| 1. |
- Denes, Anna-Maria, 1988, et al.
(författare)
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The Proportion of Diploid 46,XX Cells Increases with Time in Women with Turner Syndrome-A 10-Year Follow-Up Study
- 2015
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Ingår i: Genetic Testing and Molecular Biomarkers. - : Mary Ann Liebert Inc. - 1945-0265 .- 1945-0257. ; 19:2, s. 82-87
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Tidskriftsartikel (refereegranskat)abstract
- In the normal population, loss of one of the sex chromosomes leading to monosomy (45,X) is a part of the aging process. In Turner syndrome (TS), the classic karyotype 45,X is found in up to 50% at birth, and others have a second cell line; mosaicism. The aim was to study if the chromosomal pattern in TS women changes over time. Fluorescence in situ hybridization was performed on buccal smear cells obtained twice, 10 years apart, from 42 women with TS aged 26-66 years (mean +/- standard deviation: 42.0 +/- 11.6). DNA probes specific for chromosomes X (DXZ1) and Y (DYZ3) were used and >100 cells were analyzed/patient. Nineteen women had monosomy (45,X) (<10% 46,XX), nine had 45,X/46,XX mosaicism, and 14 had iso, ring, or a marker chromosome at baseline. At 10 years, the percentage of diploid cells had increased in 29 of 42 women (69%), with an average increase of 5.7 +/- 13.0%. There was a positive correlation between age and % change in diploid 46,XX or 46,XY cells (r=0.38, p=0.023). This new finding might have relevance for the life expectancy in TS.
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| 2. |
- Forslund, Maria, 1978, et al.
(författare)
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Health-Related Quality of Life in perimenopausal women with PCOS
- 2022
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Ingår i: Clinical and Experimental Obstetrics and Gynecology. - : IMR Press. - 0390-6663. ; 49:2
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Tidskriftsartikel (refereegranskat)abstract
- Background: Several studies have shown that younger women with polycystic ovary syndrome (PCOS) have decreased Health-Related Quality of Life (HRQoL) compared with women in general. Method: In this study peri- and postmenopausal women previously diagnosed with PCOS (n = 27) were compared with randomly selected, age-matched controls (n = 94). Mean age of the study participants was 52 years. Structured interviews and Short Form (SF)-36 questionnaires were used. Results: No differences in SF-36 scores were found, median for the physical summary score was 54 vs. 57, for women with PCOS and controls, respectively; and 53 vs. 53 for the mental summary score, with no differences in any of the eight dimensions of HRQoL. There were no significant difference in prevalence of depression and/or anxiety. The use of drugs for mood disorders was 22% in both groups. Conclusion: PCOS women of peri- and postmenopausal ages had similar HRQoL compared with age-matched controls.
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| 3. |
- Forslund, Maria, 1978, et al.
(författare)
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Higher menopausal age but no differences in parity in women with polycystic ovary syndrome compared with controls.
- 2019
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Ingår i: Acta obstetricia et gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 98:3, s. 320-326
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Tidskriftsartikel (refereegranskat)abstract
- To address the question of whether women with polycystic ovary syndrome (PCOS) reach menopause later than age-matched controls, we conducted a follow-up cohort study of women with well-characterized PCOS that was diagnosed 24years ago. The hypothesis was that women with PCOS would reach menopause later than non-PCOS women. Parity during these 24years was also studied.Twenty-seven women diagnosed with PCOS in 1992 (mean age 29.5years) were re-examined in 2016 (mean age 52.4years). Randomly selected women, n =94 (mean age 52.4years), from the same geographic area included in the World Health Organization MONICA study, Gothenburg, Sweden, served as controls.The mean menopausal age in women with PCOS was higher than in controls (53.3±2.2years vs 49.3±3.5years, P<0.01). Serum-follicle stimulating hormone levels were lower in the PCOS women than in controls (31.0±28.1IU/L vs 52.3±37.7IU/L, P=0.01). There was no difference in parity between women with PCOS (1.9±1.3 children, range 0-4) and controls (1.7±1.0, range 0-4 children).Women with PCOS reached menopause 4years later and had lower serum-follicle stimulating hormone compared with age-matched controls. Neither parity nor nulliparity differed between women with PCOS and controls.
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| 4. |
- Forslund, Maria, 1978, et al.
(författare)
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Morbidity and mortality in PCOS: A prospective follow-up up to a mean age above 80 years
- 2022
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Ingår i: European Journal of Obstetrics and Gynecology and Reproductive Biology. - : Elsevier BV. - 0301-2115 .- 1872-7654. ; 271, s. 195-203
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Despite the clear evidence of increased cardiovascular disease (CVD) risk factors, the long-term effect on CVD and mortality is still uncertain in women with PCOS, especially in the elderly. Studies in elderly women with PCOS are lacking. The objective was to study morbidity/mortality in PCOS women compared with a reference group up to a mean age above 80 years. Study design: A well-defined cohort of women with PCOS, examined in 1987 and 2008, was re-examined 32 years later in 2019 (age range 72–91 years), in parallel with an age-matched reference group. For deceased women register data was used, for women alive interviews were done, and medical records studied. Blood pressure and blood tests were analyzed. Morbidity and mortality data was available in 35/36 women with PCOS, and in 99/118 women in the reference group. Results: At mean age 81 years there was no difference in all-cause mortality (HR 1.1, ns), CVD-related mortality (HR 1.7, ns), all CVD (HR 1.2, ns), hypertension (HR 1.8, ns), type 2 diabetes (HR 1.7, ns), in levels of blood lipids, glucose, insulin or thyroid hormones. Comparing baseline data from the deceased and living women with PCOS, no differences were found regarding age, menopausal age, BMI, HOMA-IR, FAI, total testosterone or SHBG. However, deceased women with PCOS had a higher WHR (0.87 vs. 0.80; p-value < 0.01) at baseline. Conclusions: No evidence of increased all-cause mortality or CVD was found in women with PCOS. The elevated testosterone levels and CVD risk profile in PCOS present during perimenopause do not seem to be associated with increased CVD morbidity/mortality risk later in life. © 2022 The Authors
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| 5. |
- Forslund, Maria, 1978, et al.
(författare)
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No difference in morbidity between perimenopausal women with PCOS with and without previous wedge resection
- 2023
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Ingår i: European Journal of Obstetrics & Gynecology and Reproductive Biology. - 0301-2115. ; 285, s. 74-78
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Polycystic ovary syndrome (PCOS), affecting more than every 10th woman of reproductive age, is associated with increased risk factors for cardiovascular disease (CVD). Most knowledge regarding longtime consequences concerning morbidity is based on women where ovarian wedge resection (WR) was used as a surgical treatment, a method not used today. The aim of this study was to compare women with PCOS who had and had not undergone WR, regarding risk factors for CVD. The hypothesis was that women who had undergone WR had a more severe PCOS phenotype, and that this cohort thus had more associated CVD risk factors compared with women diagnosed through non-invasive methods.Study design: A cross-sectional study was performed. A PCOS cohort who underwent WR in the 1950-60 s (n = 27) were compared with a PCOS cohort diagnosed by NIH-criterions in the 1990s without WR (n = 32). Both cohorts were examined at perimenopausal age.Results: No differences were seen in prevalence of hypertension, obesity or type 2 diabetes mellitus (T2DM) between the women with PCOS with or without WR, respectively. The results were persistent irrespective of the lower mean BMI in the WR group, 26.4 vs. 30.7 kg/m2, p = 0.01. In the stratified group of overweight and obese, there was no difference in T2DM 27% vs 25% or hypertension 27% vs 25%, in WR and non-WR women with PCOS, respectively. The cohort diagnosed through WR had higher free androgen index (6.3 vs. 2.1, p < 0.01) and total testosterone (2.20 vs. 0.99 nmol/L, p < 0.01).Conclusion: No differences in CVD risk factors were found in perimenopausal women with PCOS with or without a previous WR, and irrespective of body weight. The results indicate that CVD morbidity and mortality from studies in women with PCOS who have undergone WR are generalizable to women with PCOS who have not undergone WR.
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| 6. |
- Forslund, Maria, 1978, et al.
(författare)
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Reproductive hormones and anthropometry: a follow-up of PCOS and controls from perimenopause to above 80 years of age.
- 2021
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Ingår i: The Journal of clinical endocrinology and metabolism. - : The Endocrine Society. - 1945-7197 .- 0021-972X. ; 106:2, s. 421-430
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Tidskriftsartikel (refereegranskat)abstract
- There is a lack of knowledge about hormonal and anthropometric changes in women with polycystic ovary syndrome (PCOS) after the menopause.To study reproductive hormones and anthropometry in women with PCOS up to an age above 80 years.Prospective cohort study.University Hospital.A well-defined cohort of women with PCOS, previously examined in 1987 and 2008 (21 years period) was re-examined in 2019 (11 years period). Of the original cohort (n = 37), 22 women were still alive and 21 (age range 72-91 years) participated. Comparisons were made with age-matched controls (n = 55) from the original control cohort (BMI similar to PCOS women). The results were compared with results from 1987 and 2008.Hormonal measurements and physical examination.FSH, LH, testosterone, SHBG, free androgen index (FAI), hirsutism score, BMI, and waist-hip ratio (WHR).At mean age 81 years, FSH levels were lower in women with PCOS (50 vs. 70 IU/L) who were still more hirsute than controls (33% vs. 4%). No differences were found in FAI, testosterone, SHBG or LH levels, BMI or WHR.From perimenopausal age until the present age, levels of testosterone and FAI continued to decline in women with PCOS. SHBG levels continued to increase with age. FSH had not changed over time during the last eleven years.Women with PCOS at ages 72-91 had lower FSH levels, remained clinically hyperandrogenic and had similar FAI and body composition as controls.
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| 7. |
- Forslund, Maria, 1978, et al.
(författare)
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Type 2 diabetes mellitus in women with polycystic ovary syndrome during a 24-year period: importance of obesity and abdominal fat distribution.
- 2020
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Ingår i: Human reproduction open. - : Oxford University Press (OUP). - 2399-3529. ; 2020:1
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Tidskriftsartikel (refereegranskat)abstract
- What are the predictive factors for later development of type 2 diabetes (T2DM) in women with polycystic ovary syndrome (PCOS)?Obesity and abdominal fat distribution in women with PCOS in the mid-fertile years were the major risk factors for T2DM development 24years later when lifestyle factors were similar to controls.Women with PCOS have an increased prevalence of T2DM.A longitudinal and cross-sectional study was performed. Women with PCOS were examined in 1992 and in 2016. Randomly selected, age-matched women from the general population served as controls.Women with PCOS (n=27), attending an outpatient clinical at a tertiary care centre for infertility or hirsutism were diagnosed in 1992 (mean age 30years) and re-examined in 2016 (mean age 52years). Women from the World Health Organization MONItoring of trends and determinants for CArdiovascular disease (WHO MONICA-GOT) 2008, aged 38-68years, served as controls (n=94), and they were previously examined in 1995. At both at baseline and at follow-up, women had blood samples taken, underwent a clinical examination and completed structured questionnaires, and the women with PCOS also underwent a glucose clamp test at baseline.None of women with PCOS had T2DM at baseline. At the 24-year follow-up, 19% of women with PCOS had T2DM versus 1% of controls (P<0.01). All women with PCOS who developed T2DM were obese and had waist-hip ratio (WHR) >0.85 at baseline. No difference was seen between women with PCOS and controls regarding use of high-fat diet, Mediterranean diet or amount of physical activity at follow-up at peri/postmenopausal age. However, women with PCOS had a lower usage of a high-sugar diet as compared to controls (P=0.01). The mean increases in BMI and WHR per year were similar in women with PCOS and controls during the follow-up period.The small sample size of women with PCOS and the fact that they were recruited due to infertility or hirsutism make generalization to women with milder forms of PCOS uncertain.Obesity and abdominal fat distribution, but not hyperandrogenism per se, in women with PCOS in the mid-fertile years were the major risk factors for T2DM development 24years later when peri/postmenopausal. Lifestyle factors were similar to controls at that time.The study was financed by grants from the Swedish state under the agreement between the Swedish government and the country councils, the ALF-agreement (ALFGBG-718611), the Gothenburg Medical Association GLS 694291 and 780821, the Swedish Heart Lung Foundation and Hjalmar Svensson Foundation. The authors have no conflict of interest.
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