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A normative model of Inhibin B in young males
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Abstracts / Maturitas 81 (2015) 126–143
MHT is low and of short duration, possibly affecting individual wellbeing and ability to work. Aim: To assess severity of menopausal complaints and effects of prolonged hormone treatment with special emphasis on depression, headache, vasomotor symptoms (VMS) and absence from work. Method: 142 women referred for treatment of severe menopausal complaints participated. We used medical records, CES-D and Greene Climacteric Scale (GCS) scores for baseline measurement of depression, menopausal complaints and self reported absence from work. Oral or transdermal MHT was prescribed. Data from yearly evaluations were compared to baseline using paired t-test, chi-square and Cramers-V. Results: Average age at intake was 52 yrs, 51% of women were postmenopausal, 24% hypertensive, 27% overweight. 63% had GCS score > 16 indicating bothersome menopausal complaints, 87% had VMS, 62% headaches, 46% depression (CES-D > 16) and 75% reported absence from work. Significant correlations existed between VMS, depression and headache (p < 0.05). After 3 years MHT 36% of women had GCS scores > 16, 36% VMS, 56% complained of headache and 26% was depressed (p < 0.05). Absence from work was unchanged. No major adverse effects occurred. Conclusion: The burden of menopausal complaints was impressive but decreased over time. Correlations between VMS depression and headache persisted as significant reduction of complaints occurred during prolonged use of MHT. Fear of aggravation of headaches caused by hormone therapy seems unnecessary. Expected age-related increase in absence from work did not occur, highlighting the joint result of improvement on separate determinants of absenteeism. http://dx.doi.org/10.1016/j.maturitas.2015.02.090 O6 A normative model of Inhibin B in young males Amy E. Miles 1,∗ , Tom Kelsey 2 , Hamish Wallace 1 1 University of Edinburgh, Edinburgh, United Kingdom 2 University of St Andrews, St Andrews, United Kingdom
Introduction: Measurement of Inhibin B as an indirect marker of Sertoli cell function is important in the assessment of fertility in young males treated for cancer. Individual studies have provided reference levels for infants, pre-pubertal boys, pubertal boys and adults. In this data-driven study, we derive a normative model of Inhibin B for all ages up to 19 years. Methods: Age-related Inhibin B data were extracted from three published studies and combined into a homogeneous dataset (n = 596, median age 7.4 years, IQR 1.7–11.9 years) that represents a sample taken from the healthy male population. Zero levels at conception were added to ensure that models conformed to biomedical reality; representative levels for adults were added to ensure biomedical plausibility at higher ages. Regression models were evaluated for goodness of fit and normality of residuals. Results and conclusions: Our model demonstrates that infant boys are born with an Inhibin B level of 240 pm/mL (95% prediction limits 125–410 pm/mL). This level rises to a post-natal peak of 250 pm/mL (95% prediction limits 110–440 pm/mL) occurring at around six months of age, then progressively falls to a minimum level of 85 pm/mL (95% prediction limits 15–205 pm/mL) occurring at age 5–6 years. Inhibin B levels thereafter rise though puberty and post puberty to a maximum level of 320 pm/mL (95% prediction limits 160–540 pm/mL) occurring at age 19 years. Following this
peak, Inhibin B levels decline to the reference values for healthy adult men. Our study confirms the finding by Andersson et al. that Inhibin B levels are higher in infants than in adults, and in addition we show that there is a post-pubertal peak which is higher than the post-natal peak. The derivation of a normative model of Inhibin B throughout childhood and puberty is important for the accurate interpretation of B in young males and will be of particular benefit for the assessment of Sertoli cell function in survivors of childhood cancer. http://dx.doi.org/10.1016/j.maturitas.2015.02.091 O7 Menopause and hormone replacement therapy are important aetiological factors in hand osteoarthritis: results from a cross-sectional study in secondary care Fiona E. Watt 1,2,∗ , Katharine Carlisle 3 , Donna Kennedy 3 , Tonia L. Vincent 1,2 1 University of Oxford, Kennedy Institute of Rheumatology, NDORMS, Oxford, United Kingdom 2 Imperial College Healthcare NHS Trust, Rheumatology, London, United Kingdom 3 Imperial College Healthcare NHS Trust, Therapies, London, United Kingdom
Osteoarthritis (OA) is the commonest form of arthritis, and the hand is a frequently affected site, but its pathogenesis is poorly understood. The incidence of OA is higher in women than men after the age of 50 years, and has been reported to occur around the time of the menopause in the hand. Aims: To document the relationship between menopause or cessation of HRT and onset of hand OA symptoms in a secondary care setting. Methods: Data was retrospectively extracted from a proforma completed at the standard initial consultation of consecutive patients referred to a multidisciplinary hand clinic at Charing Cross Hospital, London, UK between December 2007 and December 2014. Demographics, duration and site of hand symptoms, family history, parity, age at menopause, and current/past HRT use were analysed. Results: 115 patients fulfilled ACR diagnostic criteria for hand OA. 92 (80%) were female. Of these females, 24 had 1st carpometacarpal (CMC) joint, 52 had interphalangeal joint (IPJ) and 39 had mixed CMC/IPJ involvement. 42% reported a 1st degree relative with OA. Mean age was 60 ± 8 yrs. 23% were nulliparous, and 82 (89%) were menopausal or post-menopausal. Mean age at menopause was 50 ± 5.2 and mean age at onset of hand symptoms was 54 ± 8.3. Median time from onset of menopause to OA symptoms was 3 yrs (<1–30 yrs). Of those peri- or post-menopausal, 45 (56%) developed their hand symptoms within 4 years of menopause and 39 (48%) had ever used HRT. Of the 28 who had stopped HRT, the median time from its cessation to onset of hand symptoms was just 6 months (0–26 yrs). In total, 54 patients (67% of the postmenopausal group) developed hand symptoms either within 4 years of menopause, or within 4 years of stopping HRT. Conclusions: Symptomatic hand OA tends to occur within 4 years of menopause or HRT cessation. The climacteric and/or withdrawal of HRT appear to be important aetiological factors in the onset of hand OA: further study may give insight into disease pathogenesis. http://dx.doi.org/10.1016/j.maturitas.2015.02.092
Abstracts / Maturitas 81 (2015) 126–143
MHT is low and of short duration, possibly affecting individual wellbeing and ability to work. Aim: To assess severity of menopausal complaints and effects of prolonged hormone treatment with special emphasis on depression, headache, vasomotor symptoms (VMS) and absence from work. Method: 142 women referred for treatment of severe menopausal complaints participated. We used medical records, CES-D and Greene Climacteric Scale (GCS) scores for baseline measurement of depression, menopausal complaints and self reported absence from work. Oral or transdermal MHT was prescribed. Data from yearly evaluations were compared to baseline using paired t-test, chi-square and Cramers-V. Results: Average age at intake was 52 yrs, 51% of women were postmenopausal, 24% hypertensive, 27% overweight. 63% had GCS score > 16 indicating bothersome menopausal complaints, 87% had VMS, 62% headaches, 46% depression (CES-D > 16) and 75% reported absence from work. Significant correlations existed between VMS, depression and headache (p < 0.05). After 3 years MHT 36% of women had GCS scores > 16, 36% VMS, 56% complained of headache and 26% was depressed (p < 0.05). Absence from work was unchanged. No major adverse effects occurred. Conclusion: The burden of menopausal complaints was impressive but decreased over time. Correlations between VMS depression and headache persisted as significant reduction of complaints occurred during prolonged use of MHT. Fear of aggravation of headaches caused by hormone therapy seems unnecessary. Expected age-related increase in absence from work did not occur, highlighting the joint result of improvement on separate determinants of absenteeism. http://dx.doi.org/10.1016/j.maturitas.2015.02.090 O6 A normative model of Inhibin B in young males Amy E. Miles 1,∗ , Tom Kelsey 2 , Hamish Wallace 1 1 University of Edinburgh, Edinburgh, United Kingdom 2 University of St Andrews, St Andrews, United Kingdom
Introduction: Measurement of Inhibin B as an indirect marker of Sertoli cell function is important in the assessment of fertility in young males treated for cancer. Individual studies have provided reference levels for infants, pre-pubertal boys, pubertal boys and adults. In this data-driven study, we derive a normative model of Inhibin B for all ages up to 19 years. Methods: Age-related Inhibin B data were extracted from three published studies and combined into a homogeneous dataset (n = 596, median age 7.4 years, IQR 1.7–11.9 years) that represents a sample taken from the healthy male population. Zero levels at conception were added to ensure that models conformed to biomedical reality; representative levels for adults were added to ensure biomedical plausibility at higher ages. Regression models were evaluated for goodness of fit and normality of residuals. Results and conclusions: Our model demonstrates that infant boys are born with an Inhibin B level of 240 pm/mL (95% prediction limits 125–410 pm/mL). This level rises to a post-natal peak of 250 pm/mL (95% prediction limits 110–440 pm/mL) occurring at around six months of age, then progressively falls to a minimum level of 85 pm/mL (95% prediction limits 15–205 pm/mL) occurring at age 5–6 years. Inhibin B levels thereafter rise though puberty and post puberty to a maximum level of 320 pm/mL (95% prediction limits 160–540 pm/mL) occurring at age 19 years. Following this
peak, Inhibin B levels decline to the reference values for healthy adult men. Our study confirms the finding by Andersson et al. that Inhibin B levels are higher in infants than in adults, and in addition we show that there is a post-pubertal peak which is higher than the post-natal peak. The derivation of a normative model of Inhibin B throughout childhood and puberty is important for the accurate interpretation of B in young males and will be of particular benefit for the assessment of Sertoli cell function in survivors of childhood cancer. http://dx.doi.org/10.1016/j.maturitas.2015.02.091 O7 Menopause and hormone replacement therapy are important aetiological factors in hand osteoarthritis: results from a cross-sectional study in secondary care Fiona E. Watt 1,2,∗ , Katharine Carlisle 3 , Donna Kennedy 3 , Tonia L. Vincent 1,2 1 University of Oxford, Kennedy Institute of Rheumatology, NDORMS, Oxford, United Kingdom 2 Imperial College Healthcare NHS Trust, Rheumatology, London, United Kingdom 3 Imperial College Healthcare NHS Trust, Therapies, London, United Kingdom
Osteoarthritis (OA) is the commonest form of arthritis, and the hand is a frequently affected site, but its pathogenesis is poorly understood. The incidence of OA is higher in women than men after the age of 50 years, and has been reported to occur around the time of the menopause in the hand. Aims: To document the relationship between menopause or cessation of HRT and onset of hand OA symptoms in a secondary care setting. Methods: Data was retrospectively extracted from a proforma completed at the standard initial consultation of consecutive patients referred to a multidisciplinary hand clinic at Charing Cross Hospital, London, UK between December 2007 and December 2014. Demographics, duration and site of hand symptoms, family history, parity, age at menopause, and current/past HRT use were analysed. Results: 115 patients fulfilled ACR diagnostic criteria for hand OA. 92 (80%) were female. Of these females, 24 had 1st carpometacarpal (CMC) joint, 52 had interphalangeal joint (IPJ) and 39 had mixed CMC/IPJ involvement. 42% reported a 1st degree relative with OA. Mean age was 60 ± 8 yrs. 23% were nulliparous, and 82 (89%) were menopausal or post-menopausal. Mean age at menopause was 50 ± 5.2 and mean age at onset of hand symptoms was 54 ± 8.3. Median time from onset of menopause to OA symptoms was 3 yrs (<1–30 yrs). Of those peri- or post-menopausal, 45 (56%) developed their hand symptoms within 4 years of menopause and 39 (48%) had ever used HRT. Of the 28 who had stopped HRT, the median time from its cessation to onset of hand symptoms was just 6 months (0–26 yrs). In total, 54 patients (67% of the postmenopausal group) developed hand symptoms either within 4 years of menopause, or within 4 years of stopping HRT. Conclusions: Symptomatic hand OA tends to occur within 4 years of menopause or HRT cessation. The climacteric and/or withdrawal of HRT appear to be important aetiological factors in the onset of hand OA: further study may give insight into disease pathogenesis. http://dx.doi.org/10.1016/j.maturitas.2015.02.092