| 1. |
- Elgán, Carina, 1962-, et al.
(författare)
-
Influence of smoking and oral contraceptives on bone mineral density and bone remodeling in young women : a 2-year study
- 2003
-
Ingår i: Contraception. - : Elsevier. - 0010-7824 .- 1879-0518. ; 67:6, s. 439-447
-
Tidskriftsartikel (refereegranskat)abstract
- The objective of the study was to explore the influence of menstrual irregularities, oral contraceptives and smoking on bone mineral density (BMD) development and bone turnover with time. Healthy young women (n = 118) were divided into four categories: (a) women neither smoking nor using oral contraceptives; (b) women who were smokers; (c) women using oral contraceptives; (d) women who were smoking and using oral contraceptives. They responded to a validated questionnaire with 34 questions concerning lifestyle and the Sense of Coherence scale (SOC). BMD was measured by dual energy x-ray absorptiometry (DEXA). Deoxypyridinoline (DPD) was measured in urine. Data were analyzed by multiple linear regression analysis. Among smokers, BMD level decreased during a 2-year period and smoking was associated with a larger negative change in BMD. Use of oral contraceptives moderated the negative impact of smoking. Women using oral contraceptives at baseline and with regular bleeding induced by contraceptive pills had a significantly higher BMD at baseline and at follow-up. They also had lower SOC than women who had natural regular bleedings. Use of oral contraceptives in combination with smoking was linked to high alcohol consumption and higher frequency of self-reported body weight reduction, which reduced the negative BMD change in this category. DPD level and difference were strongly associated with estrogen influence. It is concluded that smokers without OCs had a negative BMD development and BMD in young women with irregular menstruations seems to be improved by OC.
|
|
| 2. |
- Elgán, Carina, 1962-, et al.
(författare)
-
Young women's lifestyle behaviours and their bone mineral density changes : a grounded theory analysis
- 2005
-
Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318 .- 1471-6712. ; 19:1, s. 39-45
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Only limited information is available on healthy young women's perspective of their own lifestyle behaviours. By lifestyle behaviours, e.g. smoking and physical activity, individuals have the possibility to influence bone mineral density (BMD). The aim of this study was to generate a theoretical model of lifestyle behaviours among young women with different BMD changes. METHODS: Data were collected by interviewing with 11 women, and the material was analysed by means of the grounded theory. FINDINGS: Two core categories were generated: (i) the respondents' outlook on life and (ii) their life situation. The respondents' outlook on life was either 'rigid' or 'relaxed'. Respondents who had a rigid outlook on life adjusted with others and had a decreased BMD while those with a relaxed outlook on life were doing things for fun and had an increased BMD level. Life situation also consisted of two categories: 'stagnation' and 'development'. Respondents in a static life situation did not pursue any active actions while in a developing life situation, the respondents were actively striving towards a goal. Four dimensions which characterized the respondents' outlook on life in relation to their life situation emerged: subordinating and enduring with a decreased BMD level or compromising and discerning with an increased BMD level. CONCLUSION: It seems as if the outlook on life has a greater influence than the acted lifestyle behaviour for bone development. Further research is needed to generalize the findings of this study and to explore the importance of the outlook on life among women of all ages.
|
|
| 3. |
- Moberg, L., et al.
(författare)
-
Increased blood cadmium levels were not associated with increased fracture risk but with increased total mortality in women: the Malmo Diet and Cancer Study
- 2017
-
Ingår i: Osteoporosis International. - : Springer Science and Business Media LLC. - 0937-941X .- 1433-2965. ; 28:8, s. 2401-2408
-
Tidskriftsartikel (refereegranskat)abstract
- This study aimed to investigate if high levels of blood cadmium at baseline were associated with increased fracture risk during follow-up in middle-aged women. No increased fracture risk was observed during follow-up, but women with higher levels of cadmium had an increased overall mortality. Introduction Exposure to high levels of cadmium has been associated with an increased fracture risk. The aim was to investigate a perceived association between low levels of blood cadmium (B-Cd) at baseline and risk of first incident fracture. Methods From the population-based Malm Diet and Cancer Study Cardiovascular cohort, 2920 middle-aged women with available background questionnaire and B-Cd measurements were included. Women were divided into quartiles (Q) according to their cadmium levels (Cd-Q1 < 0.18 mu g/L, Cd-Q2 0.180.28 mu g/L, Cd-Q3 0.28-0.51 ae g/ L, and Cd-Q4 > 0.51 mu g/L). National registries were analysed for prospective risk of fractures or death. Associations between B-Cd and fracture risk were assessed by survival analysis (Cox regression analysis). Results In total, 998 first incident fractures occurred in women during a follow-up lasting 20.2 years (median) (12.5-21.2 years) (25th-75th percentile). Women in Cd-Q4 were more often current smokers than in Cd-Q1 78.4 vs. 3.3% (p < 0.001) and the number of cigarettes smoked per day correlated with B-Cd (r = 0.49; p < 0.001). The risk of fracture was not associated with baseline B-Cd in adjusted models. The hazard ratio (HR) Cd-Q4 vs. Cd-Q1 was 1.06 (95% confidence interval (CI) 0.89-1.27). In the multivariate Cox regression, independent variables for increased fracture risk were history of gastric ulcer and increasing age, whereas increasing body mass index (BMI) lowered fracture risk. Overall mortality was significantly higher for women with high B-Cd, HR 2.06 (95% CI 1.57-2.69). Conclusions Higher blood levels of cadmium did not increase fracture risk in middle-aged women but reduced overall survival.
|
|
| 4. |
|
|
| 5. |
- Andersson, K, et al.
(författare)
-
Intrauterine or oral administration of levonorgestrel in combination with estradiol to perimenopausal women--effects on lipid metabolism during 12 months of treatment
- 1996
-
Ingår i: International Journal of Fertility and Menopausal Studies. - 1069-3130. ; 41:5, s. 476-483
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Limited data concerning serum lipids and lipoproteins are available on the effect of HRT in perimenopausal women, who commonly have marked bleeding disturbances and may have severe climacteric symptoms. Almost all previously published data have utilized a simplified form of lipoprotein analysis, which includes an estimation and not a determination of LDL cholesterol. To delineate the role of locally administered progestogen, perimenopausal women were studied for a year. PATIENTS AND METHODS: 40 perimenopausal women with climacteric complaints. The continuous release of low-dose levonorgestrel from an intrauterine device was used as progestogen co-medication to estradiol in a new type of continuous combined hormone replacement therapy. Women were randomized to either cyclical treatment with 2 mg of oral estradiol valerate in combination with 250 micrograms of levonorgestrel for the last ten days (Cyclo Progynova) or continuously with 2 mg estradiol valerate orally in combination with a 20 micrograms per 24 hour levonorgestrel releasing intrauterine device. RESULTS: Reduced HDL cholesterol was initially recorded in both treatment arms and disappeared after 1 year of treatment. Triglycerides were reduced in the orally treated group, but not in the device group. No changes in LDL cholesterol were noted. CONCLUSIONS: The findings suggest that continuous combined HRT with intrauterine release of 20 micrograms levonorgestrel per 24 hours in perimenopausal women is neutral as far as lipid metabolism is concerned, since no alterations compared with pretreatment values could be noted after 12 months of treatment. Less marked lipid changes were obtained in perimenopausal women as compared with data on postmenopausal women. Differences in methodology may partly account for this.
|
|
| 6. |
- Elgán, Carina, 1962-, et al.
(författare)
-
Bone mineral density and lifestyle among female students aged 16-24 years
- 2002
-
Ingår i: Gynecological Endocrinology. - 0951-3590 .- 1473-0766. ; 16:2, s. 91-98
-
Tidskriftsartikel (refereegranskat)abstract
- The objective of the study was to investigate bone mineral density and bone turnover among female students aged 16-24 years in relation to lifestyle factors, such as dietary habits and physical activity, as well as physiological factors, such as age, body weight, and menstrual pattern. Female college and university students (n = 218) were given a validated questionnaire with 34 questions concerning diet, recreational physical activity, alcohol, smoking, menstrual pattern, weight gain and loss. Bone mineral density (BMD) measurements were performed using a heel bone scanner (DEXA). Deoxypyridinoline (DPD) levels were measured in urine samples. The data were analyzed by linear regression and multiple regression analysis. The mean BMD was 0.568 g/cm2. Multiple regression showed that hormonal age was a better predictor of high BMD and low bone mineral turnover than chronological age. The best model predicting high BMD was composed of physical activity, regular menstruation, hormonal age and body weight. Smoking, alcohol consumption and current calcium intake did not contribute to the model. A negative association between BMD and DPD was found, indicating an enhanced bone remodeling. A correlation was found between DPD and hormonal age, chronological age, sugar intake and time with irregular menses. In multiple regression analysis, hormonal age, high sugar intake and weight loss were the factors best predicting DPD. BMD was positively influenced by a healthy lifestyle, including a physically active life and healthy dietary habits without dieting. Our study shows that hormonal age is a stronger BMD predictor than chronological age. Menstrual disturbances might be an indication of a risk for low BMD and might therefore be a reason for measuring BMD among young females.
|
|
| 7. |
- Elgán, Carina, et al.
(författare)
-
Bone mineral density and lifestyle among female students aged 16-24 years
- 2002
-
Ingår i: Gynecological Endocrinology. - : Taylor and Francis Ltd.. - 0951-3590 .- 1473-0766. ; 16:2, s. 91-98
-
Tidskriftsartikel (refereegranskat)abstract
- The objective of the study was to investigate bone mineral density and bone turnover among female students aged 16-24 years in relation to lifestyle factors, such as dietary habits and physical activity, as well as physiological factors, such as age, body weight, and menstrual pattern. Female college and university students (n = 218) were given a validated questionnaire with 34 questions concerning diet, recreational physical activity, alcohol, smoking, menstrual pattern, weight gain and loss. Bone mineral density (BMD) measurements were performed using a heel bone scanner (DEXA). Deoxypyridinoline (DPD) levels were measured in urine samples. The data were analyzed by linear regression and multiple regression analysis. The mean BMD was 0.568 g/cm2. Multiple regression showed that hormonal age was a better predictor of high BMD and low bone mineral turnover than chronological age. The best model predicting high BMD was composed of physical activity, regular menstruation, hormonal age and body weight. Smoking, alcohol consumption and current calcium intake did not contribute to the model. A negative association between BMD and DPD was found, indicating an enhanced bone remodeling. A correlation was found between DPD and hormonal age, chronological age, sugar intake and time with irregular menses. In multiple regression analysis, hormonal age, high sugar intake and weight loss were the factors best predicting DPD. BMD was positively influenced by a healthy lifestyle, including a physically active life and healthy dietary habits without dieting. Our study shows that hormonal age is a stronger BMD predictor than chronological age. Menstrual disturbances might be an indication of a risk for low BMD and might therefore be a reason for measuring BMD among young females.
|
|
| 8. |
- Elgán, Carina, et al.
(författare)
-
Bone mineral density changes in young women : a two year study
- 2004
-
Ingår i: Gynecological Endocrinology. - : Taylor and Francis Ltd.. - 0951-3590 .- 1473-0766. ; 19:4, s. 169-177
-
Tidskriftsartikel (refereegranskat)abstract
- Achievement of a high peak bone mass is considered a pivotal preventive strategy against future osteoporotic fractures. The ostensible interaction between physiology and lifestylefor the development of bone mass over time is sparsely outlined among young women. The aim of this study was to follow bone density and bone resorption over time among healthy young women in relation to lifestyle factors and to evaluate the perceived influence of other factors. Data were collected in 1999 and in 2001. Healthy young women (n=152) were given a structured questionnaire, a heel bone scanner (dual X-ray absorptiometry) performed bone mineral density measurements and deoxypyridinoline was measured in urine. Data were analyzed by linear, multiple and logistic regression analysis. Mean bone mineral density (BMD) was 0.562 g/cm2 (+/-0.090). Bone density at baseline was the best predictorfor the bone density atfollow-up. Bone density at baseline together with smoking and alcohol (dichotomized) accounted for 86.5% of the variation in bone density 2 years later. Of the participants 62% had decreased/unchanged bone density and 38% had increased their bone density from 1999 to 2001. Use of oral contraceptives or alcohol at baseline was associated with an increased risk of belonging to the group who decreased their bone density. Deoxypyridinoline was not a strongpredictor to bone density and all potential predictors of deoxypyridinoline had a minor influence (<10%). In conclusion, lifestyle behaviors such as use of oral contraceptives, smoking and alcohol consumption seem to have a negative influence on BMD development among young women and warrant further scrutiny.
|
|
| 9. |
- Heimer, G, et al.
(författare)
-
Effects of vaginally delivered estrogens
- 1996
-
Ingår i: Acta Obstetricia et Gynecologica Scandinavica. Supplement. - 0300-8835. ; 163, s. 1-2
-
Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Atrophic condition in the vagina and lower parts of the urethral tract are common in elderly women. From population based surveys it has been estimated that 40% or more of women over 60 complain of insufficient control of micturation. In addition, lower urinary tract infections are common in this age group and recurrent cystitis is a scourge for many women (1, 2). Vaginal problems such as vaginal dryness, dyspareunia as well as infectious and non infectious disorders in the vagina may be even more common in elderly women (3) Vasomotor symptoms such as sweats and hot flushes commonly commence around the time of the menopause. In the majority of cases urogenital dysfunction does not become a problem until a decade later. Endogenous estrogens decline during the climacteric and the fall of estradiol levels from the time of onset of vasomotor symptoms until commencement of urogenital problems cannot be disregarded. In other words, it seems as if urogenital integrity can be maintained at lower estrogen levels than those required to resist vasomotor symptoms and conserve bone mass. Further evidence for this concept is achieved from numerous clinical studies in which various estrogens have been administered both orally and vaginally to elderly women with signs of urogenital atrophy which have resulted in amelioration. Such an alleviation of urogenital symptoms can be achieved without provoking endometrial growth.
|
|
| 10. |
|
|
