Investigation of the change of adiponectin level with menopause status in middle aged women and its relationship with androgen / 中华妇产科杂志

Objective To investigate the change of adiponectin level with menopause status in women aged 40 to 65, and its relationship with androgen. Methods A cross-sectional study included woman (aged from 40 to 65) who were in hospital for routine check-up at the Sun Yat-sen Memorial Hospital from August to October in 2013. All subjects underwent laboratory examinations of adiponectin, sex hormone binding globulin (SHBG), dehydroepiandrosterone-sulfate (DHEA-S), total testosterone (TT), collected anthropometric measurements and then calculated free androgen index (FAI) and body mass index (BMI). According to their menstrual status, the subjects were divided into 4 groups: premenopausal group with 119 subjects, perimenopausal group with 60 subjects, early postmenopausal group with 62 subjects, late postmenopausal group with 64 subjects. Results (1) Adiponectin levels declined to its lowest level in menopausal transition and gradually becoming higher after menopause, which showed a U-shaped trajectory. When compared adiponectin levels in late postmenopausal group [(13 ± 5) mg/L] with those in perimenopausal [(8 ± 6) mg/L] or early postmenopausal group [(9 ± 6) mg/L], it all showed significantly difference (P<0.05). (2) Both the adiponectin levels were negatively correlated with waistline in the 4 groups (premenopausal group, r=-0.276;perimenopausal group, r=-0.334;early postmenopausal group, r=-0.211;late postmenopausal group, r=-0.218; all P<0.05). Levels of adiponectin were positively correlated with SHBG (r=0.536, P<0.05) and negatively with FAI (r=-0.363, P<0.05) in menopausal transition, while in late postmenopausal group, negatively correlated with level of DHEA-S (r=-0.450, P<0.05). When adjusted for age, BMI and waistline, the above correlations still exist. Conclusions Adiponectin levels declined to its lowest level in menopausal transition and gradually becoming higher after menopause, which showed a U-shaped trajectory during the sequential menopause status transition in middle aged women. Low level of adiponectin in menopausal transition is closely associated with the relative excess androgen occurred during this stage.

[Efficacy and safety of a combined oral contraceptive containing drospirenone 3 mg and ethinylestradiol 20 µg in a 24+4-day regimen in China].

OBJECTIVE: To assess the efficacy, bleeding pattern, cycle control and safety of a combined oral contraceptive (YAZ) containing drospirenone 3 mg and ethinylestradiol 20 µg in a 24+4-day regimen in China. METHODS: This is a multi-center, open, one-label study. Healthy females aged 18-45 years received YAZ for 13 cycles. Following-ups were scheduled during the treatment phase on Day 12-19 of Cycle 1, 4, 7 and 10 and 10-17 days after completing the study. The efficacy variables were the number of unintended pregnancies, bleeding pattern and cycle control. The safety variables were adverse events (AE), lab examinations, physical and gynecological examinations, vital signs and body weights and questionnaires. RESULTS: Four pregnancies occurred among 675 women for 603.78 women-years, resulting in a Pearl index (PI) of 0.7 and adjusted PI of 0.6. The cumulative 1-year pregnancy rate was 0.66%. The mean number of bleeding/spotting days was (26.3 ± 12.4) days in reference period 1 and (15.4 ± 5.5) days in reference period 4. 94.2% (582/618)- 96.8% (538/558) subjects experienced scheduled bleeding. The mean duration of scheduled bleeding decreased from (5.9 ± 3.2) to (5.0 ± 1.6) days. The percentage of women with intermenstrual bleeding decreased from 14.5% (90/621) at Cycle 1 to 2.3% (13/558) at Cycle 12. The common AE relating treatment include nausea (3.4%, 23/675), breast tenderness (1.2%, 8/675), dizzy (1.2%), vagina bleeding (1.2%). No serious AE relating treatment occurred. 85.6% (542/633) subjects were satisfied or very satisfied with the study treatment. CONCLUSION: YAZ is highly effective, acceptable and safe for Chinese women.

The relationship of serum testosterone and its related index with the metabolism syndrome in women at perimenopausalor postmenopausal periods / 中华妇产科杂志

ObjectiveTo investigate the relationship between testosterone level and related index and metabolic syndrome(MS) of women in perimenopause or postmenopause period.MethodsFrom May 2009 to August 2010,911 women aged 40 - 65 years underwent physical examination in the Memorial Hospital,Sun Yat-sen University were enrolled in this study,which were divided into 175 women with early perimenopause period in group A,112 women late perimenopause period in group B,161 women with early postmenopause period in group C,132 women with moderate postmenopause period in group D,88 women with late postmenopause period in group E,243 women with regular menstruation as control group (group F).MS was defined according to the International Diabetes Federation (IDF) criteria.The relationship of free testosterone level and MS of women in different stage of menopause was analyzed.Results (1) Compared with 1.13 nmol/L in group F,median testosterone level of 1.03 nmol/L in group A,0.91 nmol/L in group B,0.91 nmol/L in group C,0.87 nmol/L in group D,0.83 nmol/L in group E decreased significantly at early peri-menopause period(P ＜0.01 ).Median free androgen index(FAI) was 1.33 in group A,1.56 in group B,1.69 in group F.When compared median FAI in group A with those in group F or B,it all showed significantly difference ( P ＜ 0.01 ) ; Testosterone ( T)/estradiol ( E2 ) were 0.042 in group C,0.040 in group D,0.042 in group E,0.010 in group A.When compared T/E2 in group C with group F,D and E,it all reached statistical difference (P ＜ 0.01 ).(2)There were negative correlation among waist circumference (WC,r =- 0.287 ),fasting blood glucose ( FBG,r =- 0.281 ),triglyceride ( TG,r =-0.224) and sex hormone-binding globulin (SHBG) and positive correlation with high density lipoprotein cholesterone (HDL-C,r =0.314).The logistic regression analysis for MS showed that the MS was associated with SHBG significantly ( OR =0.993,95％ CI:0.986 - 0.999,P =0.035 ).( 3 ) When cut-off value of SHBG was defined at 56.14 nmol/L,SHBG was used to predict MS with sensitivity of 63.13％ and specificity of 69.45％.Conclusions Serum testosterone was associated with MS in women at perimenopausal and postmenopausal period,so window period of preventing MS was set at perimenopausal period.A serum testosterone level was elevated from premenopause to postmenopause period.Because there was an association between SHBG and MS,SHBG was a selectable parameter to predict MS.

Effects of levonorgestrel-releasing intrauterine system on endometrial estrogen and progesterone receptors in patients with endometrial hyperplasia / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the changes in local endometrial contents of estrogen receptors (ER) and progesterone receptors (PR) after insertion of levonorgestrel-releasing intrauterine system (LNG-IUS) and evaluate the efficacy of LNG-IUS in treating endometrial hyperplasia.</p><p><b>METHODS</b>The endometrial histological changes were observed in 25 anovulatory women with dysfunctional uterine bleeding after insertion of LNG-IUS, and the contents of ERs and PRs in the endometrium were measured by immunohistochemistry.</p><p><b>RESULTS</b>The endometrial proliferation activity was obviously inhibited 6 months after LNG-IUS insertion with decreased endometrial glands, glandular dysplasia and decidualization of interstitial cells. The positive cell rate for ERs and PRs in the glandular epithelial and interstitial cells were significantly reduced after LNG-IUS insertion.</p><p><b>CONCLUSIONS</b>LNG-IUS can reduce ER and PR expressions in the endometrium and inhibit endometrial proliferation, and therefore can be effective in treating simple and complex endometrial hyperplasia.</p>