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P827 Postpartum depression is associated with increased CSF and plasma cytokines
Poster presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S413–S729
P826 The effect of hormone therapy, tibolone and raloxifene on circulating markers of chemotaxis in healthy postmenopausal women G. Christodoulakos1 , I. Lambrinoudaki1 , E. Economou2 , C. Panoulis1 , A. Augoulea1 , S. Fotopoulos1 , A. Alexandrou3 , G. Creatsas1 . 1 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece, 2 Hormonal and biochemical Laboratory, University of Athens, Aretaieio Hospital, Athens, Greece, 3 1st Department of Surgery, University of Athens, Laiko Hospital, Athens, Greece Objective: The aim of this study was to assess the effect of estrogen, estrogen-progestin, tibolone and raloxifene therapy on circulating markers of chemotaxis in healthy postmenopausal women. Methods: Eighty-eight postmenopausal women aged 44–62 years were randomly allocated to daily: (1) conjugated equine estrogens 0.625– mg (CEE), (2) 17 beta-estradiol 1 mg plus norethisterone acetate 0.5 mg (E(2)/NETA), (3) tibolone 2.5 mg, (4) raloxifene HCl 60 mg or (5) no treatment. Serum monocyte chemoattractant protein-1 (MCP-1) and regulated upon activation, normal T-cell expressed and secreted (RANTES) were measured at baseline and at 3 months. Results: Endogenous testosterone and free androgen index (FAI) correlated negatively, while SHBG correlated positively with serum RANTES (testosterone: r = −0.27, p = 0.033; FAI: r = −0.43, p = 0.004: SHBG: r = 0.34, p = 0.026). Serum MCP-1 decreased significantly in the CEE group (baseline 125.3±51 pg/ml, 3 months 84.5±36.1 pg/ml, p = 0.043), while no difference was detected between baseline and post-treatment levels in the other groups. Furthermore, a significant decrease in serum RANTES was observed at the end of 3 months only in the E2/NETA and the raloxifene group (E2/NETA baseline 8690.6±3880.0 pg/ml, 3 months 6894.0±1720.0 pg/ml, p = 0.007; raloxifene baseline 9042.4±3765.6 pg/ml, 3 months 6718.1±2366.2 pg/ml, p = 0.011). Conclusions: Endogenous androgens may suppress chemotactic response. Postmenopausal hormone therapy and raloxifene may inhibit the expression of chemoattractant molecules and thus attenuate inflammation. P827 Postpartum depression is associated with increased CSF and plasma cytokines F. Boufidou1 , I. Zervas2 , G. Petropoulos3 , D. Hasiakos4 , K. Papadias4 , G. Christodoulakos4 , C. Nikolaou1 , G. Creatsas3 . 1 Laboratory of Biopathology and Immunology, University of Athens, Eginition Hospital, Greece, 2 Women’s Mental Health Clinic, First Department of Psychiatry, Eginition Hospital, Athens University Medical School, Athens, Greece, 3 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece, 4 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital Objectives: Despite the possibility of a relation between immune parameters and postpartum mood disturbance, few studies have explored this association. Further, no study to-date has examined CSF. Methods: Fifty-six Greek parturients were recruited and a detailed medical and obstetric history was recorded. All of them completed the Postpartum Blues Questionnaire on admission and on the 4th postpartum day. All of them completed the Edinburgh Postnatal Depression Scale at first and last week postpartum. At delivery, a blood sample and a CSF sample while puncturing for epidural analgesia were taken from 33 participants; blood samples only were obtained from the rest of the 23 parturients. TNF-a and IL-6 were quantified with an ELISA assay. Results: A multiple regression analysis of psychometric scores depending on cytokine levels revealed that cytokine levels were positively associated with depressive mood during in the 4th day
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postpartum (p = 0.035 for CSF IL-6, p = 0.025 for CSF TnF-a, p = 0.023 for serum TnF-a) and also at the last week postpartum (p = 0.012 for CSF IL-6, p = 0.072 for CSF TnF-a). Pregnancy duration had an adverse association to psychometric scores. Conclusions: It is suggested that immune mechanisms may play a role in the etiopathology of postpartum depressive mood shifts. P828 Urinary incontinence among menopausal women: cross-correlation with gonadotropins and endogenous sex steroid hormones D. Sioutis1 , A. Liapis1 , I. Lamprinoudaki1 , M. Papakonstantinou1 , G. Christodoulakos1 , A. Alexandrou2 , A. Augoulea1 , G. Creatsas1 . 1 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 2 1st Department of Surgery, University of Athens Medical School, Laiko Hospital, Athens, Greece Objective: Urinary incontinence constitutes an important problem of health that involves female population, mainly after menopause. More specifically, urinary incontinence is presented in a percentage 30% in general population which increases considerably after the 60 year of age. Series of studies involve the hormonal profile of gonadotropins and endogenous sex steroids with the appearance of pelvic floor disorders and lower urinary tract dysfunctions. Aim of study is a cross-correlation between stress urinary incontinence (SUI) and the level of gonadotropins and endogenous sex steroid hormones. Methods: A hormonal control of endogenous steroids of menopausal women is scheduled for the study. These women do not receive any treatment of hormonal substitution. More specifically, serum blood levels of following hormones are estimated: FSH (Follicle Stimulating Hormone), LH (Luteinising Hormone), E2 (oestradiol), prolactin, testosterone, D4 (androstenedione), DHEAs (dehydroepiandrosterone sulphate), SHBG (sex hormone binding globulin). In the study were included 60 patients. Comparison of the values of the group of women suffering of SUI (treatment group), to the relative values of the group of 30 healthy menopausal women (control group) and statistical analysis of data. Results: With a level of significance a = 10%, the statistical analysis concluded to the existence of statistically important difference between control and treatment group regarding the mean values of the following hormones: LH: (p-value 0.08: control 34.34 mIU/ml vs treat 28.278), E2: (p-value 0.01: control 31.6 pg/ml vs treat 22.79) and SHBG: (p-value 0.07: control 85.12 vs treat 69.58). Conclusions: Cross-correlation of the levels of certain hormones between patients with and without stress urinary incontinence is confirmed. Further development of the study is expected as well as the clinical evaluation of the results. P829 The different effect of progestin on mammographic breast density in women on low-dose hormone therapy C. Panoulis1 , I. Lambrinoudaki1 , A. Vourtsi2 , A. Augoulea1 , L. Aravantinos1 , G. Christodoulakos1 , A. Alexandrou3 , G. Creatsas1 . 1 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 2 Department of Radiology, Diagnostic and Therapeutic Center “Ygeia”, Athens, Greece, 3 1st Department of Surgery, University of Athens, Laiko Hospital, Athens, Greece Objectives: To evaluate the effect on breast density of two low dose hormone therapy regimens identical in their estrogen component but different in the progestin. Methods: 81 non-hysterectomized postmenopausal women. 43 were allocated to 17-b estradiol 1 mg and norethisterone acetate 0.5 mg (E2/NETA, n = 43). 38 were allocated to 17b estradiol 1 mg and drospirenone 2 mg (E2/DRSP, n = 38). Treatment was continuous combined and lasted one year. The changes in breast density according to Wolfe classification between baseline and 12-month mammograms were investigated.
P826 The effect of hormone therapy, tibolone and raloxifene on circulating markers of chemotaxis in healthy postmenopausal women G. Christodoulakos1 , I. Lambrinoudaki1 , E. Economou2 , C. Panoulis1 , A. Augoulea1 , S. Fotopoulos1 , A. Alexandrou3 , G. Creatsas1 . 1 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece, 2 Hormonal and biochemical Laboratory, University of Athens, Aretaieio Hospital, Athens, Greece, 3 1st Department of Surgery, University of Athens, Laiko Hospital, Athens, Greece Objective: The aim of this study was to assess the effect of estrogen, estrogen-progestin, tibolone and raloxifene therapy on circulating markers of chemotaxis in healthy postmenopausal women. Methods: Eighty-eight postmenopausal women aged 44–62 years were randomly allocated to daily: (1) conjugated equine estrogens 0.625– mg (CEE), (2) 17 beta-estradiol 1 mg plus norethisterone acetate 0.5 mg (E(2)/NETA), (3) tibolone 2.5 mg, (4) raloxifene HCl 60 mg or (5) no treatment. Serum monocyte chemoattractant protein-1 (MCP-1) and regulated upon activation, normal T-cell expressed and secreted (RANTES) were measured at baseline and at 3 months. Results: Endogenous testosterone and free androgen index (FAI) correlated negatively, while SHBG correlated positively with serum RANTES (testosterone: r = −0.27, p = 0.033; FAI: r = −0.43, p = 0.004: SHBG: r = 0.34, p = 0.026). Serum MCP-1 decreased significantly in the CEE group (baseline 125.3±51 pg/ml, 3 months 84.5±36.1 pg/ml, p = 0.043), while no difference was detected between baseline and post-treatment levels in the other groups. Furthermore, a significant decrease in serum RANTES was observed at the end of 3 months only in the E2/NETA and the raloxifene group (E2/NETA baseline 8690.6±3880.0 pg/ml, 3 months 6894.0±1720.0 pg/ml, p = 0.007; raloxifene baseline 9042.4±3765.6 pg/ml, 3 months 6718.1±2366.2 pg/ml, p = 0.011). Conclusions: Endogenous androgens may suppress chemotactic response. Postmenopausal hormone therapy and raloxifene may inhibit the expression of chemoattractant molecules and thus attenuate inflammation. P827 Postpartum depression is associated with increased CSF and plasma cytokines F. Boufidou1 , I. Zervas2 , G. Petropoulos3 , D. Hasiakos4 , K. Papadias4 , G. Christodoulakos4 , C. Nikolaou1 , G. Creatsas3 . 1 Laboratory of Biopathology and Immunology, University of Athens, Eginition Hospital, Greece, 2 Women’s Mental Health Clinic, First Department of Psychiatry, Eginition Hospital, Athens University Medical School, Athens, Greece, 3 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, Athens, Greece, 4 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital Objectives: Despite the possibility of a relation between immune parameters and postpartum mood disturbance, few studies have explored this association. Further, no study to-date has examined CSF. Methods: Fifty-six Greek parturients were recruited and a detailed medical and obstetric history was recorded. All of them completed the Postpartum Blues Questionnaire on admission and on the 4th postpartum day. All of them completed the Edinburgh Postnatal Depression Scale at first and last week postpartum. At delivery, a blood sample and a CSF sample while puncturing for epidural analgesia were taken from 33 participants; blood samples only were obtained from the rest of the 23 parturients. TNF-a and IL-6 were quantified with an ELISA assay. Results: A multiple regression analysis of psychometric scores depending on cytokine levels revealed that cytokine levels were positively associated with depressive mood during in the 4th day
S647
postpartum (p = 0.035 for CSF IL-6, p = 0.025 for CSF TnF-a, p = 0.023 for serum TnF-a) and also at the last week postpartum (p = 0.012 for CSF IL-6, p = 0.072 for CSF TnF-a). Pregnancy duration had an adverse association to psychometric scores. Conclusions: It is suggested that immune mechanisms may play a role in the etiopathology of postpartum depressive mood shifts. P828 Urinary incontinence among menopausal women: cross-correlation with gonadotropins and endogenous sex steroid hormones D. Sioutis1 , A. Liapis1 , I. Lamprinoudaki1 , M. Papakonstantinou1 , G. Christodoulakos1 , A. Alexandrou2 , A. Augoulea1 , G. Creatsas1 . 1 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 2 1st Department of Surgery, University of Athens Medical School, Laiko Hospital, Athens, Greece Objective: Urinary incontinence constitutes an important problem of health that involves female population, mainly after menopause. More specifically, urinary incontinence is presented in a percentage 30% in general population which increases considerably after the 60 year of age. Series of studies involve the hormonal profile of gonadotropins and endogenous sex steroids with the appearance of pelvic floor disorders and lower urinary tract dysfunctions. Aim of study is a cross-correlation between stress urinary incontinence (SUI) and the level of gonadotropins and endogenous sex steroid hormones. Methods: A hormonal control of endogenous steroids of menopausal women is scheduled for the study. These women do not receive any treatment of hormonal substitution. More specifically, serum blood levels of following hormones are estimated: FSH (Follicle Stimulating Hormone), LH (Luteinising Hormone), E2 (oestradiol), prolactin, testosterone, D4 (androstenedione), DHEAs (dehydroepiandrosterone sulphate), SHBG (sex hormone binding globulin). In the study were included 60 patients. Comparison of the values of the group of women suffering of SUI (treatment group), to the relative values of the group of 30 healthy menopausal women (control group) and statistical analysis of data. Results: With a level of significance a = 10%, the statistical analysis concluded to the existence of statistically important difference between control and treatment group regarding the mean values of the following hormones: LH: (p-value 0.08: control 34.34 mIU/ml vs treat 28.278), E2: (p-value 0.01: control 31.6 pg/ml vs treat 22.79) and SHBG: (p-value 0.07: control 85.12 vs treat 69.58). Conclusions: Cross-correlation of the levels of certain hormones between patients with and without stress urinary incontinence is confirmed. Further development of the study is expected as well as the clinical evaluation of the results. P829 The different effect of progestin on mammographic breast density in women on low-dose hormone therapy C. Panoulis1 , I. Lambrinoudaki1 , A. Vourtsi2 , A. Augoulea1 , L. Aravantinos1 , G. Christodoulakos1 , A. Alexandrou3 , G. Creatsas1 . 1 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 2 Department of Radiology, Diagnostic and Therapeutic Center “Ygeia”, Athens, Greece, 3 1st Department of Surgery, University of Athens, Laiko Hospital, Athens, Greece Objectives: To evaluate the effect on breast density of two low dose hormone therapy regimens identical in their estrogen component but different in the progestin. Methods: 81 non-hysterectomized postmenopausal women. 43 were allocated to 17-b estradiol 1 mg and norethisterone acetate 0.5 mg (E2/NETA, n = 43). 38 were allocated to 17b estradiol 1 mg and drospirenone 2 mg (E2/DRSP, n = 38). Treatment was continuous combined and lasted one year. The changes in breast density according to Wolfe classification between baseline and 12-month mammograms were investigated.