Association between the SUMO4 M55V (A163G) polymorphism and susceptibility to type 1 diabetes: A meta-analysis

Objective

The aim of this study was to determine whether the SUMO4 M55V (A163G) polymorphism confers susceptibility to type 1 diabetes (T1D).

Methods

A meta-analysis was conducted on the association between the SUMO4 M55V polymorphism and T1D using; (1) allelic contrast (G vs. A), and the (2) recessive (GG vs. GA+AA), (3) dominant (GG+GA vs. AA), and (4) additive models (GG vs. AA).

Results

Thirteen separate studies were considered in the meta-analysis, which in total included 5915 patients and 6660 controls, and five European and eight Asian sample populations. Europeans had a higher prevalence of the G allele than Asians (50.4% vs. 30.2%). Meta-analysis of the SUMO4 M55V polymorphism showed an association between T1D and the SUMO4 G allele in all study subjects (OR = 1.236, 95% CI = 1.112–1.373, p = 7.9 × 10⁻⁶), and stratification by ethnicity indicated a highly significant association between the SUMO4 G allele and T1D in Asians (OR = 1.303, 95% CI = 1.169–1.452, p = 1.78 × 10⁻⁷) and a marginal association with T1D in Europeans (OR = 1.177, 95% CI = 1.000–1.386, p = 0.050). Furthermore, significant associations were found between the SUMO4 M55V polymorphism and T1D and all study subjects, Europeans, and Asians using the dominant model (OR = 1.239, 95% CI = 1.144–1.342, p = 1.4 × 10⁻⁸; OR = 1.156, 95% CI = 1.051–1.271, p = 0.003; OR = 1.461, 95% CI = 1.262–1.691, p = 3.8 × 10⁻⁸, respectively).

Conclusions

This meta-analysis indicates that the SUMO4 M55V polymorphism confers susceptibility to T1D in Asians and Europeans.     

Associations between TNFSF4 and TRAF1-C5 gene polymorphisms and systemic lupus erythematosus: A meta-analysis

Objective

The aim of this study was to determine whether tumor necrosis factor superfamily 4 (TNFSF4) and TNF receptor-associated factor 1-complement 5 (TRAF1-C5) polymorphisms confer susceptibility to systemic lupus erythematosus (SLE).

Methods

The authors conducted meta-analyses on associations between polymorphisms of the TNFSF4 (rs2205960, rs1234315, rs10489265) and TRAF1-C5 (rs10818488, rs3761847) genes and SLE susceptibility, using fixed and random effects models.

Results

A total of 21 comparative studies were included in this meta-analysis; meta-analysis showed an association between the minor allele of rs2205960 of TNFSF4 and SLE in all study subjects (odds ratio [OR] = 1.356, 95% confidence interval [CI] = 1.275–1.442, p < 1.0 × 10⁻⁹). Meta-analysis revealed an association between the minor alleles of rs1234315 and rs10489265 of TNFSF4 and SLE in Asians (OR = 1.366, 95% CI = 1.295–1.440, p < 1.0 × 10⁻⁹; OR = 1.463, 95% CI = 1.208–1.771, p = 9.7 × 10⁻⁵). The minor allele of rs10818488 of TRAF1-C5 was found to be significantly associated with SLE in Europeans (OR = 1.210, 95% CI = 1.115–1.313, p = 5.0 × 10⁻⁶). The association p-values remained significant after multiple corrections.

Conclusions

This meta-analysis confirms that TNFSF4 polymorphisms are associated with susceptibility to SLE in Asians and Europeans. An association was found between the rs10818488 polymorphism of TRAF1-C5 and susceptibility to SLE in Europeans.     

Falls,injuries from falls,health related quality of life and mortality in older adults with vision and hearing impairment-Is there a gender difference?

Background

Vision and hearing decline with age. Loss of these senses is associated with increased risk of falls, injuries from falls, mortality and decreased health-related quality of life (HRQOL). Our objective was to determine if there are gender differences in the associations between visual and hearing impairment and these outcomes.

Methods

2340 men and 3014 women aged 76–81 years from the Health in Men Study and the Australian Longitudinal Study on Women's Health were followed for an average of 6.36 years. Dependent variables were self-reported vision and hearing impairment. Outcome variables were falls, injuries from falls, physical and mental components of HRQOL (SF-36 PCS and MCS) and all-cause mortality.

Results

Vision impairment was more common in women and hearing impairment was more common in men. Vision impairment was associated with increased falls risk (odds ratio (OR) = 1.77, 95% CI = 1.35–2.32 in men; OR = 1.82, 95% CI = 1.44–2.30 in women), injuries from falls (OR = 1.69, 95% CI = 1.23–2.34 in men, OR = 1.79, 95% CI = 1.38–2.33 in women), and mortality (hazard ratio (HR) = 1.44; 95% CI = 1.17–1.77 in men; HR = 1.50, 95% CI = 1.24–1.82 in women) and declines in SF-36 PCS and MCS. Hearing impairment was associated with increased falls risk (OR = 1.38, 95% CI = 1.08–1.78 in men; OR = 1.45, 95% CI = 1.08–1.93 in women) and declines in SF-36 PCS and MCS. Overall there were no gender differences in the association between vision and hearing impairment and the outcomes.

Conclusion

In men and women aged 76–81 years, there were no gender differences in the association between self-reported vision and hearing impairment and the outcomes of falls, mortality and HRQOL.     

Tau-tubulin kinase-1 gene variants are associated with Alzheimer's disease in Han Chinese

Tau-tubuline kinase 1 (TTBK1) is a recently discovered brain-specific protein kinase involved in tau phosphorylation at AD-related sites. A recent large study has identified significant association of two single nucleotide polymorphisms (SNPs) (rs2651206 and rs7764257) in the TTBK1 gene with late-onset Alzheimer's disease (LOAD) in Spanish. Here, we performed a case–control study to clarify whether the risk for LOAD might be influenced by these polymorphisms in a large Chinese cohort consisting of 400 patients and 388 healthy controls. The minor alleles of the rs2651206 polymorphism within TTBK1 was significantly associated with a reduced risk of LOAD (odds ratio/OR = 0.69, P = 0.011). Furthermore, rs2651206 polymorphism was still strongly associated with LOAD (OR = 0.72, P = 0.05) after adjusted for age, gender, and the apolipoprotein E (APOE) ?4 status. Haplotype analysis identified the TG haplotype, deriving from the two minor alleles, to decrease the risk of LOAD (OR = 0.78, P = 0.037). This study provides the evidence that variations in the TTBK1 gene may play an important role in the pathogenesis of sporadic LOAD in a Han Chinese population.     

Area-based socioeconomic status and mood disorders: cross-sectional evidence from a cohort of randomly selected adult women

Objective

Data suggest there are established socio-economic disparities associated with mental health although most research has focused on individual-level indicators of socio-economic position. The aim of this study was to investigate the association between mood disorders and area-based socio-economic status (SES), and whether both ends of the SES continuum experienced increased odds for a mood disorder.

Methods

Using a clinical interview (SCID-I/NP), psychiatric history was ascertained in a population-based sample of 1095 women (20–93 years) from the Barwon Statistical Division, south-eastern Australia. SES was determined by cross-referencing residential addresses with Australian Bureau of Statistics 2006 census data for the region and categorised into three groupings of low, mid, and upper SES. The Index of Economic Resources (IER), Index of Education and Occupation (IEO), and Index of Relative Socioeconomic Advantage/Disadvantage (IRSAD) were utilised. Lifestyle factors were self-reported.

Results

For IER, the low SES group had a 2.0-fold increased odds of a current mood disorder compared to the mid group, after adjustment for physical activity and current anxiety (OR = 2.0, 95% CI 1.0–4.1, p = 0.05). This pattern was similarly observed for IEO (OR = 1.8, 95% CI 0.9–3.7, p = 0.1) and IRSAD (OR = 1.6 95% CI 0.8–3.4, p = 0.2). Those within the upper SES group showed a non-significant increase in the odds of a current mood disorder compared to the mid-group; IER (OR = 1.4, 95% CI 0.8–2.5, p = 0.3), IEO (OR = 1.2, 95% CI 0.07–2.3, p = 0.5) and IRSAD (OR = 1.2, 95% CI 0.7–2.1, p = 0.6).

Conclusions

Women in the low SES category were most likely to have a mood disorder. Furthermore, being in an upper SES group may not be protective against mood disorders.     

Polymorphic variants of genes encoding MTHFR, MTR, and MTHFD1 and the risk of depression in postmenopausal women in Poland

Objective

Disturbances in the folate-dependent one-carbon metabolism have been reported in depression. Polymorphic variants of genes encoding key enzymes of folate and methionine metabolism may have an impact on catecholamine catabolism conducted by catechol-O-methyltransferase.

Methods

The distribution of polymorphisms of genes encoding methylenetetrahydrofolate reductase (MTHFR); methionine synthase (MTR); 5,10-methylenetetrahydrofolate dehydrogenase, 5,10-methenyltetrahydrofolate cyclohydrolase and 10-formyltetrahydrofolate synthetase (MTHFD1) was examined in postmenopausal women with (n = 83) and without depression (n = 89).

Results

We found a significant contribution of the MTHFR 677C > T polymorphic variants to depression in postmenopausal women. Odds ratio (OR) for women with depression and MTHFR TT genotype was 3.478 (95% CI = 1.377–8.783), P = 0.0096 and OR of the TT and CT genotypes was 2.345 (95% CI = 1.258–4.373), P = 0.0086. Moreover, after stratification based on depression severity in postmenopausal women, we found that the MTHFR TT genotype displayed a 4.831-fold increased risk of moderate and severe depression (95% CI = 1.975–11.820, P = 0.0008). We did not observe statistical differences in the distribution of MTR 2756A > G and MTHFD1 1958G > A polymorphic variants in groups of postmenopausal women with and without depression. However, the MTR GG genotype exhibited a 5.750-fold increased risk of moderate and severe depression in postmenopausal women (95% CI = 1.547–21.379, P = 0.013).

Conclusions

Our findings indicate a significant role of folate and possible methionine metabolism involvement in the development of depression in postmenopausal women.     

Correlates of volunteering among aging Texans: the roles of health indicators, spirituality, and social engagement

Objectives

This study aimed to identify participant characteristics associated with volunteering among older adults.

Methods

Based on data from the 2008 Aging Texas Well (ATW) Indicators Survey, we examined the degree to which demographic factors, health status, spiritual participation, and community involvement are associated with volunteering among adults aged 60 years or older (n = 525).

Results

Rates of volunteering varied by race/ethnicity: non-Hispanic Whites (56.4%), African Americans (51.1%), and Hispanics (43.2%). Bivariate analyses showed that non-Hispanic White older adults were more likely to participate in formal volunteering activities, while their African American and Hispanic counterparts tended to participate in informal volunteering activities. Logistic regression analyses revealed that volunteering was less observed among Hispanics (OR = 0.48, 95% CI 0.29–0.78). Volunteering was more observed among those who reported providing informal care (OR = 1.93, 95% CI 1.14–3.28), having very good or excellent mental health (OR = 1.90 and 2.07, 95% CI 1.09–3.32 and 1.20–3.55, respectively), having weekly or daily spiritual participation (OR = 2.15 and 2.35, 95% CI 1.28–3.63 and 1.29–4.28, respectively), perceiving community involvement very important (OR = 2.37, 95% CI 1.55–3.62), and being very satisfied with the community interaction (OR = 1.81, 95% CI 1.15–2.85).

Conclusions

Given the positive associations of mental health, spirituality, and social engagement with volunteering among older adults, system-level efforts to increase the sense of community among older adults and recognize their roles as volunteers will be helpful in recruiting and retaining older volunteers.     

Should risk of bone fragility restrict weight control for other health reasons in postmenopausal women? – A ten year prospective study

Background

The aim of the present study was to investigate the health risks of excess body weight in the light of its protective effects on bone fragility.

Methods

Femoral neck and lumbar spine dual X-ray absorptiometry was performed for 1970 Finnish women with a mean baseline age of 58.8 years (range 53.1–65.7 years) in 1994 and 2004. Women were categorized according to baseline BMI into normal <25 kg/m2, overweight 25–29.9 kg/m² and obese ≥30 kg/m². Weight change (kg) was categorized into tertiles. Co-morbidities, not allowed to be present at baseline, was based on self-reports. Osteoporosis was defined as femoral neck or spinal (L2–L4) T-score <−2.5 SD at 10-year follow-up or <−2.0 SD + low trauma energy follow-up fracture. Uni- and multivariate logistic regression models were used to estimate the 10-year risk of incident health disorders. Adjustment for age, number of diseases, alcohol intake and smoking was used in the multivariate models.

Results

Obesity (Ob) and overweight (Ow) were related with higher 10-year risk of hypertension (OR = 2.6 (Ob)/OR = 1.7 (Ow), p < 0.001), coronary artery disease (OR = 1.6, p < 0.05/OR = 1.2, p = NS), diabetes (OR = 11.7/OR = 5.3, p < 0.001), osteoarthritis (OR = 1.4, p < 0.05/OR = 1.1, p = NS), chronic back pain (OR = 1.6, p = 0.007/OR = 1.2, p = NS) and poor self-rated health (OR = 2.4, p < 0.05/OR = 1.5, p = NS) and lower risk of osteoporosis (OR = 0.13/OR = 0.28, p < 0.001). Weight change of less than +1 kg was associated 1.8 and 2.6 times lower 10-year risk of having hypertension and breast cancer than weight change over 6.2 kg. Among obese women the absolute risk increase of hypertension was 17%, of diabetes 12%, and absolute risk reduction of osteoporosis 14% in comparison to BMI <25 kg/m².

Conclusions

Health related risks of high BMI outweigh its protective effects on bone. Weight gain increases the risk hypertension and breast cancer.     

Increased fasting serum glucose concentration is associated with adverse knee structural changes in adults with no knee symptoms and diabetes

Objective

There is evidence to suggest that elevated glucose concentration and clinical diabetes are associated with osteoarthritis (OA). However, the association may be confounded by knee symptoms, concomitant treatment for OA or diabetes. We performed a longitudinal cohort study to examine the relationship between serum glucose concentration and knee structure in adults with no knee symptoms or diabetes.

Methods

179 participants who had fasting serum glucose measurements at 1990–4, with no knee symptoms or diabetes (physician-diagnosed or fasting serum glucose ≥7 mmol/L), underwent knee MRI in 2003–4 and 2 years later. Body mass index was measured at 1990–4 and 2003–4. Cartilage volume and bone marrow lesions were determined from MRI at 2003–4 and 2006–7.

Results

Fasting serum glucose concentration was positively associated with the rate of tibial cartilage volume loss over 2 years in women (B = 44.2 mm³, 95% CI 4.6, 83.8) but not in men (B = 6.0 mm³, 95% CI −68.5, 80.6). Fasting serum glucose concentration was positively associated with incident bone marrow lesions in women (OR = 5.76, 95% CI 1.06, 31.21) but not in men (OR = 0.11, 95% CI 0.01, 1.79) with significant gender difference (p = 0.001 for interaction).

Conclusion

Increased fasting serum glucose concentration in a non-diabetic population was associated with adverse structural changes at the knee in women but not in men, suggesting that there may be susceptibility to knee structural change even below the arbitrary “diabetic range” of serum glucose levels. The sex differences warrant further investigation as this may be one mechanism underlying the sex difference in knee OA.     

Physical activity and mammographic parenchymal patterns among Greek postmenopausal women

Objective

To examine whether physical activity during the last five years is related to later breast mammographic density in postmenopausal Greek women.

Methods

We designed a cross-sectional study in 724 women, of ages 45–67 years. An interview-administered questionnaire was used to obtain information on duration and intensity of recreational physical activity during five years preceding study recruitment. Mammograms were evaluated according to BIRADS classification and BIRADS score was also estimated. Multivariate ordinal logistic regression analysis was used to assess associations between physical activity index and breast density according to the BIRADS classification methods.

Results

We observed a statistically significant inverse association of mammographic breast density measured by the BIRADS classification method and recreational exercise (OR = −0.10; 95% CI −0.018, −0.001; p = 0.022). For one unit increase in physical activity as expressed by the MET-h/week score, the odds of lower versus higher breast density categories are 1.105 greater, given that all of the other variables in the model are held constant. A modifying effect by age at recruitment was evident among participants, with a stronger inverse association between recreational activity and mammographic breast density among older women (OR = −0.036; 95% CI −0.063, −0.009; p = 0.009). An inverse association between physical activity and BIRADS score was evident, not reaching statistical significance (OR = 0.00; 95% CI −0.009, 0.008; p = 0.887).

Conclusions

Mammographic breast area was lower in postmenopausal women who participated in sports/recreational physical activity compared to inactive controls. Increasing physical activity levels among postmenopausal women might be a reasonable approach to reduce mammographic density. However, until more physical activity and mammographic breast density studies are conducted that confirm our findings, they have to be interpreted with caution, due to the retrospective nature of our data and the possibility of memory bias.     

Insulin-like growth factor 1 (IGF1) polymorphism is associated with Alzheimer's disease in Han Chinese

A review of pathogenic findings in Alzheimer's brains and the functional consequences of altered insulin-like growth factor 1 (IGF1) input to the brain suggest the association between Alzheimer's disease (AD) and the disrupted IGF1 signaling. Recently, the identification of polymorphism rs972936 that was associated with both an increased risk of AD and high circulating levels of IGF1 was reported in Southern European population. In order to evaluate the involvement of the IGF1 polymorphism in the risk of developing late-onset Alzheimer's disease (LOAD) in Chinese, we performed an independent case-control association study in a Han Chinese population (794 LOAD cases and 796 controls). There were significant differences in genotype and allele frequencies between LOAD cases and controls (genotype P = 0.006, allele P = 0.047). The T allele of rs972936 demonstrated a 1.16-fold risk for developing LOAD when compared with the C allele, which diverges to the report in the Caucasian population. After stratification by apolipoprotein E (APOE) ?4-carrying status, rs972936 polymorphism was only significantly associated with LOAD in non-ApoE ?4 allele carriers (genotype P = 0.002, allele P = 0.039). Multivariate logistic regression analysis also conferred this positive association between the SNP rs972936 and LOAD in the recessive and additive model after adjustment for age, gender, and the ApoE ?4 carrier status. These results suggest that IGF1 polymorphism has a possible role in changing the genetic susceptibility to LOAD in a Han Chinese population.     

Plasmacytoid dendritic cells are increased in cerebrospinal fluid of untreated patients during multiple sclerosis relapse

Background

Toll-like receptor 2 (TLR2) represents a reasonable functional and positional candidate gene for Alzheimer's disease (AD) as it is located under the linkage region of AD on chromosome 4q, and functionally is involved in the microglia-mediated inflammatory response and amyloid-β clearance. The -196 to -174 del polymorphism affects the TLR2 gene and alters its promoter activity.

Methods

We recruited 800 unrelated Northern Han Chinese individuals comprising 400 late-onset AD (LOAD) patients and 400 healthy controls matched for gender and age. The -196 to -174 del polymorphism in the TLR2 gene was genotyped using the polymerase chain reaction (PCR) method.

Results

There were significant differences in genotype (P = 0.026) and allele (P = 0.009) frequencies of the -196 to -174 del polymorphism between LOAD patients and controls. The del allele was associated with an increased risk of LOAD (OR = 1.31, 95% CI = 1.07-1.60, Power = 84.9%). When these data were stratified by apolipoprotein E (ApoE) ε4 status, the observed association was confined to ApoE ε4 non-carriers. Logistic regression analysis suggested an association of LOAD with the polymorphism in a recessive model (OR = 1.64, 95% CI = 1.13-2.39, Bonferroni corrected P = 0.03).

Conclusions

Our data suggest that the -196 to -174 del/del genotype of TLR2 may increase risk of LOAD in a Northern Han Chinese population.     

Lack of association between rs597668 polymorphism near EXOC3L2 and late-onset Alzheimer's disease in Han Chinese

Recently, an international genome-wide association study (GWAS) additionally found rs597668 near EXOC3L2/BLOC1S3/MARK4 was a new genome-wide significance locus associated with late-onset Alzheimer's disease (LOAD) in Caucasians. Follow-up replication studies were conducted almost exclusively in Caucasians, and the effects of the risk locus in other populations are as yet unknown. This study investigated the GWAS-associated locus near EXOC3L2 in 1205 unrelated Northern Han Chinese subjects comprising 598 LOAD patients and 607 healthy controls matched for gender and age. The results showed no significant differences in the genotypic or allelic distributions of rs597668 polymorphism between LOAD cases and healthy controls (genotype: P = 0.653; allele: P = 0.603), even after stratification for apolipoprotein E (APOE) ?4 status and statistical adjustment for age, gender and APOE ?4 status. This study suggests that the rs597668 polymorphism near EXOC3L2 may not play a major role in the susceptibility to LOAD in the Northern Han Chinese population.     

The HPV vaccine and the media: How has the topic been covered and what are the effects on knowledge about the virus and cervical cancer?

Objective

In June 2006, the first vaccine for HPV was approved by the FDA and media coverage about the topic increased significantly. This study sought to explore the nature of the coverage and whether knowledge about HPV was affected by it.

Methods

A content analysis, including 321 news stories from major newspapers, the AP wire and television news networks was conducted. A monthly RDD-recruited Internet survey with a national sample (n = 3323) was used to assess changes in population knowledge.

Results

Twenty-three percent of stories did not mention the sexually transmitted nature of the disease and 80% left out information about the need for continued cervical cancer screening after vaccination. Exposure to health-related media content was significantly associated with knowledge about HPV, even controlling for baseline knowledge (OR = 1.62, 95% CI = 1.12–2.35).

Conclusions

Changes in the volume of coverage over time were associated with knowledge about HPV, but the content analysis reveals that many of the stories were missing important information.

Practice implications

Clinicians must consider the potential media source patients are using for HPV-related information in order to correct inaccurate or incomplete information that could affect health behavior.     

Association between polymorphisms in FOXP3 and EBI3 genes and the risk for development of allergic rhinitis in Chinese subjects

Objective

To investigate whether polymorphisms in forkhead box protein 3 (FOXP3) and EBV-induced gene 3 (EBI3) genes are associated with allergic rhinitis (AR) in Chinese patients.

Methods

A population-based case-control association study design was used to assess the risk of AR conferred by single nucleotide polymorphisms (SNPs) in FOXP3 and EBI3 gene regions. DNA was extracted from 378 patients with AR and 330 healthy controls and analyzed for selected and tagged SNPs. Overall, 9 SNPs were selected and genotyped.

Results

In the single-locus analyses of AR risk, the allele frequencies of rs428253 in EBI3 gene were significantly different between the AR patients and control subjects (P = 1.00E-04); even after 10,000 permutations (P < 0.05). Logistic regression analyses, adjusted for age and gender, further showed a significant association between EBI3 rs428253 and protective effects against AR (P = 0.015, OR = 0.624 for CG/CC). The diplotype rs3761548-rs4824747 in FOXP3 gene with “AG” was associated with risk of AR (P = 0.031, OR = 1.755).

Conclusions

The findings of this study support the potential role of regulatory T cells and genetic variations in the regions around FOXP3 and EBI3 genes in modifying the risk for AR development in Chinese patients.     

AASAP: a program to increase recruitment and retention in clinical trials

Objective

To evaluate a theory based, subject-centered, staff/subject communication program, AASAP (anticipate, acknowledge, standardize, accept, plan), to increase recruitment and retention in RCTs.

Methods

AASAP was evaluated with logistical regression by comparing rates of recruitment (at telephone screening, baseline assessment, initial intervention) and intervention retention (over 16 weeks) before (−AASAP) and after (+AASAP) it was introduced to a 3-arm RCT to reduce disease distress among highly distressed subjects with type 2 diabetes.

Results

Included were 250 subjects in −AASAP and 338 in +AASAP. Significant improvement in recruitment occurred at each of the 3 recruitment stages: agreed at screening (OR = 2.52; p < 0.001), attended baseline assessment (OR = 1.91; p < 0.001), attended initial intervention (OR = 1.46; p < 0.03). Higher education and shorter diabetes duration predicted better recruitment in −AASAP (OR = 2.23; p < 0.001), but not in +AASAP. AASAP also improved intervention retention over 16 weeks (OR = 3.46; p < 0.05).

Conclusion

AASAP is a structured program of subject/staff communication that helps improve external validity by enhancing both subject recruitment and retention.

Practical implications

AASAP can be taught to non-professional staff and can be adapted to a variety of health settings. It can also be used by clinicians to engage patients in programs of ongoing care.     

Impaired quality of life among middle aged women: A multicentre Latin American study

Background

Several studies indicate that quality of life (QoL) is impaired in middle aged women. Assessment of QoL using a single validated tool in Latin American climacteric women has not been reported to date at large scale.

Objective

The Menopause Rating Scale (MRS) was used to assess QoL among middle aged Latin American women and determine factors associated with severe menopausal symptoms (QoL impairment).

Methods

In this cross-sectional study, 8373 healthy women aged 40–59 years, accompanying patients to healthcare centres in 18 cities of 12 Latin American countries, were asked to fill out the MRS and a questionnaire containing socio-demographic, female and partner data.

Results

Mean age of the entire sample was 49.1 ± 5.7 years (median 49), a 62.5% had 12 or less years of schooling, 48.8% were postmenopausal and 14.7% were on hormonal therapy (HT). Mean total MRS score (n = 8373) was 11.3 ± 8.5 (median 10); for the somatic subscale, 4.1 ± 3.4; the psychological subscale, 4.6 ± 3.8 and the urogenital subscale, 2.5 ± 2.7. The prevalence of women presenting moderate to severe total MRS scorings was high (>50%) in all countries, Chile and Uruguay being the ones with the highest percentages (80.8% and 67.4%, respectively). Logistic regression determined that impaired QoL (severe total MRS score ≥17) was associated with the use of alternatives therapies for menopause (OR: 1.47, 95% CI [1.22–1.76], p = 0.0001), the use of psychiatric drugs (OR: 1.57, 95% CI [1.29–1.90], p = 0.0001), attending a psychiatrist (OR: 1.66, 95% CI [1.41–1.96], p = 0.0001), being postmenopausal (OR: 1.48, 95% CI [1.29–1.69, p = 0.0001]), having 49 years or more (OR: 1.24, 95% CI [1.08–1.42], p = 0.001), living at high altitude (OR: 1.43, 95% CI [1.25–1.62, p = 0.0001]) and having a partner with erectile dysfunction (OR: 1.69, 95% CI [1.47–1.94, p = 0.0001]) or premature ejaculation (OR: 1.34, 95% CI [1.16–1.55, p = 0.0001]). Lower risk for impaired QoL was related to living in a country with a lower income (OR: 0.77, 95% CI [0.68–0.88], p = 0.0002), using HT (OR: 0.65, 95% CI [0.56–0.76], p = 0.0001) and engaging in healthy habits (OR: 0.59, 95% CI [0.50–0.69], p = 0.0001).

Conclusion

To the best of our knowledge this is the first and largest study assessing QoL in a Latin American climacteric series with a high prevalence of impairment related to individual female and male characteristics and the demography of the studied population.     

Sleep quality and aerobic training among menopausal women--a randomized controlled trial

Background

Menopause is associated with poor sleep quality and daytime sleepiness, which may lead to impaired quality of life and impaired functioning in daily activities.

Objective

To study whether exercise training improves sleep quality or decreases the amount of night time hot flushes among menopausal women with vasomotor symptoms.

Study design

A randomized controlled trial. Sedentary women (N = 176) aged 43–63 years with menopausal symptoms were randomized to a six-month unsupervised aerobic training intervention (50 min 4 times per week) or a control group. Both groups attended lectures on physical activity and health once a month.

Main outcome measures

Sleep quality and the amount of hot flushes disturbing sleep. The women reported daily via mobile phone whether hot flushes had disturbed their sleep and how they had slept (scale 1–5). Responses received by mobile phone over the 6-month period totaled on average 125 (5.2 per week) responses per participant.

Results

At baseline there was no difference between the groups in the demographic variables. Sleep quality improved significantly more in the intervention group than in the control group (OR 1.02; 95% CI = 1.0–1.05, p = 0.043). The odds for sleep improvement were 2% per week in the intervention group and a decrease of 0.5% per week in the control group. The amount of hot flushes related to sleep diminished (p = 0.004) by the end of the intervention.

Conclusions

Aerobic training for 6 months may improve sleep quality and reduce hot flushes among symptomatic menopausal women.     

Association of CD33 rs3865444:C˃A polymorphism with a reduced risk of late‐onset Alzheimer's disease in Slovaks is limited to subjects carrying the APOE ε4 allele

CD33 rs3865444:C>A single nucleotide polymorphism (SNP) has been previously associated with the risk of late‐onset Alzheimer's disease (LOAD); however, the results have been inconsistent across different populations. CD33 is a transmembrane receptor that plays an important role in AD pathogenesis by inhibiting amyloid β42 uptake by microglial cells. In this study, we aimed to validate the association between rs3865444 and LOAD risk in the Slovak population and to evaluate whether it was affected by the carrier status of the major LOAD risk allele apolipoprotein (APOE) ε4. CD33 rs3865444 and APOE variants were genotyped in 206 LOAD patients and 487 control subjects using the polymerase chain reaction–restriction fragment length polymorphism method and direct sequencing, respectively. Logistic regression analysis revealed a significant association of rs3865444 A allele with a reduced LOAD risk that was only present in APOE ε4 allele carriers (AA + CA versus CC: p = .0085; OR = 0.45; 95% CI = 0.25?0.82). On the other hand, no such association was found in subjects without the APOE ε4 (p = .75; OR = 0.93; 95% CI = 0.61?1.42). Moreover, regression analysis detected a significant interaction between CD33 rs3865444 A and APOE ε4 alleles (p = .021 for APOE ε4 allele dosage and p = .051 for APOE ε4 carriage status), with synergy factor (SF) value of 0.49 indicating an antagonistic effect between the two alleles in LOAD risk. In conclusion, our results suggest that CD33 rs3865444:C?A substitution may reduce the risk of LOAD in Slovaks by antagonizing the effect conferred by the major susceptibility allele APOE ε4.     

Different implication of NEDD9 genetic variant in early and late-onset Alzheimer's disease

Alzheimer's disease (AD) is a complex and multifactorial progressive neurodegenerative disease. Recently, two studies reported inconsistent results on a possible involvement of the NEDD9 (neural precursor cell expressed, developmentally down-regulated 9, 6p25-p24) as a candidate gene for the risk of developing AD and/or Parkinson's disease (PD). We analyzed the distribution of the rs760678 SNP polymorphism in 735 Italian subjects: 214 unrelated sporadic late-onset AD patients (LOAD, 64.5% females, mean age-at-onset 71.8 ± 5.2 years), 135 early-onset AD patients (EOAD, 57.3% females, mean age-at-onset 57.5 ± 5.5 years) and 386 healthy controls (68.9% females, mean age 83.4 ± 17.9 years; SD). We observed a statistically significant difference between LOAD patients and controls according to genotypes (P = 0.016) and allele frequency (P = 0.007); CC genotype was more frequent in LOAD cases (44.4%) than controls (36.0%). No difference after stratification of the data in terms of gender and status of the APOE ?4 allele was observed. In conclusion, our data do support an implication of the NEDD9 allelic variant in late-onset AD, with an independent effect of the apolipoprotein E (APOE) ?4 allele in the risk of developing AD.