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PubMed1997

Hypoleptinemia in women athletes: absence of a diurnal rhythm with amenorrhea.

The possibility that chronic nutritional deficiency alters leptin regulation and its link to reproductive function was investigated by determining serum leptin levels during a 24-h period with controlled nutrient intake in highly trained athletes with and without menstrual cyclicity and in BMI-matched cycling sedentary controls (n = 8 per group). Our data show that 24th leptin levels were reduced equally (3-fold, P < 0.001) in both cyclic and amenorrheic athletes as compared to controls. Low leptin levels in the athletic groups were consistent with their reduction in body fat (r = 0.91, P < 0.0001) relative to BMI, but were also influenced by the presence of low insulin (r = 0.70, P < 0.001) and elevated cortisol (r = -0.65, P < 0.001) levels. A diurnal pattern of 24h leptin levels, with an approximate 50% rise (P < 0.001) from nadir (0900h) to peak (0100h), was present in normally cycling athletes and controls and was strikingly absent in amenorrheic athletes. The absolute increase in leptin levels from nadir to peak was directly related to insulin excursions in response to meals (r = 0.60, P = .002) and inversely related to the amplitude of the 24h cortisol rhythm (r = -0.70, P = .0002). These findings are consistent with a link between the functionality of adipocytes, nutritional status, and integrity of the reproductive axis in humans.

Adipose Tissue↗
PubMed1992

Menstrual and reproductive factors and breast cancer in women with family history of the disease.

The relationship between socio-economic indicators, body mass, reproductive and menstrual factors and risk of "familial" breast cancer has been analyzed using data from a large case-control study of breast cancer conducted in Italy. A total of 3,037 breast-cancer patients aged 75 years or less admitted to a network of hospitals in the Greater Milan area were interviewed. Controls were 2,569 women aged 75 or less, admitted for acute conditions to the same network of hospitals where cases had been identified. Women were not included as controls if they had been admitted for gynecological, hormonal or neoplastic diseases. A total of 331 cases and 121 controls reported a family history of breast cancer in their first-degree relatives, with a family history tended to be more educated and of higher social class than controls with family history, but these differences were not statistically significant. No relationship emerged with marital status and body-mass index. The estimated multivariate relative risks were, compared with nulliparous women, respectively 0.9, 1.2 and 1.2 for women reporting 1, 2 and 3 or more births. The risk of breast cancer was also greater in women reporting one or more spontaneous abortions: compared with those who did not, the estimated relative risk was 1.9 (95% confidence interval 0.8 to 3.7). Relative to women reporting their first birth below age 25, the estimated relative risks were 1.3 and 0.9 in those reporting it at age 25 to 29 and 30 or more respectively. Likewise, no consistent relationship emerged with lifelong menstrual pattern and menopausal status. These results suggest that menstrual and reproductive factors do not play an important role in the risk of breast cancer in women with a history of the disease in first-degree relatives.

Abortion, Spontaneous↗
PubMed1995

Earlobe crease in women: evaluation of reproductive factors, alcohol use, and Quetelet index and relation to atherosclerotic disease.

BACKGROUND: The diagonal earlobe crease (ELC) has been found to be associated with atherosclerotic heart disease. Although atherosclerotic cardiovascular disease is less prevalent among women than among men, no studies have been reported for women on the possible relationship of reproductive factors, contraceptive and menopausal estrogen use, and alcohol use on the expression of the ELC. SUBJECTS AND METHODS: The presence of ELC was determined in 625 white women who were seen as part of a breast research project. Information was obtained on age, height, weight, age at menarche, parity, age at first full-term pregnancy, use of oral contraceptives or menopausal estrogens, alcohol consumption, and smoking. Statistical methods used included estimation of the age-adjusted odds ratios and their 95% confidence intervals, and multiple logistic regression. RESULTS: No association was found between the ELC and reproductive factors and smoking. Only age, Quetelet index, and alcohol use were associated with the ELC. The ELC was negatively associated with alcohol use, and was more marked in women under 59 years of age. The positive association of ELC with the Quetelet index progressively became more marked with advancing age, especially after 60 years of age. CONCLUSION: The negative association found between the ELC and alcohol use is of interest because of the reported protective effect of moderate alcohol consumption on risk of coronary heart disease. No significant association was found between the ELC and reproductive risk factors. Based on events occurring during the embryonic development of the earlobes, a new hypothesis is proposed for the formation and peculiar diagonal localization of the ELC in adult earlobes in association with atherosclerotic vascular disease.

Adult↗
PubMed2002

Height, weight, menstrual and reproductive factors and risk of gastric cancer among Japanese postmenopausal women: analysis by subsite and histologic subtype.

To clarify whether reproductive factors have an impact on gastric cancer in Japanese females, a case-control study was conducted using data from the Hospital-based Epidemiologic Research Program at Aichi Cancer Center (HERPACC), Japan. The study subjects included 365 postmenopausal women with gastric cancer and 1,825 age-class frequency-matched noncancer outpatients presenting at Aichi Cancer Center in 1988-1998. Cases were further divided with regard to the anatomic subsite (upper third, middle third, lower third) and histologic subtypes (differentiated, nondifferentiated) and the association was evaluated using odds ratios (ORs) estimated by the logistic regression model, adjusting for potential confounding factors. A high body weight and corresponding body mass index at age 20 moderately increased the risk of gastric cancer, especially for middle third and nondifferentiated cancers. Risk fluctuation with early or late age at menarche and menopause and total duration of fertility was not consistent. Individuals with a high age at first parity tended to show decreased risk of cancer, irrespective of their subsite or histologic subtype. The ORs were decreased with a short average period of breastfeeding, especially for upper third and nondifferentiated cancers. From these results, however, it appears that height, weight, menstrual and reproductive factors have less impact on gastric cancer than environmental factors such as smoking and dietary habits or family history of gastric cancer.

Adult↗
PubMed1999

Relative hypoleptinaemia in women with mild gestational diabetes mellitus.

AIMS: There is increasing evidence suggesting that leptin plays a major role in the regulation of energy homeostasis, as well as in the neuroendocrine and reproductive systems. Leptin is synthesized in the human placenta. The aim of this study was to relate serum leptin levels during pregnancy to glucose tolerance, body mass index (BMI) and specific metabolic variables, such as specific insulin and proinsulin. METHODS: A 2-h 75 g oral glucose tolerance test was performed in 221 pregnant women at 22-29 weeks of gestation (median 25th week). Serum leptin was measured using a radioimmunoassay. In 49 women, sequential leptin measurements were performed (during pregnancy and post partum (median 5 months)). RESULTS: During pregnancy serum leptin was significantly related to body weight (r = 0.49), BMI (r = 0.51), fasting immunoreactive insulin (r = 0.46), specific insulin (r = 0.43) and proinsulin (r = 0.29) (all P-values <0.0001). In women with mild gestational diabetes (GDM, n = 55), leptin levels were lower compared to women with normal glucose tolerance (n = 166) after adjusting for BMI and fasting insulin (26.9 vs. 19.4 ng/ml, P = 0.0001). Leptin was significantly higher during pregnancy compared to post partum (mean +/- SE: 24.3+/-1.5 vs. 19.6+/-1.6 ng/ml, P = 0.0003), even after adjustment for changes in BMI and changes in fasting insulin (P = 0.013). CONCLUSIONS: Leptin levels are elevated in pregnancy. Women with mild GDM presented with relative hypoleptinaemia compared to women with normal glucose tolerance.

Adult↗
PubMed2005

Is the CAG repeat of mitochondrial DNA polymerase gamma (POLG) associated with male infertility? A multi-centre French study.

BACKGROUND: Recent data emphasized the implication of polymerase gamma (POLG) CAG repeats in infertility, making it a very attractive gene for study. A comparison of POLG CAG repeats in infertile and fertile men showed a clear association between the absence of the usual 10-CAG allele and male infertility, excluding azoospermia. It has also been suggested that the POLG gene polymorphism should be considered as a possible contributing factor in unexplained couple infertility where semen parameters are normal. In this study, we investigated the POLG CAG repeats, in a well-defined population of patients with severe male factor infertility. METHODS: We conducted a large study of POLG CAG repeats in 433 infertile and 91 fertile, normozoospermic and healthy males. In all subjects, phenotypic data, including semen parameters, hormonal status and clinical profiles, were available. RESULTS: Thirteen 'homozygous mutants' (3%) were found among the 433 idiopathic infertile patients. The follow-up of the 13 'homozygous mutant' resulted in pregnancy for more than half of the couples, through assisted reproductive techniques or even spontaneously. In addition, one 'homozygous mutant' was identified in 91 fertile men (1.1%) CONCLUSION: Under our conditions, our study does not confirm any relationship between the polymorphic CAG repeat in the POLG gene and male infertility.

Adult↗
PubMed2006

Prioritising for fertility treatments--the effect of excluding women with a high body mass index.

The effect of clinical priority access criteria for access to infertility treatment was examined for women outside the body mass index (BMI) range of 18-32 kg/m2. Treatments and outcomes were analysed from 1280 cases referred from 1998 to May 2005. Sixteen percent of women had a BMI of >32 kg/m2. Overall, 38% of these women had a birth from conceiving a treatment-related pregnancy or spontaneous pregnancy, compared with 52% of women with BMI < 32 kg/m2. Weight loss allowed women in the BMI group >32<35 kg/m2 to access treatment, but women in higher BMI groups were less successful.

Adult↗
PubMed2006

[Factors associated with minor psychiatric disorders among women selected from a healthcare center in Rio de Janeiro, Brazil].

The aim was to investigate factors potentially associated with minor psychiatric disorders, including maternal nutritional status variables. A cohort was studied with 479 women 15-45 years of age. The reduced General Health Questionnaire (GHQ-12 items) was applied at nine months post-partum with the 312 women who had completed follow-up. Minor psychiatric disorder was defined as a GHQ score of > or = 4 points and was treated as the response variable. Statistical analysis used hierarchical multivariate logistic regression models. The prevalence of minor psychiatric morbidity was 54.2% (95%CI: 48.6-59.7). According to the final model, the following variables remained statistically associated with minor psychiatric morbidity: level 1: total family income (1st quartile: OR = 2.71, 95%CI: 1.42-5.19; 2nd quartile: OR = 2.13; 95%CI: 1.13-4.04); level 3: body fat > or = 30% (OR = 1.66; 95%CI: 1.03-2.65). In conclusion, low income and obesity were the only factors potentially associated with minor psychiatric disorders, even after adjusting for confounding variables, while there are few studies relating maternal nutritional status and minor psychiatric morbidity.

Adolescent↗
PubMed1999

The association of body fat distribution with lifestyle and reproductive factors in women aged 45-54 in Kinmen County, Republic of China.

This community-based cross-sectional study was conducted in Kinmen County, R.O.C. The purpose of this study was to investigate the factors that influence Chinese women's body fat distribution, including demographic, lifestyle, reproductive, and anthropometric variables. Participants were 1310 women aged 45-54 years. We measured waist/hip ratio (WHR), age, education level, occupation, alcohol consumption, diet, physical exercise, smoking, age at menarche, parity, menopausal status, age at menopause, and obesity (body mass index, BMI). Lower BMI, premenopausal status, and higher education level were primary correlated factors of gynecoid pattern body fat distribution. Higher BMI and postmenopausal status were the main correlated factors of android pattern body fat distribution. Lifestyle factors did not show any significant association with body fat distribution. As in Western countries, overall obesity and menopausal status are the determinants of body fat distribution. Controlling overall obesity is the key factor that can be addressed in public education programs to reduce the risk of high WHR, which plays an important role in the development of some chronic diseases.

Adipose Tissue↗
PubMed1998

Lifestyle factors fail to explain the variation in plasma leptin concentrations in women.

To assess the relationship between circulating leptin concentrations, metabolic parameters, and lifestyle factors such as alcohol intake, physical activity level, smoking habits, and reproductive history, a cohort of 359 women was drawn from a population-based study conducted in Victoria, Australia. The parameters measured included body mass index (BMI); waist and hip circumference; blood pressure; and fasting glucose, insulin, triacylglycerol, cholesterol, and leptin concentrations. In addition, a self-administered questionnaire was used to assess reproductive history, physical activity level, alcohol intake, and smoking habits. Our results demonstrated that BMI, body weight, waist circumference, and hip circumference were all strongly correlated with circulating leptin concentrations in this population (r > 0.56, P < 0.001 in all cases). Waist/hip ratio, triacylglycerols, insulin, glucose, and cholesterol were also associated with leptin (P < 0.05), but there was no association between leptin and age, height, or blood pressure. When these associations were adjusted for BMI, age, glucose, and waist circumference were significantly associated with leptin. The lifestyle factors examined did not help to explain the observed variation in leptin concentrations between individuals when results were adjusted for degree of adiposity and age.

Adult↗
PubMed2006

Bone mineral density in postmenarchal adolescent girls in the United States: associated biopsychosocial variables and bone turnover markers.

PURPOSE: During adolescence, bone formation prevails over resorption, resulting in accumulation of 40% of peak bone mass throughout this time period. Although multiple studies have explored bone mass accrual during the early stages of puberty, less is known about factors that may influence bone accrual during later years of adolescence. In the present cross-sectional study we examined relationships among bone mineral density (BMD) and demographic factors, behavioral variables, and bone metabolism markers in postmenarchal adolescent girls. METHODS: The population was comprised of 389 healthy postmenarchal adolescent girls aged 11-18 years, who were recruited into a prospective study of the effect of depot medroxyprogesterone acetate (DMPA) on bone health in adolescents. At the baseline visit, investigators collected demographic, reproductive health, and lifestyle data, and performed a complete physical examination. Body mass index (BMI) was calculated. Before study initiation, BMD at the lumbar spine, total hip, and femoral neck was measured by dual-energy X-ray absorptiometry (DXA), and markers of bone metabolism (serum bone-specific alkaline phosphatase [BAP], serum osteocalcin, and urinary N-telopeptide [uNTX]) were measured. The baseline data from this study were analyzed to evaluate possible correlates of BMD in postmenarchal adolescent girls. Potential associations between BMD values and other parameters were assessed by analysis of variance and Pearson's correlation coefficient. RESULTS: Participants enrolled in the study had a mean (+/- SD) chronological age of 14.9 +/-1.7 years (range 11-18), mean gynecologic age of 39.9 +/-23.0 months (range 1-120) postmenarche, and mean BMI of 23.5 +/-4.6 kg/m(2) (range 16.0-42.2). Racial/ethnic distribution was 46% African American, 35% Caucasian, and 19% other races; 9% had previously been pregnant. Positive correlations were observed between lumbar spine BMD and chronological age (r = .301, p < .0001), gynecologic age (r = .349, p < .0001), and BMI (r = .371, p < .0001). Total hip and femoral neck BMD values were significantly higher (p < .05 and p < .05, respectively) in African American participants compared with non-African American participants. Previous history of pregnancy was significantly associated with a lower BMD at the lumbar spine (p < .0001) and the total hip (p < .01) when compared with the BMD of adolescents who had never been pregnant. Cigarette smoking and alcohol use were not associated with significant differences in BMD. Negative correlations were observed between gynecologic age and the levels of BAP (r = -.564, p < .0001), osteocalcin (r = -.349, p < .0001), and uNTX (r = -.281, p < .0001), and between lumbar spine BMD and BAP (r = -.363, p < .0001), osteocalcin (r = -.129, p < .05), and uNTX (r = -.202, p < .001) levels. CONCLUSIONS: Our data demonstrate that chronological age, gynecologic age, race/ethnicity, BMI, and previous history of pregnancy are markedly associated with BMD in postmenarchal adolescent girls. Bone accretion in the postmenarchal years continues in the face of a slowdown in bone turnover during this time period.

Adolescent↗
PubMed1998

The relationship between serum oestradiol concentration and energy balance in young women distance runners.

Reproductive dysfunction in women distance runners has been linked to an imbalance between energy intake (EI) and energy expenditure (EE) which leads to an energy deficit. To determine whether ovarian suppression is associated with an energy deficit, the relationships between serum oestradiol (E2) concentration and indices of energy balance (EB) were explored in a group of women runners with a variety of menstrual patterns and a range of activity levels. Subjects comprised 33 women distance runners of mean (SD) age 27.2 (1.8) years. Sixteen of these women were defined as eumenorrhoeic (11-13 menstrual bleeds per year during the past 2 years), 8 as oligomenorrhoeic (< or = 3 menstrual bleeds per year for 2 years) and 9 as amenorrhoeic (absence of menses for > 1 year). Their volume of running training ranged from 36 to 97 km x wk(-1) [mean (SD): 68.6 (21.4) km x wk(-1). The body mass index (BMI) and percent body fat (BF) of each subject was measured. Their mean daily energy balance (EB) was calculated by subtracting their dietary EI from their estimated EE recorded over 7 days. Serum concentrations of E2, total T3 and IGF-1 were measured from a fasting blood sample (taken in early follicular phase for Eu women). Relationships between serum E2, T3 and IGF-1, EB, BMI and BF were explored using bivariate correlation and regression analysis. The results showed that the most powerful predictors of serum E2 concentration were estimated EB (r = 0.88, P<0.001), serum T3 (r=0.94, P<0.001) and IGF-1 (r=0.84; P<0.001). Weaker correlations were observed between serum E2 and BMI (r=0.42; P=0.008) and serum E2 and BF (r=0.48; P=0.004). These relationships add support to the hypothesis that reproductive dysfunction in women distance runners is associated with an energy deficit.

Adipose Tissue↗
PubMed1990

Serum free 1,25-dihydroxyvitamin D and the free 1,25-dihydroxyvitamin D index during a longitudinal study of human pregnancy and lactation.

The changes in three different indices of 1,25-dihydroxyvitamin D (1,25(OH)2D) biological activity were studied longitudinally in 35 women during late pregnancy and lactation and in 26 control women. Measurements were made of maternal serum total 1,25(OH)2D and free 1,25(OH)2D concentration (by centrifugal ultrafiltration) and the free 1,25(OH)2D index (the molar ratio of total 1,25(OH)2D and vitamin D binding protein (DBP]. During late pregnancy total 1,25(OH)2D concentrations were significantly elevated when compared to controls, as were free 1,25(OH)2D and DBP concentrations and the free 1,25(OH)2D index. Serum total 1,25(OH)2D, free 1,25(OH)2D and DBP concentrations all fell dramatically during the first 2 weeks of lactation with total 1,25(OH)2D and free 1,25(OH)2D concentrations falling to levels below those of controls. During the course of lactation both total 1,25(OH)2D and free 1,25(OH)2D levels rose significantly although they were not different from controls at 18 weeks of lactation. In contrast, the free 1,25(OH)2D index fell during the first 2 weeks of lactation, but remained at this level, significantly lower than controls. Neither urinary calcium excretion nor dietary calcium intake correlated with total or free 1,25(OH)2D, DBP, or the free 1,25(OH)2D index. The disagreement in the results of free 1,25(OH)2D concentration and free 1,25(OH)2D index demonstrates that these two approaches to measuring biologically active 1,25(OH)2D are not equivalent. In attempting to account for the increased calcium requirements of human reproduction we conclude that in pregnancy any of the 1,25(OH)2D measurements may be appropriate. In lactation, however, either 1,25(OH)2D is not a major factor or 1,25(OH)2D biological activity is inadequately represented by any of the currently available methods.

Adult↗
PubMed2004

Comparison between hospitalized and screening controls in studies assessing breast cancer risk.

BACKGROUND: In case-control studies, selection of an appropriate group of controls is a critical step which may affect the outcome of the analysis. METHODS: We studied the differences in reproductive, lifestyle, and anthropometric variables between controls from a hospital-based study and controls from a screening clinic. Odds ratios for breast cancer were calculated using the two types of controls, and the impact on the resulting odds ratio was studied. RESULTS: Some interesting differences in odds ratios obtained with the two sets of controls were found. Among premenopausal screening subjects, the odds ratio for breast cancer did not change across quartiles of body mass,while among hospital subjects, the risk of breast cancer significantly decreased with increasing body mass. For liquor and beer consumption, a three-fold increase in breast cancer risk was observed among premenopausal hospital subjects, whereas no association was found among screening subjects. Among postmenopausal women, a significant decrease in breast cancer risk with ovariectomy was only observed in the hospital-based study. CONCLUSIONS: Our results suggest that in examining the association between body mass, alcohol consumption, or ovariectomy and breast cancer risk, the choice of control group used should be carefully considered.

Alcohol Drinking↗
PubMed2004

[Craniopharyngioma and its impact upon human reproduction: analysis of 15 cases at the Hospital Juarez de Mexico].

BACKGROUND: Craniopharyngiomas are intracranial tumors of non-glial origin derived from cellular remnants of the Rathke's pouch. Their frequency is 1-3% of intracranial tumors and 13% of suprasellar neoplasms. Histologically, it is a benign lesion, albeit clinically severe with a high index of relapse and sequelae upon the reproductive function. OBJECTIVE: To identify the clinical characteristics of patients with craniopharyngiomas before and after treatment. MATERIAL AND METHODS: We reviewed our experience of 15 cases with craniopharyngioma seen at the Hospital Juarez de Mexico from 1995 throughout 2002. RESULTS: Prevalence was higher in males (ratio 2:1) with ages between 6-45 years old (X 17.9 +/- 6.45 years). The most common symptoms were cephalalgia (100%) and visual disorders (93%); the average levels of hormonal determination were in females: FSH 1.0 mIU/mL, LH 0.5 mIU/mL, estradiol 11.0 pg/mL, PRL 80 mg/mL. In males: FSH 1.7 mIU/mL, LH 2.6 mIU/mL, testosterone 0.6 mg/dL and PRL 29 mg/mL. All patients had hypogonadotropic hypogonadism. Tumoral relapse was mostly seen in patients who underwent only surgery (n = 7, 46.6%). The ones with surgery and radiotherapy (n = 8, 53.3%) did not disclose symptoms that required another surgery. CONCLUSIONS: The main repercussion of craniopharyngioma, due to its proximity to hypothalamus and hypophysis, is on the endocrine and reproductive areas of human being.

Adolescent↗
PubMed1999

Risk factors for breast cancer in Japan, with special attention to anthropometric measurements and reproductive history.

BACKGROUND: Breast cancer incidence has increased rapidly in Japan recently, but there have been only a few studies on the risk factors for breast cancer in Japan. A case-control study was conducted to evaluate the roles of anthropometric and reproductive factors in the etiology of breast cancer in Osaka. METHODS: Based on information from a self-administered questionnaire at Osaka Medical Center for Cancer and Cardiovascular Diseases, body mass index, body weight and height were compared between 376 cases and 430 controls, together with other factors such as age at menarche, age at first delivery and family history of breast cancer by menopausal status. Logistic regression analysis was employed for adjusting confounding factors and estimating odds ratios with their 95% confidence interval for breast cancer. RESULTS: A body mass index of >25 was significantly associated with the risk among post-menopausal women (age-adjusted odds ratio: 1.90, 95% confidence interval: 1.10-3.24) as compared with the risk for a body mass index of < or = 20. A weight of > or =58 kg showed significantly increased risk compared with a weight of < or = 47 kg among post-menopausal women (1.83, 1.10-3.01), while height of > or = 159 cm showed a significantly elevated risk than height of < or = 149 cm among pre-menopausal women (2.51, 1.17-5.39). Age at menarche of < or = 13 years resulted in a higher risk of breast cancer among post-menopausal women, while age at first delivery of > or = 28 years was associated with the risk among pre-menopausal women. Family history of breast cancer was associated with the risk for breast cancer. CONCLUSIONS: These results were all very consistent with findings observed in western countries.

Adult↗