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27 results on '"MESH: Menopause"'

1. Les médecins généralistes et le traitement hormonal substitutif de la ménopause : leurs représentations sur les risques et bénéfices du traitement

Author

Benchorba, Nouhad, Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), and Agathe Scemama

Subjects
Hormone replacement therapy, MESH: Menopause, Médecins généralistes, Ménopause, Traitement hormonal de la ménopause, MESH: Estrogen Replacement Therapy, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, MESH: General Practitioners
Abstract

The risks of hormone replacement therapy (HRT) resulted in a decrease of prescription since the publication of the Women's Health Initiative (WHI) in 2002. Since then, many studies have rehabilitated the HRT without increasing of prescription. Our study was designed to assess the understanding of GPs (General Practitioners) who practice in Paris of the benefits and risks of HRT. It was a quantitative observational study from May to September 2017. GP’s were asked with an anonymous survey to estimate the benefits and risks of HRT on death, breast cancer, endometrial cancer, colon cancer, heart disease, stroke, venous thromboembolism, femoral fracture and Alzheimer's disease. The answers were compared to the real risks and benefits. The secondary objectives were to analyze the responses in subgroups, the representations of menopause and HRT. The analysis was performed using the Chi-2 test. 200 GP’s were selected by sampling. 67 physicians (29.8%) were included in the analysis. Only 24% of the answers were correct. 48% of respondents overestimated the risk or benefit of THM. 10.4% of the answers were false, with an error in the direction of the risk. Practitioners overestimated the risks of THM for breast cancer, VTE and endometrial cancer. Women and younger physicians significantly overestimated breast cancer. Our study suggests that the results of different THM studies are misunderstood. Inaccurate clinician’s expectations of the risks and benefits of treatment can influence the practitioners in their prescription decision. The multiplicity of studies makes access to information difficult. There is a great need for GP’s education about the risks and benefits of HRT.; Les risques du traitement hormonal substitutif de la ménopause (THM) ont conduit à une diminution majeure et mondiale de sa prescription depuis la publication de l’étude Women’s Health Initiative (WHI) en 2002. Depuis, de nombreuses études ont réhabilité le THM sans reprise de sa prescription pour autant. Notre objectif a été d’étudier les représentations de médecins généralistes parisiens sur les bénéfices et risques du THM. Il s’agissait d’une étude observationnelle quantitative chez des médecins généralistes parisiens de mai à septembre 2017. Par un questionnaire anonyme, il leur a été demandé d’estimer les bénéfices et risques du THM sur le décès, le cancer du sein, le cancer de l’endomètre, le cancer du côlon, le syndrome coronarien aigu, l’accident vasculaire cérébral, la maladie thrombo-embolique veineuse (MTEV) , la fracture du col fémoral et la maladie d’Alzheimer. Les réponses ont été comparées aux risques et bénéfices réels. Les objectifs secondaires ont été : d’analyser les réponses en sous-groupes et d’étudier les représentations de la ménopause et du THM par les médecins et les freins à la prescription. L’analyse a été réalisée à l’aide du test du Chi-2. 200 médecins généralistes ont été sélectionnés par échantillonnage. 67 médecins (29,8%) ont été inclus dans l’analyse. Seuls 24% des réponses étaient correctes. 48% des réponses surestimaient le risque ou bénéfice du THM. 10,4% des réponses étaient fausses, avec une erreur dans le sens du risque. Les praticiens surestimaient majoritairement les risques de cancer du sein, de MTEV et de cancer de l’endomètre. Les femmes et les plus jeunes médecins surestimaient significativement plus le cancer du sein. Notre étude suggère que les résultats des études sur le THM sont mal interprétés par les praticiens et que la multiplicité des études rend l’accès à l’information difficile. Les représentations, erronées, sur les risques et bénéfices du traitement influencent probablement les médecins dans leur décision de prescription. Une meilleure formation des médecins généralistes sur les risques et bénéfices du THM apparaît donc essentielle.

Published
2018

2. Vécu des femmes ménopausées souffrant de troubles trophiques

Author

Beaujard, Clémentine, Thèses d'exercice et mémoires - UFR de Médecine Montpellier-Nîmes, Université de Montpellier (UM), and Élodie Million

Subjects
MESH: Ménopause, MESH: Femmes, MESH: Recherche qualitative, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Syndrome génito-urinaire
Abstract

Introduction : le syndrome génito-urinaire est une affection chronique due à la diminution du taux d’œstrogène lors de la survenue de la ménopause. Une femme ménopausée sur deux souffre de ce syndrome. Il entraine un impact sur leur qualité de vie et notamment sur leur qualité de vie sexuelle. Les études montrent pourtant qu’il reste sous reconnu par les patientes, sous diagnostiqué et sous-traité par les médecins. L’objectif de cette étude est de recueillir et d’analyser le vécu des femmes ménopausées souffrant de ce syndrome afin d’améliorer leur prise en charge médicale.Matériels et méthode : il s’agit d’une étude qualitative avec des entretiens individuels semi directifs. Deux modes de recrutement ont été utilisés : via des cabinets médicaux et para médicaux et via des relations personnelles. Cette étude a été analysée avec une analyse phénoménologique des verbatims faisant émerger des catégories conceptualisantes.Résultats : 11 entretiens ont été réalisés jusqu’à saturation des données. 5 catégories conceptualisantes ont émergé. La femme par ce qu’elle a été, ce qu’elle est et ce à quoi elle croit devait nécessairement être prise en compte dans la prise en charge médicale des troubles trophiques. L’absence de prise en charge entrainait de lourdes conséquences sur la patiente avec la perte de son statut de femme sexuellement active. Les femmes faisaient face à un entourage et une société insuffisamment aidante. La prise en charge des troubles trophiques devait être personnalisée dans le but de récupérer une vie normale, avec un traitement accepté et bien suivi par la patiente. Une meilleure préparation à la survenue de la ménopause et des troubles trophiques devait permettre une meilleure prise en charge des patientes.Discussion : des études à l’étranger venaient confirmer nos résultats. Plusieurs perspectives d’amélioration pourraient être envisagées comme l’établissement de recommandations françaises concernant la prise en charge des troubles trophiques et une amélioration de l’information faite aux femmes afin de mieux les préparer à la ménopause.Conclusion : la prise en charge du syndrome génito-urinaire n’est pas optimale. L’amélioration des prises en charge de ces femmes passe par une relation médecin patient de qualité mais aussi par une sensibilisation de notre société.

Published
2018

3. Emergence and maintenance of menopause in humans: A game theory model

Author

Michel Raymond, Valentin Thouzeau, Institut des Sciences de l'Evolution de Montpellier (UMR ISEM), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université de Montpellier (UM)-Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Centre National de la Recherche Scientifique (CNRS)-Institut de recherche pour le développement [IRD] : UR226, Eco-Anthropologie et Ethnobiologie (EAE), and Muséum national d'Histoire naturelle (MNHN)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS)

Subjects
0106 biological sciences, 0301 basic medicine, Statistics and Probability, MESH: Menopause, media_common.quotation_subject, [SDV]Life Sciences [q-bio], MESH: Biological Evolution, Kin selection, Biology, MESH: Reproduction, 010603 evolutionary biology, 01 natural sciences, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Reproductive senescence, Game Theory, medicine, MESH: Family Characteristics, Humans, ESS, Grandmothering, Ovulation, media_common, Pleiotropy, Family Characteristics, MESH: Humans, General Immunology and Microbiology, Life span, Applied Mathematics, Reproduction, Conflict over resources, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, General Medicine, medicine.disease, Biological Evolution, Menopause, 030104 developmental biology, Pleiotropy (drugs), MESH: Game Theory, Modeling and Simulation, Maternity cost, Female, General Agricultural and Biological Sciences, Game theory, MESH: Female, Demography
Abstract

International audience; Menopause, the permanent cessation of ovulation, occurs in women well before the end of their expected life span. Several adaptive hypotheses have been proposed to solve this evolutionary puzzle, each based on a possible fitness benefit derived from an early reproductive senescence, but no consensus has emerged. The construction of a game theory model allowed us to jointly study the main adaptive hypotheses in emergence and maintenance of menopause. Four classical hypotheses on the benefits of menopause were considered (decreased maternal mortality, increased grandmothering, decreased conflict over reproductive resources between older and younger females, and changes in their relatedness) plus a fifth one derived from a possible pleiotropic trade-off. Interestingly, the conditions for the emergence of menopause are more restrictive than those for its maintenance due to the social and familial changes induced by the occurrence of non-reproductive older women.

Published
2017

4. Age at natural menopause genetic risk score in relation to age at natural menopause and primary open-angle glaucoma in a US-based sample

Author

Pasquale, Louis, Aschard, Hugues, Kang, Jae, Bailey, Jessica, Lindström, Sara, Chasman, Daniel, Christen, William, Allingham, R Rand, Ashley-Koch, Allison, Lee, Richard, Moroi, Sayoko, Brilliant, Murray, Wollstein, Gadi, Schuman, Joel, Fingert, John, Budenz, Donald, Realini, Tony, Gaasterland, Terry, Gaasterland, Douglas, Scott, William, Singh, Kuldev, Sit, Arthur, Igo, Robert, Song, Yeunjoo, Hark, Lisa, Ritch, Robert, Rhee, Douglas, Gulati, Vikas, Havens, Shane, Vollrath, Douglas, Zack, Donald, Medeiros, Felipe, Weinreb, Robert, Pericak-Vance, Margaret, Liu, Yutao, Kraft, Peter, Richards, Julia, Rosner, Bernard, Hauser, Michael, Haines, Jonathan, Wiggs, Janey, Allingham, R. Rand, Harvard Medical School [Boston] (HMS), Brigham & Women’s Hospital [Boston] (BWH), Harvard T.H. Chan School of Public Health, Case Western Reserve University [Cleveland], Program in Genetic Epidemiology and Statistical Genetics (PGESG - BOSTON), Harvard School of Public Health, Brigham and Women's Hospital [Boston], Lawrence Livermore National Laboratory (LLNL), The NIH/NEI R01EY022305 (J.L.W.) supports data collection and analysis for the National Eye Institute Glaucoma Human Genetics Collaboration Heritable Overall Operational Database (NEIGHBORHOOD) consortium. Support for collection of cases, controls, and analysis for individual datasets is as follows. Genotyping services for the predecessor National Eye Institute Glaucoma Human Genetics Collaboration (NEIGHBOR) study were provided by the Center for Inherited Disease Research (CIDR) and were supported by the National Eye Institute (NEI) through grant HG005259-01 (J.L.W.). In addition, CIDR is funded through a federal contract from the National Institutes of Health to The Johns Hopkins University—contract number HHSN268200782096C. Genotyping for the Mass Eye and Ear dataset and some Nurses Health Study (NHS) and Health Professionals Follow-up Study (HPFS) participants that formed the Glaucoma Genes and Environment (GLAUGEN) study was completed at the Broad Institute and supported by GENEVA project grant HG004728 (L.R.P.) and U01-HG004424 (Broad Institute). NIH/NHGRI U01 HG004446 (C Laurie) supported genotype data cleaning and analysis for the GLAUGEN study. The NEI through ARRA grants 3R01EY015872-05S1 (J.L.W.) and 3R01EY019126-02S1 (M.A.H.) supported the collection and processing samples for the NEIGHBOR dataset. The funding for the collection of NEIGHBOR cases and controls was provided by NIH grants: EY015543 (R.R.A.), U02HG004608 (M.H.B.), HG006389 (M.H.B.), UL1TR000427 (M.H.B.), EY006827 (D.G.), HL73042, HL073389, EY13315 (M.A.H.), CA87969, CA49449, CA55075, EY009149 (PR Lichter), HG004608 (C McCarty), EY008208 (F.M.), EY015473 (L.R.P.), EY012118 (M.A.P.-V.), EY015682 (T.R.), EY011671 (J.E.R.), EY09580 (J.E.R.), EY013178 (J.S.S.), EY010886 (J.L.W.), EY009847 (J.L.W.), EY011008, EY144428 (K Zhang), EY144448 (K Zhang), EY18660 (K Zhang), and Research to Prevent Blindness (multiple institutions). The collection of Marshfield clinic cases and controls was supported by 1U02HG004608-01, 5U01HG006389-02, and NCATS/NIH grant UL1TR000427. In addition, some NHS/HPFS cases and controls and analysis of genome-wide data were supported by R01 CA131332 (RM Tamimi, I De Vivo), UM1 CA186107, UM1 CA167552, R01 CA49449, P01 CA87969. The Women's Genome Health Study (WGHS) is supported by HL043851 and HL080467 from the National Heart, Lung, and Blood Institute and CA047988 from the National Cancer Institute, the Donald W. Reynolds Foundation and the Foundation Leducq, with collaborative scientific support and funding for genotyping provided by Amgen. POAG case identification in Women's Genome Health Study was supported by 3RO1 EY015473-05S1 (LR Pasquale). Blood collection at New York Eye & Ear Infirmary was supported by the New York Glaucoma Research Institute., H.A., J.N.C.B., S.L., D.L.C., W.G.C., A.A.-K., S.E.M., D.G., M.H.B., G.W., R.P.I., Y.E.S., L.H., S.H., D.V., M.A.P.-V., and J.E.R. have no conflicts to declare. J.L.W., J.H.K., R.R.A., M.A.H., R.K.L., T.G., V.G., D.J.Z., Y.L., P.K., and B.A.R. sole disclosure is that they receive grant support from NIH. L.R.P. received grant support from NIH and has been a speaker for Allergan. He also served as a paid consultant to Novartis and to Bausch + Lomb. He has received support to travel to meetings by The Glaucoma Foundation (NYC), Glaukos and Aerie Pharmaceuticals. J.S.S. received grant support from NIH and is an inventor on a patent. J.F. received grant support from NIH and Regeneron. D.L.B. received consulting fees from Alcon Labs and travel support from New World Medical, Inc. He is also compensated for Data Safety Monitoring Board activity from Ivantis. He received grant support from New World Medical. T.R. received grant support from NIH and is a consultant for Alcon, Alimera, Bausch and Lomb, Reichert, Sensimed, and Inotek. W.K.S. holds a patent regarding the use of genetic data for risk assessment in age-related macula degeneration (Duke University). He received grant support from NIH, Florida Biomedical Research Program and the American Health Assistance Foundation. K.S. is a consultant to Alcon, Allergan, Santen, and Shire. A.H.S. serves as a consultant to Allergan, Alcon and Sensimed. He has received research support from NIH, Aerie Pharmaceuticals, and Glaukos. R.R. is on the advisory board of Isonic Inc, Intelon Optics and Xoma (US) LLC. He serves as consultant for Aeon Astron Europe B.V., Diopsyc, Inc, GLIA LLC, Gerson Lehrman Group, Guardian Health Sciences and Mobius Therapeutics. He is on the Board of Directors for International Eye Wellness Institute and receives royalties from Ocular Instruments. D.J.R. received research support from Merck, Allergan, Ivantis, and Glaukos. He is on the Scientific Advisory Board of Aerie and Transcend and is on the Data Safety Monitoring Board of Sanofi. F.M. received research support from Carl-Zeiss Meditec, Heidelberg Engineering, Allergan, Topcon, Reichert and Genentech. R.N.W. had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant/Advisory Board: Alcon, Allergan, Bausch & Lomb Incorporated, ForSight VISION5, and Valeant, Contracted Research: Genentech, Inc, and and Quark. J.L.H. receives travel support and speaker honoraria from Novartis. He has received royalties from John Wiley and Sons and Athena Diagnostics. The NIH supports his research

Subjects
0301 basic medicine, Percentile, Aging, genetic structures, MESH: Menopause, Neurodegenerative, MESH: Risk Assessment, Medical and Health Sciences, MESH: Genotype, 0302 clinical medicine, Risk Factors, MESH: Risk Factors, Reproductive history, MESH: Genetic Variation, Genetic risk, [STAT.AP]Statistics [stat]/Applications [stat.AP], Natural menopause, MESH: Middle Aged, Age Factors, Obstetrics and Gynecology, Middle Aged, Genetic risk score, 3. Good health, Open-Angle, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Female, Menopause, Primary open-angle glaucoma, [STAT.ME]Statistics [stat]/Methodology [stat.ME], Glaucoma, Open-Angle, medicine.medical_specialty, Genotype, Age at natural menopause, Risk Assessment, 03 medical and health sciences, medicine, Genetics, MESH: United States, Humans, Obstetrics & Reproductive Medicine, Eye Disease and Disorders of Vision, Gynecology, MESH: Age Factors, MESH: Humans, business.industry, Human Genome, Genetic variants, Neurosciences, Genetic Variation, Glaucoma, Odds ratio, Original Articles, Confidence interval, United States, eye diseases, 030104 developmental biology, Good Health and Well Being, [SDV.GEN.GH]Life Sciences [q-bio]/Genetics/Human genetics, 030221 ophthalmology & optometry, MESH: Glaucoma, Open-Angle, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, [INFO.INFO-BI]Computer Science [cs]/Bioinformatics [q-bio.QM], business, MESH: Female, Demography
Abstract

Supplemental Digital Content is available in the text, Objective: Several attributes of female reproductive history, including age at natural menopause (ANM), have been related to primary open-angle glaucoma (POAG). We assembled 18 previously reported common genetic variants that predict ANM to determine their association with ANM or POAG. Methods: Using data from the Nurses’ Health Study (7,143 women), we validated the ANM weighted genetic risk score in relation to self-reported ANM. Subsequently, to assess the relation with POAG, we used data from 2,160 female POAG cases and 29,110 controls in the National Eye Institute Glaucoma Human Genetics Collaboration Heritable Overall Operational Database (NEIGHBORHOOD), which consists of 8 datasets with imputed genotypes to 5.6+ million markers. Associations with POAG were assessed in each dataset, and site-specific results were meta-analyzed using the inverse weighted variance method. Results: The genetic risk score was associated with self-reported ANM (P = 2.2 × 10–77) and predicted 4.8% of the variance in ANM. The ANM genetic risk score was not associated with POAG (Odds Ratio (OR) = 1.002; 95% Confidence Interval (CI): 0.998, 1.007; P = 0.28). No single genetic variant in the panel achieved nominal association with POAG (P ≥0.20). Compared to the middle 80 percent, there was also no association with the lowest 10th percentile or highest 90th percentile of genetic risk score with POAG (OR = 0.75; 95% CI: 0.47, 1.21; P = 0.23 and OR = 1.10; 95% CI: 0.72, 1.69; P = 0.65, respectively). Conclusions: A genetic risk score predicting 4.8% of ANM variation was not related to POAG; thus, genetic determinants of ANM are unlikely to explain the previously reported association between the two phenotypes.

Published
2017

5. Lifelong Endocrine Fluctuations and Related Cognitive Disorders

Author

Karen Ritchie, Marie-Laure Ancelin, Pathologies du système nerveux : recherche épidémiologique et clinique, Université Montpellier 1 (UM1)-IFR76-Institut National de la Santé et de la Recherche Médicale (INSERM), and Villebrun, Dominique

Subjects
Male, Aging, MESH: Menopause, [SDV.MHEP.PSM] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, MESH: Cognition, Disease, MESH: Neurotransmitter Agents, MESH: Estrogens, Cognition, 0302 clinical medicine, Drug Discovery, MESH: Puberty, MESH: Aging, 030212 general & internal medicine, [SDV.MHEP.EM] Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, Neurotransmitter Agents, Sex Characteristics, MESH: Hormone Replacement Therapy, Cognitive disorder, Brain, MESH: Neuroprotective Agents, [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, 3. Good health, Neuroprotective Agents, Female, Menopause, Alzheimer's disease, MESH: Sex Characteristics, Clinical psychology, Sex characteristics, Hormone Replacement Therapy, MESH: Brain, 03 medical and health sciences, Fetus, Alzheimer Disease, medicine, Humans, Dementia, Cognitive skill, Pharmacology, MESH: Humans, business.industry, Puberty, MESH: Fetus, Estrogens, medicine.disease, MESH: Male, MESH: Cognition Disorders, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Immunology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Verbal memory, Cognition Disorders, business, MESH: Female, MESH: Alzheimer Disease, 030217 neurology & neurosurgery
Abstract

International audience; The aim of this review is to examine the relationship between endocrine fluctuation and cognitive functioning. A plethora of in vitro and in vivo studies has demonstrated the neuroprotective role of estrogens and their impact on the neurotransmitter systems implicated in cognition. Recent hormonal replacement therapy (HRT) trials in non-demented post-menopausal women suggest a temporary positive effect (notably on verbal memory), and four recent meta-analyses converge to suggest a possible protective effect in relation to Alzheimer's disease (reducing risk by 29 to 44%). However, data from the only large randomised controlled trial published to date, the Women's Health Initiative Memory Study, did not confirm these observations and have even suggested an increase in dementia risk for women using HRT compared to controls. Several methodological differences between observation studies and controlled trials with regard to patient group, type, timing and duration of HRT, cognitive measures and analyses, are discussed to explain these discrepancies. The association between hormonal serum level and cognitive functioning remains controversial suggesting high inter-individual vulnerability in risk. Moreover, research on the impact of endocrine functioning on cognition during the female reproductive cycle suggests life-long fluctuations in vulnerability. Etiological models taking into account the interaction of clinical, reproductive, and menstrual events throughout life may provide a more valid approach in understanding the effects of steroids on the brain and in determining sub-groups at heightened risk. Cognitive disorders in the elderly are more likely be related to cumulated lifelong exposure to steroids, rather than to a specific exposure to a given steroid. Multifactorial models based on an exhaustive view of all hormonal events throughout reproductive life together with other risk factors (notably genetic risk factors related to estrogen receptor polymorphisms) should be explored to clarify the role of hormonal risk factors, or protective factors for cognitive dysfunction and dementia.

Published
2005

6. A validation study on status and age of natural menopause reported in the E3N cohort

Author

Françoise Clavel-Chapelon, N. Dormoy-Mortier, Clavel-Chapelon, F., Epidémiologie des cancers, Institut National de la Santé et de la Recherche Médicale (INSERM), and The E3N cohort study is being carried out with the financial support of the ‘Europe against Cancer' Programme of the European Union, the ‘French League Against Cancer', the ‘3M Company', the ‘Mutuelle Générale de l'Education Nationale' and the ‘Institut National de la Santé et de la Recherche Médicale'.

Subjects
Adult, Gerontology, medicine.medical_specialty, Validation study, MESH: Menopause, MESH: Age of Onset, Concordance, Health status, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, 0302 clinical medicine, Cohen's kappa, Surveys and Questionnaires, Humans, Medicine, 030212 general & internal medicine, Age of Onset, Aged, MESH: Aged, Medical records, MESH: Humans, MESH: Middle Aged, 030219 obstetrics & reproductive medicine, Natural menopause, business.industry, Obstetrics, MESH: Questionnaires, Medical record, Obstetrics and Gynecology, MESH: Adult, Age at menopause, Middle Aged, medicine.disease, Self-reported menopausal status, Menopause, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Cohort, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Age of onset, business, MESH: Female
Abstract

The accuracy of self-reported menopausal status and age at menopause has been analysed in a validation study using the gynecologist's medical records as the reference. Concordance between the two sources for menopausal status was assessed in 151 women. The kappa coefficient obtained was 0.85 (95% CI, 0.69-1.00). Agreement on age at menopause was tested in 57 women and the kappa coefficient obtained was 0.64 (95% CI, 0.34-0.94). Age at menopause was accurately reported by 32% of the subjects. This percentage increased to 69 and 86% when agreement within 1 and 2 year(s) was considered, respectively. These results suggest that women can provide data on their natural menopause history with sufficient accuracy to test some hypotheses associating this event with the evolution of their health status.

Published
1998

7. Age at menopause, reproductive history, and venous thromboembolism risk among postmenopausal women: the Women's Health Initiative Hormone Therapy clinical trials

Author

Geneviève Plu-Bureau, Barbara B. Cochrane, Marianne Canonico, Marcia L. Stefanick, JoAnn E. Manson, Pierre-Yves Scarabin, Mary Jo O'Sullivan, Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Université Paris Descartes - Paris 5 (UPD5), Recherche en épidémiologie et biostatistique, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Maison du patrimoine Oral de Bourgogne (Anost) (MPOB), Stanford Prevention Research Center, Stanford Medicine, Stanford University-Stanford University, University of Washington [Seattle], Departments of Ophthalmology and Microbiology and Molecular Genetics, Harvard Medical School [Boston] (HMS), National Heart, Lung, and Blood Institute, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), SZTAJNBOK, Pascale, Centre de recherche en épidémiologie et santé des populations ( CESP ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Paris Descartes - Paris 5 ( UPD5 ), Université Paris-Sud - Paris 11 ( UP11 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Maison du patrimoine Oral de Bourgogne ( MPO ), Maison du patrimoine Oral de Bourgogne, Stanford University School of Medicine, and Harvard Medical School [Boston] ( HMS )

Subjects
MESH : Venous Thromboembolism, MESH: Reproductive History, MESH: Menopause, medicine.medical_treatment, MESH : Aged, 030204 cardiovascular system & hematology, MESH: Venous Thromboembolism, MESH: Pregnancy, 0302 clinical medicine, MESH : Child, MESH: Risk Factors, Pregnancy, Risk Factors, MESH: Child, MESH : Female, 030212 general & internal medicine, Child, Reproductive History, MESH: Aged, Clinical Trials as Topic, MESH : Estrogen Replacement Therapy, MESH: Middle Aged, Obstetrics, Women's Health Initiative, Hazard ratio, Estrogen Replacement Therapy, MESH : Menopause, Age Factors, MESH : Menarche, Obstetrics and Gynecology, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Venous Thromboembolism, MESH : Adult, Middle Aged, MESH : Risk Factors, 3. Good health, MESH : Women's Health, Menopause, Postmenopause, Parity, MESH : Ovariectomy, MESH: Menarche, MESH : Postmenopause, Menarche, Female, MESH: Postmenopause, Adult, medicine.medical_specialty, MESH: Clinical Trials as Topic, Adolescent, Ovariectomy, MESH: Ovariectomy, Article, 03 medical and health sciences, MESH : Adolescent, MESH : Reproductive History, medicine, Humans, MESH : Middle Aged, cardiovascular diseases, MESH : Parity, Aged, MESH: Adolescent, MESH: Age Factors, Gynecology, MESH: Humans, Proportional hazards model, business.industry, MESH : Humans, MESH: Parity, Oophorectomy, MESH: Adult, equipment and supplies, medicine.disease, MESH: Estrogen Replacement Therapy, MESH : Clinical Trials as Topic, MESH : Pregnancy, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Women's Health, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Age Factors, Hormone therapy, business, MESH: Women's Health, MESH: Female
Abstract

International audience; This study aims to investigate venous thromboembolism (VTE) risk in relation to age at menopause, age at menarche, parity, bilateral oophorectomy, and time since menopause, as well as any interaction with randomized hormone therapy (HT) assignment, among postmenopausal women. Using pooled data from the Women's Health Initiative HT clinical trials including 27,035 postmenopausal women aged 50 to 79 years who had no history of VTE, we assessed the risk of VTE in relation to age at menopause, age at menarche, parity, bilateral oophorectomy, and time since menopause by Cox proportional hazards models. Linear trends, quadratic relationships, and interactions of reproductive life characteristics with HT on VTE risk were systematically tested. During follow-up, 426 women reported a first VTE, including 294 non-procedure-related events. No apparent interaction of reproductive life characteristics with HT assignment on VTE risk was detected, and there was not a significant association between VTE and age at menarche, age at menopause, parity, oophorectomy, or time since menopause. However, analyses restricted to non-procedure-related VTE showed a U-shaped relationship between age at menopause and thrombotic risk that persisted after multivariable analysis (P < 0.01). Compared with women aged 40 to 49 years at menopause, those who had early menopause (age 55 y) had a significantly increased VTE risk (hazard ratio [95% CI]: 1.8 [1.2-2.7] and 1.5 [1.0-2.4], respectively). Reproductive life characteristics have little association with VTE and do not seem to influence the effect of HT on thrombotic risk among postmenopausal women. Nevertheless, early and late onset of menopause might be newly identified risk factors for non-procedure-related VTE.

Published
2013

8. Differences in breast carcinoma in situ between menopausal and premenopausal women

Author

Claire, Pradier, Marion, Cornuau, Johanne, Norca, Habiba, Mesbah, Philippe, Poree, Gilles, Body, Jean-Marc, Classe, Jean, Leveque, Service d'oncologie chirurgicale, CRLCC Eugène Marquis (CRLCC), Département de Biologie Oncologique, CRLCC René Gauducheau, Département d'information médicale, and Le Corre, Morgane

Subjects
MESH: Survival Rate, MESH: Menopause, MESH: Mammography, Breast Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Prognosis, Immunoenzyme Techniques, [SDV.CAN] Life Sciences [q-bio]/Cancer, Humans, skin and connective tissue diseases, MESH: Immunoenzyme Techniques, Neoplasm Staging, Retrospective Studies, MESH: Humans, MESH: Middle Aged, MESH: Carcinoma, Intraductal, Noninfiltrating, Carcinoma, Ductal, Breast, MESH: Retrospective Studies, MESH: Neoplasm Staging, Middle Aged, Prognosis, Survival Rate, MESH: Carcinoma, Ductal, Breast, Carcinoma, Intraductal, Noninfiltrating, MESH: Premenopause, Premenopause, Female, Menopause, MESH: Female, MESH: Breast Neoplasms, Mammography
Abstract

International audience; AIM: To seek differences between ductal carcinoma in situ (DCIS) according to the menopausal status of patients and to analyze their repercussions on patient care. PATIENTS AND METHODS: A multicenter retrospective study of 384 patients from 3 centers specialized in breast cancer surgery was carried out based on an analysis of the various characteristics (clinical, therapeutic, histologic, outcome) of DCIS between two groups of post- and pre-menopausal patients. RESULTS: At the time of diagnosis, 58.6% of the patients were menopausal. Compared to these patients, DCIS in premenopausal women was more frequently associated with initial clinical signs (p=0.006), a larger tumor size (p=0.02), involved margins after initial surgery (p=0.005), and surgical re-excision (p=0.03). The mammograms of the menopausal patients indicated a worse prognosis (using the American College of Radiology Classification) (p=0.025), and according to the histology report findings, more marked comedo necrosis (p=0.01). There was no difference in the other criteria (nuclear grade, multifocality, benign lesions associated with malignancy, relapse and its time of occurrence). The use of hormone replacement therapy had no effect on these data. CONCLUSION: The characteristics of DCIS are similar, whether occuring before or after the menopause, but the phenotypic expression is different. Menopausal status should not be a criterion for changing patient care.

Published
2011

9. Timing of the vascular actions of estrogens in experimental and human studies: why protective early, and not when delayed?

Author

Jean-François Arnal, Françoise Lenfant, Pierre Gourdy, Florence Trémollières, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), and Simon, Marie Francoise

Subjects
MESH: Menopause, medicine.medical_treatment, Estrogen receptor, Coronary Disease, 030204 cardiovascular system & hematology, Bioinformatics, MESH: Estrogens, MESH: Atherosclerosis, 0302 clinical medicine, Medroxyprogesterone acetate, MESH: Animals, 0303 health sciences, Estradiol, Human studies, Obstetrics and Gynecology, Plaque, Atherosclerotic, 3. Good health, Menopause, Receptors, Estrogen, Preventive action, MESH: Receptors, Estrogen, Female, MESH: Endothelium, Vascular, MESH: Estradiol, hormones, hormone substitutes, and hormone antagonists, medicine.drug, medicine.medical_specialty, medicine.drug_class, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Internal medicine, medicine, Animals, Humans, MESH: Plaque, Atherosclerotic, 030304 developmental biology, MESH: Humans, business.industry, Estrogens, Atherosclerosis, medicine.disease, Endocrinology, Estrogen, MESH: Progestins, Endothelium, Vascular, Hormone therapy, MESH: Coronary Disease, Progestins, business, MESH: Female, Hormone
Abstract

International audience; Estrogens, and in particular 17β-estradiol (E2), play a pivotal role in sexual development and reproduction and are also implicated in a large number of physiological processes including the cardiovascular system. Although epidemiological studies and Nurses' Health Study suggested, and all animal models of early atheroma clearly demonstrated a vasculoprotective action of both endogenous and exogenous estrogens, the Women's Health Initiative did not confirm the preventive action of estrogens against coronary heart disease (CHD). However, women who initiated hormone therapy closer to menopause tended to have reduced CHD risk compared with increased CHD risk among women more distant from menopause. Thus, it is now mandatory to try to understand the mechanisms that could have influenced the actions of estrogens at various stages of atherosclerosis and/or of life. In this current review, we will summarize our understanding of the potential cellular targets and mechanisms of the vasculoprotective actions of estrogens, as well as of the lack of action of estrogens when administered after a period of hormonal deprivation. The mechanisms of the aggravating role of progestogens such as medroxyprogesterone acetate will be considered. Finally, we will analyze the possibilities to uncouple some beneficial from other undesirable actions following the partial/selective activation of estrogen receptors.

Published
2011

10. N-acetyltransferase 2 polymorphisms, tobacco smoking, and breast cancer risk in the breast and prostate cancer cohort consortium

Author

Cox, Dg, Dostal, L, Hunter, Dj, Le Marchand, L, Hoover, R, Ziegler, Rg, Thun, Mj, Diver, Wr, Stevens, Vl, Amiano, P, Boutron Rualt MC, Campa, Daniele, van Duijnhoven FJ, Gram, It, Kaaks, R, Khaw, K. T., Riboli, E, Sund, M, Trichopoulos, D, Tumino, R, Vogel, U, Kraft, P, Buring, Je, Hankinson, Se, Lee, Im, Zhang, Sm, Lindstrom, S, Berg, Cd, Chanock, S, Isaacs, C, Mccarty, C, Haiman, Ca, Henderson, Be, Prostate Cancer Cohort Consortium, Equipe 6, Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Cancer Epidemiology, German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), DURHAM, Durham, University of Hawai‘i [Mānoa] (UHM), Division of Cancer Epidemiology and Genetics, National Cancer Institute [Bethesda] (NCI-NIH), and National Institutes of Health [Bethesda] (NIH)-National Institutes of Health [Bethesda] (NIH)

Subjects
Oncology, Male, single nucleotide, MESH: Menopause, Epidemiology, MESH: Logistic Models, arylamine N-acetyltransferase, polymorphism, Cohort Studies, Prostate cancer, 0302 clinical medicine, MESH: Risk Factors, Risk Factors, breast neoplasms, Brief Original Contribution, MESH: Cohort Studies, 0303 health sciences, MESH: Middle Aged, MESH: Polymorphism, Single Nucleotide, Middle Aged, MESH: Case-Control Studies, 3. Good health, NAT2 protein, human, polymorphism, single nucleotide, smoking, 030220 oncology & carcinogenesis, Cohort, Female, Menopause, Cohort study, MESH: Smoking, medicine.medical_specialty, NAT2 protein, [SDV.CAN]Life Sciences [q-bio]/Cancer, Polymorphism, Single Nucleotide, 03 medical and health sciences, Breast cancer, Internal medicine, medicine, Humans, human, 030304 developmental biology, MESH: Humans, Bladder cancer, business.industry, Case-control study, Cancer, Odds ratio, medicine.disease, MESH: Arylamine N-Acetyltransferase, MESH: Male, Logistic Models, Case-Control Studies, business, MESH: Female, MESH: Breast Neoplasms
Abstract

International audience; Common polymorphisms in the N-acetyltransferase 2 gene (NAT2) modify the association between cigarette smoking and bladder cancer and have been hypothesized to determine whether active cigarette smoking increases breast cancer risk. The authors sought to replicate the latter hypothesis in a prospective analysis of 6,900 breast cancer cases and 9,903 matched controls drawn from 6 cohorts (1989-2006) in the National Cancer Institute's Breast and Prostate Cancer Cohort Consortium. Standardized methods were used to genotype the 3 most common polymorphisms that define NAT2 acetylation phenotype (rs1799930, rs1799931, and rs1801280). In unconditional logistic regression analyses, breast cancer risk was higher in women with more than 20 pack-years of active cigarette smoking than in never smokers (odds ratio (OR) = 1.28, 95% confidence interval (CI): 1.17, 1.39), after controlling for established risk factors other than alcohol consumption and physical inactivity. However, associations were similar for the slow (OR = 1.25, 95% CI: 1.11, 1.39) and rapid/intermediate (OR = 1.24, 95% CI: 1.08, 1.42) acetylation phenotypes, with no evidence of interaction (P = 0.87). These results provide some support for the hypothesis that long-term cigarette smoking may be causally associated with breast cancer risk but underscore the need for caution when interpreting sparse data on gene-environment interactions.

Published
2011

11. Discontinuation of hormone therapy in the French GAZEL cohort 1990-2006

Author

Virginie Ringa, Céline Quelen, Noëlle Varnoux, Marie Zins, Xavier Fritel, Jean Bouyer, Santé reproductive, sexualité, infection à VIH - épidémiologie, démographie, sciences sociales, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Sud - Paris 11 (UP11)-Institut national d'études démographiques (INED), Recherches épidémiologiques en santé périnatale et santé des femmes, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé, Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Institut national d'études démographiques (INED)-Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Longitudinal study, MESH: Menopause, medicine.medical_treatment, menopause, Cohort Studies, 0302 clinical medicine, Surveys and Questionnaires, Medicine, Longitudinal Studies, 030212 general & internal medicine, MESH: Longitudinal Studies, MESH: Cohort Studies, 030219 obstetrics & reproductive medicine, MESH: Middle Aged, MESH: Withholding Treatment, Estrogen Replacement Therapy, Outcome measures, Obstetrics and Gynecology, Middle Aged, MESH: Patient Compliance, 3. Good health, Menopause, Cohort, MESH: Power Plants, Female, France, Cohort study, Adult, medicine.medical_specialty, MESH: Patient Education as Topic, 03 medical and health sciences, Patient Education as Topic, cohort study, Humans, Gynecology, Postmenopausal women, MESH: Humans, hormone therapy, business.industry, MESH: Questionnaires, MESH: Adult, medicine.disease, MESH: Estrogen Replacement Therapy, Discontinuation, MESH: France, Withholding Treatment, Reproductive Medicine, Patient Compliance, Women's Health, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Hormone therapy, business, MESH: Women's Health, MESH: Female, Power Plants, Demography, discontinuation
Abstract

International audience; OBJECTIVE: To analyze changes in hormone therapy (HT) use after the publication of the Women's Health Initiative (WHI) results, in a country (France) where HT is different from that assessed in the WHI. DESIGN: Longitudinal study. SETTING: Women in the GAZEL cohort of employees of the French national power company. PARTICIPANT(S): One thousand six hundred five postmenopausal women ever-users of HT. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Discontinuation of HT. RESULT(S): Rates of discontinuation were higher after 2002: 65% of users who began HT in 1998 were still using it after 5 years. In contrast, >90% of those who began before 1994 were still using it after 5 years. Discontinuation was associated with women's social and medical characteristics and with factors related to side effects and expectations concerning HT. After adjustment for these factors, women were twice as likely to stop HT after publication of the WHI. CONCLUSION(S): Even in France, publication of the WHI has led to a decline in HT use.

Published
2010

12. Discontinuation of hormone therapy in the French GAZEL cohort 1990-2006

Author

Ringa, Virginie, Fritel, Xavier, Varnoux, Noëlle, Zins, Marie, Quélen, Céline, Bouyer, Jean, Ringa, Virginie, Santé reproductive, sexualité, infection à VIH - épidémiologie, démographie, sciences sociales, Institut national d'études démographiques (INED)-Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Recherches épidémiologiques en santé périnatale et santé des femmes, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé, Epidémiologie, sciences sociales, santé publique (IFR 69), and Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
MESH: Humans, MESH: Middle Aged, hormone therapy, MESH: Menopause, MESH: Questionnaires, MESH: Withholding Treatment, menopause, MESH: Adult, MESH: Patient Education as Topic, MESH: Patient Compliance, MESH: Estrogen Replacement Therapy, MESH: France, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, cohort study, MESH: Power Plants, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Longitudinal Studies, MESH: Cohort Studies, MESH: Women's Health, MESH: Female, discontinuation
Abstract

International audience; OBJECTIVE: To analyze changes in hormone therapy (HT) use after the publication of the Women's Health Initiative (WHI) results, in a country (France) where HT is different from that assessed in the WHI. DESIGN: Longitudinal study. SETTING: Women in the GAZEL cohort of employees of the French national power company. PARTICIPANT(S): One thousand six hundred five postmenopausal women ever-users of HT. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Discontinuation of HT. RESULT(S): Rates of discontinuation were higher after 2002: 65% of users who began HT in 1998 were still using it after 5 years. In contrast, >90% of those who began before 1994 were still using it after 5 years. Discontinuation was associated with women's social and medical characteristics and with factors related to side effects and expectations concerning HT. After adjustment for these factors, women were twice as likely to stop HT after publication of the WHI. CONCLUSION(S): Even in France, publication of the WHI has led to a decline in HT use.

Published
2010

13. Effect of two oral doses of 17beta-estradiol associated with dydrogesterone on thrombin generation in healthy menopausal women: a randomized double-blind placebo-controlled study

Author

Grigoris T. Gerotziafas, Eric Dasque, Jean-Louis Démolis, Dahlia Torchin, Karine Lacut, Annie Robert, Faiez Zannad, Tabassome Simon, Alexandra Rousseau, Christian Libersa, Ismail Elalamy, Service de pharmacologie - Dosage de médicaments [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service d'hématologie biologique [CHU Tenon], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Risque cardiovasculaire, rigidité-fibrose et hypercoagulabilité (RCV), Université Henri Poincaré - Nancy 1 (UHP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'investigation clinique plurithématique Pierre Drouin [Nancy] (CIC-P), Centre d'investigation clinique [Nancy] (CIC), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO), Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC CHU ( Lille)/inserm, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé, Signalisation cellulaire, dynamique circulatoire et athérosclérose précoce (SCDCAP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Service d'Histologie-Biologie tumorale [Hôpital Tenon], and Université Pierre et Marie Curie - Paris 6 (UPMC)

Subjects
Time Factors, MESH: Menopause, Administration, Oral, 030204 cardiovascular system & hematology, Dydrogesterone, MESH: Estrogens, MESH: Dose-Response Relationship, Drug, MESH: Thrombin, 0302 clinical medicine, Oral administration, Pharmacology (medical), MESH: Double-Blind Method, 030212 general & internal medicine, Clotting factor, MESH: Aged, MESH: Middle Aged, Estradiol, Thrombin, Middle Aged, Blood Coagulation Factors, 3. Good health, Menopause, MESH: Administration, Oral, Drug Therapy, Combination, Female, MESH: Estradiol, medicine.drug, medicine.medical_specialty, medicine.drug_class, Placebo, 03 medical and health sciences, Tissue factor, Double-Blind Method, Internal medicine, medicine, Humans, Aged, Pharmacology, MESH: Humans, Dose-Response Relationship, Drug, business.industry, MESH: Time Factors, MESH: Blood Coagulation Factors, Estrogens, medicine.disease, MESH: Drug Therapy, Combination, Endocrinology, Estrogen, MESH: Progestins, MESH: Dydrogesterone, Progestins, business, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Oral hormone therapy is associated with an increased risk of venous thrombosis. Drug agencies recommend the use of the lowest efficient dose to treat menopausal symptoms for a better risk/ratio profile, although this profile has not been totally investigated yet. The aim of the study was to compare the effect of the standard dose of 17beta-estradiol to a lower one on thrombin generation (TG). In a 2-month study, healthy menopausal women were randomized to receive daily 1mg or 2 mg of 17beta-estradiol (E1, n = 24 and E2, n = 26; respectively) with 10 mg dydrogesterone or placebo (PL, n = 22). Plasma levels factors VII, X, VIII and II were assessed before and after treatment as well as Tissue factor triggered TG, which allows the investigation of the different phases of coagulation process. The peak of thrombin was higher in hormone therapy groups (E1: 42.39 +/- 50.23 nm, E2: 31.08 +/- 85.86 nm vs. 10.52 +/- 40.63 nm in PL, P = 0.002 and P = 0.01). Time to reach the peak was also shortened (PL: 0.26 +/- 0.69 min vs. E1: -0.26 +/- 0.80 min, E2: -0.55 +/- 0.79 min, P

Published
2009

14. How do scoliotic women shrink throughout life?

Author

Vincent Gremeaux, Christian Hérisson, Jean-Marie Casillas, Dominic Pérennou, Isabelle Benatru, Motricité - Plasticité, Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Pôle Rééducation - Réadaptation (Médecine Physique et Réadaptation) (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Service de Neurologie générale, vasculaire et dégénérative (CHU de Dijon), SPM, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications [Grenoble] ( TIMC-IMAG ), Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut polytechnique de Grenoble - Grenoble Institute of Technology ( Grenoble INP ) -IMAG-Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA ) -Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut polytechnique de Grenoble - Grenoble Institute of Technology ( Grenoble INP ) -IMAG-Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA ), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Santé, Plasticité, Motricité (TIMC-IMAG-SPM), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), and VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)

Subjects
MESH: Menopause, Cross-sectional study, MESH : Spondylolisthesis, Osteoporosis, MESH : Aged, [ SDV.NEU.SC ] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Cognitive Sciences, 0302 clinical medicine, MESH : Cross-Sectional Studies, MESH : Scoliosis, Orthopedics and Sports Medicine, MESH : Female, Rachis, MESH: Aged, 030222 orthopedics, education.field_of_study, MESH: Middle Aged, Cobb angle, Age Factors, MESH : Menopause, MESH: Scoliosis, [SDV.NEU.SC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Cognitive Sciences, MESH: Follow-Up Studies, Middle Aged, Low back pain, MESH: Predictive Value of Tests, Scoliosis, Predictive value of tests, Disease Progression, Female, MESH: Disease Progression, medicine.symptom, Menopause, medicine.medical_specialty, Population, MESH : Body Height, MESH: Spondylolisthesis, 03 medical and health sciences, MESH: Cross-Sectional Studies, Predictive Value of Tests, MESH: Body Height, medicine, Humans, MESH : Middle Aged, MESH : Predictive Value of Tests, education, Aged, MESH: Age Factors, MESH: Humans, business.industry, MESH : Humans, MESH : Follow-Up Studies, MESH : Disease Progression, medicine.disease, Body Height, Radiography, Cross-Sectional Studies, Physical therapy, Neurology (clinical), MESH : Age Factors, Spondylolisthesis, business, MESH: Female, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract

International audience; STUDY DESIGN: Cross-sectional study among a population of scoliotic and nonscoliotic women aged 40 years or more with low back pain from a spine rehabilitation unit. OBJECTIVES: (1) To test the hypothesis that scoliotic (SW) women shrink faster than nonscoliotic women (NSW) in adulthood. (2) To investigate the effects of age and curve progression in the scoliotic group, and to develop a model to assess the natural history of scoliosis and shrinkage. SUMMARY OF BACKGROUND DATA: Little is known about the decrease in body height in adult scoliotic patients. A simple method to help predict the future course of the curvature in patients without radiograph follow-up could help clinicians make treatment decisions. METHODS: Sixty SW and 40 NSW women matched for age, with no history of vertebral fracture or osteoporosis, were questioned about their peak body height and measured. Total spine radiographs were performed, and compared with previous images if available. Correlations between self-reported peak body height and current height, shrinkage, age, time since menopause, and the Cobb angle were searched for. In women with documented radiograph follow-up, correlations between shrinkage and progression of the Cobb angle were sought to develop a predictive model of curve progression. RESULTS: Average shrinkage in the SW was twice that in the NSW (5.1 +/- 3.5 vs. 2.3 +/- 0.7 cm, P < 0.001), had begun early in adulthood, was due to the combined effect of age and scoliosis, and was strongly associated with rotatory olisthesis. In the 17 women with radiograph follow-up (19.7 +/- 7.3 years), curve progression was closely related to shrinkage (r = 0.74; P < 0.001; y = 0.7 + 2.7x; SE = 0.42). This allowed us to generate prediction limits of the scoliosis for a given individual. CONCLUSION: Determination of shrinkage could provide a simple, noninvasive, and cheap method to monitor the natural history of scoliosis in adults. It could therefore be used in routine clinical practice to help make treatment decisions for patients with no documented radiograph follow-up.

Published
2009

15. Bone mineral density at menopause does not predict breast cancer incidence

Author

Jean-Michel Pouilles, J. Laparra, C. Ribot, F. Tremollieres, Unité Ménopause et Maladies Osseuses Métaboliques, CHU Toulouse [Toulouse]-Hôpital Paule de Viguier, CHU Toulouse [Toulouse], Institut de médecine moléculaire de Rangueil (I2MR), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-IFR150-Institut National de la Santé et de la Recherche Médicale (INSERM), Simon, Marie Francoise, Service Gynécologie [CHU Toulouse], Pôle Femme-Mère-Couple [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées- Institut Fédératif de Recherche Bio-médicale Institution (IFR150)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
MESH: Menopause, Endocrinology, Diabetes and Metabolism, Osteoporosis, MESH: Epidemiologic Methods, MESH: Lumbar Vertebrae, 0302 clinical medicine, Bone Density, Prospective cohort study, MESH: Bone Density, MESH: Femur Neck, Bone mineral, Lumbar Vertebrae, MESH: Middle Aged, Anthropometry, Obstetrics, Femur Neck, Estrogen Replacement Therapy, Age Factors, Middle Aged, Prognosis, Menopause, Postmenopause, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Menarche, Female, Breast disease, MESH: Postmenopause, medicine.medical_specialty, 030209 endocrinology & metabolism, Breast Neoplasms, MESH: Prognosis, 03 medical and health sciences, Breast cancer, MESH: Anthropometry, medicine, Humans, Femoral neck, Gynecology, MESH: Age Factors, MESH: Humans, business.industry, medicine.disease, MESH: Estrogen Replacement Therapy, Perimenopause, MESH: Perimenopause, business, Epidemiologic Methods, MESH: Female, MESH: Breast Neoplasms
Abstract

International audience; SUMMARY: In this prospective study in 2,137 perimenopausal and early postmenopausal women who were followed over a 13.1-year period of time, we observed no association between bone mineral density measured at the beginning of menopause and the subsequent risk of breast cancer. INTRODUCTION: This study aimed to investigate the relationship between BMD and the risk of breast cancer (BC) in young postmenopausal women. METHODS: As part of a clinical research program, 2,137 women who were perimenopausal or within their 5 first postmenopausal years were scanned between 1988-1990 and reviewed on average 13.1 years after their initial examination. Ninety-eight incident BC cases were recorded throughout the follow-up. RESULTS: Women with incident BC significantly differed from those who had never had BC with regard to age at menarche, age of birth of 1st child, familial history of BC and postmenopausal hormone therapy (PHT) use. There was no significant difference between the two groups for baseline DXA of the spine. There was a trend for BC cases for having lower femoral neck BMD compared to women without BC. However, women with low BMD were more likely to have taken PHT by the end of the study. In Cox multivariate analyses the relationship between BC risk and femoral neck BMD no longer existed. CONCLUSIONS: There was no relationship between BMD measured within the first postmenopausal years and the risk of BC, which makes unlikely the possibility of using BMD as a predictor factor for BC in early postmenopausal women.

Published
2008

16. Senescence of reproduction may explain adaptive menopause in humans: a test of the 'mother' hypothesis

Author

Evelyne Heyer, C. Jessica E. Metcalf, Samuel Pavard, Eco-Anthropologie et Ethnobiologie (EAE), Muséum national d'Histoire naturelle (MNHN)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Max Planck Institute for Demographic Research (MPIDR), Max-Planck-Gesellschaft, and Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7)-Muséum national d'Histoire naturelle (MNHN)

Subjects
0106 biological sciences, Aging, MESH: Menopause, [SDV]Life Sciences [q-bio], [SHS.ANTHRO-BIO]Humanities and Social Sciences/Biological anthropology, MESH: Reproduction, 01 natural sciences, MESH: Child, Adaptation, Psychological, Medicine, MESH: Aging, Survivors, Child, Maternal Behavior, ComputingMilieux_MISCELLANEOUS, media_common, MESH: Survivors, 0303 health sciences, Reproduction, Stillbirth, Mother-Child Relations, Menopause, MESH: Stillbirth, MESH: Survival Analysis, Female, Anatomy, Senescence, MESH: Mother-Child Relations, media_common.quotation_subject, Fertility, 010603 evolutionary biology, 03 medical and health sciences, Humans, MESH: Adaptation, Psychological, Survival analysis, Selection (genetic algorithm), 030304 developmental biology, MESH: Humans, [SDV.GEN.GPO]Life Sciences [q-bio]/Genetics/Populations and Evolution [q-bio.PE], business.industry, medicine.disease, Survival Analysis, El Niño, Anthropology, MESH: Maternal Behavior, Adaptation, business, MESH: Female, Demography
Abstract

The "mother" hypothesis is one of the main adaptive explanations of human menopause. It postulates that reproductive cessation constitutes a strategy that has been selected for during human evolution because mothers at older ages might maximize their fitness by investing resources in the survival and reproduction of their living children rather than by continuing to reproduce. This study provides a test of this hypothesis. Fertility functions that maximize fitness are built into a model incorporating the fact that the survival of females during the rearing period is a major determinant of their children's survival. Results are given according to different scenarios of increase with mothers' age of maternal mortality risk and risk of stillbirth and birth defects (on the assumption that these females do not experience menopause). Different estimates of the effect of a mother's death on her child's survival were also incorporated. Finally, a population genetics framework allows us to estimate selection on these optimal fertility functions. To determine whether or not these fertility functions show a menopause, three criteria are discussed: the rapidity of fertility decline, if any; the magnitude of selection on menopause compared with a nonmenopausal strategy; and the selection on survival during post-reproductive life. Our results show that menopause and subsequent post-reproductive life are significantly advantageous when two conditions are satisfied: a marked increase in stillbirth and risk of birth defects as well as in maternal mortality with mother's age.

Published
2008

17. Menstrual and reproductive factors in the risk of differentiated thyroid carcinoma in native women in French Polynesia : a population-based case-control study

Author

Joseph Sebbag, J. Teuri, John Paoaafaite, Pauline Brindel, Vaïana Chungue, Frédérique Rachédi, Florent de Vathaire, Jean-Louis Boissin, Françoise Doyon, Larrys Shan, Laure Yen Kai Sun, Frédérique Bost-Bezeaud, Patrice Petitdidier, Epidémiologie des cancers : Radiocarcinogénèse et effets iatrogènes des traitements, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Statistique Théorique et Appliquée (LSTA), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Centre d'études et de recherches appliquées à la gestion (CERAG), Université Pierre Mendès France - Grenoble 2 (UPMF)-Centre National de la Recherche Scientifique (CNRS), Epidémiologie des cancers, Institut National de la Santé et de la Recherche Médicale (INSERM), Association pour la Recherche contre le Cancer (ARC), Direction Générale de la Santé (DGS), Comité de radioprotection de l'EDF, Agence Française de Sécurité Sanitaire, Environnementale (AFSSE), the CHILD-THYR EEC programme., Université Pierre et Marie Curie - Paris 6 (UPMC), and Centre National de la Recherche Scientifique (CNRS)-Université Pierre Mendès France - Grenoble 2 (UPMF)

Subjects
Native Hawaiian or Other Pacific Islander, MESH: Abortion, Spontaneous, MESH: Menopause, Epidemiology, menopause, MESH: Comorbidity, Comorbidity, GROUPE A RISQUE, MESH: Reproduction, Miscarriage, 0302 clinical medicine, MESH: Pregnancy, menstruations, Risk Factors, MESH: Risk Factors, GROSSESSE, Odds Ratio, 030212 general & internal medicine, MENSTRUATION, SANTE PUBLIQUE, Thyroid cancer, Menstruation Disturbances, education.field_of_study, MESH: Middle Aged, thyroid neoplasms, Reproduction, MESH: Polynesia, Middle Aged, MESH: Case-Control Studies, 3. Good health, Menopause, case control studies, Breast Feeding, MESH: Menarche, MESH: Thyroid Neoplasms, CANCER DE LA THYROIDE, 030220 oncology & carcinogenesis, MESH: Breast Feeding, Female, pregnancy, women, MESH: Oceanic Ancestry Group, Maternal Age, Adult, medicine.medical_specialty, MENOPAUSE, Population, FACTEUR DE RISQUE, Gravidity, Polynesia, MESH: Multivariate Analysis, 03 medical and health sciences, SURVEILLANCE, medicine, Humans, MESH: Menstruation Disturbances, Risk factor, education, Gynecology, Menarche, Pregnancy, MESH: Gravidity, MESH: Humans, business.industry, case-control studies, Case-control study, MESH: Adult, Odds ratio, medicine.disease, MESH: Odds Ratio, Abortion, Spontaneous, FEMME, ETUDE DE CAS, Multivariate Analysis, MESH: Maternal Age, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female, Demography
Abstract

French Polynesia has one of the world's highest incidence rates of thyroid cancer. A case-control study among native residents of French Polynesia included 201 women diagnosed with differentiated thyroid cancer before the age of 56 years, between 1981 and 2004, matched to 324 population controls on date of birth. Face-to-face interviews were conducted from 2002 to 2004. Odds ratios were calculated by using conditional logistic regression and were reported in the total group and by ethnic group ("Polynesian" vs. "mixed"). The risk of thyroid cancer increased with natural (odds ratio = 1.9) or artificial (odds ratio = 4.5) menopause compared with that associated with a premenopausal status and with number of births (p for trend = 0.03): odds ratios for one, two, three, four or five, six or seven, and eight or more births were, respectively, 0.90, 1.6, 2.3, 2.2, 2.7, and 1.7 compared with a nulliparous status. Similar results were observed for Polynesian women. No association was observed with irregular menstrual cycles, age at menopause, history of miscarriage or induced abortion, time since last birth, age at and outcome of first pregnancy, or breastfeeding. This study confirms the role of menstrual and reproductive factors in the risk of differentiated thyroid cancer in Pacific island populations.

Published
2008

18. [Environmental factors for asthma severity and allergy: results from the EGEA study]

Author

Siroux, Valérie, Oryszczyn, Marie-Pierre, Varraso, Raphaëlle, Le Moual, Nicole, Bousquet, Jean, Charpin, Denis, Gormand, Frédéric, Kennedy, Susan, Maccario, Jean, Pison, Christophe, Rage, Estelle, Scheinmann, Pierre, Vervloet, Daniel, Pin, Isabelle, Kauffmann, Francine, Groupe de Recherche Sur Le Cancer du Poumon : Bases Moléculaires de la Progression Tumorale, Dépistage et Thérapie Génique, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale (INSERM), Recherche en épidémiologie et biostatistique, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Immunopathologie de l'Inflammation, Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de pneumologie-allergologie, Assistance Publique - Hôpitaux de Marseille (APHM), Service de pneumologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), School of Occupational & Environmental Hygiene, University of British Columbia (UBC), Département de médecine aiguë spécialisée, CHU Grenoble-Hôpital Michallon, Service de Pneumologie Allergologie [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Pneumologie-Allergologie [Hôpital de la Timone - APHM], Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Convention INSERM-MSD, réseau INSERM de recherche clinique (489012) et de santé publique (493009), Ministère de la santé, Ministère de l'environnement, Direction de la Recherche Clinique du CHU de Grenoble et COMARES, EGEA, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Paris-Sud - Paris 11 ( UP11 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Montpellier 1 ( UM1 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance Publique - Hôpitaux de Marseille ( APHM ), Centre Hospitalier Lyon Sud [CHU - HCL] ( CHLS ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), University of British Columbia ( UBC ), CHU Necker - Enfants Malades [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP), and Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille ( APHM ) -Hôpital Sainte-Marguerite [CHU - APHM] ( Hôpitaux Sud )

Subjects
MESH: Premenstrual Syndrome, MESH: Asthma, MESH: Menopause, allergie, MESH : Hypersensitivity, Immediate, MESH : Child, MESH: Risk Factors, MESH: Child, MESH : Female, MESH: Epidemiologic Studies, MESH: Immunoglobulin E, MESH : Menopause, MESH : Menarche, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Adult, MESH : Eosinophils, MESH : Risk Factors, MESH: Case-Control Studies, MESH : Environment, Environnement, MESH : Smoking, MESH : Phenotype, MESH: Menarche, MESH: Hypersensitivity, Immediate, MESH: Contraceptives, Oral, MESH : Case-Control Studies, MESH: Smoking, MESH: Hypersensitivity, MESH : Male, asthme sévère, MESH : Bronchial Hyperreactivity, MESH : Asthma, MESH: Phenotype, MESH : Epidemiologic Studies, MESH : Immunoglobulin E, MESH: Body Mass Index, MESH: Eosinophils, MESH : Premenstrual Syndrome, MESH : France, MESH: Environment, MESH: Age Factors, MESH : Hypersensitivity, MESH: Humans, MESH : Humans, MESH: Biological Markers, MESH: Bronchial Hyperreactivity, MESH: Adult, MESH: Male, respiratory tract diseases, asthme, MESH : Biological Markers, MESH : Contraceptives, Oral, MESH: France, MESH : Body Mass Index, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Age Factors, MESH: Female
Abstract

International audience; INTRODUCTION: EGEA (Epidemiological study on the genetics and environment of asthma, bronchial hyperresponsiveness and atopy), a case control and family study including 2048 individuals, was initiated to look for environmental and genetic risk factors for asthma. A synthesis of the results obtained since 2002 on phenotypic and environmental aspects of asthma severity and allergy are presented in this article. METHODS AND RESULTS: The results support a role for hormonal factors in asthma severity and in various allergic markers of asthma. A greater body mass index was related to a more severe asthma in women with early menarche. Associations between markers of allergy (eosinophils, IgE and atopy) and hormonal dependent events in women (premenstrual asthma, menopause and oral contraceptive use) have been found. In asthmatics, exposure to agents known to be associated with occupational asthma, active and passive smoking were associated with an increased clinical asthma severity score. The study underlines the protective role of country living and exposure to pets in early life on allergy markers in adulthood, supporting the hygiene hypothesis. CONCLUSIONS: New hypothesis will be tested in the near future from the second stage of this survey.

Published
2007

19. Relationships between selenium, lipids, iron status and hormonal therapy in women of the SU.VI.MAX cohort

Author

Anne-Marie Roussel, Sandrine Bertrais, Pilar Galan, Serge Hercberg, Josiane Arnaud, Alain Favier, Nathalie Arnault, D. Ruffieux, Laboratoire de bioénergétique fondamentale et appliquée (LBFA), Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), Département de biologie intégrée, CHU Grenoble-Hôpital Michallon, Unité de Recherche en Epidémiologie Nutritionnelle (UREN), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Sorbonne Paris Cité (USPC)-Université Paris 13 (UP13)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Institut National de la Recherche Agronomique (INRA), Hamant, Sarah, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris 13 (UP13)-Institut National de la Recherche Agronomique (INRA)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)

Subjects
MESH: Selenium, MESH: Menopause, 030309 nutrition & dietetics, 010501 environmental sciences, 01 natural sciences, Biochemistry, Cohort Studies, Contraceptive Agents, Female, MESH: Cohort Studies, MESH: Lipid Metabolism, MESH: Aged, 0303 health sciences, MESH: Iron, MESH: Middle Aged, biology, medicine.diagnostic_test, Estrogen Replacement Therapy, Middle Aged, 3. Good health, Menopause, Cohort, Molecular Medicine, Apolipoprotein A1, Female, Cohort study, Adult, medicine.medical_specialty, Iron, chemistry.chemical_element, Intrauterine device, Inorganic Chemistry, 03 medical and health sciences, Selenium, Contraceptive Agents, Internal medicine, medicine, [SDV.BBM] Life Sciences [q-bio]/Biochemistry, Molecular Biology, Humans, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, 0105 earth and related environmental sciences, Aged, MESH: Humans, business.industry, MESH: Adult, medicine.disease, Lipid Metabolism, MESH: Estrogen Replacement Therapy, Ferritin, Endocrinology, chemistry, biology.protein, MESH: Contraceptive Agents, Female, Lipid profile, business, MESH: Female
Abstract

International audience; Significant differences in serum selenium concentration according to contraceptive treatment and age have been evidenced in women of the SU.VI.MAX cohort. This study aimed at verifying the physiopathological hypothesis that the observed increase in serum selenium concentration could be related to serum lipid increase and/or bleeding decrease. Women were divided into six groups: menopausal with or without hormonal replacement therapy; non-menopausal using contraceptive pills; intrauterine device; other contraceptive treatment or no contraceptive treatment. Adjusted linear regression indicated positive associations between selenium and apolipoprotein A1 (r(2) from 0.038 to 0.074, p

Published
2007

20. Environnement, asthme sévère, allergie : EGEA

Author

Siroux, Valérie, Oryszczyn, Marie-Pierre, Varraso, Raphaëlle, Le Moual, Nicole, Bousquet, Jean, Charpin, Denis, Gormand, Frédéric, Kennedy, Susan, Maccario, Jean, Pison, Christophe, Rage, Estelle, Scheinmann, Pierre, Vervloet, Daniel, Pin, Isabelle, Kauffmann, Francine, Faraldo, Beatrice, Groupe de Recherche Sur Le Cancer du Poumon : Bases Moléculaires de la Progression Tumorale, Dépistage et Thérapie Génique, Institut Albert Bonniot-Institut National de la Santé et de la Recherche Médicale (INSERM), Recherche en épidémiologie et biostatistique, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Immunopathologie de l'Inflammation, Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de pneumologie-allergologie, Assistance Publique - Hôpitaux de Marseille (APHM), Service de pneumologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), School of Occupational & Environmental Hygiene, University of British Columbia (UBC), Département de médecine aiguë spécialisée, CHU Grenoble-Hôpital Michallon, Service de Pneumologie Allergologie [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Pneumologie-Allergologie [Hôpital de la Timone - APHM], Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Convention INSERM-MSD, réseau INSERM de recherche clinique (489012) et de santé publique (493009), Ministère de la santé, Ministère de l'environnement, Direction de la Recherche Clinique du CHU de Grenoble et COMARES, and EGEA

Subjects
MESH: Premenstrual Syndrome, MESH: Smoking, MESH: Asthma, MESH: Menopause, MESH: Hypersensitivity, asthme sévère, allergie, MESH: Phenotype, MESH: Body Mass Index, MESH: Eosinophils, MESH: Risk Factors, MESH: Child, MESH: Environment, MESH: Age Factors, MESH: Epidemiologic Studies, MESH: Humans, MESH: Immunoglobulin E, MESH: Biological Markers, MESH: Bronchial Hyperreactivity, MESH: Adult, MESH: Case-Control Studies, MESH: Male, respiratory tract diseases, Environnement, asthme, MESH: France, MESH: Menarche, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Hypersensitivity, Immediate, MESH: Contraceptives, Oral, MESH: Female
Abstract

International audience; INTRODUCTION: EGEA (Epidemiological study on the genetics and environment of asthma, bronchial hyperresponsiveness and atopy), a case control and family study including 2048 individuals, was initiated to look for environmental and genetic risk factors for asthma. A synthesis of the results obtained since 2002 on phenotypic and environmental aspects of asthma severity and allergy are presented in this article. METHODS AND RESULTS: The results support a role for hormonal factors in asthma severity and in various allergic markers of asthma. A greater body mass index was related to a more severe asthma in women with early menarche. Associations between markers of allergy (eosinophils, IgE and atopy) and hormonal dependent events in women (premenstrual asthma, menopause and oral contraceptive use) have been found. In asthmatics, exposure to agents known to be associated with occupational asthma, active and passive smoking were associated with an increased clinical asthma severity score. The study underlines the protective role of country living and exposure to pets in early life on allergy markers in adulthood, supporting the hygiene hypothesis. CONCLUSIONS: New hypothesis will be tested in the near future from the second stage of this survey.

Published
2007

21. Indicators of lifetime endogenous estrogen exposure and risk of venous thromboembolism

Author

Simon, T., Beau Yon De Jonage-Canonico, M., Oger, Emmanuel, Wahl, Denis, Conard, Jacqueline, Meyer, Guy, Emmerich, Joseph, Barrellier, Marie-Thérèse, Guiraud, A., Scarabin, Pierre-Yves, Renseigné, Non, Epidémiologie cardiovasculaire et métabolique, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO), Service de Médecine Interne et Vasculaire [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Unité d'hémostase-thrombose (JC - UHT), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Risque Thrombotique et Mecanismes de l'Hemostase (U765), Institut des sciences du Médicament -Toxicologie - Chimie - Environnement (IFR71), Institut National de la Santé et de la Recherche Médicale (INSERM)-Ecole Nationale Supérieure de Chimie de Paris - Chimie ParisTech-PSL (ENSCP), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Ecole Nationale Supérieure de Chimie de Paris - Chimie ParisTech-PSL (ENSCP), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Paris Descartes - Paris 5 (UPD5)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des Explorations Fonctionnelles [CHU Caen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Département de Pharmacologie Clinique (APHP - DPC), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Ecole Nationale Supérieure de Chimie de Paris- Chimie ParisTech-PSL (ENSCP)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Ecole Nationale Supérieure de Chimie de Paris- Chimie ParisTech-PSL (ENSCP)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Paris Descartes - Paris 5 (UPD5)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris-Sud - Paris 11 ( UP11 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Département de Pharmacologie Clinique ( APHP - DPC ), Assistance publique - Hôpitaux de Paris (AP-HP), Groupe d'Etude de la Thrombose de Bretagne Occidentale ( GETBO ), Université de Brest ( UBO ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Unité d'hémostase-thrombose ( JC - UHT ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Risque Thrombotique et Mecanismes de l'Hemostase ( U765 ), Institut des sciences du Médicament -Toxicologie - Chimie - Environnement ( IFR71 ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Ecole Nationale Supérieure de Chimie de Paris- Chimie ParisTech-PSL ( ENSCP ) -Centre National de la Recherche Scientifique ( CNRS ) -Institut de Recherche pour le Développement ( IRD ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Ecole Nationale Supérieure de Chimie de Paris- Chimie ParisTech-PSL ( ENSCP ) -Centre National de la Recherche Scientifique ( CNRS ) -Institut de Recherche pour le Développement ( IRD ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service d'Explorations Fonctionnelles, and Hôpital côte de nacre

Subjects
MESH: Pulmonary Embolism, MESH: Menopause, MESH : Risk, Osteoporosis, MESH : Aged, 030204 cardiovascular system & hematology, MESH: Estrogens, 0302 clinical medicine, MESH: Pregnancy, Pregnancy, Odds Ratio, Medicine, MESH : Female, 030212 general & internal medicine, Venous Thrombosis, First episode, MESH: Aged, MESH: Risk, MESH: Middle Aged, Obstetrics, Confounding, Age Factors, MESH : Menopause, Hematology, Middle Aged, MESH : Venous Thrombosis, MESH: Case-Control Studies, 3. Good health, Menopause, Parity, MESH: Thromboembolism, MESH : Pulmonary Embolism, Female, Risk, MESH : Case-Control Studies, medicine.medical_specialty, 03 medical and health sciences, Breast cancer, Thromboembolism, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, Humans, MESH : Middle Aged, MESH : Parity, Aged, Gynecology, MESH: Age Factors, MESH: Humans, business.industry, MESH : Humans, MESH: Parity, Case-control study, Estrogens, Odds ratio, medicine.disease, MESH : Thromboembolism, Confidence interval, MESH: Odds Ratio, MESH : Pregnancy, Case-Control Studies, MESH: Venous Thrombosis, MESH : Estrogens, MESH : Odds Ratio, MESH : Age Factors, Pulmonary Embolism, business, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; BACKGROUND: Lifetime estrogen exposure has been related to breast cancer risk, osteoporosis, and cardiovascular disease but data on venous thromboembolism (VTE) risk are limited. METHODS: Data from a hospital-based case-control study among 608 postmenopausal women (191 with a first episode of idiopathic VTE and 417 age-matched controls) were used to determine whether estrogen exposure, as assessed by age at menopause [classified as early (< or = 45 years), normal (46-54 years) and late menopause (> or = 55 years)] and parity, was associated with the risk of VTE. RESULTS: After adjustment for potential confounding variables, the risk of VTE was increased with each year's delay in the menopause [odds ratio (OR) = 1.06, 95% confidence interval (CI) = 1.02-1.10, P < 0.0075]. When compared with women with normal menopause used as a reference, the adjusted OR for VTE was 0.59 (95% CI = 0.36-0.97) and 2.53 (95% CI = 1.28-4.99) for women with early menopause and late menopause, respectively (P = 0.001). Adjusted OR for VTE was also higher for women with more than two children when compared with those with less than or equal to two children (1.56, 95% CI = 1.03-2.34, P = 0.03). The lowest risk of VTE was observed in women with early menopause and lower parity (adjusted OR = 0.60, 95% CI = 0.30-1.24), the highest risk was among women with late menopause who have had more than two children (adjusted OR = 3.41, 95% CI = 1.46-9.25). CONCLUSION: These results show that the longer exposure to endogenous estrogen is associated with an increased VTE risk.

Published
2006

22. Mode of delivery and severe stress incontinence. a cross-sectional study among 2,625 perimenopausal women

Author

Stéphanie Piault, Xavier Fritel, Arnaud Fauconnier, Virginie Ringa, Noëlle Varnoux, Gérard Bréart, Recherches épidémiologiques en santé périnatale et santé des femmes, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Fritel, Xavier, and Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Stress incontinence, MESH: Menopause, Cross-sectional study, Urinary Incontinence, Stress, Urinary incontinence, MESH: Urinary Incontinence, Stress, MESH: Epidemiologic Methods, Body Mass Index, 0302 clinical medicine, MESH: Pregnancy, Pregnancy, Surveys and Questionnaires, Epidemiology, Prevalence, 030212 general & internal medicine, 2. Zero hunger, education.field_of_study, 030219 obstetrics & reproductive medicine, MESH: Middle Aged, Obstetrics, Obstetrics and Gynecology, Middle Aged, 3. Good health, MESH: Pregnancy Complications, Cohort, Female, France, Menopause, medicine.symptom, medicine.medical_specialty, Population, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Article, MESH: Body Mass Index, 03 medical and health sciences, medicine, Humans, Risk factor, education, MESH: Prevalence, Gynecology, MESH: Humans, business.industry, MESH: Questionnaires, Delivery, Obstetric, medicine.disease, Pregnancy Complications, MESH: France, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, MESH: Delivery, Obstetric, Epidemiologic Methods, business, Body mass index, MESH: Female
Abstract

International audience; OBJECTIVE: To estimate the prevalence of severe stress urinary incontinence (SUI) among perimenopausal women and to examine potential obstetric risk factors. DESIGN: Mail survey of female volunteers for epidemiological research. SETTING: Postal questionnaire on SUI. POPULATION: Three thousand one hundred and fourteen women aged 49-61 years who comprised the GAZEL cohort. METHODS: Logistic regression using data from the entire cohort to estimate the impact of risk factors. A second logistic regression using data from women who had given birth included obstetric history. MAIN OUTCOME MEASURE: Prevalence of severe SUI defined by the response 'often' or 'all the time' to the question 'Does urine leak when you are physically active, cough or sneeze?' RESULTS: Two thousand six hundred and twenty-five women (85%) completed and returned the questionnaire The frequency of SUI reported in the preceding four weeks was as follows: 'never' 32%, 'occasionally' 28%, 'sometimes' 26%, 'often' 10% and 'all the time' 5%. Prevalence of severe SUI was lowest among nulliparous women (7%), but it was similar among parous women regardless of birth number (14-17%). The prevalence of severe SUI was not associated with mode of delivery (14% for women delivered by caesarean only vs 16% for vaginal births). Significant risk factors for severe SUI were high body mass index (BMI >30), diabetes mellitus, previous incontinence surgery, parity and first delivery under the age of 22 years. CONCLUSION: Previous pregnancy itself is a risk factor for severe SUI among women who reach the age of 50. In this age group the impact of the mode of delivery (spontaneous, forceps or caesarean) on severe SUI is slight.

Published
2005

23. Estimated number of women likely to benefit from bone mineral density measurement in France

Author

Nassira Amamra, Muriel Rabilloud, Francis Derriennic, Pierre Ducimetière, Claudine Berr, Marcel Goldberg, Cécile Delcourt, Françoise Clavel-Chapelon, Luc Letenneur, Pierre D. Delmas, Anne-Marie Schott, Pierre-Jean Meunier, Département d'information médicale, Hospices Civils de Lyon (HCL)-Université de Lyon, Recherches épidémiologiques en neurologie et psychopathologie, Institut National de la Santé et de la Recherche Médicale (INSERM), Epidémiologie des cancers, Epidémiologie des maladies chroniques et du vieillissement, Physiopathologie des Osteopathies Fragilisantes, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Recherches épidémiologiques et statistiques sur l'environnement et la santé., Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Epidémiologie cardiovasculaire et métabolique, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Epidémiologie, santé publique et environnement professionnel et général: méthodes et applications, Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Epidémiologie, santé publique et développement, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de biostatistique, Hospices Civils de Lyon (HCL), Université de Lyon, This study was funded by the National Health Agency (Direction Générale de la Santé)., Biostatistiques santé, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), and Clavel-Chapelon, F.

Subjects
Gerontology, MESH: Menopause, Osteoporosis, Medical Records, Body Mass Index, Fractures, Bone, Absorptiometry, Photon, 0302 clinical medicine, Bone Density, MESH: Risk Factors, Prevalence, 030212 general & internal medicine, MESH: Bone Density, 2. Zero hunger, Bone mineral, education.field_of_study, MESH: Middle Aged, Age Factors, Middle Aged, MESH: Mothers, 3. Good health, Menopause, medicine.anatomical_structure, Female, France, Femoral Fractures, Cohort study, MESH: Osteoporosis, MESH: Medical Records, [SDV.OT]Life Sciences [q-bio]/Other [q-bio.OT], Population, Mothers, MESH: Femoral Fractures, MESH: Drug Administration Schedule, Drug Administration Schedule, MESH: Body Mass Index, 03 medical and health sciences, MESH: Densitometry, X-Ray, Rheumatology, medicine, Bone mineral density, Humans, Risk factor, Absorptiometry, education, Glucocorticoids, MESH: Prevalence, Femoral neck, 030203 arthritis & rheumatology, MESH: Age Factors, MESH: Humans, business.industry, MESH: Fractures, Bone, medicine.disease, MESH: France, Risk factors, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Glucocorticoids, Body mass index, MESH: Female, Demography
Abstract

International audience; OBJECTIVES: To determine the number of women in France at least 50 years of age with risk factors for osteoporosis likely to lead to bone mineral density measurement, an investigation reimbursed by the French national health insurance system in patients at risk for osteoporosis. The study was commissioned by the French health authorities. MATERIALS AND METHODS: Risk factors for osteoporosis were defined as recommended by the French Agency for Accreditation and Evaluation in Health (ANAES) in 2001. The study data were from nine cohort studies done in France and from the National Health Insurance Agency for the Rhone-Alpes region of France. Risk factor prevalences in France were standardized by extrapolation according to the age distribution in France. RESULTS: Overall, data were collected in 123,986 women aged 50 years or older. From these data, risk factor estimates were as follows: menopause before 40 years of age, 1.5 million women; body mass index (BMI) lower than 19 kg/m(2), nearly 700,000; history of fracture, more than 2 million; history of femoral neck fracture in the mother, more than 1 million; history of health problems potentially responsible for osteoporosis, 400,000; and history of long-term glucocorticoid therapy, 612,000. In all, 3,186,318 (30%) women were estimated to have at least one risk factor and 785,512 (7.5%) at least two risk factors. CONCLUSIONS: Although our study sample was not representative of the population residing in France, the large sample size and diversity of data sources support the validity of our estimate of the prevalence of risk factors for osteoporosis in postmenopausal women living in France.

Published
2004

24. [Hormone replacement therapy in menopause and risk of breast cancer]

Author

Fournier, Agnès, Hill, Catherine, Clavel-Chapelon, Françoise, Nutrition, hormones et cancer: épidémiologie et prévention (E3N), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de biostatistique et d'épidémiologie (SBE), Direction de la recherche clinique [Gustave Roussy], Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), Clavel-Chapelon, F., and Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Gustave Roussy (IGR)-Université Paris-Sud - Paris 11 (UP11)

Subjects
Risk, MESH: Menopause, menopause, MESH: Meta-Analysis, Breast Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, breast cancer, [SDV.CAN] Life Sciences [q-bio]/Cancer, Meta-Analysis as Topic, Humans, Aged, Randomized Controlled Trials as Topic, MESH: Aged, MESH: Risk, MESH: Humans, MESH: Middle Aged, MESH: Hormone Replacement Therapy, Estrogen Replacement Therapy, MESH: Randomized Controlled Trials, progestogens, Middle Aged, MESH: Estrogen Replacement Therapy, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, hormone replacement therapy, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Female, MESH: Breast Neoplasms, estrogens
Abstract

Many studies have analysed the relation between hormone replacement therapy use and breast cancer risk. We performed a synthesis of their results based on a meta-analysis published in 1997, on fifteen observational studies published afterwards, and on a recent randomised trial. The accumulated evidence shows a higher risk of breast cancer among HRT ever users compared to non users. The risk increases with treatment duration and disappears a few years after the end of the treatment. Furthermore, recent observational studies showed that this risk may be higher when progestational agents are added to estrogens than when estrogens are used alone. This may be important in terms of public health since combination therapy with estrogen and progestational agents have become the standard of care among women with an intact uterus and are now commonly used. The effects of the treatments used in France, that are not those widely studied until now, must be evaluated, ideally through a randomized trial.

Published
2003

25. [Deep venous thrombosis: epidemiology, acquired risk factors]

Author

Oger, Emmanuel, Lacut, Karine, Scarabin, Pierre-Yves, Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO), Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), and Calvez, Ghislaine

Subjects
Adult, Male, MESH: Menopause, Hormone Replacement Therapy, MESH: Phlebography, Sex Factors, MESH: Pregnancy, MESH: Aged, 80 and over, MESH: Sex Factors, Pregnancy, Risk Factors, MESH: Risk Factors, MESH: Thrombophlebitis, Humans, MESH: Obesity, Obesity, MESH: Incidence, Aged, Aged, 80 and over, Venous Thrombosis, MESH: Age Factors, MESH: Aged, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, MESH: Middle Aged, MESH: Humans, Incidence, MESH: Hormone Replacement Therapy, Age Factors, MESH: Adult, Phlebography, Middle Aged, Thrombophlebitis, MESH: Case-Control Studies, MESH: Male, Case-Control Studies, MESH: Venous Thrombosis, Female, Menopause, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Deep vein thrombosis is a frequent disease with an annual incidence reaching 5 per thousand among subjects over 75 years. Major acquired risk factors for venous thrombosis include surgery, neoplasm, reduced mobility or paresis, and a previous episode of deep vein thrombosis. Among women, hormonal status (pregnancy, oral contraceptive, hormone replacement therapy) is responsible for the majority of all venous thrombotic events. The impact of other factors is controversial: obesity, tobacco use and varicose veins. Venous thrombosis is a multifactorial disease and analysis of the interactions between acquired and inherited risk factors is an extremely interesting field of investigation.

Published
2002

26. Impact des facteurs biologiques et socioculturels sur l’âge à la ménopause en France

Author

Vernazza-Licht, Nicole, Bley, Daniel, Ringa, Virginie, Varnoux, Noëlle, Études des Structures, des Processus d’Adaptation et des Changements de l’Espace (ESPACE ), Université de la Méditerranée - Aix-Marseille 2-Université de Provence - Aix-Marseille 1-Avignon Université (AU)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nice Sophia-Antipolis (UNSA), Aménagement, Développement, Environnement, Santé et Sociétés (ADES), Centre National de la Recherche Scientifique (CNRS)-Université Bordeaux Segalen - Bordeaux 2-Université Bordeaux Montaigne, Santé reproductive, sexualité, infection à VIH - épidémiologie, démographie, sciences sociales, Institut national d'études démographiques (INED)-Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), GUERCI A., CONSIGLIERE S. (ss.d), Université Bordeaux Segalen - Bordeaux 2-Université Bordeaux Montaigne (UBM)-Centre National de la Recherche Scientifique (CNRS), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), and VERNAZZA, Nicole

Subjects
[SDV]Life Sciences [q-bio], anthropologie biologique, [SHS.ANTHRO-BIO]Humanities and Social Sciences/Biological anthropology, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, [SHS]Humanities and Social Sciences, genre, facteurs biologiques, Ménopause, déterminants âge à la ménopause, santé, [SDV.BDLR] Life Sciences [q-bio]/Reproductive Biology, ComputingMilieux_MISCELLANEOUS, [SHS.ANTHRO-SE] Humanities and Social Sciences/Social Anthropology and ethnology, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, âge à la ménopause, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, [SHS.ANTHRO-SE]Humanities and Social Sciences/Social Anthropology and ethnology, environnement, [SHS.ANTHRO-BIO] Humanities and Social Sciences/Biological anthropology, anthropologie, [SDV] Life Sciences [q-bio], [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, cohorte gazel, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, facteurs culturels, MESH: ménopause, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, [SHS] Humanities and Social Sciences, santé reproductive, France, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, femmes
Abstract

International audience

Published
2002

27. [Hormone replacement therapy in menopause and risk of breast cancer]

Author

Clavel-Chapelon , Françoise, Hill , Catherine, Epidémiologie des cancers, Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut Gustave Roussy ( IGR ), Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Gustave Roussy (IGR), and Clavel-Chapelon, F.

Subjects
Time Factors, MESH: Menopause, MESH: Lymphatic Metastasis, MESH : Risk, MESH : Aged, MESH : Breast Neoplasms, MESH: Estrogens, Body Mass Index, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, Cohort Studies, MESH: Risk Factors, Risk Factors, MESH : Female, MESH : Progestins, MESH: Cohort Studies, [ SDV.MHEP.GEO ] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, MESH: Aged, MESH: Middle Aged, MESH: Risk, MESH : Estrogen Replacement Therapy, MESH: Hormone Replacement Therapy, Estrogen Replacement Therapy, MESH : Menopause, MESH : Lymphatic Metastasis, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Follow-Up Studies, Middle Aged, MESH : Adult, MESH : Maternal Age, MESH: Case-Control Studies, MESH : Risk Factors, Parity, enquête épidémiologique, Lymphatic Metastasis, Drug Therapy, Combination, Female, Menopause, Maternal Age, MESH : Time Factors, Adult, Risk, MESH : Case-Control Studies, Hormone Replacement Therapy, MESH: Meta-Analysis, MESH : Cohort Studies, [SDV.CAN]Life Sciences [q-bio]/Cancer, Breast Neoplasms, MESH : Hormone Replacement Therapy, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, MESH: Body Mass Index, [SDV.CAN] Life Sciences [q-bio]/Cancer, Meta-Analysis as Topic, Humans, MESH : Middle Aged, MESH : Parity, Aged, MESH: Humans, cancer du sein, MESH : Drug Therapy, Combination, MESH: Parity, MESH: Time Factors, MESH : Humans, ménopause, MESH: Adult, Estrogens, MESH : Follow-Up Studies, Traitement hormonal substitutif, MESH: Estrogen Replacement Therapy, MESH : Meta-Analysis, MESH: Drug Therapy, Combination, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, MESH : Body Mass Index, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Case-Control Studies, MESH: Progestins, MESH: Maternal Age, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Estrogens, Progestins, MESH: Female, MESH: Breast Neoplasms, Follow-Up Studies
Abstract

International audience; OBJECTIVES: Many epidemiological studies have analysed the relation between hormonal replacement therapy and risk of breast cancer. We present here a synthesis of the available results. MATERIAL AND METHODS: In 1997, a meta-analysis synthesised 90% of the data available at the time, obtained from 15 cohort and 36 case-control studies. This meta-analysis collected 53,000 breast cancers, 22% of these breast cancers having been observed in cohort studies. Since the publication of this meta-analysis, six studies totalling 8,000 cases (32% from cohort studies) have been published: two of these studies were partially included in the meta-analysis and the other four provided entirely new data. RESULTS: The conclusion, based on the available evidence, is that the risk of breast cancer diagnosis is higher among women who have used hormonal replacement therapy than among women who have not. The risk increases with treatment duration, is reduced when treatment is stopped and disappears almost completely a few years (5 in the meta-analysis) after the end of the treatment. The increase in the risk of breast cancer may be larger with estrogen-progestogen therapy than with estrogen alone. What are the consequences in terms of public health? From the results of the meta-analysis, one can estimate that the use of replacement therapy for 10 years between age 50 and 60 by 1,000 women will lead to the diagnosis of 6 extra breast cancers. This corresponds to the observation of 69 cases per 1,000 treated women after 20 years follow-up, as compared to the 63 cases expected among 1,000 untreated women. DISCUSSION: These results require confirmation. The observed increase in the risk of breast cancer is open to biases, particularly to a screening bias if women receiving hormonal replacement therapy have a more intensive surveillance than other women. Overall, the total number of women, across studies, who have received estrogen-progestogen therapy is small and their treatment was usually a combination of natural estrogens and medroxy progesterone acetate; therefore, the long term consequences of the treatments commonly used in France (synthetic estrogens and a variety of progestogens) have not been evaluated, this evaluation is much needed. CONCLUSION: What is needed is a global view of the risks and benefits of hormonal replacement therapy, and more epidemiologic data are required to reach this goal. In the present state of knowledge, the moderate excess risk of breast cancer observed does not justify a change in medical practice, neither in the selection of women to whom hormonal replacement therapy should be offered nor in the duration of their treatment.

Published
2000

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