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Background: Comprehensive investigations of the associations between 21-gene recurrence assay and metabolic profiles in Chinese breast cancer patients are limited., Methods: We evaluated the relations of the 21-gene recurrence risk score (RS) and the expression of cancer-related genes with metabolic factors and biomarkers of insulin and the insulin-like growth factor (IGF) axis, and examined the interactions between the 21-gene RS and these metabolic profiles on breast cancer recurrence in Chinese women with HR-positive, HER2-negative early-stage breast cancer., Results: The 21-gene RS was inversely associated with body mass index ([BMI]β: -0.178 kg/m 2 ; P=0.040), the homeostasis model assessment of insulin resistance index ([HOMA-IR] β: -0.031; P=0.042), insulin (β: -0.036 uIU/ml; P=0.009), and C-peptide (β: -0.021 ug/L; P=0.014) and was positively associated with high-density lipoprotein cholesterol (β: 0.025 mmol/L; P=0.004), which were driven by the relation patterns between specific cancer-related genes and these metabolic profiles. Each 10-unit increase in the 21-gene RS was associated with 28% (95% CI: 5-47%) higher risk of breast cancer recurrence; this association was also observed in patients with favorable metabolic profiles in relevant to an absence of obesity, insulin resistance, hyperglycemia, hypertension, or dyslipidemia (28-44% higher risk) and among women with a low level of insulin, C-peptide, or the IGF1/IGFBP3 ratio (41-155% higher risk)., Conclusions: The 21-gene RS was related to favorable metabolic profiles including lower BMI, HOMA-IR, insulin, and C-peptide, and higher HDL in Chinese breast cancer patients, and its prognostic impact on breast cancer recurrence was more likely to present among patients with relatively favorable metabolic profiles., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Zhu, Wang, Tong, Chen and Shen.)

Background: Body weight management was an important component in breast cancer survivorship care. The present study described the change patterns of body weight and waist-to-hip ratio (WHR) during the first 5 years of survival, and investigated potential factors associated with very substantial changes., Patients and Methods: Based on a longitudinal cohort with 1462 Chinese women with breast cancer, anthropometric measurements including body weight, height, waist and hip circumferences were measured by trained interviewers following standard protocol at four time-points: baseline at study entry, 18-, 36- and 60-months follow up assessments (termed as T0, T1, T2 and T3, respectively). Body height was measured at baseline and body weight at cancer diagnosis were retrieved from medical record., Results: Compared to weight at breast cancer diagnosis, the median weight change was - 0.5 kg, 0 kg, + 0.5 kg, and + 1 kg at T0, T1, T2 and T3, respectively. During the first 5 years of survival, the proportion of women who were obese have slightly increased. At 60-months after diagnosis, only 14.3% of women had weight gain by > 5 kg; and the percentage of women who had weight gain by > 10% was 10.7%. Nearly half of patients had abdominal obesity at study entry, and this proportion were gradually increased to nearly 70% at 60-months follow-up. Multivariate analysis indicated that older age, and frequent sports participation during the first 5 years of survival were related to lower risk of very substantial weight gain (> 10%) at 60-month follow-up; patients aged 40-49 years, having ≥2 comorbidities and ER negative were associated with less likelihood of very substantial WHR substantial increase (> 10%) at 60-month follow-up., Conclusion: Weight gain was modest in Chinese breast cancer survivors during the first 5 years of survival, while central adiposity has become a contemporary public health issue. The incorporation of healthy weight and abdominal circumference patient education and management has a potential to improve cancer survivorship., (© 2021. The Author(s).)

Background: Irregular menstrual cycles including the length of cycles and menses, and heavy menstrual blood loss are linked to many gynaecological diseases. Obesity has been reported to be associated with irregular menstrual cycles. However, to date, most studies investigating this association are focused on adolescence or university students. Whether this association is also seen in adult women, especially women who had a history of birth has not been fully investigated., Methods: Questionnaire data were collected from 1012 women aged 17 to 53 years. Data on age, weight and height, gravida, the length of menstrual cycles and menses, and the number of pads used during menses were collected. Factors associated with menstrual cycle according to BMI categories were analysed., Results: There were no differences in the length of menstrual cycles and menses in women of different body mass index (BMI) groups. However, there was a significant difference in menstrual blood loss in women of different BMI categories. The odds ratio of having heavy menstrual blood loss in obese women was 2.28 (95% CL: 1.244, 4.193), compared to women with normal weight, while there was no difference in the odds ratio of having heavy menstrual blood loss in overweight, compared to normal weight, women. In contrast, the odds ratio of having heavy menstrual blood loss in underweight women was 0.4034 (95% CL: 0.224, 0.725), compared to women with normal weight., Conclusion: Although BMI was not correlated with the length of menstrual cycle and menses, BMI is positively associated with menstrual blood loss. Our data suggest that BMI influences menstrual blood loss in women of reproductive age and weight control is important in women's reproductive years.

Aims: To investigate the association between self-reported preconception body mass index (BMI) and the risk of abnormal glucose tolerance (AGT)., Methods: Data were obtained from a prospective cohort study conducted in China. We recruited 5305 qualified women who registered during 22-24 gestational weeks. Blood glucose was measured by trained professionals, and other health-related information was recorded prospectively. We used logistic regression to evaluate the relationship between preconception BMI with AGT and its subtypes, after controlling for potential confounders., Results: 649 of the 5305 participants (12.2%) were diagnosed with AGT. The prevalences of AGT in underweight, normal weight, overweight and obese population indicated a significant linear increased trend (8.4%, 11.1%, 20.0% and 27.7%, respectively) (p < 0.001), regardless of parity status. After adjustment for maternal age, education and parity, the adjusted odds ratios of AGT for underweight: OR = 0.82 (95% CI: 0.62, 1.06); overweight: OR = 1.92 (95% CI: 1.54, 2.38); obese: OR = 2.82 (95% CI: 1.88, 4.22) compared with normal weight. Stratified analysis showed preconception BMI had a greater impact on primiparous women., Conclusions: Our results support an association between self-reported preconception BMI with increased risk of AGT, and it was dependent on parity., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background: To evaluate the association between rate of gestational weight gain and preterm birth varying prepregnancy body mass indices and trimester., Methods: Data from Maternal and Newborn's Health Monitoring System on 17475 pregnant women who delivered live singletons at ≥ 28 weeks of gestation between October 2013 and September 2014 from 12 districts/counties of 6 provinces in China and started prenatal care at ≤ 12 weeks of gestation was analyzed. Gestational weight gain was categorized by rate of weight gain during the 2(nd) and 3(rd) trimester, based on the 2009 Institute of Medicine guidelines. Multivariable binary logistic regression models were conducted to investigate the association between rate of gestational weight gain and preterm birth stratified by prepregnancy body mass indices and trimester., Results: Excessive weight gain occurred in 57.9 % pregnant women, and insufficient weight gain 12.5 %. Average rate of gestational weight gain in 2(nd) and 3(rd) trimester was independently associated with preterm birth (U-shaped), and the association varied by prepregnancy body mass indices and trimesters. In underweight women, excessive gestational weight gain was positively associated with preterm birth (OR 1.93, 95 % confidence interval (CI): 1.29- 2.88) when compared with women who gained adequately. While in overweight/obese women, insufficient gestational weight gain was positively associated with preterm birth (OR 3.92, 95 % CI: 1.13-13.67). When stratifying by trimester, we found that excessive weight gain in 3(rd) trimester had a significantly positive effect on preterm birth (OR 1.27, 95 % CI: 1.02-1.58)., Conclusions: Excessive gestational weight gain among underweight pregnant women, insufficient gestational weight gain among overweight/obese women and excessive gestational weight gain in 3(rd) trimester were important predictors of preterm birth.

Background The 2009 Institute of Medicine (IOM) gestational weight gain (GWG) guidelines were initially developed for pregnant women in the United States. Objective This study aimed to investigate whether the IOM guidelines were suitable for pregnant Chinese women. Methods A retrospective cohort study comprising 20,593 singleton pregnant women was conducted at the Beijing Obstetrics and Gynaecology Hospital (1 January 2018 to 31 December 2019). Applicability was evaluated by comparing the GWG corresponding to the lowest point of the predicted composite risk curve with the 2009 IOM GWG Guidelines. The IOM Guidelines serve as the standard for the GWG categories and the pre-pregnancy body mass index. An exponential function model was used to fit the weight gain during pregnancy and the probability of caesarean section, preterm birth, small for gestational age, and large for gestational age. A quadratic function model was used to fit the combined probability of the above-mentioned adverse pregnancy outcomes. The applicability of the IOM guidelines was evaluated by comparing the weights corresponding to the lowest predicted probability with the GWG range recommended by the IOM guidelines. Results According to the 2009 IOM GWG Guidelines, 43% of the women achieved adequate weight, almost 32% gained excessive weight, and 25% gained inadequate weight. The GWG range proposed by the IOM included the lowest predicted probability value for underweight women and exceeded the lowest predicted probability for normal weight, overweight, and obese women. Conclusions The 2009 IOM guidelines were suitable for Chinese women whose pre-pregnancy body mass index was classified as underweight. The guidelines were not suitable for normal, overweight, or obese pre-pregnancy body mass index classifications. Therefore, based on the above evidence, the 2009 IOM guidelines are not suitable for all Chinese women.

Aim: To investigate the prevalence of SUI and explore the factors that could influence the severity of SUI in adult females. Design: A cross‐sectional study. Methods: A total of 1178 subjects were assessed using a risk‐factor questionnaires and International Consultation on Incontinence Questionnaire Short Form (ICIQ‐SF) and then divided into no SUI group, mild SUI group and moderate‐to‐severe SUI group according to the ICIQ‐SF score. Univariate analysis between adjacent groups and ordered logistic regression models in three groups were then performed to analysis the possible associated factor with the progressive of SUI. Results: The prevalence of SUI among adult women was 22.2% of them; 16.2% and 6% had mild SUI and moderate‐to‐severe SUI, respectively. Moreover, logistic analysis revealed that age, BMI, smoking, position preference for urination, urinary tract infections, urinary leaks during pregnancy, gynaecological inflammation and poor sleep quality were independent risk for the severity of SUI. Conclusion: SUI symptoms were mostly mild among Chinese females, specific risk factors such as unhealthy living habits and urination behaviours increased the risk of SUI and the aggravation of symptoms. Therefore, targeted interventions should be formulated for women to delay disease progression. [ABSTRACT FROM AUTHOR]

The 2009 Institute of Medicine (IOM) gestational weight gain (GWG) guidelines were initially developed for pregnant women in the United States. This study aimed to investigate whether the IOM guidelines were suitable for pregnant Chinese women. A retrospective cohort study comprising 20,593 singleton pregnant women was conducted at the Beijing Obstetrics and Gynaecology Hospital (1 January 2018 to 31 December 2019). Applicability was evaluated by comparing the GWG corresponding to the lowest point of the predicted composite risk curve with the 2009 IOM GWG Guidelines. The IOM Guidelines serve as the standard for the GWG categories and the pre-pregnancy body mass index. An exponential function model was used to fit the weight gain during pregnancy and the probability of caesarean section, preterm birth, small for gestational age, and large for gestational age. A quadratic function model was used to fit the combined probability of the above-mentioned adverse pregnancy outcomes. The applicability of the IOM guidelines was evaluated by comparing the weights corresponding to the lowest predicted probability with the GWG range recommended by the IOM guidelines. According to the 2009 IOM GWG Guidelines, 43% of the women achieved adequate weight, almost 32% gained excessive weight, and 25% gained inadequate weight. The GWG range proposed by the IOM included the lowest predicted probability value for underweight women and exceeded the lowest predicted probability for normal weight, overweight, and obese women. The 2009 IOM guidelines were suitable for Chinese women whose pre-pregnancy body mass index was classified as underweight. The guidelines were not suitable for normal, overweight, or obese pre-pregnancy body mass index classifications. Therefore, based on the above evidence, the 2009 IOM guidelines are not suitable for all Chinese women. [ABSTRACT FROM AUTHOR]

Objective: To assess the relationship between preconception body mass index (BMI) and cervical length (CL).Methods: Data was collected from a prospective cohort study conducted in Beijing, China. A total of 4843 qualified women participated in this study, whose health-related information was recorded at the very beginning and their cervical length was measured with transvaginal ultrasound examination during 22-24 gestational weeks. Logistic regression was used to evaluate the relationship between preconception BMI and cervical length, after adjusting for potential confounders.Results: Of all the participants in the analysis, 580 (12.0%) women had a short cervical length (CL less than 30 mm). After adjusting for the age and parity status, the adjusted odds ratios of short CL for underweight: adjusted OR = 1.28 (95% CI: 1.02, 1.60); overweight: adjusted OR = 0.74 (95% CI: 0.55, 0.99); obesity: adjusted OR = 0.38 (95% CI: 0.17, 0.88) compared with normal weight. The mean CL in underweight, normal weight, overweight and obesity group demonstrated a significant linear increased trend (33.47, 34.16 and 34.96 mm, respectively) (p < .05), dependent of age and parity.Conclusions: This research revealed that low preconception BMI women were more likely to have a short CL. [ABSTRACT FROM AUTHOR]

Body image comparisons on social networking sites (SNS) have been found to be associated with disordered eating among western young women, however, the inner mechanism driving this association is largely unknown. Based on social comparison, sociocultural, and objectification theories, the present study aimed to investigate the association between body image comparisons on SNS and restrained eating, as well as the mediating role of body shame and the moderating roles of body appreciation and body mass index (BMI) among Chinese young adult women. A sample of 567 Chinese college women were recruited to complete a questionnaire assessing body image comparisons on SNS, body shame, body appreciation, restrained eating, and information about weight and height. Results showed that body image comparisons on SNS were positively associated with restrained eating and that body shame significantly mediated this association. Furthermore, body appreciation and BMI each moderated the association between body shame and restrained eating as well as the association between body image comparisons on SNS and restrained eating. These results not only have theoretical implications, but also provide guidance for prevention interventions targeting negative body image and disordered eating among college women. [ABSTRACT FROM AUTHOR]

Abstract Background The generalizability of the gestational weight gain (GWG) ranges recommended by the Institute of Medicine (IOM) to Chinese women is disputed. Methods In 2016, 16,780 pregnant women who gave birth to live singletons in Changsha, China, were enrolled. First, subjects with optimal pregnancy outcomes were identified for the GWG percentile distribution description and for comparison to the IOM recommendations. Second, all subjects with optimal GWG according to the IOM body mass index (BMI) cutoffs and those with optimal GWG according to the Asian BMI cutoffs were selected. Pregnancy outcomes were compared between those two groups. Results A total of 13,717 births with optimal pregnancy outcomes were selected to describe the GWG distribution. The height and central position of the GWG distributions determined by the Asian BMI cutoffs differed from those determined by the IOM BMI cutoffs among the overweight and obese groups. The recommended IOM GWG ranges were narrower than and shifted to the left of the observed distributions. In both BMI classification schemes, however, the IOM-recommended ranges were within the middle 70% (Pc 15th–85th) and 50% (Pc 25th–75th) of the observed distribution. A total of 6438 (38.37%) and 6110 (36.41%) women gained optimal GWG, according to the IOM and Asian BMI classifications, respectively. Compared with those with optimal GWG according to IOM BMI cutoffs, women with optimal GWG according to the Asian BMI cutoffs had lower risks of both macrosomia (adjusted OR = 0.79, 95%CI: 0.67–0.94) and large-for-gestational age (adjusted OR = 0.86, 95%CI: 0.76, 0.98). However, no significantly different risks of preterm, low birthweight, small-for-gestational age, pregnancy-induced hypertension, or gestational diabetes were found between them. Conclusions The IOM-recommended GWG ranges are within the middle 70% of the distributions in Chinese women, and pre-pregnancy weight status should be determined by the Asian BMI cut-off points for monitoring and making GWG recommendations to Chinese women.

Objectives: This study aimed to establish normal blood pressure reference ranges across gestation and maternal characteristics.Methods: We conducted a follow-up study including 29,200 Chinese normal pregnant women. Multilevel restrictive cubic spline models were used to calculate normal blood pressure reference ranges among all population and stratified groups.Results: In all normal pregnancies, the normal reference range of systolic blood pressure were 93.94-118.74 mmHg(2.5th-97.5th) and 97.35-124.63 mmHg at 12 and 37 weeks gestation, respectively while 58.79-74.21 mmHg and 59.19-78.25 mmHg were for diastolic blood pressure at 12 and 37 weeks gestation, which differed in subgroups stratified by prepregnancy body mass index and maternal age.Conclusion: This study provides evidence for blood pressure management in Chinese pregnant women. [ABSTRACT FROM AUTHOR]

Aim: To investigate the association between patterns of nutrient intake and serum lipids in Chinese women aged 18–80 years. Methods: In the present study, cross‐sectional data were analysed from 2886 female participants aged 18–80 years from the China Health and Nutrition Survey wave 2009. Nutrient patterns were identified using factor analysis combined with cluster analysis based on the data of nutrient intake for three consecutive days. Multivariate linear regression models were used to estimate the association of nutrient patterns with serum lipids. Results: Four nutrient patterns were identified in Chinese adult women, which were the plant‐based pattern, carbohydrate and animal fat pattern, plant fat and sodium pattern, and the animal‐based pattern. Participants following different patterns varied significantly in sociodemographic characteristics, lifestyle behaviours and food consumption. Compared with the plant‐based pattern, the carbohydrate and animal fat pattern was positively associated with low‐density lipoprotein cholesterol (β = 4.57, 95% CI: 0.29–8.85, P = 0.036) and total cholesterol (β = 4.89, 95% CI: 0.34–9.44, P = 0.035). The corresponding rises for the animal‐based pattern were 4.91 (95% CI: 0.99–8.82, P = 0.014) and 4.98 (95% CI: 0.82–9.15, P = 0.019), respectively. Conclusions: Nutrient patterns with a high intake of animal fat and a low intake dietary fibre and with high intakes of animal fat, animal protein and cholesterol may increase the serum cholesterol in Chinese women. [ABSTRACT FROM AUTHOR]

Background: Few studies have examined the age‐standardized incidence of gestational diabetes mellitus (GDM) for comparison between populations. Information on delivery outcomes is also lacking for Chinese women with GDM. Therefore, the present study aimed to determine age‐standardized GDM incidence and assess its association with maternal and neonatal outcomes. Methods: A total of 1901 pregnant women were recruited in Chengdu, Sichuan Province. GDM was diagnosed between 24 and 28 weeks' gestation using oral glucose tolerance tests. Age‐standardized incidence rates of GDM were calculated using the direct method. Delivery outcomes were extracted from medical records and compared between the GDM and non‐GDM groups. Results: The age‐standardized GDM incidence was 18.3% (95% CI 15.6‐21.1) and increased with maternal age and prepregnancy body mass index (BMI). Women with GDM experienced longer length of stay in hospital, shorter gestation at delivery, and a higher risk of cesarean delivery. Their newborns were more likely to be macrosomic or small for gestational age, and to require neonatal intensive care. Conclusions: The incidence of GDM was high in Western China, especially among older and overweight women. Moreover, women with GDM had higher rates of adverse delivery outcomes. The findings lend further support for the screening, prevention, and management of GDM in Chinese women. [ABSTRACT FROM AUTHOR]

Background The prevalence of both obesity and type 2 diabetes has been on the rise in China. This randomized controlled trial was conducted to test the feasibility and effectiveness of an evidence-based diabetes prevention program in Yuci, Shanxi Province, China from 2012 to 2014. Methods Women with pre-diabetes, ages 25–65 y, were assigned randomly to a comparison (n=75) or 6-mo lifestyle intervention condition (n=109). Weight, fasting glucose, hemoglobin A1c and self-reported diet and physical activity were measured at baseline, 6 mo and 12 mo. Results All measures except fasting glucose improved favorably in both comparison and intervention participants at the 6- and 12-mo follow-ups. Participants in the intervention group lost more weight (−0.91 kg, p<0.05) and had a lower body mass index (−0.39 kg/m2, p<0.05) than the comparison group at follow-up. A total of 31.6% (31/98) and 16.2% (11/68) of the participants in the intervention and comparison groups, respectively, achieved the weight loss goal of 5% at follow-up. There was no significant group difference in outcome measures at the 12-mo follow-up. Participants in the intervention group also showed favorable changes in self-reported diet and physical activity measures. Conclusions A lifestyle intervention to prevent diabetes in at-risk women in community health centers in China is feasible and acceptable but effect sizes were small. [ABSTRACT FROM AUTHOR]

Introduction: Understanding of quality of life (QoL) of young Chinese breast cancer patients after adjuvant cytotoxic chemotherapy is limited. This study aims to assess the QoL of premenopausal Chinese breast cancer women after receiving adjuvant chemotherapy. Patients and methods: Eligibility criteria included stage I-III breast cancer, premenopausal and age ≤45 years at cancer diagnosis and having received adjuvant chemotherapy within 3-10 years before entry to the present study. Patients' background demographics at the time of breast cancer diagnosis, together with tumor characteristics and anticancer treatments, were collected. At the time of study entry, the menopausal status based on menstrual history, body mass index, and QoL (assessed using Functional Assessment of Cancer Therapy-Breast +4) were recorded. Results: Two hundred and eighty patients were recruited. Ninety-five patients (33.9%) underwent breast-conserving surgery, and nearly all (98.6%) underwent axillary dissection. For adjuvant therapies, 249 patients (88.9%) received anthracycline-containing chemotherapy and 79 (28.2%) received taxane-containing chemotherapy, while 68 (24.3%) received both. One hundred and eighty six patients (66.4%) received adjuvant radiotherapy, and 214 (76.4%) received adjuvant tamoxifen. The median time from breast cancer diagnosis to study entry was 5.01 years. QoL assessment at study entry revealed that older patients had worse social well-being (SWB; mean scores for age &#88000004;40, 41-45, 46-50 and >50 years were 22.0, 19.3, 19.1 and 18.1, respectively, P=0.0442). Patients who underwent axillary dissection had worse scores for breast cancer subscale (BCS; mean score 22.2 vs. 28.3, P=0.0212). Patients who underwent taxane-containing chemotherapy had worse scores for arm subscale (mean score 13.8 vs. 15.3, P=0.0053). Conclusion: At a median follow-up of 5 years post-diagnosis, patients who were younger had fewer disturbances in their SWB. Patients who had axillary dissection had worse BCS scores, while those who received taxane had worse scores for arm subscale. Further studies are warranted for breast-specific QoL to address the specific issues encountered by breast cancer patients. [ABSTRACT FROM AUTHOR]

Objective: To assess the 10-year cardiovascular risk in middle-aged Chinese women living in the same community and the impact of reproductive aging and age.Methods: This was a cross-sectional study in the Yuetan Community of Beijing. Data on lifestyle habits, prevalence and treatment of chronic diseases with significance for cardiovascular disease (CVD) development were collected by interview. CVD risk factors were assessed by physical examination and laboratory tests. The 10-year cardiovascular risk was calculated using the Framingham 10-year risk score. STRAW +10 criteria were used for the stages of reproductive aging.Results: A total of 536 women, aged 40-60 years, were enrolled. The incidences of hypertension, dyslipidemia, abdominal obesity, glucose intolerance and diabetes were 32.6%, 45.7%, 65.5%, 37.9% and 10.1%, respectively. After adjustment, the incidence of hypertension and diabetes increased with age and with reproductive aging. Dyslipidemia and glucose intolerance were only associated with age. Abdominal obesity was related neither to age nor to reproductive aging. The 10-year cardiovascular risk ranged from 1% to 24.8%; 11.6% of women had a moderate or high Framingham 10-year risk score.Conclusions: CVD risk factors were frequent and more than 10% of the women were at moderate or high risk of developing cardiovascular disease within the next 10 years. To our knowledge, this was demonstrated for the first time in middle-aged Chinese women. Thus, women should maintain a healthy lifestyle and physicians should monitor them to prevent CVD. [ABSTRACT FROM AUTHOR]

Large comparative studies of androgen profiles in women with polycystic ovary syndrome (PCOS) and healthy women are scarce, and the application of the free androgen index (FAI) in diagnosing PCOS has lagged behind in China. Androgen profiles of women aged between 19 and 45 years with PCOS ( n = 833) were compared with controls ( n = 2732). The women with PCOS had an elevated androgen level (total testosterone, androstenedione and free androgen index) through their reproductive years. In the ‘healthy’ reference population (consisting of 821 controls without PCOS and without disorders affecting androgen concentrations), FAI, total testosterone and androstenedione were weakly but negatively correlated with age. In women with PCOS, androstenedione was negatively correlated with age (r = −0.106; P = 0.002), whereas increased total testosterone and FAI, and decreased SHBG, were observed in the group aged 40–45 years. After adjusting for body mass index (BMI), age was negatively correlated with FAI and androstenedione, and positively correlated with sex hormone-binding globulin (SHBG) (all P < 0.001). Hyperandrogenaemia seemed to worsen in the oldest women with PCOS, which might be explained by the increasing BMI. About 1.9% of the PCOS control population was diagnosed with PCOS using the FAI upper limit of 6.0, determined by the 95th percentile of the ‘healthy’ reference group. Body weight management should be emphasized for women with PCOS throughout their lives, and assay of SHBG and FAI is highly recommended in China. [ABSTRACT FROM AUTHOR]

Importance: Acupuncture is used to induce ovulation in some women with polycystic ovary syndrome, without supporting clinical evidence.Objective: To assess whether active acupuncture, either alone or combined with clomiphene, increases the likelihood of live births among women with polycystic ovary syndrome.Design, Setting, and Participants: A double-blind (clomiphene vs placebo), single-blind (active vs control acupuncture) factorial trial was conducted at 21 sites (27 hospitals) in mainland China between July 6, 2012, and November 18, 2014, with 10 months of pregnancy follow-up until October 7, 2015. Chinese women with polycystic ovary syndrome were randomized in a 1:1:1:1 ratio to 4 groups.Interventions: Active or control acupuncture administered twice a week for 30 minutes per treatment and clomiphene or placebo administered for 5 days per cycle, for up to 4 cycles. The active acupuncture group received deep needle insertion with combined manual and low-frequency electrical stimulation; the control acupuncture group received superficial needle insertion, no manual stimulation, and mock electricity.Main Outcomes and Measures: The primary outcome was live birth. Secondary outcomes included adverse events.Results: Among the 1000 randomized women (mean [SD] age, 27.9 [3.3] years; mean [SD] body mass index, 24.2 [4.3]), 250 were randomized to each group; a total of 926 women (92.6%) completed the trial. Live births occurred in 69 of 235 women (29.4%) in the active acupuncture plus clomiphene group, 66 of 236 (28.0%) in the control acupuncture plus clomiphene group, 31 of 223 (13.9%) in the active acupuncture plus placebo group, and 39 of 232 (16.8%) in the control acupuncture plus placebo group. There was no significant interaction between active acupuncture and clomiphene (P = .39), so main effects were evaluated. The live birth rate was significantly higher in the women treated with clomiphene than with placebo (135 of 471 [28.7%] vs 70 of 455 [15.4%], respectively; difference, 13.3%; 95% CI, 8.0% to 18.5%) and not significantly different between women treated with active vs control acupuncture (100 of 458 [21.8%] vs 105 of 468 [22.4%], respectively; difference, -0.6%; 95% CI, -5.9% to 4.7%). Diarrhea and bruising were more common in patients receiving active acupuncture than control acupuncture (diarrhea: 25 of 500 [5.0%] vs 8 of 500 [1.6%], respectively; difference, 3.4%; 95% CI, 1.2% to 5.6%; bruising: 37 of 500 [7.4%] vs 9 of 500 [1.8%], respectively; difference, 5.6%; 95% CI, 3.0% to 8.2%).Conclusions and Relevance: Among Chinese women with polycystic ovary syndrome, the use of acupuncture with or without clomiphene, compared with control acupuncture and placebo, did not increase live births. This finding does not support acupuncture as an infertility treatment in such women.Trial Registration: clinicaltrials.gov Identifier: NCT01573858. [ABSTRACT FROM AUTHOR]

Background: A novel line of research suggests that eating at nighttime may have several metabolic consequences that are highly relevant to breast cancer. We investigated the association between nighttime eating habits after 10 p.m. and breast cancer in Hong Kong women.Methods: A hospital-based case-control study was conducted during 2012-2015. A total of 922 patients with incident breast cancer (cases) and 913 hospital controls were recruited and interviewed using a standard questionnaire including information on eating behavior during both daytime and nighttime. We collected the timing, duration, types and frequencies of food intake of eating at nighttime. Odds ratios (ORs) for the risk of breast cancer in relation to nighttime eating-related variables were calculated by unconditional multivariable logistic regression.Results: Eating at night after 10 pm was significantly associated with breast cancer with an adjusted OR of 1.50 (95% confidence interval (CI) 1.06-2.12, P = 0.02), and the associations were stronger in women who had the longest duration of nighttime eating (≥20 years) (adjusted OR = 2.28 (95% CI 1.13-4.61, P = 0.02) and who ate late (midnight to 2 a.m.) (adjusted OR = 2.73, 95% CI 1.01-6.99, P = 0.04). Interestingly, nighttime eating was only associated with breast cancer among women who consumed staple foods (OR = 2.16, 95% CI 1.42-3.29, P < 0.001) but not those who ate vegetables or fruits as nighttime meals. The significant association between nighttime eating and breast cancer was observed among women with body mass index (BMI) <25 (OR = 2.29, 95% CI 1.48-3.52, P < 0.001) but not among women with BMI ≥25.Conclusions: Results from this study suggest a possible association between nighttime eating behavior and breast cancer. These findings need to be confirmed by independent large studies. [ABSTRACT FROM AUTHOR]

Background: Both high and low prepregnancy body mass index (BMI) has been associated with small for gestational age births (SGA; birthweight below the population specific 10th centile for the gestational age), but results remain inconsistent. We examined the association between maternal BMI and SGA, and evaluated if the associations were modified by preterm birth (being born prior to 37 weeks) status.Methods: A population-based cohort study was conducted in Wuhan, China from June 2011, to June 2013. Women who delivered a non-malformed livebirth (n = 76 695) were included using the Wuhan Maternal and Child Health Management Information System. Log-binomial regression models were used to analyse the associations between prepregnancy BMI, categorized using thresholds adapted to the Chinese population, and SGA. Stratified analyses were used to examine the relationship of prepregnancy BMI to preterm-SGA and term-SGA.Results: Of the 76 695 live births, 3058 (4.0%) were delivered preterm. For babies born at term, prepregnancy underweight (<18.5 kg/m2 ) was associated with an increased risk of SGA, the adjusted risk ratio (RR) was 1.41 (95% confidence interval (CI) 1.33, 1.49), whereas, being overweight (24.0-27.9 kg/m2 ) was associated with a decreased risk (RR 0.84, 95% CI 0.74, 0.94). For babies born preterm, prepregnancy underweight was not associated with risk of SGA, but being overweight was associated with an increased risk (RR 1.57, 95% CI 1.04, 2.35).Conclusions: These data suggest that the association of overweight and underweight prepregnancy BMI and SGA differs depending on whether the baby is full term or preterm. [ABSTRACT FROM AUTHOR]

Background: To evaluate the association between rate of gestational weight gain and preterm birth varying prepregnancy body mass indices and trimester. Methods: Data from Maternal and Newborn's Health Monitoring System on 17475 pregnant women who delivered live singletons at ≥ 28 weeks of gestation between October 2013 and September 2014 from 12 districts/counties of 6 provinces in China and started prenatal care at ≤ 12 weeks of gestation was analyzed. Gestational weight gain was categorized by rate of weight gain during the 2nd and 3rd trimester, based on the 2009 Institute of Medicine guidelines. Multivariable binary logistic regression models were conducted to investigate the association between rate of gestational weight gain and preterm birth stratified by prepregnancy body mass indices and trimester. Results: Excessive weight gain occurred in 57.9 % pregnant women, and insufficient weight gain 12.5 %. Average rate of gestational weight gain in 2nd and 3rd trimester was independently associated with preterm birth (U-shaped), and the association varied by prepregnancy body mass indices and trimesters. In underweight women, excessive gestational weight gain was positively associated with preterm birth (OR 1.93, 95 % confidence interval (CI): 1.29-2.88) when compared with women who gained adequately. While in overweight/obese women, insufficient gestational weight gain was positively associated with preterm birth (OR 3.92, 95 % CI: 1.13-13.67). When stratifying by trimester, we found that excessive weight gain in 3rd trimester had a significantly positive effect on preterm birth (OR 1.27, 95 % CI: 1.02-1.58). Conclusions: Excessive gestational weight gain among underweight pregnant women, insufficient gestational weight gain among overweight/obese women and excessive gestational weight gain in 3rd trimester were important predictors of preterm birth. [ABSTRACT FROM AUTHOR]

Background The present study evaluated the relationship between dietary fatty acid ( FA) intakes and human milk FA levels. Methods Healthy lactating women ( n = 514) from Northern China participated in the study. Dietary intake was assessed with a 24-h dietary recall questionnaire and evaluated using golden key maternal nutrition software (Wincome, Shanghai, China) and China Food Composition 2009. Human milk FA composition was determined by gas chromatography. Results The maternal daily median intakes of linoleic acid ( LA), α-linolenic acid ( ALA) and arachidonic acid ( AA) were 19.93 g, 3.08 g and 16.33 mg, respectively. Eicosapentaenoic acid ( EPA) and docosahexaenoic acid ( DHA) intakes were below the recommended levels. FA levels in 100 g of human milk were 0.363 g LA, 0.038 g γ-linolenic acid ( GLA), 0.052 g dihomo γ-linolenic acid ( DGLA), 0.144 g ALA, 0.079 g AA, 0.007 g EPA, 0.018 g docosatetraenoic acid ( DTA) and 0.048 g DHA. Multiple linear regression analysis revealed that human milk DGLA levels were negatively correlated with dietary LA intake (β = −0.223, P = 0.030), and human milk GLA and DTA levels were negatively correlated with dietary ALA intake (β = −2.189, P = 0.031; β = −2.252, P = 0.027) after adjusting for possible confounding factors. Conclusions The results of the present study suggest the presence of competitive interactions between n-3 fatty acids ( ALA) and n-6 fatty acids ( GLA and DTA). [ABSTRACT FROM AUTHOR]

Background: The increasing use of anti-Müllerian hormone (AMH) in clinic has raised concerns regarding the reliable reference range for this test. However, the reference range for AMH in normal Chinese female population has not been established. Furthermore, relationship between AMH and other clinical markers such as body mass index (BMI) and antral follicle counts (AFCs) and other sex-related hormones have not been examined in normal population-based women. Objective: We aimed to determine the age-specific reference range for serum AMH in healthy Chinese women throughout reproductive age to menopause and to estimate relationship between AMH and other clinical markers in healthy women. Study Design: In this multicenter and nationwide study, advertisements were used to recruit 2055 women, aged 20 to 55 years, from 6 different regions in China; 1590 (77.37%) women met the inclusion criteria for the reference range population. We measured the baseline serum AMH levels using new Beckman Coulter Gen II assay. Serum concentration of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), testosterone (T), prolactin (PRL), progesterone (PRG), and AFCs were also determined in the follicular phase. Main Outcome Measures: The AMH-Age nomogram and AMH levels of different age-groups and the relationship between AMH and other clinical markers. Results: Serum AMH concentrations declined progressively with age. A quadratic model defined as log (AMH) = (−1.970 + 0.296 × Age − 0.006 × Age2) fitted best the decline of AMH with age. The median AMH levels were 6.23, 5.65, 4.55, 3.74, 2.78, and 1.09 ng/mL for the 20 ≤ age < 25, 25 ≤ age < 30, 30 ≤ age < 33, 33 ≤ age < 37, 37 ≤ age < 40, and 40 ≤ age < 55 groups, respectively. The 5th to 95th percentiles of the AMH levels, as the reference range, were 2.06 to 12.66, 1.77 to 13.83, 1.48 to 11.45, 0.87 to 9.76, 0.56 to 9.49, and 0.08 to 5.70 ng/mL for each age-group. The AMH levels were positively correlated with AFCs and T, LH, PRL and PRG levels and negatively correlated with BMI and FSH levels and were not significantly correlated with E2 levels. The relationship between AMH and other variables remain unchanged except for PRL, which was not significantly correlated with AMH levels after controlling for both age and BMI. Conclusions: This study determined the normal reference ranges for serum AMH levels in a large population-based sample of healthy Chinese women. [ABSTRACT FROM AUTHOR]

Objective To examine the concentration of C-reactive protein (CRP) in relation to gestational weeks during pregnancy among Chinese women. Methods From a randomized control trial of prenatal supplementation with folic acid, iron-folic acid, and multiple micronutrients in China, we examined 834 pregnant women with CRP measured initially between 5 and 20 weeks and at follow-up between 28 and 32 weeks gestation. We calculated and plotted CRP geometric means by gestational weeks. The same analysis was repeated for women who had normal pregnancies (624 women) by excluding women with stillbirth, preterm, small for gestational age, body mass index <18.5 kg/m2 or >30 kg/m2 at enrollment, and hypertension or anemia during pregnancy. Results We observed a significant positive trend between log-transformed CRP and gestational age from 5 to 20 weeks and from 28 to 32 weeks both in the full sample and in the subset of women who had normal pregnancies. CRP geometric mean was 0.81 mg/l at 5-7 weeks of gestation, 2.85 mg/l at 19-20 weeks of gestation, and 3.89 mg/l at 32 weeks of gestation. A similar increasing trend in the CRP median or percentage of elevated CRP were also observed. Conclusion We concluded that CRP increased with gestational age among healthy Chinese women who delivered healthy infants. Am. J. Hum. Biol. 28:574-579, 2016. © 2016 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background and Objectives: MC4R (melanocortin-4 receptor) gene polymorphisms have been associated with serum triglycerides (TG) in Caucasians and Japanese, but no reports are available Chinese. The purpose of this study was to find whether there was an association of rs17782313 polymorphisms at the MC4R gene with serum TG in elderly Chinese.Methods and Study Design: 2,012 over 40 years participated in a cross-sectional study in which their body mass index (BMI), TG, high density lipoprotein-cholesterol (HDL-C), and MC4R rs17782313 polymorphisms were determined.Results: For women, carriers of the T/T genotype had significantly lower serum TG than those with C/C genotype (p=0.006). Carriers of the C/C genotype of this polymorphisms exhibited significantly lower fasting HDL-C levels compared with T/T and T/C genotypes (p=0.025), and increased glycosylated hemoglobin (HbA1c) (p=0.043), but no change in blood pressure. Higher serum TG in carriers of the C/C genotype of MC4R gene remained stable after adjustment for age, smoking, drinking, BMI, waist circumference (WC) and three or more components of the metabolic syndrome (MS) by multivariable linear regression (p=0.01) in women. The carriers of the C/C genotype of MC4R gene showed significantly greater odds ratio for TG than T/C and T/T genotypes, even when adjusted for age, smoking, drinking, BMI and WC in women.Conclusions: The rs17782313 C/C genotype is associated with higher TG levels in older Chinese women. [ABSTRACT FROM AUTHOR]

The article offers information on the risk factors for breast cancer among Chinese women. Topics discussed include failure in finding association for mammographic density with breast cancer, quantitative methods of mammographic density (MD) and implications for breast cancer screening strategies based on MD.

Background: The American Heart Association developed the Life's Simple 7 metric for defining cardiovascular health. Little is known, however, whether co-occurring reproductive factors, which affects endogenous oestrogen levels during a woman's life, also influences ideal cardiovascular health in postmenopausal women.Methods: Using data on a cross-sectional study with a convenience sample of 1,625 postmenopausal women (median age, 60.0 years) in a medical health checkup program at a general hospital in central south China 2013-2014, we examined the association between cumulative reproductive risk and ideal cardiovascular health in postmenopausal women. A cumulative risk score (range 0 to 4) was created by summing four reproductive risk factors (age at menarche, age at menopause, number of children, and pregnancy losses) present in each individual from binary variables in which 0 stands for favorable and 1 for less-than-favorable level. Ideal levels for each component in Life's Simple 7 (blood pressure, cholesterol, glucose, BMI, smoking, physical activity, and diet) were used to create an ideal Life's Simple 7 score [0-1 (low), 2, 3, 4, 5 and 6-7 (high)].Results: Participants with earlier age at menarche (odds ratio [OR] =0.42 [95 % CI 0.26-0.48]), earlier age at menopause [0.46 (0.32-0.58)], who have more than three children (0.42 [0.38-0.56]) and have history of pregnancy losses [0.76 (0.66-0.92)] were more likely to attain low (0-1) ideal Life's Simple 7 after adjustment for age. Participants were more likely to attain low (0-1) ideal Life's Simple 7 as exposure to the number of reproductive risk factors increased [OR (95 % CI) of 0.52 (0.42-0.66), 0.22 (0.16-0.26), and 0.16 (0.12-0.22) for cumulative reproductive risk scores of 1, 2, and 3 or 4, respectively, each versus 0].Conclusions: The postmenopausal Chinese women with an increasing number of reproductive risk factors were progressively less likely to attain ideal levels of cardiovascular health factors. [ABSTRACT FROM AUTHOR]

Objective: To determine whether metabolic syndrome (MetS) and its components are risk factors for breast cancer among postmenopausal women in China.Methods: Based on the baseline data of the Jinchang Cohort, a case-control study was carried out among postmenopausal women, including 43 cases and 86 controls. Both MetS and its components were evaluated. Odds ratios and 95% confidence intervals (CI) for the association were estimated by conditional logistic regression analysis.Results: The odds ratio of postmenopausal breast cancer was 3.505 (95% CI 1.282-9.583) for MetS, 3.016 (95% CI 1.044-8.715) for body mass index (BMI) ≥ 25 kg/m(2), and 3.191 (95% CI 1.253-8.125) for dyslipidemia. There was no significant association between postmenopausal breast cancer and hypertension as well as diabetes. Women with four metabolic factors showed greater risk for postmenopausal breast cancer (p(trend) < 0.05). Dyslipidemia and BMI ≥ 25 kg/m(2) showed most significant interaction on breast cancer (odds ratio = 11.359; 95% CI 2.663-48.450). With BMI ≥ 25 kg/m(2), the interaction of dyslipidemia and other metabolic factors on breast cancer was higher than that without BMI ≥ 25 kg/m(2).Conclusion: This case-control study suggested that MetS was associated with an elevated risk of breast cancer among postmenopausal women in north-west China. Overweight and dyslipidemia had the strongest adverse effects on postmenopausal breast cancer. [ABSTRACT FROM AUTHOR]

This study measured and assessed facial soft tissue depths ( FSTDs) in adult female Chinese and New Zealand ( NZ) Europeans (Caucasoids). Ultrasound was used to obtain depths at nine landmarks on 108 healthy subjects (51 Chinese, 57 NZ European), erect positioned, of same age group (18-29 years). Height and weight were also recorded. Statistical analysis focused on comparison of tissue depth between the two ancestry groups and the influence of Body Mass Index ( BMI) (kg/m2). Results showed mean depth differences at Supra M2 and Infra M2 landmarks significantly greater for Chinese than Caucasoid women for all three BMI Classes ( BMI <20, 20 ≤ BMI < 25, 25 ≤ BMI < 30), even BMI <20. For both groups BMI positively correlated with FSTD values at all landmarks except Labrale superius. This study enabled ancestry and BMI influence on FSTDs to be observed and compared for two distinct groups. Results add to knowledge about facial tissue depth variation. [ABSTRACT FROM AUTHOR]

STUDY QUESTION: Should fasting glucose (FG) or an oral glucose tolerance test (OGTT) be used to screen for dysglycaemia in women with polycystic ovary syndrome (PCOS)? SUMMARY ANSWER: A full OGTT should be recommended as the screening method for dysglycaemia in women with PCOS, regardless of BMI or family history of diabetes mellitus (DM). STUDY DESIGN, SIZE, DURATION: A cross-sectional study on 467 Chinese women diagnosed with PCOS by the Rotterdam criteria between January 2010 to December 2013. PARTICIPANTS, SETTING, METHODS: The study was done at a university hospital in Hong Kong. All subjects underwent a 75 g OGTT after overnight fasting. We evaluated the performance of FG alone, when compared with the full OGTT, in identifying subjects with dysglycaemia (prediabetes or DM, according to the 2010 diagnostic criteria of the American Diabetes Association). MAIN RESULTS AND THE ROLE OF CHANCE: Of the 467 subjects, 58 (12.4%) had dysglycaemia, among which 46 (9.8%) had prediabetes and 12 (2.6%) had DM, including 4 with known DM. Of the 46 subjects with prediabetes, 25 (54.3%) had normal FG and of the 8 subjects with screened DM in this study, 1 (12.5%) had normal FG. The sensitivity of FG alone in screening for prediabetes, DM and overall dysglycaemia were 45.7, 87.5 and 48.1%, respectively, i.e. missing 54.3% of prediabetes and 12.5% of DM cases as defined by the OGTT. Among the 54 subjects with screened dysglycaemia, 20 (37.0%) had BMI < 25 kg/m2 and 35 (64.8%) had no family history of DM. LIMITATIONS, REASONS FOR CAUTION: We only reported on the biochemical diagnosis of DM based on a single time point. In clinical practice, confirmatory results at another time point is required for definitive diagnosis in asymptomatic subjects. WIDER IMPLICATIONS OF THE FINDINGS: There is an ongoing debate as to whether FG or an OGTT should be used as a screening method for dysglycaemia in women with PCOS. Some guidelines also recommend glucose screening only in those who are overweight and/orhavingfamily history of diabetes (DM). There have been scarce data on this issue in the Chinese population, which the current study aims at addressing. STUDY FUNDING/COMPETING INTEREST(S): The study was supported by a research grant from the Hong Kong Obstetrical and Gynaecological Trust Fund, as well as internal research funding of the Department of Obstetrics and Gynaecology, The University of Hong Kong. All authors have no competing interests. [ABSTRACT FROM AUTHOR]

Background.Despite substantial research, uncertainty remains about the clinical and etiological heterogeneity of major depression (MD). Can meaningful and valid subtypes be identified and would they be stable cross-culturally?Method.Symptoms at their lifetime worst depressive episode were assessed at structured psychiatric interview in 6008 women of Han Chinese descent, age ⩾30 years, with recurrent DSM-IV MD. Latent class analysis (LCA) was performed in Mplus.Results.Using the nine DSM-IV MD symptomatic A criteria, the 14 disaggregated DSM-IV criteria and all independently assessed depressive symptoms (n = 27), the best LCA model identified respectively three, four and six classes. A severe and non-suicidal class was seen in all solutions, as was a mild/moderate subtype. An atypical class emerged once bidirectional neurovegetative symptoms were included. The non-suicidal class demonstrated low levels of worthlessness/guilt and hopelessness. Patterns of co-morbidity, family history, personality, environmental precipitants, recurrence and body mass index (BMI) differed meaningfully across subtypes, with the atypical class standing out as particularly distinct.Conclusions.MD is a clinically complex syndrome with several detectable subtypes with distinct clinical and demographic correlates. Three subtypes were most consistently identified in our analyses: severe, atypical and non-suicidal. Severe and atypical MD have been identified in multiple prior studies in samples of European ethnicity. Our non-suicidal subtype, with low levels of guilt and hopelessness, may represent a pathoplastic variant reflecting Chinese cultural influences. [ABSTRACT FROM AUTHOR]

This study recorded maternal perceptions of preschool children's weight in Chinese mothers living in Australia and China. A survey was undertaken of 1951 mothers living in Chengdu and Wuhan, China and 89 Chinese mothers living in Perth, Australia. All participants were mothers with children aged 2-4 years. The children's weight and height were measured and their weight status were classified using the International Obesity Task Force 2012 revised international child body mass index cut-offs. The prevalence of overweight or obese in children was 16.7% in China and 8% in Australia. The overall percentages of correct maternal perception of the child's weight were 35% in underweight children, 69.2% in normal weight children but only 10.8% in overweight/obese children. Among the overweight/obese children, only 14% in Australia and 10.8% in China were classified as overweight/obese by their mothers. Within the group of underweight children, normal weight mothers (p=0.004) and mothers with older age children (p=0.015) were more likely to correctly classify children's weight status. A higher percentage of overweight/obese mothers (p=0.002) and mothers who over-estimated her own weight status (p<0.001) have correct perception of the weight status of their overweight/obese children, compared to their counterparts. There was a high prevalence of incorrect maternal perception of preschool children's weight status in Chinese mothers, especially those with overweight/obese children. To address the obesity epidemic in children, future health promotion programs should put improved efforts to educate parents about obesity and its health consequences in order to reduce misperceptions. [ABSTRACT FROM AUTHOR]

In this paper we try to define insulin resistance (IR) precisely for a group of Chinese women. Our definition deliberately does not depend upon body mass index (BMI) or age, although in other studies, with particular random effects models quite different from models used here, BMI accounts for a large part of the variability in IR. We accomplish our goal through application of Gauss mixture vector quantization (GMVQ), a technique for clustering that was developed for application to lossy data compression. Defining data come from measurements that play major roles in medical practice. A precise statement of what the data are is in Section 1. Their family structures are described in detail. They concern levels of lipids and the results of an oral glucose tolerance test (OGTT). We apply GMVQ to residuals obtained from regressions of outcomes of an OGTT and lipids on functions of age and BMI that are inferred from the data. A bootstrap procedure developed for our family data supplemented by insights from other approaches leads us to believe that two clusters are appropriate for defining IR precisely. One cluster consists of women who are IR, and the other of women who seem not to be. Genes and other features are used to predict cluster membership. We argue that prediction with “main effects” is not satisfactory, but prediction that includes interactions may be. [ABSTRACT FROM AUTHOR]

Objective Serum uric acid levels have been reported to be associated with metabolic syndrome (MetS). However, few studies specifically examining the relationship between serum uric acid (SUA) levels and MetS in postmenopausal women have been reported in China. Thus, we conducted this study in order to assess the relationship between SUA levels and MetS in Chinese postmenopausal women. Methods A cross-sectional study of 1022 Chinese postmenopausal women (aged 42-80 years) who participated in annual health check-ups was employed. MetS was defined by National Cholesterol Education Program/Adult Treatment Panel III criteria (NCEP-ATP III). Of all the participants, 385 women were diagnosed with MetS (MetS group) and the others were without MetS (non-MetS group). SUA quartiles were defined as follows: Q1, < 3.9 mg/dl; Q2, 3.9-4.5 mg/dl; Q3, 4.6-5.1 mg/dl; Q4, 5.2-6.0 mg/dl. The association between SUA quartiles and MetS was assessed using binary logistic regression. Results The adjusted odds ratio (95% confidence interval) for the presence of metabolic syndrome in the highest SUA quartile vs. the lowest quartile was 3.768 (2.386-5.950) for all women ( p < 0.01) after adjusting for age, body mass index, blood urea nitrogen, serum creatinine, total cholesterol, low density lipoprotein cholesterol and C-reactive protein. The presence of MetS significantly increased in the second, third and fourth quartiles of SUA. The prevalence of MetS increased gradually with an increasing serum uric acid quartile ( p for trend < 0.001). Conclusion Higher SUA levels are positively and independently associated with the presence of MetS in Chinese postmenopausal women. [ABSTRACT FROM AUTHOR]

Aim: To explore the factors affecting menarcheal age by investigating two groups of women differing in age by 10-15 years in Shanghai. Methods: Data on 5,207 women were collected from January 2011 to May 2012: 2,151 women of reproductive age from the Obstetrical Department and 3,056 women in menopause from the Medical Center of the Sixth Hospital of Shanghai City. General data and data on menarcheal age and medical history were collected. The two groups were divided into subgroups from <10 to ≥20 years, i.e. 12 subgroups in total, respectively. SPSS 17.0 software was used to examine statistical differences. Results: The onset of menarcheal age of reproductive age women was 0.5 years earlier than that of menopause women (p < 0.05). In the early menarche age group (<13 years old), there were more reproductive age and high-educated women. Correlation analysis found the current body mass index in menopausal women was significantly negatively correlated with their menarcheal age (r = -0.033, p < 0.05). Conclusions: There was a downward trend in menarcheal age in women of Shanghai and its surrounding areas. Economic environment and education background were the main factors affecting menarcheal age, and menarcheal age may be considered as a predictor of adult obesity. © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background Genetic determinations are important in type 2 diabetes ( T2DM) pathology. We investigated associations between genetic variants of 17 diabetes-related genes/loci, T2DM and diabetic complications in Chinese She subjects. Methods A comprehensive gene-based association study was conducted using 17 single nucleotide polymorphisms in Chinese She subjects with normal glucose tolerance ( n = 1119), impaired glucose regulation ( n = 1767), and T2DM ( n = 443). We applied major abnormal Minnesota Code findings to predict cardiovascular risk and estimated glomerular filtration rate to assess kidney function. Results Nine variants in FTO rs8050136, WFS1 rs10010131, CDKN2A/B rs10811661, KCNJ11 rs5219, CDC123/CAMK1D rs12779790, JAZF1 rs864745, SLC30A8 rs13266634, CDKAL1 rs10946398, and HHEX/IDE rs5015480 were significantly associated with T2DM ( P < 0.05). Single nucleotide polymorphisms in WFS1 rs10010131, CDKN2A/B rs10811661, CDC123/CAMK1D rs12779790, JAZF1 rs864745, FTO rs8050136, and HHEX/IDE rs5015480 were associated with T2DM and impaired glucose regulation. Risk alleles in WFS1 rs10010131, IGF2BP2 rs4402960, CDKAL1 rs10946398, FTO rs8050136, KCNQ1 rs2237897, and ADAMTS9 rs4607103 were significantly associated with decreased homeostatic model assessment ( HOMA)-β ( P < 0.05). After adjusting for age, gender and body mass index, genetic variants JAZF1 rs864745, FTO rs8050136, and HHEX/IDE rs5015480 were significantly related to reduced estimated glomerular filtration rate ( P < 0.05). Genetic variants in WFS1 rs10010131, CDKN2A/B rs10811661, CDC123/CAMID rs12779790, JAZF1 rs864745, FTO rs80501360, CDKAL1 rs10946398, and HHEX/IDE rs5015480 correlated with abnormal major Minnesota Code findings ( P < 0.05). Conclusion Variants in WFS1, CDKN2A/B, KCNJ11, CDC123/CAMK1D, JAZF1, SLC30A8, FTO, CDKAL1, and HHEX/IDE genes are significantly associated with T2DM in She Chinese subjects. JAZF1, FTO, CDKAL1, and HHEX/IDE are associated with diabetic nephropathy. WFS1, CDKN2A/B, CDC123/CAMK1D, JAZF1, FTO, CDKAL1, and HHEX/IDE are associated with cardiovascular risk. [ABSTRACT FROM AUTHOR]

Genome-wide association studies have identified approximately 20 susceptibility loci for breast cancer. A cumulative genetic risk score (GRS) was constructed from 10 variants with replicated associations among participants of the Shanghai Breast Cancer Genetics Study (Shanghai, China, 1996–1998 and 2002–2005). Interactions between the GRS and 11 breast cancer risk factors were evaluated. Among the 6,408 study participants, no evidence of effect modification was found with the GRS for age at menarche, age at menopause, age at first live birth/parity, total months of breastfeeding, family history of breast cancer, history of benign breast disease, hormone replacement therapy, body mass index, waist/hip ratio, or regular physical activity. The effect of the GRS was least homogeneous by duration of menstruation; further analysis indicated a nominally significant interaction with one genetic variant. The mitochondrial ribosomal protein S30 gene (MRPS30) rs10941679 was associated with breast cancer risk only among women with more than 30 years of menstruation (odds ratio = 1.15, 95% confidence interval: 1.05, 1.26). Although this multiplicative interaction reached a nominal significance level (P = 0.037), it did not withstand correction for multiple comparisons. In conclusion, this study revealed no apparent interactions between genome-wide association study-identified genetic variants and breast cancer risk factors in the etiology of this common cancer.Abbreviations: CI, confidence interval; GRS, genetic risk score; OR, odds ratio; SNP, single nucleotide polymorphism. [ABSTRACT FROM PUBLISHER]

Vitamin D deficiency has been consistently associated with obesity. However, it is unclear whether vitamin D deficiency is the cause or consequence of obesity. We investigated this question by evaluating the association between genetic variants in vitamin D metabolism pathway genes and obesity-related traits. Using directly genotyped and imputed data from a genome-wide association study of 6922 women aged 25-70 years, we examined the association of 198 single-nucleotide polymorphisms (SNPs) in vitamin D pathway genes (CYP27A1, CYP27B1, CYP24A1, CYP2R1, group-specific component (GC) and vitamin D nuclear receptor (VDR)) with body mass index (BMI) and body weight. Per allele beta (β) estimates were calculated for this association using linear regression models, controlling for age, square of age, menopausal status and sample sets. Overall, only two SNPs (rs2248359 in CYP24A1 and rs10832313 in CYP2R1) had a nominally significant association with BMI and weight (P<0.05 for all), with no variation observed by menopausal status, physical activity or dietary energy intake. None of the SNPs examined in the VDR gene were associated with BMI or weight. Our findings suggest that common genetic variants in vitamin D pathway genes do not have a major role in obesity among Chinese women. This comprehensive evaluation of genetic polymorphisms in vitamin D metabolism-related genes and obesity-related traits did not provide strong evidence to support low vitamin D levels as a cause of obesity. [ABSTRACT FROM AUTHOR]

Summary Objective The aim of this study was to describe the endocrine and metabolic characteristics of Chinese women with polycystic ovarian syndrome (PCOS) according to different phenotypes, including menstrual cycle pattern and body mass index (BMI). Design Retrospective study. Patient(s) A total of 3539 patients with PCOS and 590 controls were recruited from the Centre for Reproductive Medicine. Patients with PCOS were divided into three groups according to the characteristics of the menstrual cycle (amenorrhoea, oligomenorrhea and eumenorrhea) and the BMI (<25 kg/m2; 25 ≤ and ≤ 30 kg/m2; and BMI > 30 kg/m2). Measurements Waist circumference, hip circumference, weight, height, Ferriman-Gallwey score, and endocrine and metabolic variables were measured. Results The serum testosterone, luteinizing hormone (LH) and oral glucose tolerance test 2 h-glucose levels were increased in the amenorrhoea group ( P < 0·05). The triglycerides (TG) and low-density lipoprotein-cholesterol (LDL) levels were the highest in the amenorrhoea group ( P < 0·05). The same trend existed in total cholesterol and non- high-density lipoprotein-cholesterol (HDL) levels, although there was no statistical significance ( P > 0·05). Subjects with a BMI<25 kg/m2 had higher values of follicle stimulating hormone (FSH), LH, LH/FSH and prolactin ( P < 0·001) than the other two groups. The levels of TG, LDL and non-HDL and the indices of glucose and insulin metabolism increased with the change in BMI ( P < 0·001). Conclusions The amenorrhoea group had severe endocrine and metabolic abnormalities, which appeared to be related to latent long-term complications and higher morbidity. The degree of dysbolism was positively associated with the change in BMI. [ABSTRACT FROM AUTHOR]

In previous studies among 1,144 cases and 1,256 controls recruited in stage 1 of the Shanghai Breast Cancer Study (SBCS I; 1996–1998), 18 known or potentially functional single nucleotide polymorphisms (SNPs) in 16 genes were found to be associated with breast cancer risk. The authors evaluated these associations among 1,918 cases and 1,819 controls recruited in stage 2 of the SBCS (SBCS II; 2002–2005) using genetic effect models and subgroup analyses predetermined from SBCS I results. Five SNPs (AHR rs2066853, ATM rs1003623, ESR1 rs2234693, GSTP1 rs1695, and SHBG rs6259) showed generally consistent results in SBCS I and SBCS II and statistically significant associations with breast cancer risk in combined analyses, mostly in subgroups defined by age or menopausal status. Further, the relation between breast cancer risk and SHBG rs6259 was found to vary by body mass index (weight (kg)/height (m)2) (P for interaction = 0.003). The strongest reduction in risk associated with SHBG rs6259 was found for lean (body mass index <23) postmenopausal minor allele carriers (odds ratio = 0.6, 95% confidence interval: 0.5, 0.8; P = 4.6 × 10−4). This biologically plausible and highly significant finding provides strong evidence for a true association among Asian women. This study also highlights the value of gene-environment interaction analyses in evaluating genetic factors for complex diseases. [ABSTRACT FROM PUBLISHER]

Abstract: Background: Substantial evidence shows that psychological factors are associated with cardiovascular diseases. However, data on the association between psychological factors and subclinical atherosclerosis is lacking in postmenopausal Chinese women. Objectives: To examine the associations of perceived stress and trait anxiety with subclinical atherosclerosis in postmenopausal Chinese women in Hong Kong. Their relationships with biological and behavioral risk factors were also examined. Methods: Between 2002 and 2004, we recruited 518 postmenopausal women aged 50–64 years. Perceived stress and trait anxiety were evaluated by the perceived stress scale and the state-trait anxiety inventory, respectively. Subclinical atherosclerosis was determined by measuring carotid intima-media thickness (IMT) and plaque using B-mode ultrasonography. Results: Perceived stress and trait anxiety showed no significant association with IMT or plaque. Multivariate analyses showed high perceived stress scores were associated with an increased risk of elevated total cholesterol (OR=2.10; 95% CI=1.17–3.77) and elevated low-density lipoprotein cholesterol (LDL-C) (OR=2.39; 95% CI=1.36–4.21). High trait anxiety scores were associated with a 2.7-fold risk of elevated LDL-C (OR=2.74; 95% CI=1.56–4.80). Women with high perceived stress or trait anxiety scores were more likely to be physically inactive. Conclusions: Perceived stress and trait anxiety were associated with atherogenic lipid levels, but not subclinical atherosclerosis. Maintaining high physical activity may help alleviate psychological stress and anxiety. [Copyright &y& Elsevier]

Objective. To investigate the effects of body mass index (BMI) on ovarian stimulation and the outcome of IVF or ICSI treatment in Asian population who have different characteristics of BMI from white people. Design. In this retrospective study, the first fresh cycles of 1107 Chinese women were classified by BMI: underweight (BMI <18.5 kg/m2), normal weight (BMI: 18.5–23.9 kg/m2) and overweight (BMI ≥ 24 kg/m2). Dose and days of ovarian simulation, cancelled cycles and number of oocytes collected, fertilisation and embryo utilisation rates and pregnancy outcome were compared among BMI groups. Results. It showed that overweight women required more ampoules of gonadotrophin ( P = 0.002) and had lower peak oestradiol concentration ( P = 0.001), increased cycle cancellation due to insufficient follicle development ( P = 0.018) and a higher miscarriage rate (10.5 vs. 5.4%, P = 0.018, OR = 2.006 (95% CI: 1.09–3.69, P = 0.025)) compared with normal weight women. However, no differences were found in clinical pregnancy and live-birth rates. Underweight compared with normal weight women showed no differences in ovarian stimulation and IVF outcome although the clinical pregnancy rate was lower (31.1 vs. 37.3%). Conclusion. At a lower cutoff point of BMI in Chinese women, overweight is associated with increased miscarriage risks and impaired response to ovarian stimulation after IVF and ICSI. [ABSTRACT FROM AUTHOR]

Most studies linking obesity and metabolic syndrome (MS) have used body mass index (BMI) and waist circumference (WC) to measure obesity. While BMI is correlated with direct measures of total and central adiposity, it is influenced by lean body and bone mass. We hypothesize that direct measures of adiposity may help develop further insight into the link between obesity and MS, thus more accurately identifying individuals at high risk for MS. We examined how surrogate and direct measures of adiposity were associated with MS risk and if direct adiposity measures enhanced BMI and WC identification of MS risk. 3,734 Chinese female twins aged 20–39 years were studied. Percent body fat (%BF) and proportion of trunk fat to total BF (%TF) were assessed by DEXA. Graphic plots and generalized estimating equations were used to examine the associations of adiposity measures with MS and its components. Concordance of adiposity measures and MS abnormalities between monozygotic (MZ) and dizygotic (DZ) twin pairs were compared. The prevalence of MS increased for high BMI (≥23 kg/m2), %BF (≥32), WC (≥80 cm), and (to a lesser degree) %TF (≥50). Below those thresholds, the prevalence of MS was low (0–5.3%). %TF was independently associated with higher risk of MS and its components even after adjusting for BMI and WC. As a result, among women with normal BMI and WC, high %TF was associated with 1.3–2.0-fold elevated risk of MS components. In contrast, women with high BMI but normal WC and %TF neither have significantly increased risk of MS, nor for any component other than high BP. MZ twins showed higher concordance for MS and its components than DZ twins. In this lean Chinese rural female sample, BMI ≥ 23 and WC ≥ 80 were associated with a markedly increased risk of MS, which was further enhanced by elevated %TF. Even in women with a normal BMI and WC, %TF was independently associated with MS and its components. Twin analysis findings suggest that adiposity measurements and MS risk are influenced by genetics. [ABSTRACT FROM AUTHOR]

Objectives: To identify using three-dimensional (3D) ultrasound the morphological features and normal biometry of the levator hiatus in nulliparous Chinese women and to explore ethnic differences between these measurements and those in nulliparous Caucasian women. Methods: 3D sonographic data from 59 nulliparous Chinese women (aged 19-38 years) who had no pelvic organ prolapse and no symptoms of pelvic floor dysfunction were retrieved from an image dataset and analyzed by offline post-processing. The pubovisceral muscle and levator hiatus were measured in the planes of maximal pubovisceral muscle thickness and minimum hiatal dimension, respectively. In addition, the genitohiatal and levator ani angles were measured. These values were compared with those in a published study of Caucasian women. Results: In Chinese women there was no relationship between minimum anteroposterior (AP) hiatal diameter and minimum lateral hiatal diameter. Body weight was correlated with hiatal area and minimum AP hiatal diameter (r = 0.391, P = 0.003 and r = 0.378, P = 0.004, respectively), whereas body mass index was correlated only with minimum AP hiatal diameter (r = 0.349, P = 0.008). There was a significant difference in average pubovisceral muscle thickness (P = 0.001) between nulliparous Chinese and Caucasian women. Conclusions: Body weight, body mass index, and ethnicity are factors affecting the biometry of the levator hiatus in Chinese nulliparous women. [ABSTRACT FROM AUTHOR]