| 1. |
- Amundson, Emily, et al.
(författare)
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Impact of growth hormone therapy on quality of life in adults with turner syndrome.
- 2010
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Ingår i: The Journal of clinical endocrinology and metabolism. - : The Endocrine Society. - 1945-7197 .- 0021-972X. ; 95:3, s. 1355-9
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Tidskriftsartikel (refereegranskat)abstract
- Context: GH and/or oxandrolone are used to promote growth in Turner syndrome (TS). Objective: The aim of this study was to compare quality of life (QoL) in TS women with controls and determine the impact of growth promoting therapy on QoL in TS women. Design: This was a cross-sectional, case-control study. Setting: The study was conducted at an outpatient clinic at Sahlgrenska University Hospital, Göteborg, Sweden. Patients: Patients included 111 TS women (age range 18-59 yr) and 111 randomly selected, age-matched women (25-54 yr) from the World Health Organization Monitoring Trends and Determinants for Cardiovascular Disease project (Göteborg, Sweden) served as controls. Main Outcome Measures: QoL was estimated by the Psychological General Well-Being scale (anxiety, depressed mood, positive well-being, self-control, general health and vitality) and the Nottingham Health Profile (physical mobility, pain, sleep, energy, social isolation, and emotional reactions). Results: TS women reported more social isolation than controls (P < 0.001). After age adjustment, significantly less pain (<0.05) was reported attributable to GH treatment within TS. No significant difference in any other subscales used could be shown. In TS, QoL was negatively affected by higher current age and age at diagnosis and positively affected by better body balance, fine motor function, and higher bone mineral density. Conclusions: Social isolation was more commonly reported in the whole TS cohort than in the population. Except for less pain, no significant impact on QoL attributable to GH treatment could be found, despite the mean +5.1 cm final height.
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| 2. |
- Bryman, Inger, et al.
(författare)
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Pregnancy rate and outcome in Swedish women with Turner syndrome
- 2011
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Ingår i: Fertility and Sterility. - : Elsevier BV. - 1556-5653 .- 0015-0282. ; 95:8, s. 2507-2510
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Tidskriftsartikel (refereegranskat)abstract
- Pregnancies occurred in 57 (12%) of 482 Swedish women with Turner syndrome with a liveborn rate of 54% in 124 pregnancies. Spontaneous pregnancies occurred in 40%, mainly in women with 45,X/46,XX mosaicism, and oocyte donation in 53% where miscarriages were less frequent, odds ratio 0.43 (95% confidence interval 0.17-1.04). (Fertil Steril (R) 2011; 95: 2507-10. (c) 2011 by American Society for Reproductive Medicine.)
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| 3. |
- Hagman, Anna, et al.
(författare)
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Morbidity and mortality after childbirth in women with Turner karyotype.
- 2013
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Ingår i: Human reproduction (Oxford, England). - : Oxford University Press (OUP). - 1460-2350 .- 0268-1161. ; 28:7, s. 1961-1973
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Tidskriftsartikel (refereegranskat)abstract
- STUDY QUESTION: Do women with Turner karyotype have increased mortality and morbidity in the years after childbirth? SUMMARY ANSWER: No mortality occurred during pregnancy and follow-up in women with Turner karyotype, but a higher rate of circulatory and endocrine diseases and a high risk of aortic aneurysm were confirmed. WHAT IS KNOWN ALREADY: Pregnancies in women with Turner karyotype are high-risk pregnancies with an increased risk of maternal mortality from aortic dissection and morbidity from hypertensive disorders. STUDY DESIGN, SIZE, DURATION: A retrospective Swedish population-based registry study of 124 women with Turner karyotype born between 1957 and 1987 and who gave birth between 1973 and 2010. Women with Turner karyotype without childbirth (n = 378) were selected as controls. A second control group consisted of women from the Swedish Medical Birth Register (MBR) (n = 1230) matched for maternal age, number of children and year of birth of the first child. PARTICIPANTS/MATERIALS, SETTING AND METHODS: Women with Turner karyotype were identified in the Swedish Genetic Turner Register. Data were obtained by using the unique personal identification number with cross linkage to the Swedish MBR, the Cause of Death Register, the National Patient Register and the Swedish Cancer Register. Hazard ratio (HR) with 95% confidence interval (CI) was used in the analysis of morbidity. MAIN RESULTS AND THE ROLE OF CHANCE: No mortality occurred in women with Turner karyotype and childbirth. Diseases of the circulatory system occurred more often in women with Turner syndrome under the age of 40 years compared with the MBR control group (HR 4.59; 95% CI 2.75-7.66) but was similar at or above the age of 40 years. Morbidity from circulatory diseases was increased before pregnancy (HR 3.83; 95% CI 1.02-14.43) and during pregnancy or within 1 year after (HR 5.78; 95% CI 1.94-17.24), but was similar after 1 or more years after delivery (HR 1.91; 95% CI 0.74-4.96). Aortic aneurysm occurred in 11/502 (2.2%) women with Turner karyotype and in three women (2.4%) during pregnancy. The long-term follow-up showed that aortic dissection was a common cause of death in young women with Turner karyotype without childbirth. A thorough cardiac evaluation before pregnancy in women with Turner karyotype is of utmost importance. LIMITATIONS, REASONS FOR CAUTION: Although this was a population-based registry study performed over a period of more than 20 years, a much longer follow-up and larger series are needed to assess rare events. The study also lacks information on phenotype and mode of conception in women with Turner karyotype. Women who gave birth probably represent a selection of healthier women with Turner karyotype. WIDER IMPLICATIONS OF THE FINDINGS: The high risk of aortic aneurysm in young women with Turner karyotype is in agreement with the literature. STUDY FUNDING/COMPETING INTEREST(S): No conflicts of interest exist. The study has been supported by grants from the Gothenburg Medical Society, the Medical Care executive Board of the Region Västra Götaland, grants from the ALF agreement at the Sahlgrenska University Hospital, the Hjalmar Svensson foundation, the Swedish Board of Health and Welfare, the Swedish Heart Lung Foundation and the Swedish Council for Working Life and Social Research. TRIAL REGISTRATION NUMBER: None.
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| 4. |
- Hagman, Anna, et al.
(författare)
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Obstetric Outcomes in Women with Turner Karyotype.
- 2011
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Ingår i: The Journal of clinical endocrinology and metabolism. - : The Endocrine Society. - 1945-7197 .- 0021-972X. ; 96:11, s. 3475-3482
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Tidskriftsartikel (refereegranskat)abstract
- Context: Women with Turner syndrome (TS) have high risk of cardiovascular complications and hypertensive disorders. Few studies have analyzed obstetric outcome in women with TS. Objective: This study compared obstetric outcome in women with TS karyotype with women in the general population. Design: The Swedish Genetic Turner Register was cross-linked with the Swedish Medical Birth Register between 1973 and 2007. Obstetric outcome in singletons was compared with a reference group of 56,000 women from the general population. Obstetric outcome in twins was described separately. Results: A total of 202 singletons and three sets of twins were born to 115 women with a TS karyotype that was unknown in 52% at time of pregnancy. At first delivery, TS women of singletons were older than controls (median 30 vs. 26 yr, P < 0.0001). Preeclampsia occurred in 6.3 vs. 3.0% (P = 0.07). Aortic dissection occurred in one woman. Compared with the general population, the gestational age was shorter in children born by TS women (-6.4 d, P = 0.0067), and median birth weight was lower (-208 g, P = 0.0012), but sd scores for weight and length at birth were similar. The cesarean section rate was 35.6% in TS women and 11.8% in controls (P < 0.0001). There was no difference in birth defects in children of TS women as compared with controls. Conclusions: Obstetric outcomes in women with a TS karyotype were mostly favorable. Singletons of TS women had shorter gestational age, but similar size at birth, adjusted for gestational age and sex. Birth defects did not differ between TS and controls.
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| 5. |
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| 6. |
- Hagman, Anna, et al.
(författare)
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Women who gave birth to girls with Turner syndrome: maternal and neonatal characteristics.
- 2010
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Ingår i: Human reproduction (Oxford, England). - : Oxford University Press (OUP). - 1460-2350 .- 0268-1161. ; 25:6, s. 1553-60
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The aim was to identify maternal risk factors in women giving birth to girls with Turner syndrome (TS) and to describe the characteristics of newborns with TS. METHODS: The Swedish Genetic Turner Register was cross-linked with the Swedish Medical Birth Register. Between 1973 and 2005, 494 children with TS were born. Maternal age, parity, height, smoking habits and neonatal characteristics; mode of delivery, gestational age, size at birth and Apgar score, were compared with women in the general population who gave birth to girls during the same period. RESULTS: More women with advanced maternal age (40+) delivered girls with TS, 3.2% when compared with 1.8% in the general population [OR 1.83, 95% confidence interval (CI) 1.09-3.08, after adjustment for year of birth]. Maternal height was inversely associated with TS pregnancies (P = 0.005). Late preterm birth occurred in newborns with TS in 10.5% when compared with 4.8% in the general population (OR 2.23; 95% CI: 1.67-2.97, after adjustment for year of birth and maternal age). Newborns with TS had birthweight less than -2SD in 17.8% and birth length less than -2SD in 21.0% when compared with 3.5 and 3.4%, in the general population (OR 6.55; 95% CI: 5.12-8.38 and OR 8.69; 95% CI: 6.89-10.97, after adjustment for year of birth and maternal age). CONCLUSION: Advanced maternal age and short stature were risk factors for giving birth to a girl with TS. More TS girls were born late preterm and were smaller for gestational age than non-TS girls in the general population.
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| 7. |
- Osmancevic, Amra, 1968, et al.
(författare)
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Vitamin D status in psoriasis patients during different treatments with phototherapy
- 2010
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Ingår i: Journal of Photochemistry and Photobiology B: Biology. - 1011-1344. ; 101:2, s. 117-123
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Phototherapy (broadband UVB (BUVB), narrowband UVB (NBUVB) and heliotherapy) is commonly used treatment modalities for widespread psoriasis. Vitamin D3, cholecalciferol, is produced in the epidermis by ultraviolet radiation (290-315 nm) of 7-dehydrocholesterol. 25-hydroxyvitamin D [25(OH)D], and 1,25-dihydroxyvitamin D [1,25(OH)(2)D] are the major circulating metabolites. Sun exposure is the strongest factor influencing 25(OH)D. The similar wavelength spectrum of UVB responsible for D vitamin synthesis (BUVB, 280-315 nm) has been successfully used for years to treat psoriasis. PURPOSE: The aim was: (1) To increase the knowledge about the effects of phototherapy on vitamin D production during treatment of psoriasis. (2) To examine if there were differences between the effect of BUVB, NBUVB and heliotherapy on vitamin D synthesis in psoriasis patients. METHODS: Serum concentrations of 25(OH)D, 1,25(OH)(2)D, PTH, calcium and creatinine, measured before and after phototherapy in white Caucasian patients with moderate to severe active plaque psoriasis, were aggregated from three studies. RESULTS: Psoriasis improved in all patients, with a reduction in PASI ((Psoriasis Area and Severity Index) score of about 75% on all regimes. Serum 25(OH)D increased and PTH decreased after the phototherapy. The increase in 25(OH)D was higher in the BUVB treated patients compared with NBUVB. There was no correlation between the dose of UVB and the increase of 25(OH)D. CONCLUSION: UVB and heliotherapy improved the psoriasis score, increased the serum 25(OH)D levels and reduced the serum PTH concentrations. Vitamin D production in psoriasis patients increased less with NBUVB than with BUVB phototherapy.
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| 8. |
- Trimpou, Penelope, 1973, et al.
(författare)
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High serum total cholesterol is a long-term cause of osteoporotic fracture.
- 2011
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Ingår i: Osteoporosis international. - : Springer Science and Business Media LLC. - 0937-941X .- 1433-2965. ; 22:5, s. 1615-20
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Tidskriftsartikel (refereegranskat)abstract
- Risk factors for osteoporotic fractures were evaluated in 1,396 men and women for a period of 20 years. Serum total cholesterol was found to be an independent osteoporotic fracture risk factor whose predictive power improves with time. The purpose of this study was to evaluate long-term risk factors for osteoporotic fracture. A population random sample of men and women aged 25-64 years (the Gothenburg WHO MONICA project, N = 1,396, 53% women) was studied prospectively. The 1985 baseline examination recorded physical activity at work and during leisure time, psychological stress, smoking habits, coffee consumption, BMI, waist/hip ratio, blood pressure, total, HDL and LDL cholesterol, triglycerides, and fibrinogen. Osteoporotic fractures over a period of 20 years were retrieved from the Gothenburg hospital registers. Poisson regression was used to analyze the predictive power for osteoporotic fracture of each risk factor. A total number of 258 osteoporotic fractures occurred in 143 participants (10.2%). As expected, we found that previous fracture, smoking, coffee consumption, and lower BMI each increase the risk for osteoporotic fracture independently of age and sex. More unexpectedly, we found that the gradient of risk of serum total cholesterol to predict osteoporotic fracture significantly increases over time (p = 0.0377). Serum total cholesterol is an independent osteoporotic fracture risk factor whose predictive power improves with time. High serum total cholesterol is a long-term cause of osteoporotic fracture.
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| 9. |
- Trimpou, Penelope, 1973, et al.
(författare)
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Male risk factors for hip fracture-a 30-year follow-up study in 7,495 men.
- 2010
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Ingår i: Osteoporosis international. - : Springer Science and Business Media LLC. - 1433-2965 .- 0937-941X. ; 21:3, s. 409-416
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Tidskriftsartikel (refereegranskat)abstract
- Risk factors for hip fracture were studied in 7,495 randomly selected men during 30 years; 451 men had a hip fracture. High degree of leisure-time, but not work-related, physical activity, high occupational class, and high body mass index (BMI) protected against hip fracture. Smoking, tall stature, interim stroke, and dementia increased the risk. PURPOSE: The purpose was to prospectively study risk factors for hip fracture in men. METHODS: We studied midlife determinants of future hip fractures in 7,495 randomly selected men aged 46-56 years in Gothenburg, Sweden. The subjects were investigated in 1970-1973 and followed for over 30 years. Questionnaires were used regarding lifestyle factors, psychological stress, occupational class, and previous myocardial infarction, stroke, and diabetes mellitus. Alcohol problems were assessed with the aid of registers. Using the Swedish hospital discharge register, data were collected on intercurrent stroke and dementia diagnoses and on first hip fractures (X-ray-verified). RESULTS: Four hundred fifty-one men (6%) had a hip fracture. Age, tall stature, low occupational class, tobacco smoking, alcoholic intemperance, and interim stroke or dementia were independently associated with the risk of hip fracture. There were inverse associations with leisure-time physical activity, BMI, and coffee consumption. The gradient of risk for one standard deviation of multivariable risk decreased with time since measurement yet was a good alternative to dual energy X-ray absorptiometry measurements. CONCLUSIONS: High degree of leisure-time physical activity, high occupational class, and high BMI protected against hip fracture. However, work-related physical activity was not protective. Smoking, tall stature, and interim stroke or dementia increased the risk.
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| 10. |
- Trimpou, Penelope, 1973, et al.
(författare)
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Secular trends in sex hormones and fractures in men and women
- 2012
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Ingår i: European Journal of Endocrinology. - : Oxford University Press (OUP). - 0804-4643 .- 1479-683X. ; 166:5, s. 887-895
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To study secular trends in sex hormones, anthropometry, bone measures and fractures. Design: A random population sample was studied twice and subjects of similar age group were compared 13 years apart. Methods: X-ray-verified fractures were retrieved from a random population sample of 2400 men and women (participants 1616=67%) aged 25-64 years from the WHO, MONICA Project in Gothenburg, Sweden, in 1995 and 2008. Fasting serum hormones and calcaneal ultrasound were measured in every fourth subject. In fertile women, measurements were performed on cycle day interval 7-9. Results: In 2008, men had lower serum free testosterone than men of similar age in 1995 (P < 0.001). Body composition, physical activity and fracture incidence were similar. In women, hormone replacement therapy (HRT) was lower in 2008, 7 vs 28% (P < 0.0001), as was serum oestradiol, although use of tranquilisers and leisure time physical activity were higher. In 2008, the fracture incidence was higher in postmenopausal women, 29 vs 17% (P < 0.001), and vertebral crush had increased from 8 to 19% of all fractures (P=0.031). Serum cholesterol and triglycerides were lower in all subjects in 2008 compared with that in 1995. Conclusions: Secular trends were observed with lower serum testosterone in men in 2008, but no effect was seen on the fracture incidence of these fairly young men. In postmenopausal women in 2008, there was a higher fracture incidence along with more vertebral compressions. Lower HRT use, lower serum oestradiol and higher fall risk exposure due with more tranquilisers and leisure time physical activity in 2008 may explain the results.
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| 11. |
- Hammarsten, Ola, et al.
(författare)
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Troponin T percentiles from a random population sample, emergency room patients and patients with myocardial infarction
- 2012
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Ingår i: Clinical Chemistry. - : Oxford University Press (OUP). - 1530-8561 .- 0009-9147. ; 58:3, s. 628-637
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: High-sensitivity cardiac troponin T (cTnT) assays detect small clinically important myocardial infarctions (MI) but also yield higher rates of false-positive results owing to increased concentrations sometimes present in patients without MI. Better understanding is needed of factors influencing the 99th percentile of cTnT concentrations across populations and the frequency of changes in cTnT concentrations >20% often used in combination with increased cTnT concentrations for diagnosis of MI. METHODS: cTnT percentiles were determined by use of the Elecsys® hscTnT immunoassay (Modular® Analytics E170) in a random population sample, in emergency room (ER) patients, and in patients with non–ST-elevation MI (NSTEMI). Changes in cTnT concentrations were determined in hospitalized patients without MI. RESULTS: The 99th cTnT percentile in a random population sample (median age, 65 years) was 24 ng/L. In ER patients <65 years old without obvious conditions that increase cTnT, the 99th cTnT percentile was 12 ng/L with little age dependence, whereas in those >65 years old it was 82 ng/L and highly age dependent. In hospitalized patients without MI the 97.5th percentile for change in the cTnT concentration was 51%–67%. cTnT remained below the 99th percentile (12 ng/L) in 1% of patients with NSTEMI until 8.5 h after symptom onset and 6 h after ER arrival. CONCLUSIONS: Age >65 years was the dominant factor associated with increased cTnT in ER patients. This age association was more prominent in ER patients than in a random population sample. Changes in serial cTnT concentrations >20% were common in hospitalized patients without MI.
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| 12. |
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| 13. |
- Månsson, Mattias, et al.
(författare)
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Sexuality and psychological wellbeing in women with polycystic ovary syndrome compared with healthy controls.
- 2011
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Ingår i: European journal of obstetrics, gynecology, and reproductive biology. - : Elsevier BV. - 1872-7654 .- 0301-2115. ; 155:2, s. 161-165
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders affecting women of fertile age. The aim was to study whether PCOS has an effect on sexual functioning. STUDY DESIGN: Women meeting the Rotterdam criteria for PCOS (n=49), and 49 age-matched controls identified from the population registry, were recruited. Sexual functioning was assessed by means of (i) an in-person, structured interview covering various aspects of sexuality, and (ii) the nine-item McCoy questionnaire of female sexual satisfaction. Participants also completed the Psychological General Well-Being Index. RESULTS: Almost half the women with PCOS reported that the disorder had a great impact on their sex life. Despite having the same number of partners and about the same frequency of sexual intercourse, women with PCOS were generally less satisfied with their sex lives compared to the population-based controls. Within the group of women with PCOS, high body mass index had only a minor effect on sexual functioning, while the total serum level of testosterone correlated positively to sexual satisfaction. PCOS women scored numerically lower than controls on the McCoy total score, but this difference was not statistically significant. CONCLUSION: Women with PCOS reported decreased satisfaction with their sex life. Sexual function should be taken into account in treatment trials of PCOS, which traditionally target only symptoms related to insulin resistance, overweight, and hirsutism.
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| 14. |
- Schmidt, Johanna, 1974, et al.
(författare)
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Body composition, bone mineral density and fractures in late postmenopausal PCOS women - A long-term follow-up study.
- 2012
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Ingår i: Clinical endocrinology. - : Wiley. - 1365-2265 .- 0300-0664. ; 77:2, s. 207-214
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Hyperandrogenism is one of the characteristic features of the polycystic ovary syndrome (PCOS). Androgens are important for bone mass. Studies on bone mineral density (BMD) and fractures in postmenopausal women with PCOS are lacking. The aim of this study was to investigate whether postmenopausal PCOS women differ from controls regarding body composition, BMD, and prevalence of fractures, and to compare PCOS women with controls regarding correlations between total BMD and sex hormones. DESIGN: A prospective 21-year follow-up study. Anthropometry, hormonal measurements and questionnaires were performed in 1987 and in 2008. Fractures were X-ray-verified. BMD measurements were performed in 1992, using single photon absorptiometry (SPA), and in 2008 using dual-energy X-ray absorptiometry (DXA), to also enable measurements of body composition. PATIENTS: Twenty-five PCOS women (Rotterdam criteria), aged 61-78 years, and 68 randomly allocated age-matched controls. MEASUREMENTS: Body composition, BMD, fractures and sex steroids. RESULTS: At follow-up, the postmenopausal women with PCOS maintained a higher free androgen index (FAI), but had similar body fat, lean mass and BMD compared with controls. The hip circumference increased only in PCOS women (p<0.01), during follow-up. The fracture incidence was similar to that of controls (56% vs. 41%, ns). In the controls, total BMD was positively correlated with oestradiol (R=0.322, P<0.01) and FAI (R=0.307, P<0.05), and negatively correlated with SHBG (R= -0.429, P<0.001), but not in the women with PCOS. CONCLUSIONS: Postmenopausal women with PCOS with persistently higher FAI had similar muscle mass, BMD and fracture incidence as controls during this long-term follow-up. © 2012 Blackwell Publishing Ltd.
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| 15. |
- Schmidt, Johanna, 1974, et al.
(författare)
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Cardiovascular Disease and Risk Factors in PCOS Women of Postmenopausal Age: A 21-Year Controlled Follow-Up Study.
- 2011
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Ingår i: The Journal of clinical endocrinology and metabolism. - : The Endocrine Society. - 1945-7197 .- 0021-972X. ; 96:12, s. 3794-3803
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Tidskriftsartikel (refereegranskat)abstract
- Context:Polycystic ovary syndrome (PCOS) is associated with the metabolic syndrome and, consequently, with a potentially increased risk of cardiovascular disease (CVD) and related mortality later in life. Studies regarding CVD and mortality in PCOS women well into the postmenopausal age are lacking.Objective:Our objective was to examine whether postmenopausal PCOS women differ from controls regarding cardiovascular risk factors, myocardial infarction (MI), stroke and mortality.Design and Setting:We conducted, at a university hospital, a prospective study of 35 PCOS women (61-79 yr) and 120 age-matched controls. The study was performed 21 yr after the initial study.Participants:Twenty-five PCOS women (Rotterdam criteria) and 68 controls participated in all examinations. Data on morbidity were based on 32 of 34 PCOS women and on 95 of 119 controls.Interventions:Interventions included reexamination, interviews, and data from the National Board of Health and Welfare and from the Hospital Discharge Registry.Main Outcome Measures:Blood pressure, glucose, insulin, triglycerides, total cholesterol, high- and low-density lipoprotein, apolipoprotein A1 and B, fibrinogen, and plasminogen activator inhibitor antigen were studied. Incidences of MI, stroke, hypertension, diabetes, cancer, cause of death, and age at death were recorded.Results:PCOS women had a higher prevalence of hypertension (P = 0.008) and higher triglyceride levels (P = 0.012) than controls. MI, stroke, diabetes, cancer, and mortality prevalence was similar in the two cohorts with similar body mass index.Conclusions:The well-described cardiovascular/metabolic risk profile in pre- and perimenopausal PCOS women does not entail an evident increase in cardiovascular events during the postmenopausal period.
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| 16. |
- Schmidt, Johanna, 1974, et al.
(författare)
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Reproductive Hormone Levels and Anthropometry in Postmenopausal Women with Polycystic Ovary Syndrome (PCOS): A 21-Year Follow-Up Study of Women Diagnosed with PCOS around 50 Years Ago and Their Age-Matched Controls.
- 2011
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Ingår i: The Journal of clinical endocrinology and metabolism. - : The Endocrine Society. - 1945-7197 .- 0021-972X.
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Tidskriftsartikel (refereegranskat)abstract
- Context: The hormonal and anthropometric profile of premenopausal women with polycystic ovary syndrome (PCOS) is well described, but there is a lack of data concerning changes in these variables into the postmenopausal period. Objective: Our objective was to examine whether PCOS women differ from normal women regarding levels of reproductive hormones, anthropometry, and presence of hirsutism/climacteric symptoms also after menopause. Design and Setting: In this prospective study, women with PCOS (61-79 yr) and age-matched controls, examined in 1987, were reinvestigated at a university hospital. Participants: Twenty-five PCOS patients (Rotterdam criteria) and 68 controls (randomly allocated from the Gothenburg WHO MONICA study) participated. Interventions: Reexamination and hormonal measurements were done 21 yr after previous visit. Main Outcome Measures: FSH, LH, TSH, thyroid peroxidase antibodies, prolactin, estrone, estradiol, SHBG, androstenedione, total testosterone, dehydroepiandrosterone sulfate, free androgen index, and anthropometry were determined. Presence of climacteric symptoms, hirsutism, and menopausal age were recorded. Results: PCOS women had higher free androgen index (P = 0.001) but lower FSH (P < 0.001) and SHBG (P < 0.01) than controls. Menopausal age, body weight, body mass index, waist to hip ratio, LH, prolactin, androstenedione, dehydroepiandrosterone sulfate, total testosterone, estradiol, and estrone were similar in PCOS and controls. Women with PCOS reported hirsutism more frequently (P < 0.001) but had fewer climacteric symptoms (P < 0.05) and hypothyroidism than controls (P < 0.05). Conclusions: PCOS women differ from controls with regard to levels of certain reproductive hormones also after menopause, but the established premenopausal increase in waist to hip ratio in PCOS patients disappeared after menopause, mainly due to weight gain among controls. A novel finding was the lower prevalence of hypothyroidism in PCOS women.
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| 17. |
- Trimpou, Penelope, 1973, et al.
(författare)
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High correlation between quantitative ultrasound and DXA during 7 years of follow-up.
- 2010
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Ingår i: European journal of radiology. - : Elsevier BV. - 1872-7727 .- 0720-048X. ; 73:2, s. 360-4
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Tidskriftsartikel (refereegranskat)abstract
- Ultrasound is a quick, cheap and non-radiating device for assessing bone quality. We wanted to validate the method for clinical and epidemiological use. Eighty women, aged 53-73 years, with osteoporosis and/or fractures were followed repeatedly during 7 years. Quantitative ultrasound (QUS) measurements (LUNAR Achilles) were compared with bone mineral density (BMD) and bone mineral content (BMC) estimated by DXA (LUNAR) in regions of interest. Changes in the speed of sound, broadband ultrasound attenuation and stiffness were positively correlated with changes in BMD and BMC in all regions measured with DXA (r=0.20-0.53; p=0.09 to <0.0001). The QUS t-score at the left heel was positively correlated with the t-score at the right heel (r=0.90, p<0.0001). The DXA t-score of the left vs. the right femur was also positively correlated (r=0.72-0.86; p<0.0001). A t-score<-2.5 S.D. was found in 70% and 56% at baseline, and 74% and 65% at follow-up measured with QUS and DXA, respectively. The mean sensitivity of QUS vs. DXA was 79% and the mean specificity 45% over a 7-year period. A QUS t-score of <-3.65 S.D. was consistent with a DXA t-score of <-2.5 S.D. In conclusion, QUS was well correlated with DXA in all regions over the 7-year period. QUS can be used in settings without access to DXA and in epidemiological studies. The sensitivity was high but the specificity was low, implicating that DXA, if available, is recommended before treatment for osteoporosis. However, treatment can be started without DXA at a QUS t-score<-3.65 S.D., and especially in the presence of fractures.
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