早卵泡期促性腺激素释放激素激动剂降调节联合人绝经期促性腺激素在卵巢储备功能低下者促排卵中应用

目的:探讨促性腺激素释放激素激动剂(GnRH-a)早卵泡期降调节联合尿促性腺激素(HMG)方案用于卵巢储备功能低下不孕患者超促排卵的临床疗效。方法:回顾性分析2010年5月至2011年3月行体外受精(IVF)或单精子卵胞浆内注射(ICSI)治疗的109例卵巢储备功能下降患者的新鲜周期。根据促排方案分为早卵泡期降调节组(A)、微刺激组(B)和短方案组(C)。比较3组患者的临床及实验室结局。结果:B组患者促性腺激素用量低于A、C组患者,差异有显著统计学意义(P<0.01)。注射人绒毛膜促性腺激素(HCG)日,A组患者血清黄体生成素(LH)水平显著低于B、C组,C组患者血清E2水平显著高于A、B组,差异均有显著统计学意义(P<0.01)。3组患者获卵数、卵子成熟率、受精率和移植胚胎数比较均无统计学差异(P>0.05)。3组每移植周期临床妊娠率比较无统计学差异(33.33%vs32.35%vs36.00%,P>0.05)。B组周期取消率(34.62%)高于A组(11.11%),差异有统计学意义(P=0.02),与C组(16.67%)比较差异无统计学意义(P=0.05)。C组孕早期流产率(33.33%)高于A组(12.50%)和B组(18.18%),差异均有统计学意义(P=0.028,P=0.03)。结论:对于卵巢储备功能低下的不孕患者采用GnRH-a卵泡期长方案联合HMG促排卵,可获得与微刺激和短方案相同的临床妊娠率,且周期取消率和妊娠早期自然流产率降低。     

Plasma 25-hydroxyvitamin D and prostate cancer risk: The Multiethnic Cohort

The purpose of this study was to examine the relationship of plasma 25-hydroxyvitamin D (25(OH)D) concentrations to prostate cancer within a large multiethnic cohort in Hawaii and California using a nested case-control design. The study included 329 incidents of prostate cancer of African American, Native Hawaiian, Japanese, Latino and White ancestry, and 656 controls matched on age, race/ethnicity, date/time of blood collection and fasting status. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CI). No association with prostate cancer risk was found in an analysis based on quartiles of 25(OH)D. When clinically defined cutpoints were used, there was no increased risk for the lowest 25(OH)D concentration (OR for <20 versus 30–<50 ng/ml = 1.10, 95% CI = 0.68–1.78), while there was a suggestive increased risk for higher concentrations (OR for ?50 ng/ml = 1.52, 95% CI = 0.92–2.51). The findings from this prospective study of men in the Multiethnic Cohort do not support the hypothesis that vitamin D lowers the risk of prostate cancer. Further follow-up is warranted to determine whether the findings are consistent across ethnic groups.     

Comprehensive association testing of common genetic variation in DNA repair pathway genes in relationship with breast cancer risk in multiple populations

Genetic association studies of multiple populations investigate a wider range of risk alleles than studies of a single ethnic group. In this study, we developed a multiethnic tagging strategy, exploiting differences in linkage disequilibrium (LD) structure between populations, to comprehensively capture common genetic variation across 60 genes spanning multiple DNA repair pathways, in five racial/ethnic populations. Over 2600 SNPs were genotyped in each population and single- and multi-marker predictors of common alleles were selected to capture the LD patterns specific to each group. Coding variants (n = 211) were genotyped to test whether combinations of putative functional variants in DNA repair pathway genes could have cumulative effects on risk. Tests of association were conducted in a multiethnic breast cancer study (2093 cases and 2303 controls), with validation of the top allelic associations (P 相似文献   

Plasma carotenoids, retinol, and tocopherols and postmenopausal breast cancer risk in the Multiethnic Cohort Study: a nested case-control study

Introduction  

Assessments by the handful of prospective studies of the association of serum antioxidants and breast cancer risk have yielded inconsistent results. This multiethnic nested case-control study sought to examine the association of plasma carotenoids, retinol, and tocopherols with postmenopausal breast cancer risk.     

Nonsteroidal anti-inflammatory drugs (NSAIDs) and mammographic density

Mammographic density has been established as a strong risk factor for breast cancer while use of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) has been associated with a reduction in risk of breast cancer. The hypothesis is that NSAIDs reverses the expression of prostaglandin E₂, thereby reducing the local production of estrogens. This report describes the differences in mammographic densities by duration of NSAID use in a multiethnic population. Information for this analysis was available from two previous investigations: a nutritional intervention study with 218 women and a nested case-control study of breast density with 1274 women. On the basis of self-reported medication use from a questionnaire common to both investigations, women were categorized into no use, up to 1 year, 2–5 years, 6–10 years, and 11+ years. Screening mammograms were assessed for density using a computer-assisted method. We applied general linear models to calculate mean percent densities for each medication use category while adjusting for covariates. The analysis of the overall study population did not show a significant association between total NSAID use and mammographic density. Contrary to our hypothesis, women with long-term total NSAID use had non-significantly higher densities than non-users. In addition, the results differed by menopausal status. Whereas the trend of higher densities with longer duration of total NSAID use was significant among postmenopausal women, breast density was slightly lower among premenopausal women with long-term NSAID use. Experimental studies need to be performed to study the effect, if any, of NSAID use on breast density.     

A case-control study of diet and colorectal cancer in a multiethnic population in Hawaii (United States): lipids and foods of animal origin

Temporal trend and migrant studies have indicated that the etiologyof colorectal cancer is predominantly environmental and, hence, modifiable.Animal fat intake has been frequently, but inconsistently, associated withthe risk of this disease. We conducted a population-based case-control studyin Hawaii (United States) among ethnic groups at different risks of thedisease to evaluate the role of dietary lipids and foods of animal origin onthe risk of colorectal cancer. We interviewed 698 male and 494 femaleJapanese, Caucasian (White), Filipino, Hawaiian, and Chinese patientsdiagnosed during 1987-91 with pathologically confirmed adenocarcinoma of thecolon or rectum, and 1,192 population controls matched to cases on age,gender and ethnicity. Odds ratios (OR), adjusted for caloric intake and otherdietary and non-dietary risk factors, were estimated using conditionallogistic regression. Intakes of total fat, saturated fat (S) andpolyunsaturated fat (P) were not related to the risk of colorectal cancer.However, an inverse association was found for the P/S ratio, with ORs of 0.6in both genders (95 percent confidence interval [CI] = 0.4-1.0 for males; CI= 0.3-0.9 for females) for the highest compared with the lowest quartile (P 0.05 for trend). Intakes of red meat and processed meat were associatedwith the risk of cancer in the right colon and rectum, respectively, in menonly. Fat-trimmed red meat and fish intakes were not related to risk. Chickeneaten without skin was associated inversely with risk in both genders. Thestrongest association was found for eggs, with an OR of 2.7 (CI = 1.7-4.0)and 2.3 (CI = 1.4-3.7) for the highest compared with the lowest quartile ofintake in men and women, respectively (P < 0.001 for trend). This associationwas dose-dependent, not explained by known confounders or other dietaryvariables, and was very consistent between genders, among ethnic groups, andacross all segments of the large bowel. These data sugg est that the ratio ofpolyunsaturated to saturated fat may be a better indicator of colorectalcancer risk than the absolute amount of specific fats in the diet. They alsosuggest that eggs and, possibly, untrimmed red meat and processed meatincrease, and chicken eaten without skin decreases, colorectal cancer risk.     

Nutrient intake from multivitamin/mineral supplements is similar among users from five ethnic groups: the Multiethnic Cohort Study

A multivitamin/mineral supplement is the most widely used type of dietary supplement among American adults. Therefore, accurate assessment of intake from this supplement is crucial when studying diet and chronic diseases. From 1999 to 2001, the Multiethnic Cohort Study collected detailed information on multivitamin/mineral use among five ethnic groups: African Americans, Native Hawaiians, Japanese Americans, Latinos, and whites. Daily nutrient intakes from multivitamin/minerals were calculated using the nutrient composition specified on the product label. For reported supplements with insufficient detail to match to a specific product, default nutrient profiles were assigned. Multivitamin/mineral use was reported by 50% of the participants (38% for Native Hawaiians to 57% for whites). Default profiles were assigned for 38% of users. The median daily nutrient intakes from multivitamin/minerals among users (n=75,865) were well above the Recommended Daily Allowance or Adequate Intake for vitamins A, B-6, B-12, and E, thiamin, riboflavin, niacin, pantothenic acid, folate, and zinc. Although nutrient intakes from multivitamin/minerals varied widely among individuals, there was no substantial difference in the median intake across ethnic groups. To accurately estimate nutrient intakes from multivitamin/minerals, detailed information on the product consumed should be collected. When detailed information is not available, the same default nutrient profiles can be used when estimating intakes for these five ethnic groups.     

Genetic variation at the CYP19A1 locus predicts circulating estrogen levels but not breast cancer risk in postmenopausal women

The CYP19A1 gene encodes the enzyme aromatase, which is responsible for the final step in the biosynthesis of estrogens. In this study, we used a systematic two-step approach that included gene resequencing and a haplotype-based analysis to comprehensively survey common genetic variation across the CYP19A1 locus in relation to circulating postmenopausal steroid hormone levels and breast cancer risk. This study was conducted among 5,356 invasive breast cancer cases and 7,129 controls comprised primarily of White women of European descent drawn from five large prospective cohorts within the National Cancer Institute Breast and Prostate Cancer Cohort Consortium. A high-density single-nucleotide polymorphism (SNP) map of 103 common SNPs (> or =5% frequency) was used to identify the linkage disequilibrium and haplotype patterns across the CYP19A1 locus, and 19 haplotype-tagging SNPs were selected to provide high predictability of the common haplotype patterns. We found haplotype-tagging SNPs and common haplotypes spanning the coding and proximal 5' region of CYP19A1 to be significantly associated with a 10% to 20% increase in endogenous estrogen levels in postmenopausal women [effect per copy of the two-SNP haplotype rs749292-rs727479 (A-A) versus noncarriers; P = 4.4 x 10(-15)]. No significant associations were observed, however, with these SNPs or common haplotypes and breast cancer risk. Thus, although genetic variation in CYP19A1 produces measurable differences in estrogen levels among postmenopausal women, the magnitude of the change was insufficient to contribute detectably to breast cancer.     

Smoking, alcohol, occupation, and hair dye use in cancer of the lower urinary tract

This case-control study was based on 137 Caucasian and 124 Japanese cases of urinary tract cancer identified in Hawaii between 1977 and 1986. Each case was matched on sex, age, and race to two population-based controls. Heavy cigarette smokers (41 or more pack-years for men; 21 or more pack-years for women) had a significantly elevated risk compared with nonsmokers (odds ratio (OR) = 6.2, 95% confidence interval (CI) 3.4-11.1 for the men; OR = 2.8, 95% CI 1.2-6.3 for the women). When the men and women were combined, employment in high-risk industries (includes machinery, automotive, and textiles, among others) was significantly associated with cancer risk (OR = 1.6, 95% CI 1.1-2.3). Alcohol intake and hair dye use showed weaker positive associations with risk that were not statistically significant.