Increased bone mineral density according to increase of skeletal muscle mass in 534 Korean women: A retrospective cohort study conducted over 2.7 years

OBJECTIVE: To determine the impact of the changes in the amount of abdominal fat, directly measured by computed tomography, body composition, and the metabolic syndrome (MetS) risk factors on the bone mineral density (BMD) of Korean women. METHODS: A retrospective cohort study involving 534 Korean women aged 29 to 78 years, who had undergone both dual-energy X-ray absorptiometry and abdominal adipose tissue analysis by computed tomography scan more than twice between January 2004 and December 2010. The changes in the BMD values were examined in association with the changes in fat amount, body composition parameters, and risk factors of MetS. RESULTS: On cross sectional analysis, there was a significant positive correlation between femoral BMD and total abdominal fat amount at the initial visit. However, the correlation disappeared when the impact of change of the fat amount on the change in BMD was analyzed over the study period. When the MetS and body composition parameters were analyzed, a significantly positive correlation was found between skeletal muscle mass and BMD. There was no significant relationship between the MetS risk factors or other body composition parameters and BMD throughout the study period after adjusting for age (time interval). CONCLUSION: Among body composition parameters, only increased skeletal muscle mass had a positive correlation with increased BMD over the study period of 2.7 years.

Vitamin D deficiency in women with polycystic ovary syndrome / 대한생식의학회지

OBJECTIVE: To investigate: the prevalence of vitamin D deficiency in Korean women with polycystic ovary syndrome (PCOS), and the relationship between vitamin D status and clinical or metabolic features in this group. METHODS: We recruited 38 women with PCOS using the Rotterdam criteria. A total of 109 premenopausal control women were matched with patients based on age and body mass index. Serum 25-hydroxy vitamin D concentrations less than 20 ng/mL were classified as frank vitamin D deficiency. Since vitamin D may play a significant role in metabolic disturbances in women with PCOS, correlations between clinical or metabolic parameters and vitamin D status were analyzed separately in patients and controls. RESULTS: Women with PCOS showed no differences in the level of 25-hydroxy vitamin D (19.6+/-6.6 ng/mL in patients vs. 20.1+/-7.4 ng/mL in controls, respectively, p=0.696) or prevalence of vitamin D deficiency (57.9% in patients vs. 56.5% in controls, respectively, p=0.880). In addition, we did not find any correlations between serum vitamin D level and clinical or metabolic profiles in either PCOS patients or controls. CONCLUSION: Our study found no differences in the absolute level of serum vitamin D between PCOS patients and matched controls. Prevalence of vitamin D deficiency was equally common among both patients and controls. Additionally, we did not find any correlations between serum vitamin D level and clinical or metabolic profiles, suggesting that the role of vitamin D in the pathogenesis of PCOS is not yet clear.

Carotid intima-media thickness in mainly non-obese women with polycystic ovary syndrome and age-matched controls

OBJECTIVE: Metabolic disturbances are well-recognized clinical features of polycystic ovary syndrome (PCOS). Carotid intima-media thickness (CIMT) has been widely used as a surrogate marker of atherosclerosis and cardiovascular disease (CVD). CIMT in women with PCOS has been investigated in many studies, but there has been only one report in the Korean population. The aim of the present study was to compare the presence of subclinical atherosclerosis in young untreated Korean women with PCOS and age-matched controls, specifically by measuring their CIMT. METHODS: CIMT was measured by one radiologist in 56 PCOS patients and 56 controls. To compare the CIMT according to PCOS phenotypes, women with PCOS were divided into two subgroups according to the presence of hyperandrogenism. RESULTS: Although PCOS patients were more obese and had higher blood pressure and insulin resistance index than the age-matched controls, the CIMT was not different between the two groups (0.49 +/- 0.09 mm in PCOS patients vs. 0.50 +/- 0.11 mm in controls, respectively, p = 0.562). When the CIMT in the control group was compared with hyperandrogenic and non-hyperandrogenic PCOS groups, also no significant differences were found. CONCLUSION: Despite the significant differences in some vascular risk factors between women with PCOS and controls, PCOS patients did not have a significantly higher CIMT (even in the hyperandrogenic subgroups). Although our study did not show the increased risk of subclinical atherosclerosis in PCOS patients, the role of CIMT continues to be investigated considering the importance of screening and monitoring CVD risk factors in women with PCOS.

Natural conception rate following laparoscopic surgery in infertile women with endometriosis / 대한생식의학회지

OBJECTIVE: To investigate the influence of laparoscopic surgery on the natural conception rate in infertile women with endometriosis during the first year after the operation. METHODS: We retrospectively studied 43 infertile women with surgically proven endometriosis. The natural conception rate was investigated for the 12 months after the laparoscopy. RESULTS: The overall pregnancy rate was 41.9% (18/43). 66.7% (12/18) and 94.4% (17/18) of the patients conceived within postoperative 3 months and 6 months, respectively. The spontaneous pregnancy rate was not associated with the severity of endometriosis or laparoscopic findings or the type of surgery. The pregnancy rate for stage IV was relatively low (20.0%) compared to stage I, II, and III (35.7%, 44.4%, and 53.3%, respectively), although it did not reach statistical significance. CONCLUSION: Conservative surgical treatment with laparoscopy and a prompt attempt at natural conception may be effective for infertile patients with endometriosis.

Comparison of the efficacy of three once-weekly bisphosphonates on bone mineral density gains in Korean women

OBJECTIVE: To assess the efficacies of once-weekly bisphosphonates on bone mineral density (BMD) gains in Korean women aged 50 years or more. METHODS: We selected 166 patients who received: alendronate 70 mg (n=48), alendronate 70 mg + cholecalciferol 2,800 IU (n=31) or risedronate 35 mg (n=87) for one year. The baseline BMD and the % changes of BMD at one-year were compared among the three medication groups. RESULTS: The menopausal status and number of women with osteoporosis was not different among the three groups, but mean age of women was significantly lower in alendronate group. Baseline BMD at L1-4 and femur neck (FN) was similar, but baseline BMD at femur total (FT) was significantly lower in alendronate group. After one-year use, the median % changes of BMD at three sites were similar among the three groups; however, the median values were highest in alendronate + cholecalciferol group (L1-4: 4.48%, 6.74%, and 4.50%; FT: 2.09%, 3.70%, and 2.31%; FN: 3.05%, 3.79%, and 2.03%). CONCLUSION: Among three once-weekly bisphosphonates, BMD gains were highest after one-year use of alendronate+cholecalciferol, although statistically not significant.

The Association among Serum Leptin System, Bone Biochemical Markers and Bone Mineral Density Before and After Hormone Therapy / 대한골다공증학회지

OBJECTIVES: To investigate the relationships between serum leptin, soluble leptin receptor (sLR) and bone mineral density (BMD) and bone biochemical markers and to evaluate association among these factors after hormone therapy (HT) in postmenopausal Korean women. METHODS: Serum leptin, sLR, biochemical markers, osteoprotegerin (OPG) and soluble receptor activator of NF-kB ligand (sRANKL) were measured by enzyme linked immunosorbent assay in 159 postmenopausal Korean women. The BMD at the lumbar spine (LS) and femoral neck (FN) was determined by dual energy X-ray absorptiometry, and changes of these factors were also measured in 70 postmenopausal women receiving HT. RESULTS: After adjustment for age and year since menopause, body mass index (BMI) was found to be significantly correlated with leptin (r=0.42, P25 kg/m2) were significantly higher than those in women with normal weight, whereas sLR levels were lower in the former women than in the latter women. After HT, serum leptin levels (P<0.005) and FLI (P<0.05) decreased significantly and decreased serum sLR levels (P<0.05) was found only in obese women. The percent changes in BMD at FN after HT were negatively correlated with the changes of sLR after HT. CONCLUSIONS: Circulating leptin system is not associated with BMD but BMI. Leptin and FLI decrease after HT and the changes of sLR reflects changes in BMD at FN after HT.

Effects of insulin-sensitizing agents and insulin resistance in women with polycystic ovary syndrome / 대한생식의학회지

OBJECTIVE: The aim of this study was to investigate the effect of insulin sensitizing agents on hormonal and metabolic parameters as well as menstrual patterns in women with polycystic ovary syndrome (PCOS). METHODS: One hundred and twenty-three patients with PCOS were included. Metformin was administered to patients at 1,500 mg or 1,700 mg daily for 3 months. If the patients had no improvement of the menstrual cycle or metformin-related adverse effects developed, the patients changed medication to a daily dose of either 15 mg pioglitazone or up to 45 mg. Then resumption of a regular menstrual cycle or recovery of ovulation was evaluated. Hormonal and metabolic profiles were compared between the response and non-response group to insulin sensitizing agents. RESULTS: One hundred and five patients with PCOS were treated with metformin for 3 months. Forty-eight patients (45.7%) showed improvement of menstrual cycle regularity after 3 months of metformin use, whereas 57 patients (54.3%) had no change. The mean free testosterone measured after 3 months of treatment was significantly lower in metformin responders than in non-responders. The other parameters did not differ between the groups. Of the 23 patients who used pioglitazone for 3 to 6 months, 19 patients (82.6%) showed improvement in their menstrual cycles. CONCLUSION: Metformin treatment seems to be effective for the improvement of menstrual cyclicity irrespective of insulin resistance in women with PCOS. When metformin related adverse effect occurred, pioglitazone would be effective for aiding the resumption of the menstrual cycle.

The Influence of Thyroid Function on Bone Mineral Density in Korean Postmenopausal Women / 대한폐경학회지

OBJECTIVES: Osteoporosis, defined as decreased bone mass and structural deterioration of bone, increases the incidence of fractures. Recently, there have been reports suggesting that thyroid hormones are related to bone mineral density (BMD). It has been reported that low normal circulating thyrotropin (TSH) levels correlate with lower BMD and that thyroxine (T4) and bone density are negatively related. This research aims to examine the relationship between BMD and thyroid diseases and other functional changes in postmenopausal women. METHODS: The medical records of 2,279 postmenopausal women who attended the health care clinic in eight university hospitals between March 2001 and December 2007 were reviewed retrospectively. We determined the baseline characteristics of the women, including age, height, weight, and body mass index (BMI). The BMD was measured by dual-energy X-ray absorptiometry (DEXA). The correlation between the thyroid status and BMD was analyzed using the SPSS 12.0 program. RESULTS: This research used data from a relatively large number of postmenopausal women gathered in a multicenter approach. Of the thyroid functional tests, thyroid stimulating hormone (triiodothyronine or T3) and T4 correlated with BMD, while free T4 and TSH did not show a statistically significant correlation. After adjusted age, thyroid function test did not correlate with BMD. Osteopenia was significantly higher in the group with TSH below 0.5 mU/L compared with groups that had normal or high TSH. There was no statistically significant difference in lumbar BMD and total hip BMD among patients with thyroid diseases and healthy patients. CONCLUSION: The level of T3 and T4 correlated well with BMD in Korean post-menopausal women.

Bone Response to Hormone Therapy according to Basal Bone Mineral Density and Previous Response to Hormone Therapy / 대한폐경학회지

OBJECTIVES: To investigate bone responses to hormone therapy (HT) according to basal bone mineral density (BMD) and previous responses to HT, as well as the frequency and clinical characteristics of HT non-responders in Korean postmenopausal women. METHODS: We retrospectively reviewed a total of 1,836 postmenopausal women who received HT from seven university hospitals. BMD data at the lumbar spine (LS), femur neck (FN), femur trochanter (FT) and total hip (TH) before HT, and at one, two, and three years after HT were collected. All patients were divided into three groups according to basal BMD: normal, osteopenia, and osteoporosis. RESULTS: Women with a greater loss of BMD during the first year of HT were more likely to gain BMD in the second year at any of the four skeletal sites. Bone responses to HT during the third year were not related to the responses during the first year. Mean BMD changes during the first year were significantly higher in the osteoporosis group, but mean BMD changes during the second year were not different between three groups except in LS. The frequency of non-responder (annual BMD losses more than 3%) during the first year was significantly higher in the normal basal BMD group. Mean basal BMDs were higher in the two-year consecutive non-responder group at LS, FN and FT, but those of the three-year consecutive non-responder group were not significantly higher except in FN. CONCLUSION: Most women who lose BMD after HT are likely to gain BMD during the next year. The frequency of non-responders is higher in the higher basal BMD group, and patients with lower basal BMD will be likely to respond better to HT.

Changing Korean Menopausal Women's Awareness on Hormone Therapy: 7-years after Women's Health Initiative Study / 대한폐경학회지

OBJECTIVES: The purpose of this survey was to compare Korean menopausal women's perceptions of hormone replacement therapy before and after publication of the Women's Health Initiative (WHI) study. METHODS: This study was conducted through a survey of 713 postmenopausal women, who attended lectures on health to commemorate Korean Menopause Awareness Month, during 2009 in Seoul and the provinces (Incheon, Daejeon, Daegu, Gwangju and Busan). RESULTS: Respondents' knowledge concerning the cause of menopause have been increased to 86.7% in 2009, compared to 56.6% in 2002. Women who required hormone therapy increased to 57.6% in 2009, compared to 56.6% in 2002. As a source of information about hormone therapy, media was about 34.0% in 2009, different from the previous study that doctor's advice was 60.7%. Among the women who stopped hormone therapy, the most common reason was fear of cancer (31.8%), which increased compared to 9.3% in 2002. Women who received regular screening for breast cancer increased to 82.3% in 2009, compared to 35.0% in 2002. Women who checked bone mineral density (BMD) increased to 71.8% in 2009, compared to 40.2% in 2002. CONCLUSION: Menopausal women in Korea have increased their awareness of menopause. They responded that hormone therapy was helpful to manage menopausal symptoms, even after WHI study. They obtained menopause-related information through various sources, and the role of mass media has been greatly increased. But they were concerned about the increased risk for cancer, especially breast cancer.

The Relationship between Wnt Antagonist Genes Polymorphisms and Changes in Production of Osteoprotegerin and Soluble Receptor Activator of NF-kB by Whole Blood Cells after Hormone Therapy / 대한골다공증학회지

OBJECTIVES: To investigate the relationship between single nucleotide polymorphism (SNP)s in Wnt antagonist genes, and production of osteoprotegerin (OPG) and soluble receptor activator of NF-kappaB ligand (sRANKL) by whole blood cells after hormone therapy (HT) in postmenopausal Korean women. MATERIALS AND METHODS: The Dkk1 c.318A>G, Dkk2 c.437G>A, Dkk3 c.1003A>G polymorphisms and sFRP3 c.970C>G, sFRP4 c.958C>A, and c.1019G>A polymorphisms, and sFRP5 c.20G>C polymorphisms were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), direct sequencing, and Taqman assay in 75 postmenopausal Korean women receiving estrogen-progestogen therapy. The production of OPG and sRANKL by lipopolysaccharide-stimulated whole blood cells (WBC) before and after HT of 6 months were also measured. RESULTS: Changes in the production of OPG and sRANKL by lipopolysaccharide-stimulated WBC, and in ratios of sRANKL(x1,000)/OPG after HT of 6 months were not different according to SNPs in Wnt signal pathway genes except Dkk1 c.318A>G SNP. The AA genotype of Dkk1 c.318A>G SNP showed significantly higher changes (pA, and c.1019G>A polymorphisms after HT. CONCLUSIONS: Dkk1 c.318A>G SNP are related with changes in ratios of sRANKL(x1,000)/OPG in terms of the production of OPG and sRANKL by lipopolysaccharide-stimulated whole blood cells after HT.

The Association between Single Nucleotide Polymorphisms of Sclerostin (SOST) Gene, Bone Mineral Density and Circulating Osteoprotegerin (OPG) / 대한골다공증학회지

OBJECTIVES: To investigate the relationship between polymorphisms of sclerostin (SOST) gene and bone mineral density (BMD) in postmenopausal Korean women. MATERIALS AND METHODS: The SOST rs865429 (g.5942C>T), rs17882143 (c.28G>A), rs10534024 (-1396TCC/Del) polymorphisms were analyzed by Taqman assay and direct DNA sequencing in 399 postmenopausal Korean women. Serum CrossLaps (CTX), bone alkaline phosphatase (BAP), osteocalcin, osteoprotegerin (OPG) and soluble receptor activator of NF-kB ligand (sRANKL) were measured by enzyme linked immunosorbent assay. The BMD at the lumbar spine (LS) and femoral neck (FN) were determined by dual energy X-ray absorptiometry, and in 311 postmenopausal women receiving hormone therapy (HT) BMD was also measured after HT of 1 year.

The Effect of Tibolone and Estradiol-based Hormone Therapy on Bone Mineral Density and Serum Lipid Profiles / 대한골다공증학회지

OBJECTIVES: To investigate the differences between the effect of tibolone and estradiol (E2)-based hormone therapy (HT) on bone mineral density (BMD) and serum lipid profiles in postmenopausal Korean women. MATERIALS AND METHODS: A retrospective study was conducted with 65 postmenopausal women receiving tibolone or E2-based hormone therapy in university hospital. BMD at lumbar spine (LS) and proximal femur was measured before and after 1 year of therapy and serum total cholesterol, triglyceride (TG) and high-density lipoprotein (HDL) was determined by enzymatic methods. RESULTS: BMD at LS increased after 1 year of tibolone (mean change: 3.0%) or E2-based HT (mean change: 1.6%), and the changes were significant (P=0.002 and 0.04, respectively). In E2 group, serum total cholesterol has decreased significantly after 1 year of therapy (P=0.02). Moreover, the change of HDL level was statistically significant in tibolone group compared to E2 group (P=0.01). The changes of levels of total cholesterol, TG and HDL has demonstrated negative relationship of BMD changes at femur neck and trochanter in tibolone group, whereas only the HDL changes were significantly related to the change of trochanter BMD in E2 group. CONCLUSIONS: Both tibolone and E2-based hormone therapy increased BMD at lumbar spine. The changes of serum lipid levels may be associated with the BMD changes in both groups although the relationships were different according to the regimen.

Characteristics of Body Fat, Body Fat Percentage and Other Body Composition for Koreans from KNHANES IV

Accurate measurement of fat mass has become increasingly important with the increasing incidence of obesity. We assessed fat and muscle mass of Koreans with the Korea National Health and Nutrition Examination Survey IV (KNHANES IV). We studied 10,456 subjects (aged 20 to 85 yr; 4,476 men, 5,980 women). Fat and muscle mass were measured by dual-energy x-ray absorptiometry. Reference values of body compositions were obtained using the LMS method. The fat mass index (FMI, body fat mass/height2; kg/m2) of Korean men did not correlate with age (P = 0.452), but those of Korean women (P 9 kg/m2) in men and 2.7% (FMI > 13 kg/m2) in women. It is concluded that the muscle mass decreases and obesity increases with aging in Korean men, whereas both fat mass and obesity increase with aging in Korean women.

Serum Concentration of Estradiol and Estrone Following Oral Administration of Low-dose Hormone Therapy in Postmenopausal Korean Women / 대한폐경학회지

OBJECTIVES: To determine the baseline serum concentrations of estradiol and estrone in postmenopausal Korean women and the serum concentrations of estradiol and estrone after 4 and 16 weeks of treatment using 1 mg of estradiol and 2 mg of drospirenone. METHODS: This was a multicenter study. Thirty-six subjects were screened. Serum estradiol, estrone and drospirenone levels were determined by gas chromatography-mass spectrometry and radioimmunoassay. RESULTS: The mean estradiol concentration was 8.37 +/- 12.1 pg/mL at baseline and increased to 53.7 +/- 52.1 and 41.4 +/- 26.1 pg/mL after 4 and 16 weeks of treatment, respectively. The mean estrone concentrations were 28.7 +/- 26.8, 266.1 +/- 182.9, and 256.1 +/- 179.1 pg/mL at baseline, and after 4 and 16 weeks of treatment, respectively. When women were stratified according to the basal estradiol level, the level after 4 weeks of treatment was significantly higher in the women with a detectable level (> or = 5 pg/mL) than in women with an undetectable level (< 5 pg/mL; 65.2 +/- 21.5 vs. 37.4 +/- 25.8 pg/mL, P = 0.008). After 16 weeks of treatment, the estradiol level was still higher in the detectable group (51.6 +/- 28.6 vs. 38.7 +/- 21.7 pg/mL, P = 0.09). CONCLUSION: This study showed that 1 mg of estradiol and 2 mg of drospirenone is an appropriate regimen to achieve the desired serum estradiol level. The difference in serum hormonal levels after 4 weeks of treatment could be caused by different basal levels.

Significance of the serum CA-125 level in intrauterine insemination cycles / 대한생식의학회지

OBJECTIVE: There are limited data regarding the significance of elevated serum CA-125 level during IUI cycles, even though it is used widely during the initial evaluation of infertile patients. The aim of this study was to investigate the prognostic value of serum CA-125 levels during IUI cycles. METHODS: Among the patients with controlled ovarian stimulation and IUI cycles at Seoul National University Hospital from Jan 2005 through Dec 2009, 92 cases with no identified endometriotic lesion, ovarian tumor, salpingeal lesion, or uterine myoma were selected. To compare the clinical characteristics between the pregnancy group and the non-pregnancy group, the Mann-Whitney U test and Fisher's exact test were used. RESULTS: The overall pregnancy rate was 18.5% (17/92). The pregnancy group showed a higher number of follicles 16 mm in diameter (p=0.036), endometrial thickness (p<0.001), ampules of gonadotropin (p=0.009), and higher body mass index (p=0.022) than the non-pregnancy group. No significant difference was observed in the serum CA-125 level or the proportion of patients with CA-125 exceeding 17 IU/mL between the two groups. CONCLUSION: The prognostic value of serum CA-125 level among infertile patients with IUI cycles is considered limited.

Retrospective Multicenter Study on Clinical Aspects in Premature Ovarian Failure / 대한폐경학회지

OBJECTIVES: Premature ovarian failure (POF) is a syndrome defined as the cessation of ovarian function before the age of 40 years that is characterized by amenorrhoea associated with elevated gonadotropin levels. The aim of this study was to compare clinical manifestation of primary amenorrhea and secondary amenorrhea group. METHODS: This study was designed as a retrospective multicenter study of 262 women with premature ovarian failure. Sixty eight women with primary amenorrhea and 194 women with secondary amenorrhea were evaluated and hormonal level, lipid profile, bone mineral density, and pregnancy rates were compared. RESULTS: The estradiol level was markedly lower in primary amenorrhea than secondary amenorrhea. The pregnancy rate of 43.3% before the diagnosis in secondary amenorrhea was markedly higher than the rate of 0% in primary amenorrhea. The pregnancy rates after treatment was 5.9% in primary amenorrhea, but 1.0% after diagnosis and 2.8% after treatment in secondary amenorrhea. The pregnancy rate after hormonal treatment was 3.7% in total, 8.3% in primary amenorrhea, and 2.8% in secondary amenorrhea. In nine cases of pregnancy, seven cases were after estrogen-progestin (EP), one case was after clomiphene citrate and one case was after EP/human menopausal gonodotropin (hMG). And In nine cases of pregnancy, six cases resulted from oocyte donation. The prevalence of osteopenia/osteoporosis was markedly higher in primary amenorrhea than in secondary amenorrhea. CONCLUSION: Premature ovarian failure has negative influences on the physical and psychological health of young patients. Effective management should include earlier diagnosis and intensive medical intervention to relieve symptoms of estrogen deficiency and to treat long-term disease such as osteoporosis and in assisted pregnancy by oocyte donation.

The Association of Polymorphisms of Secreted Frizzled Related Protein Genes with Circulating Osteoprotegerin (OPG): Soluble Receptor Activator of NF-kB Ligand (sRANKL) and Bone Mineral Density / 대한골다공증학회지

OBJECTIVES: To investigate the relationship between polymorphisms of secreted frizzled related protein (sFRP) genes, circulating osteoprotegerin (OPG), and soluble receptor activator of NF-kB ligand (sRANKL), and bone mineral density (BMD) in postmenopausal Korean women. METHODS: The sFRP1 c.3132C>T, rs16890444, sFRP2 c.-38C>G, and sFRP5 c.20G>C, and c.34A>T polymorphisms were analyzed by Taqman assay and dierect DNA sequencing in 170 postmenopausal Korean women. Serum CrossLaps (CTX), bone alkaline phosphatase (BAP), OPG, and sRANKL were measured by enzyme linked immunosorbent assay. The BMD at the lumbar spine and femoral neck was determined by dual energy X-ray absorptiometry. RESULTS: The sFRP2 c.-38C>G, and sFRP5 c.34A>T polymorphisms were not observed. No significant differences in adjusted BMD of lumbar spine and femoral neck and in risk for osteoporosis were noted among single genotypes of the sFRP genes polymorphisms measured or haplotype genotypes composed of the sFRP1 c.3132C>T and rs16890444 polymorphisms. No statistical significances in serum levels of bone chemical markers except BAP were observed according to single or haplotype genotypes. Serum BAP was significantly higher in women with the GG genotype than those in women with the GC genotype of the sFRP5 c.20G>C polymorphism. CONCLUSIONS: The sFRP1 c.3132C>T, rs16890444 and sFRP5 c.20G>C polymorphisms do not affect BMD at the lumbar spine and femoral neck in postmenopausal Korean women.

The Relationship between Polymorphisms in Tumor Necrosis Factor (TNF) Genes and Changes in Bone Mineral Density after Hormone Therapy in Postmenopausal Korean Women / 대한골다공증학회지

OBJECTIVES: To determine the association between polymorphisms in tumor necrosis factor-alpha (TNF-alpha), and TNF-beta genes, and changes in bone mineral density (BMD) after hormone therapy (HT) in postmenopausal Korean women. MATERIALS & METHODS: The TNF-alpha G(-308)A, C(-857)T, C(-863)A, T(-1031)C, and TNF-beta A252G polymorphisms were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) or Taqman assay in 218 postmenopausal Korean women receiving sequential HT for 1 year. Bone mineral density (BMD) at the lumbar spine and femoral neck was examined by dual energy X-ray absorptiometry. Serum levels of bone specific alkaline phosphatase (BAP), osteocalcin (OST), type I C-telopeptide breakdown products (CTX), parathyroid hormone (PTH), calcium, and phosphorus were measured using enzyme-linked immunosorbent assay (ELISA), immunoassay, and atomic absorptiometry, respectively. RESULTS: The TNF-alpha G(-308)A, C(-857)T, C(-863)A, T(-1031)C, and TNF-beta A252G polymorphisms were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) or Taqman assay in 218 postmenopausal Korean women receiving sequential HT for 1 year. Bone mineral density (BMD) at the lumbar spine and femoral neck was examined by dual energy X-ray absorptiometry. Serum levels of bone specific alkaline phosphatase (BAP), osteocalcin (OST), type I C-telopeptide breakdown products (CTX), parathyroid hormone (PTH), calcium, and phosphorus were measured using enzyme-linked immunosorbent assay (ELISA), immunoassay, and atomic absorptiometry, respectively CONCLUSIONS: The TNF-alpha G(-308)A, C(-857)T, C(-863)A, T(-1031)C, and TNF-beta A252G polymorphisms are not associated with changes in BMD after HT in postmenopausal Korean women.

The Use of Tenaculum During Intrauterine Insemination May Not Affect the Pregnancy Outcome

PURPOSE: The association between tenaculum application to the cervix just before embryo transfer and lower pregnancy rate has been reported. However, studies on the use of tenaculum in intrauterine insemination (IUI) cycles are not available. This study attempted to investigate whether the use of tenaculum affects the clinical outcomes of IUI. MATERIALS AND METHODS: Two hundred and thirty three CC/hMG/IUI cycles of one hundred and forty three couples were recruited at Seoul National University Hospital from October 2006 to December 2008. Mock insemination and IUI with or without tenaculum application to the cervix were also performed, and clinical pregnancy rate was compared. RESULTS: The incidence of difficult mock insemination at the beginning of cycle was higher in the tenaculum use group (p < 0.001). No significant statistical difference in the clinical pregnancy rate was observed between the groups with or without tenaculum application (12.1% vs. 18.5%; p = 0.175), which was not influenced by the difficulty of mock insemination. CONCLUSION: The use of tenaculum during IUI may not affect the pregnancy outcome. Our results need to be confirmed by a prospective study in a larger population.