Risk factor for first-incident hip fracture in Taiwanese postmenopausal women.

OBJECTIVE: The variation in hip fracture risk between countries is greater than 10-fold. The present study aimed at identifying risk factors that resulted in the first occurrence of hip fracture in Taiwanese postmenopausal women. MATERIALS AND METHODS: A case-control study with a patient group of 50 postmenopausal women, who were admitted to Keelung Chang Gung Hospital, Keelung, Taiwan due to the first incident of accidental hip fracture, was used to examine potential risk factors, including bone mass. Fifty women without hip fracture, selected from those undergoing general health evaluation at the Gynecology Outpatient Clinic at Keelung Chang Gung Hospital, were used as the control group and were matched to the case patients according to age. Evaluation consisted of a questionnaire, interview to document risk factors, physical examination (to record body height and body weight), and examination [dual-energy X-ray absorptiometry used to measure bone mineral density (BMD) of the hip and spine]. RESULTS: The average age of participants of both groups was 79.6 years. Lower level of education, younger age at menopause, increased body height, weight-bearing exercise less than three times per week, and lower BMD were associated with first-incident hip fracture. Total hip BMD was a stronger predictor than the BMD of different sites. Participants in the control group had a significantly higher prevalence of chronic diseases and a history of cataracts or glaucoma compared with those in the patient group. CONCLUSION: While total hip BMD is the strongest predictor of hip fracture, increasing awareness of osteoporosis prevention by educating people about good lifestyle habits and how to maintain BMD is prioritized for preventing the first-incident hip fracture in Taiwanese women.

Impact of low concentrations of phthalates on the effects of 17ß-estradiol in MCF-7 breast cancer cells.

OBJECTIVE: To explore whether lower concentrations of phthalates interfere with the effects of 17ß-estradiol on the growth of MCF-7 breast cancer cells. MATERIALS AND METHODS: MCF-7 cells were treated with 17ß-estradiol (E2), phthalates, including butyl benzyl phthalate (BBP), di(n-butyl) phthalate (DBP), and di(20ethylhexyl) phthalate (DEHP), or with both E2 and phthalates, all at 10nM. After incubation for 48 hours, the cells were harvested and extracted for MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay. The proteins involving proliferative and apoptotic pathway were then evaluated using Western blot analysis. RESULTS: In MCF-7 cell cultures, the MTT assay revealed a significant increase in cell viability with E2 and these three phthalates, and significantly more cell proliferation with the combination of E2 and phthalates. Proliferating cell nuclear antigen, as well as phosphatidylinositide 3-kinase (PI3K) and p-Akt, were all substantially increased in cultures with E2, phthalates, and the two combined. An additive effect of phthalates on the obvious increase of Bcl-2 and ER α expression was also noted in the presence of E2. CONCLUSION: The present study demonstrates that even at a very low concentration, BBP, DBP, and DEHP were not only still capable of displaying estrogenic activity, but also of inducing an additive proliferative effect through the PI3K/Akt signaling pathway and preventing apoptosis in the presence of E2. Therefore, the effects of current reference doses for phthalates defined by the government, especially for premenopausal women, should be further considered.