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Revista Brasileira de Ginecologia E... 2024To validate the 10-item Cervantes Scale (CS-10) among Brazilian women. (Observational Study)
Observational Study
OBJECTIVE
To validate the 10-item Cervantes Scale (CS-10) among Brazilian women.
METHODS
This is a cross-sectional observational study involving women in the community aged 40-55 years in the Southern region of Brazil. They completed a general health, habits and socio-demographic questionnaire, the CS-10 and the Women's Health Questionnaire (WHQ). Women unable to understand the survey, not consenting to participate, or having incapacity imposing difficulties during the completion of the questionnaire were excluded. A Confirmatory Factor Analysis (CFA) was conducted with the AMOS 16.0 software. Chi-square of degrees of freedom (χ2/df), the Comparative Fit Index (CFI), the Tucker-Lewis Index (TLI) and the Root-Mean-Square Error of Approximation (RMSEA) were used as indices of goodness of fit. Cronbach's alpha coefficient was used for internal consistency.
RESULTS
A total of 422 women were included (premenopausal n=35, perimenopausal n=172, postmenopausal n=215). The CFA for the CS-10 showed a good fit (χ²/df=1.454, CFI=0.989; TLI=0.985; RMSEA=0.033; CI 90%=0.002-0.052; PCLOSE=0.921; Model p=0.049). Good reliability was established in CS-10 and WHQ (Cronbach's alpha=0.724). Postmenopausal women had higher total CS-10 scores (p≤0.0001), reflecting worse quality of life (QoL) related to menopause symptoms and confirming the greater symptomatology evaluated by high total scores for WHQ found in this population when compared to those in the premenopausal period (p=0.041).
CONCLUSION
The CS-10 is a consistent tool for health-related QoL in Brazilian mid-aged women.
Topics: Humans; Female; Middle Aged; Cross-Sectional Studies; Brazil; Menopause; Adult; Surveys and Questionnaires
PubMed: 38765526
DOI: 10.61622/rbgo/2024AO07 -
Injury Jul 2024This study aimed to investigate age- and menopause-related differences in bone mineral density (BMD), bone structure and estimated bone strength at surgical neck of...
AIMS
This study aimed to investigate age- and menopause-related differences in bone mineral density (BMD), bone structure and estimated bone strength at surgical neck of humerus in Chinese female sample.
METHODS
We conducted a cross-sectional cohort study of 171 Chinese women. Bone mass, indices of geometric properties and estimated mechanical strength of the surgical neck were evaluated by quantitative computed tomography (QCT). Comparisons were performed across menstrual status categories. Age-related changes in QCT-derived bone parameters were calculated.
RESULTS
The age-related difference of BMD and cortical thickness was 40.25 % and 32.86 % between the age of 20 and 86 years. Progressive periosteal and endosteal expansion was associated linearly with age. Estimated mechanical strength indexes showed significant quadratic associations with age, with their peak occurred at the age of 46-55 years. The quartile of women with the greatest medullary diameter also had the lowest valve of BMD and cortical thickness and the greatest in skeletal width. Compared to premenopausal individuals, perimenopausal women were distinguished by lower cortical thickness (18.63 %) and BMD (20.05 %). The continued decrease in cortical thickness and BMD was noted after menopause. The medullary and periosteal diameter increased by 17.98 % and 9.34 % respectively in perimenopausal period, but not after menopause. The accelerated loss of the maximum and polar section modulus was observed in late postmenopausal women.
CONCLUSIONS
The increase in bone size only occurred during the menopause transition. Obvious loss of resistance to bending was in late postmenopausal period.
Topics: Humans; Female; Bone Density; Middle Aged; Adult; Cross-Sectional Studies; Aged; Humerus; Aging; China; Tomography, X-Ray Computed; Aged, 80 and over; Young Adult; Menopause; Asian People; East Asian People
PubMed: 38761710
DOI: 10.1016/j.injury.2024.111611 -
International Journal of Cardiology Aug 2024Public campaigns such as the "Go-red-for-women"-initiative have raised heart-disease awareness and may trigger overutilization of coronary computed tomography...
OBJECTIVES
Public campaigns such as the "Go-red-for-women"-initiative have raised heart-disease awareness and may trigger overutilization of coronary computed tomography angiography (CTA). Objective was to investigate the diagnostic efficacy of coronary CTA stratified by age and gender.
METHODS
1882 consecutive patients (58.9 ± 11 years;42.5% females) with low-to-intermediate pre-test-probability of coronary artery disease (CAD) referred to coronary CTA according to ESC-2019 guidelines, were included. Diagnostic efficacy was defined by the 1)negative CTA-rate 2)obstructive CAD (>50%stenosis) 3)High-risk-plaque and 4)CAC-score.
RESULTS
The negative CTA rate was higher in females compared to males with 360/801 vs 292/1081 (45% vs 27%;p < 0.001). Females had a higher likelihood (OR 2.2:95%CI:1.81-2.67) of a negative CTA than males, despite they were older (p < 0.001). Obstructive disease prevalence was 25.6% and acceptable in both sexes (males vs females: 28.4% vs 21.8%;p = 0.0012). Males had more high-risk-plaque (23.6% vs 11.5%;p < 0.001). When stratifying age groups, negative CTA rate was highest in females <47 years (82.8%), but lower in males with 68.1% (p < 0.001), while obstructive disease prevalence was not different (males:6.5% vs females:4.6%:p = 0.874). Above 50 years, negative CTA rate (39.1% vs 17.6%,p < 0.001;OR 3.02:95%CI:2.381-3.823) was higher, and the obstructive disease rate was lower in females (24.8% vs 34.7%,p = 0.0003). SSPS(V.25,IBM) was used for statistical analysis.
CONCLUSIONS
Above 50 years of age, diagnostic efficacy of coronary CTA is high in both males and females. In females <47 years, the negative CTA rate was highest with 82.8% and obstructive disease prevalence was low (4.6%), still justifying testing but recommending the use of specific tools (PROMISE minimal risk score) or other clinical tests for pre-selection.
Topics: Humans; Female; Middle Aged; Male; Computed Tomography Angiography; Coronary Angiography; Aged; Coronary Artery Disease; Sex Factors; Perimenopause; Retrospective Studies; Sex Characteristics
PubMed: 38754587
DOI: 10.1016/j.ijcard.2024.132181 -
International Journal of Medical... Aug 2024Metabolic syndrome (MetS) is considered to be an important parameter of cardio-metabolic health and contributing to the development of atherosclerosis, type 2 diabetes....
INTRODUCTION
Metabolic syndrome (MetS) is considered to be an important parameter of cardio-metabolic health and contributing to the development of atherosclerosis, type 2 diabetes. The incidence of MetS significantly increases in postmenopausal women, therefore, the perimenopausal period is considered a critical phase for prevention. We aimed to use four machine learning methods to predict whether perimenopausal women will develop MetS within 2 years.
METHODS
Women aged 45-55 years who underwent 2 consecutive years of physical examinations in Ninth Clinical College of Peking University between January 2021 and December 2022 were included. We extracted 26 features from physical examinations, and used backward selection method to select top 10 features with the largest area under the receiver operating characteristic curve (AUC). Extreme gradient boosting (XGBoost), Random forest (RF), Multilayer perceptron (MLP) and Logistic regression (LR) were used to establish the model. Those performance were measured by AUC, accuracy, precision, recall and F1 score. SHapley Additive exPlanation (SHAP) value was used to identify risk factors affecting perimenopausal MetS.
RESULTS
A total of 8700 women had physical examination records, and 2,254 women finally met the inclusion criteria. For predicting MetS events, RF and XGBoost had the highest AUC (0.96, 0.95, respectively). XGBoost has the highest F1 value (F1 = 0.77), followed by RF, LR and MLP. SHAP value suggested that the top 5 variables affecting MetS in this study were Waist circumference, Fasting blood glucose, High-density lipoprotein cholesterol, Triglycerides and Diastolic blood pressure, respectively.
CONCLUSION
We've developed a targeted MetS risk prediction model for perimenopausal women, using health examination data. This model enables early identification of high MetS risk in this group, offering significant benefits for individual health management and wider socio-economic health initiatives.
Topics: Humans; Metabolic Syndrome; Female; Machine Learning; Perimenopause; Middle Aged; Risk Factors; Risk Assessment; ROC Curve; Logistic Models
PubMed: 38754284
DOI: 10.1016/j.ijmedinf.2024.105480 -
Gynecological Endocrinology : the... May 2024As women approach perimenopause, the incidence of Subjective Cognitive Decline (SCD) rises. This study aims to investigate the association between SCD and the severity...
OBJECTIVE
As women approach perimenopause, the incidence of Subjective Cognitive Decline (SCD) rises. This study aims to investigate the association between SCD and the severity of perimenopausal symptoms.
SETTING
Conducted at The Affiliated Hospital of Guizhou Medical University Menopause Clinic from November 2022 to June 2023. Participants, aged 40-55 years, were classified as perimenopausal using the STRAW + 10 criteria.
METHODS
SCD was assessed separately using the Chinese version of the SCD-Q9 scale and the SCD International Working Group (SCD-I) conceptual framework, while perimenopausal symptoms were evaluated with the Modified Kupperman Index (MKI). Linear relationships between MKI scores and SCD-Q9 scores were clarified using both univariate and multivariate linear regression analyses. Additionally, a multivariate Logistic regression analysis was conducted to examine the association between MKI scores and SCD classification based on SCD-I criteria.
MAIN OUTCOME MEASURES
The primary outcomes were the Modified Kupperman Index scores, SCD-Q9 questionnaire scores, and the diagnosis of SCD based on SCD-I criteria.
RESULTS
Among 101 participants, the average MKI score was 18.90 ± 9.74, and the average SCD-Q9 score was 4.57 ± 2.29. Both univariate and multivariate linear regressions demonstrated a positive correlation between these scores. A multivariate Logistic regression analysis, using MKI as the independent variable and SCD-I criteria classification as the dependent variable, revealed a significant positive association.
CONCLUSIONS
A notable association exists between SCD and perimenopausal symptoms severity. This underscores the potential clinical importance of addressing perimenopausal symptoms to mitigate SCD risks in women. Further studies should focus on clarifying the causality between these factors.
Topics: Humans; Female; Perimenopause; Middle Aged; Cognitive Dysfunction; Adult; Severity of Illness Index; Surveys and Questionnaires; China
PubMed: 38752362
DOI: 10.1080/09513590.2024.2352134 -
Planta Medica Jun 2024, which contains isoflavones and prenylated derivatives, has analgesic and anti-inflammatory properties and is an ingredient in traditional Thai medicine for...
, which contains isoflavones and prenylated derivatives, has analgesic and anti-inflammatory properties and is an ingredient in traditional Thai medicine for perimenopause and menopause. However, the estrogenic activity of has not yet been explored. Therefore, this study aimed to examine the estrogenic activity of the stem extract of and its isoflavone derivatives. In this study, we conducted a proliferation assay in MCF-7 cells, and used quantitative reverse transcription polymerase chain reaction to assess gene expression. We found that the relative cell proliferation of the compounds (1 µM) was ranked in the following order as compared to 0.1 nM 17-estradiol (100%): genistein (97.84%) > derrisisoflavone A (83.17%) > genistein-7--[-rhamnopyranosyl-(1 → 6)-glucopyranoside] (69.55%) > 6,8-diprenylgenistein (51.91%) > lupalbigenin (18.72%). Furthermore, cotreatment with 1 µM lupalbigenin and 0.1 nM 17-estradiol was performed, which decreased cell proliferation to 80.38%. results suggest that lupalbigenin has an estrogen-antagonistic effect. At a dose of 1 µM, genistein had the strongest efficacy in increasing the expression of human estrogen receptor by 4.0-fold compared to the control. Furthermore, genistein-7--[-rhamnopyranosyl-(1 → 6)]--glucopyranoside augmented the gene expression of human estrogen receptor and human estrogen receptor by 1.5- and 3.4-fold, respectively. Prenylated derivatives of genistein (derrisisoflavone A, 6,8-diprenylgenistein, and lupalbigenin) significantly suppressed the gene expression of the human androgen receptor. The administration of the crude extract at 10 µg/mL significantly suppressed human androgen receptor (0.6-fold) and transmembrane protease serine 2 (0.1-fold) expression but did not significantly affect human estrogen receptor and human estrogen receptor gene expression. This herbal medicine may be safe for estrogen-exposed breast cancer patients.
PubMed: 38749481
DOI: 10.1055/a-2328-2750 -
Journal of Affective Disorders Aug 2024An association between the menopause and depression is widely reported. This review aims to determine the global prevalence of depression in menopausal women (this... (Meta-Analysis)
Meta-Analysis
BACKGROUND
An association between the menopause and depression is widely reported. This review aims to determine the global prevalence of depression in menopausal women (this includes women in perimenopause and postmenopause).
METHODS
PubMed, Web of Science, Embase, and PsycINFO databases were systematically searched from database inception until March 1, 2024. Studies with validated methods for assessing the prevalence of depression in perimenopausal and postmenopausal women were included. Two authors independently extracted relevant data. Random effects meta-analysis and Meta-regression analysis were performed using Stata software.
RESULTS
Total of 55 studies (76,817 participants) were included in the review. A random effects model was used to calculate pooled prevalence. The pooled depression prevalence in menopausal women was 35.6 % (95 % CI: 32.0-39.2 %), with 33.9 % (95 % CI: 27.8-40.0 %) in perimenopausal women, and 34.9 % (95 % CI: 30.7-39.1 %) in postmenopausal women. Subgroup analyses indicated that region, screening tool, study design, and setting moderated the prevalence of depression. Meta-regression indicated that smaller sample sizes and poorer study quality were significantly associated with a higher prevalence.
LIMITATIONS
There was a high degree of heterogeneity across the included studies. Only articles published in English were included. There was significant publication bias in this meta-analysis. There is insufficient information about many risk factors of menopausal depression in current meta-analysis.
CONCLUSIONS
Depression is common among menopausal women worldwide. To reduce the negative impact of depression on health outcomes in menopausal women, regular screening and the availability of effective prevention and treatment measures should be made available for this population.
Topics: Female; Humans; Middle Aged; Depression; Global Health; Menopause; Perimenopause; Postmenopause; Prevalence
PubMed: 38735578
DOI: 10.1016/j.jad.2024.05.051 -
Fertility and Sterility Jul 2024Uterine fibroids (UFs) are the most common female benign pelvic tumors, affecting >60% of patients aged 30-44 years. Uterine fibroids are asymptomatic in a large... (Review)
Review
Uterine fibroids (UFs) are the most common female benign pelvic tumors, affecting >60% of patients aged 30-44 years. Uterine fibroids are asymptomatic in a large percentage of cases and may be identified incidentally using a transvaginal ultrasound or a magnetic resonance imaging scan. However, in approximately 30% of cases, UFs affect the quality of life and women's health, with abnormal uterine bleeding and heavy menstrual bleeding being the most common complaints, along with iron deficiency (ID) and ID anemia. Medical treatments used for UFs-related abnormal uterine bleeding include symptomatic agents, such as nonsteroidal antiinflammatory drugs and tranexamic acid, and hormonal therapies, including combined oral contraceptives, gonadotropin-releasing hormone agonists or antagonists, levonorgestrel intrauterine systems, selective progesterone receptor modulators, and aromatase inhibitors. Nevertheless, few drugs are approved specifically for UF treatment, and most of them manage the symptoms. Surgical options include fertility-sparing treatments, such as myomectomy, or nonconservative options, such as hysterectomy, especially in perimenopausal women who are not responding to any treatment. Radiologic interventions are also available: uterine artery embolization, high-intensity focused ultrasound or magnetic resonance-guided focused ultrasound, and radiofrequency ablation. Furthermore, the management of ID and ID anemia, as a consequence of acute and chronic bleeding, should be taken into account with the use of iron replacement therapy both during medical treatment and before and after a surgical procedure. In the case of symptomatic UFs, the location, size, multiple UFs, or coexistent adenomyosis should guide the choice with a shared decision-making process, considering long- and short-term treatment goals expected by the patient, including pregnancy desire or wish to preserve the uterus independently of reproductive goals.
Topics: Humans; Female; Leiomyoma; Uterine Neoplasms; Uterine Hemorrhage; Treatment Outcome; Uterine Myomectomy; Uterine Artery Embolization; Adult
PubMed: 38723935
DOI: 10.1016/j.fertnstert.2024.04.041 -
Cardiovascular Diabetology May 2024The association between iron biomarkers and cardiovascular disease risk factors (CVD-RFs) remains unclear. We aimed to (1) evaluate the cross-sectional and longitudinal... (Comparative Study)
Comparative Study
Cross-sectional and longitudinal associations of Iron biomarkers and cardiovascular risk factors in pre- and postmenopausal women: leveraging repeated measurements to address natural variability.
BACKGROUND
The association between iron biomarkers and cardiovascular disease risk factors (CVD-RFs) remains unclear. We aimed to (1) evaluate the cross-sectional and longitudinal associations between iron biomarkers (serum ferritin, transferrin saturation (TSAT), transferrin) and CVD-RFs among women, and (2) explore if these associations were modified by menopausal status.
METHOD
Cross-sectional and longitudinal analyses including 2542 and 1482 women from CoLaus cohort, respectively. Multiple linear regression and multilevel mixed models were used to analyse the associations between Iron biomarkers and CVD-RFs. Variability of outcomes and iron markers between surveys was accessed using intraclass correlation (ICC).
RESULTS
After multivariable adjustment, elevated serum ferritin levels were associated with increased insulin and glucose levels, while higher transferrin levels were linked to elevated glucose, insulin and total cholesterol, and systolic and diastolic blood pressure (p < 0.05). No association was observed between CVD-RFs and TSAT (p > 0.05). Iron biomarkers demonstrated low reliability across reproductive stages but exhibited stronger associations in the perimenopausal group. In longitudinal analysis, we found association only for transferrin with lower glucose levels [β = - 0.59, 95% CI (- 1.10, - 0.08), p = 0.02] and lower diastolic blood pressure [β = - 7.81, 95% CI (- 15.9, - 0.56), p = 0.04].
CONCLUSION
In cross-sectional analysis, transferrin was associated with several CVD-RFs, and the associations did not change according to menopausal status. Conversely, in the longitudinal analyses, changes in transferrin were associated only with lower glucose and diastolic blood pressure levels. These differences might stem from the substantial longitudinal variation of iron biomarkers, underscoring the need for multiple iron measurements in longitudinal analyses.
Topics: Humans; Female; Biomarkers; Cross-Sectional Studies; Middle Aged; Ferritins; Longitudinal Studies; Cardiovascular Diseases; Transferrin; Heart Disease Risk Factors; Postmenopause; Risk Assessment; Adult; Iron; Time Factors; Brazil; Aged; Blood Glucose; Reproducibility of Results; Age Factors
PubMed: 38715055
DOI: 10.1186/s12933-024-02242-x -
Journal of Menopausal Medicine Apr 2024This study aimed to assess sexual health status and associated factors in menopausal women.
OBJECTIVES
This study aimed to assess sexual health status and associated factors in menopausal women.
METHODS
The study employed a descriptive, cross-sectional design. It included 420 menopausal women aged 40-65 years from Ilesa West Local Government Area of Osun State. A structured questionnaire was used, and the data were analyzed using descriptive and inferential statistics.
RESULTS
The mean age of the study respondents was 54.74 ± 5.49 years. A little over half (52.4%) of the respondents exhibited good sexual health status, whereas 47.6% had poor sexual health status. Logistic regression analysis revealed that lack of financial resources ( = 0.01; odds ratio [OR], 4.00; 95% confidence interval [95% CI], 1.45-11.02), loss of partner ( = 0.01; OR, 9.18; 95% CI, 2.89-29.09), and limited communication with partner ( = 0.01; OR, 3.12; 95% CI, 1.51-6.46) were predictors of poor sexual health status.
CONCLUSIONS
This study provides insight into the determinants of the sexual health status of menopausal women, which may help health care providers and policymakers develop effective strategies to improve the sexual health of menopausal women.
PubMed: 38714493
DOI: 10.6118/jmm.22028