 5 years. They had lupus nephritis 52,54 %, severe activity 24,5 %, hypocomplementemia 45 %. Mean ANA 995,5 ± 1164, mean anti DNA 274,2 ± 830,8, anti Ro positive 54,7 %, anti Sm positive 24,5 %. Vitamin D normal value 18,5 %, insufficient 50,9 %, deficient 32,6 %. 7 patients had low bone mass, 11,4 %. No association was found between traditional risk factors, those related to the disease (systemic inflammation, laboratory), metabolic and treatment with low bone mass, (p ≥ 0,05). Conclusion: they had a low bone mass 11,4 %. The traditional risk factors, those related to the disease, laboratory, metabolic and treatment did not present a statistically significant association with low bone mass.

Histopathological evaluation of endometrium and its clinical correlation in patients of abnormal uterine bleeding

Background: Abnormal uterine bleeding (AUB) is a very common, challenging gynaecological problem in all age group women. Neoplastic lesions are responsible for very less number of cases but they should be diagnosed early. Endometrial biopsy is necessary for histopathological diagnosis of endometrial lesions and to rule out any malignancy. In present study, we evaluated histopathological pattern of endometrium and different clinical parameters in AUB patients.Methods: A retrospective observational study done in Obstetrics and Gynecology department of SSMC Rewa, Madhya Pradesh in 2 year from 1st October 2017 to 30th September 2019. AUB patients who fulfilled inclusion criteria were included in study. All data were collected from department records in predesigned proforma and statistically analyzed by statistical package for the Social sciences (SPSS) version 20.Results: Total 366 AUB patients were included in study; most frequent clinical presentation was HMB (56%). Mostly patient’s age ranged from 24-84 years, belonged to 41-50 years age group (44%), multiparous (78%), and premenopausal (53%). On histopathological evaluation of endometrium most commonly nonneoplastic lesions (75%) were seen, out of which proliferative phase endometrium was most frequent. Neoplastic lesions were seen in 25% cases. Out of which benign lesions were noted in 7%, premalignant in 17.3% and malignant in 1% (all in >45 year patients).Conclusions: Endometrial biopsy should be done in all AUB patients >45 years and in selected premenopausal in order to get early diagnosis, to rule out malignancy and to help in management. Endometrial biopsy should be considered as first diagnostic modality.

Comparison of risk profile in pre-menopausal and post-menopausal women with acute coronary syndrome

Background: The physiological changes associated with menopause are responsible for increase in cardiovascular disease after menopause. BMI, physical inactivity, metabolic syndrome, hypertension and diabetes mellitus increase in post-menopausal women which are all powerful predictors of cardiovascular events. The risk factor profile between pre-menopausal and post-menopausal women presenting with acute coronary syndrome was thus studied.Methods: This study was a prospective cross-sectional hospital based study and was conducted in the Department of Medicine and Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana wherein 50 pre-menopausal women and 50 post- menopausal women who presented with acute coronary syndrome were enrolled. The risk factor profile and angiography findings amongst the 2 groups were compared.Results: There was no difference in the incidence of Diabetes Mellitus and Hypertension among the pre & post-menopausal groups. The prevalence of family history of cardiovascular disease was higher in the pre-menopausal group. The post-menopausal women showed a significant decrease in physical activity due to sedentary lifestyle. Both the groups had high BMI and increased waist circumference. Lipid parameters did not show any significant difference between the two groups. However, pre-menopausal women had higher LDL-C and triglyceride levels and lower HDL-C levels. On analysis of the angiographic findings in diabetics and non-diabetics, of both the groups diabetes mellitus was much higher in subjects presenting with triple vessel disease suggesting extensive atherosclerosis.Conclusions: study showed physical inactivity as an important cardiovascular risk factor in post-menopausal women. Obesity is an important risk factor for coronary artery disease in both pre- and post-menopausal women.

Clinical and Angiographic Profile of ST-elevation Myocardial Infarction in Premenopausal Women

 Introduction: Ischemic heart disease and its complications are on a rise in premenopausal women unlike previously thought that estrogen provides protective effects from cardiovascular diseases. There are less number of studies for premenopausal women with ST-elevation myocardial infarction and very few took into account the clinical and angiographic pattern. Purpose: In this study, we took into account clinical and angiographic pattern as well as certain risk factor profile. Materials and Methods: Women <50 years admitted in the Intensive Coronary Care Unit of Government Rajaji Hospital, Madurai, with ST-elevation myocardial infarction were taken into the study (43 in number). Their clinical presentation, risk factor profile, biochemical data, electrocardiogram and echo findings, and the angiographic findings were collected. The study was conducted over a period of 1 year. Results: In our study, most of them were diabetics, non-vegetarians were using sunflower oil or palm oil, and almost 100% had dyslipidemia. Most of them had anterior wall myocardial infarction with ejection fraction >40%. Most of them had singlevessel disease. Thirty days mortality was very less. In about five patients, none of the conventional risk factors for coronary artery disease (CAD) were present. Conclusion: Premenopausal women with ST-elevation myocardial infarction are on a rise in the current era, unlike previously thought. The previous studies were of comparative studies between premenopausal and postmenopausal women. Studies about the risk factors among this age group were very less. Although conventional risk factors such as diabetes and dyslipidemia played major role, some of the unusual risk factors and unidentified risk factors were found to contribute to the disease. Further studies are needed to identify the unusual risk factors for CAD present in this age group

Risk Factors Associated with Endometrial Pathology in Premenopausal Breast Cancer Patients Treated with Tamoxifen

PURPOSE: To evaluate factors associated with endometrial pathology during tamoxifen use in premenopausal breast cancer (BC) patients.MATERIALS AND METHODS: We reviewed the medical records of premenopausal BC patients treated with tamoxifen who underwent endometrial biopsy with or without hysteroscopy. Clinical characteristics were compared between women with endometrial pathology (endometrial hyperplasia or cancer) and those with normal histology or endometrial polyps.RESULTS: Among 284 endometrial biopsies, endometrial hyperplasia was diagnosed in 7 patients (2.5%), endometrial cancer was diagnosed in 5 patients (1.8%), normal histology was noted in 146 patients (51.4%), and endometrial polyp was present in 114 patients (40.1%). When comparing women with endometrial cancer (n=5) to women with normal histology, abnormal uterine bleeding was more common (p=0.007), and endometrial thickness was greater (p=0.007) in women with endometrial cancer. Chemotherapy for BC was also more common in patients with endometrial cancer (p=0.037). When comparing women with endometrial polyps and those with endometrial hyperplasia or cancer, the presence of abnormal uterine bleeding was more common in patients with endometrial hyperplasia or cancer (p<0.001); however, tamoxifen duration and endometrial thickness did not differ significantly between the two groups.CONCLUSION: In premenopausal BC patients treated with tamoxifen, abnormal uterine bleeding, increased endometrial thickness, and chemotherapy for BC were associated with the occurrence of endometrial cancer. These findings may provide useful information for gynecologic surveillance and counseling during tamoxifen treatment in premenopausal BC patients.

Evaluation of Lifestyle and Some Biochemical Parameters Involved in Bone Health in Pre and Postmenopausal Cameroonian Women

Aims: A healthy skeletal system with strong bones is essential to overall health. This study aimed to assess lifestyle and bone’s biomarkers of women. Study Design:This was a cross-sectional study.Place and Duration of Study:The enrollment took place at the Yaounde Military Hospital from November 2016 to July 2017.Methodology:A set of 105 postmenopausal and 127 premenopausal participants were enrolled from November 2016 to July 2017 in Yaounde. Their physical activities level was evaluated using a questionnaire. Sunlight exposure between 10:00AM and 4:00PM was assessed. Colorimetric methods were used to evaluate calcium, albumin, and alkaline phosphatase activityin plasma. These parameters were then compared within year since menopause (YSM) and osteoporosis risk assessment instrument (ORAI) sub-groups.Results:13.4% participants were moderately active. Only 22.8% participants had at least 30 minutes sun exposure daily. A multivariable analysis of demographic, lifestyle, biochemical characteristic revealed age, BMI, albumin and calcium were the main factors that influenced bone health among our participants. A significant difference of calcium concentration was found between the two groups whereas albumin was significantly higher in premenopausal than postmenopausal. Albumin was the only variable with a significant difference in the YSM sub-groups while only calcium was non-significantly higher among the ORAI sub-groups. Conclusion:Elevated plasma level of calcium, albumin and alkaline phosphatase could be indicators of high bone turnove

Analysis of Risk Factors of Osteoporosis among Premenopausal Women And Postmenopausal Women at a Tertiary care Teaching Centre

Introduction: Osteoporosis is a serious health concern thataffects millions of people around the world. Especiallyosteoporosis in postmenopausal women is one of the majorpublic health concerns growing worldwide. In order to preventosteoporosis there is a need to understand its risk factors. Sothe present study is designed to assess and compare the riskfactors of osteoporosis among women and BMD at lumbarspine and femur neck in premenopausal and postmenopausalwomen.Materials and Methods: This hospital based prospectivestudy was conducted on 350 women aged 30-65 years referredto the department of Radio diagnosis for Dexa scan assuspected cases of osteoporosis form various outpatientdepartment. The data collected was evaluated usingstandardized statistical methods in order to derive a logicalconclusion i.e. mean, standard deviation and Pearson Chisquare test.Results: A highly significant difference was observed b/w twogroups in age, weight, BMI, WC, HC, BMDLS, LS T &Z score,FNBMD, FN T & Z score of normal and low BMD group ofPostmenopausal group. A highly significant difference wasobserved b/w two groups in Age, weight, BMI, Waistcircumference, Hip circumference, BMD Lumbar, Lumbar spineT score & Lumbar spine Z score, BMD Femur neck, Femurneck T score & Femur neck Z score of normal and low BMDgroup of Postmenopausal group.Conclusion: Based on the result of our study we conclude thatpostmenopausal women with older age, Low socioeconomicstatus and with low level of physical activity were at higher riskof low BMD. Body mass index found to be positively associatedwith Bone mineral density in postmenopausal women onlywhereas negative correlation was found with age in both preand postmenopausal women.

Characteristics of non-small cell lung cancer: differences by sex and hormonal status in a Mexican population / Características del cáncer de pulmón de células no pequeñas: diferencias por sexo y estado hormonal en una población mexicana

Abstract: Objective: To analyze the differences in the clinico-pathological and molecular characteristics of non-small cell lung cancer (NSCLC) as well as the clinical outcome of patients by sex and hormonal status. Materials and methods: We performed a retrospective study among 1 104 NSCLC patients. Clinic-pathologic data was recorded and survival outcomes were compared between male and female sex patients, and further by pre and postmenopausal status in females. Results: Women were significantly more likely to be non-smokers (p<0.001), had higher frequency of wood-smoke exposure (p<0.001), EGFR-sensitizing mutations (p<0.001), had better performance status (p=0.020) and had a better overall survival (OS) compared to men (p=0.021). Differences were found also by hormonal status, postmenopausal women had a longer OS compared to premenopausal women (31.1 vs. 19.4 months p=0.046). Conclusion: Our results support the differences in lung cancer presentation by sex and also by hormonal status.

Resumen: Objetivo: Analizar las diferencias en las características clínico-patológicas, moleculares y en la evolución del cáncer de pulmón de células no pequeñas (CPCNP) por sexo y estadio hormonal. Material y métodos: Estudio retrospectivo (N=1 104) en pacientes con CPCNP. Se recabaron datos clínico-patológicos y desenlaces de sobrevida y se compararon entre hombres y mujeres, y entre mujeres pre y postmenopáusicas. Resultados: Las mujeres de este estudio tuvieron significativamente mayor probabilidad de ser no fumadoras (p<0.001), tener exposición a humo de leña (p<0.001), mutaciones en EGFR (p<0.001), mejor estado funcional (p=0.020), y una mejor sobrevida global (SG) en comparación con los hombres (p=0.021). Estas diferencias también se encontraron en cuestión al estatus hormonal, con las mujeres postmenopáusicas presentando una mayor sobrevida en comparación con las premenopáusicas (31.1 vs. 19.4 meses; p=0.046). Conclusión: Los presentes resultados apoyan las diferencias en la presentación del CPCNP de acuerdo con el sexo y estatus hormonal.

Lipid Profile and Prevalence of Dyslipidemia in Pre- and Postmenopausal Women in Yaounde, Cameroon

Aims: Lipids serve several important physiologic functions like energy homeostasis or biosynthesis of hormone within the human body. The deterioration of lipid metabolism which is favoured by menopause is the source of cardiovascular diseases. This study aimed to determine the plasma lipid profile and dyslipidemia prevalence of some Cameroonian women.Study Design:This was a cross-sectional study.Place and Duration of Study:The enrollment took place at the Yaounde Military Hospital from November 2016 to July 2017.Methodology:To achieve this goal, two sets of 105 postmenopausal and 127 premenopausal participants were enrolled in this study. 5ml of blood were collected on EDTA coated tubes from each participant. Enzymatic methods were used to evaluate total cholesterol, HDL cholesterol and triglyceride, while LDL cholesterol was determined using the Friedewald equation. These biological parameters were used to determine dyslipidemia. Thereafter, they were compared within age and year since menopause subgroups. Results:There was no significant difference in the mean values of total cholesterol, HDL-C, LDL-C as well as triglyceride between premenopausal and postmenopausal women. The mean HDL-C concentration wasstable in the age subgroups while the mean total cholesterol and LDL-C were slightly increasing as postmenopausal participants got older. LDL-C level was significantly higher in women who had been in menopause for more than 15 years. The overall dyslipidemia prevalence was 53%. Dyslipidemia was significantly higher in the subgroup of women who had freshly entered menopause.Conclusion:Even though there was no change in the mean concentration of the plasma lipid parameters, of pre-and postmenopausal participants there was a general need to improve their lifestyle in order to reduce dyslipidemia prevalence

Association between carbohydrate and fat intake and estradiol levels with body fat percentage in Minangkabau ethnic premenopausal women, in Padang City West Sumatra year 2018

Background: Excessive carbohydrate and fat intake with excess estradiol levels will cause an increase in body fat percentage, thus causing obesity in premenopausal women. Objective was to determine the association between carbohydrate intake with fat percentage, the association between fat intake with fat percentage, the association between SAFA intake with fat percentage, the association between MUFA intake with fat percentage, the association between PUFA intake with fat percentage, and the association between estradiol levels with fat percentage in Minangkabau ethnic premenopausal women in Padang City, West Sumatra.Methods: This research was carried out in Padang City. Research conducted was observational research with cross sectional research design. Subjects in this research were 52 people. Variables in body fat percentage were measured using Bioelectrical Impedance Analysis (BIA), carbohydrate and fat intake data were obtained by interviewing the Food Frequency Questionnaire (FFQ), and estradiol levels were examined by ELISA. Data analysis was performed using Pearson correlation test.Results: In premenopausal women in the city of Padang, low carbohydrate intake was found with an average of 227.25grams, high fat intake was found with an average of 77.84grams, high SAFA intake was found with an average of 27.59grams, low MUFA intake was found with an average of 9.91grams, normal PUFA intake was found with an average of 9.37grams, normal estradiol levels was found with an average of 145.95pg/ml, and more fat percentage was found with an average of 33.31.Conclusions: There was an association between carbohydrate intake with fat percentage, there was an association between fat intake with fat percentage, there was an association between SAFA intake with fat percentage, there was an association between MUFA intake with fat percentage, there was an association between PUFA intake with fat percentage, and no association between estradiol levels with of fat percentage in premenopausal women in Padang City.

Expression level and clinical significance of MicroRNA-15b in premenopausal endometrial carcinoma / 中国医师进修杂志

Objective To determine the expression level of MicroRNA-15b in premenopausal endometrial carcinoma and analyze its relationship with pathological parameters. Methods From March 2016 to June 2018, 64 cases of premenopausal endometrial carcinoma tissues and 28 cases of premenopausal normal endometrial tissues that were surgically resected and examined in Shaanxi People′s Hospital were collected. The expression of microrna- 15b was detected by reverse transcription polymerase chain reaction (rt-pcr), and the relationship between the expression level of microrna-15b and the pathological parameters of premenopausal endometrial carcinoma was analyzed. Results The relative expression level of microrna-15b in premenopausal endometrial cancer (1.38 ± 0.28) was lower than that in normal endometrial tissue (2.55 ± 0.36), and the difference was statistically significant (P<0.05). MicroRNA-15b expression level in premenopausal endometrial carcinoma tissue of Ⅲ period, infiltration depth 1/2 or more muscle layer, lymph node metastasis, ER negative and negative PR was significantly lower than that of stage Ⅰ ～ Ⅱ, < 1/2 muscularis infiltration depth, no lymph node metastasis, and positive ER and PR(P < 0.05). However, there was no significant difference in the expression level of microrna-15b in premenopausal endometrial cancer tissues with different ages, pathological types and pathological grades (P>0.05). Conclusions The expression of MicroRNA-15b in premenopausal endometrial carcinoma is low, and it is closely related to pathological stage, depth of invasion, lymph node metastasis and hormone receptor. Up-regulation of microRNA-15b expression may become a new treatment direction for premenopausal endometrial cancer.

Factores de riesgo para cáncer de endometrio en premenopáusicas con hemorragia uterina disfuncional / Risk factors for endometrial cancer in pre-menopausal women with dysfunctional uterine hemorrhage

El objetivo de la investigación fue establecer los factores de riesgo para cáncer de endometrio en premenopáusicas con diagnóstico de hemorragia uterina disfuncional. Se realizó un estudio observacional en mujeres con diagnóstico de hemorragia uterina disfuncional. Se evaluaron la asociación entre la histología endometrial y los factores de riesgo para el cáncer de endometrio, de ellos se analizaron: irregularidades del ciclo menstrual, diabetes mellitus, nuliparidad, hipertensión, obesidad y edad mayor de 40 años. La regresión logística se utilizó para investigar la importancia relativa de cada factor de riesgo. El estudio incluyó 266 mujeres con edad promedio de 41 años. La prevalencia de los factores de riesgo fue la siguiente: edad mayor de 40 años (67,2 %), menstruaciones irregulares (22,1 %), nuliparidad (16,9 %), obesidad (10,1 %), hipertensión (8,6 %) y diabetes (2,2 %). Los resultados de la biopsia endometrial incluyeron: 14 casos (5,2 %) de hiperplasia simple, 16 casos (6,0 %) de hiperplasia compleja y 4 casos (1,5 %) de hiperplasia con atipia. No se observaron casos de adenocarcinoma de endometrio. Se encontró que las menstruaciones irregulares eran el único factor de riesgo estadísticamente significativo asociado a alteración de la histología endometrial (p = 0,0132). En el grupo de pacientes con menstruaciones regulares y sin factores de riesgo, la incidencia de biopsia anormal observada fue inferior al 1 %. Las irregularidades del ciclo menstrual aumentan la probabilidad de un resultado anormal de la biopsia a un 14,2 %. Se concluye que las mujeres premenopáusicas diagnosticadas con hemorragia uterina disfuncional cuyos ciclos menstruales son regulares tienen un riesgo insignificante de desarrollar hiperplasia endometrial.

The objective of the research was to establish risk factors for endometrial cancer in pre-menopausal women with a diagnosis of dysfunctional uterine hemorrhage. An observational study was conducted in women with a diagnosis of dysfunctional uterine bleeding. The association between endometrial histology and risk factors for endometrial cancer analyzed were menstrual cycle irregularities, diabetes mellitus, nulliparity, hypertension, obesity and age over 40 years. Logistic regression was used to investigate the relative importance of each risk factor. The study included 266 women with an average age of 41 years. The prevalence of risk factors was the following: age over 40 years (67,2 %), irregular menses (22,1 %), nulliparity (16,9 %), obesity (10,1 %), hypertension (8,6 %) and diabetes (2,2 %). The results of the endometrial biopsy included: 14 cases (5,2 %) of simple hyperplasia, 16 cases (6,0 %) of complex hyperplasia and 4 cases (1,5 %) of complex hyperplasia with atypia. No cases of endometrial adenocarcinoma were observed. It was found that irregular menses were the only statistically significant risk factor associated with alteration of endometrial histology (p = 0.0132). In the group of patients with regular menses and without risk factors, the incidence of abnormal biopsy observed was less than 1 %. The irregularities of the menstrual cycle increases the probability of an abnormal result of the biopsy to 14,2 %. It is concluded that premenopausal women diagnosed with dysfunctional uterine bleeding whose menstrual cycles are regular have a negligible risk of developing endometrial hyperplasia.

Metastasizing uterine mullerian adenosarcoma in a young female: Diagnostic enigma

Uterine adenosarcomas are uncommon tumors. It is a biphasic tumor with both epithelial and mesenchymal component. The epithelial component is benign in nature, and the mesenchymal component is malignant. Metastasis is rare in adenosarcoma. We report a case of adenosarcoma with lymph nodal metastasis. A 20-year-old female presented with history of per vaginal bleeding for 1 month. Per vaginal examination revealed a fungating mass protruding through the cervical os. Ultrasonography and magnetic resonance imaging showed a large intrauterine mass. Biopsy of the mass done at an outside hospital was reported as rhabdomyosarcoma. Hence, she was given one cycle of neoadjuvant chemotherapy. Following this, she had profuse bleeding. Emergency hysterectomy with pelvic lymph nodal dissection was performed. The final histopathology was reported as adenosarcoma. One pelvic lymph node showed metastatic deposit of rhabdomyosarcomatous element. In young females presenting with polypoidal mass, uterine adenosarcoma can be considered in the differential diagnosis.

Association between cadmium and anti-Mullerian hormone in premenopausal women at particular ages

BACKGROUND: Anti-Mullerian hormone (AMH) in women is secreted by granulosa cells of antral follicles. AMH appears to be a very stable marker for ovarian function. It may be used to diagnosis cases of premature ovarian failure, polycystic ovary syndrome (PCOS), and ovarian tumors. It has been suggested that cadmium exposure can reduce female fecundity. The purpose of this study was to investigate whether environmental exposure to cadmium was associated with alterations in AMH with regards to age. METHODS: In a cross-sectional study, the data of premenopausal women living in Seoul, ranging from 30 to 45 of age was collected. The study included a total of 283 women who completed serum AMH and whole blood cadmium assessments. Linear regression analyses were used in order to examine the association between cadmium and AMH. Given that age was the strongest confounder in both cadmium and AMH concentrations, we stratified subjects by 5 years old and analyzed their data. RESULTS: Geometric mean concentrations of blood cadmium and AMH were 0.97 μg/L and 3.02 ng/ml, respectively. Total association between cadmium and AMH was statistically significant (adjusted coefficient = − 0.34 (0.15), p = 0.02). After stratification, the only age group with a negative association between cadmium and AMH were the women raging between 30 and 35 years (adjusted coefficient = − 0.43 (0.18), p = 0.01). CONCLUSIONS: The results of this study suggest that environmental exposure to cadmium may alter the AMH level of premenopausal women, depending on their age group.

Prevalencia de causas secundarias de baja masa ósea en una población de mujeres premenopáusicas / Prevalence of secondary causes in a population of premenopausal women with low bone mass

La osteoporosis es un trastorno común en las mujeres posmenopáusicas; sin embargo, también puede afectar a hombres y mujeres jóvenes premenopáusicas. El objetivo del presente trabajo fue evaluar la prevalencia de causas secundarias de baja masa ósea en un grupo de mujeres premenopáusicas que consultaron en una Institución especializada en Osteología. Material y métodos: se realizó un estudio retrospectivo, de corte transversal, descriptivo y observacional. Se analizaron las historias clínicas de 88 pacientes que consultaron por baja masa ósea durante un período de 19 meses, con la finalidad de encontrar posibles causas secundarias. A su vez, se definió como pacientes con diagnóstico de baja masa ósea idiopática aquellas en las cuales no se encontró ninguna causa secundaria de pérdida ósea. Resultados: de las 88 mujeres evaluadas, el 48,9% presentaba al menos una causa secundaria para baja masa ósea (amenorrea secundaria, hipercalciuria, tratamiento con glucorticoides, hipovitaminosis D y enfermedad celíaca) y el 51,1% fueron consideradas idiopáticas. Conclusiones: es esencial evaluar exhaustivamente a las mujeres premenopáusicas con baja masa ósea a fin de descartar posibles causas secundarias y tomar las medidas preventivas necesarias para mejorar esa condición. (AU)

Objective: osteoporosis is a common disorder in postmenopausal women, however it can also affect men and premenopausal young women. The purpose of this study was to evaluate the prevalence of secondary causes of low bone mass in premenopausal women that consulted physicians in an institution specialized in osteology for a period of 19 months. Material and methods: this is a retrospective, transversal, descriptive and observational study. The clinical history of 88 patients who consulted a physician due to low bone mass for a period of 19 months in an institution specialized in osteology. Were analyzed the patient's clinical history in order to find secondary causes. We define as suffering Low Bone Mass those patients who did not have secondary causes. Results: of the 88 women tested, 48,9% had one or more secondary causes or risks factors for low bone mass (secondary amenorrea, hypercalciuria, treatment with glucocorticoids, hypovitamiosis D and celiac disease) and 51,1% patients were considered idiopathic. Conclusions: we conclude that it is essential to exhaustively search for secondary causes of low bone mass in premenopausal women, due to the high prevalence of secondary osteoporosis in this population. (AU)