Limitations of follicle-stimulating hormone in assessing menopause status: findings from the National Health and Nutrition Examination Survey (NHANES 1999-2000)*

Henrich, Janet B.; Hughes, Jeffery P.; Kaufman, Steven C.; Brody, Debra J.; Curtin, Lester R.

doi:10.1097/01.gme.0000198489.49618.96

Cited by 40 publications

(25 citation statements)

References 19 publications

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“…Although an FSH level of 40 IU/L was strongly associated with the occurrence of these markers, this FSH level was similarly associated with occurrence of bleeding markers of the late menopausal transition (33). A recent publication from the cross-sectional population based National Health and Nutrition Study reported a geometric mean FSH value of 21.4 mIU/mL for women identified as being in transition (34). Additional studies of the association of bleeding criteria with other biologic markers of ovarian reserve such as inhibin and anti-mullerian hormone (14,28,31, 32 35,36) are needed.…”

Section: Discussionmentioning

confidence: 97%

The ReSTAGE Collaboration: defining optimal bleeding criteria for onset of early menopausal transition

Harlow

Mitchell

Crawford

et al. 2008

Fertility and Sterility

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Study objective-Criteria for staging the menopausal transition are not established. This paper evaluates five bleeding criteria for defining early transition and provides empirically-based guidance regarding optimal criteria. Main outcome measure(s)-Age at and time to menopause for: standard deviation >6 and >8 days, persistent difference in consecutive segments >6 days, irregularity, and >=45 day segment. Serum follicle stimulating hormone concentration.Results-Most women experienced each of the bleeding criteria. Except for persistent >6 day difference which occurs earlier, the criteria occur at a similar age and at approximately the same age as late transition in a large proportion of women. FSH was associated with all proposed markers.Conclusions-The early transition may be best described by ovarian activity consistent with the persistent >6 day difference, but further study is needed, as other proposed criterion are consistent with later menstrual changes.

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Section: Discussionmentioning

confidence: 97%

The ReSTAGE Collaboration: defining optimal bleeding criteria for onset of early menopausal transition

Harlow

Mitchell

Crawford

et al. 2008

Fertility and Sterility

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“…We included women who had follicle-stimulating hormone (FSH) levels >45 (IU/L) (38,39) and did not have a period in the previous 12 months or had surgical menopause (hysterectomy and bilateral oophorectomy). Women who had missing RHQ data or reported hysterectomy only were included if they were over 50 years of age with FSH levels >45 (IU/L).…”

Section: Design and Settingmentioning

confidence: 99%

“…Women who had missing RHQ data or reported hysterectomy only were included if they were over 50 years of age with FSH levels >45 (IU/L). (38,39) We excluded those who reported a liver condition, had serum concentrations of alkaline phosphatase >283 (U/L), aspartate aminotransferase >83 (U/L), alanine transaminase >75(U/L), (40) reported weak or failing kidneys, or had serum creatinine concentrations >2.74 (mg/dL). (41) Women with missing data for inclusion or exclusion criteria, or both outcome variables were excluded from our study sample.…”

Section: Design and Settingmentioning

confidence: 99%

Effects of vitamin E on bone turnover markers among US postmenopausal women

Hamidi

Corey

Cheung

2012

Journal of Bone and Mineral Research

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Increased oxidative stress and inflammation resulting from aging and declining estrogen levels can lead to increased bone loss in postmenopausal women. Alpha-tocopherol and gamma-tocopherol, the two predominant isomers of vitamin E, have antioxidant and anti-inflammatory properties, but their effects on bone metabolism have not been well studied in humans. We examined the associations between dietary and total (diet and supplements) alpha-tocopherol intake, serum alpha-tocopherol and gamma-tocopherol levels and their ratio, and bone turnover markers (BTMs) among postmenopausal women aged !45 years. We used cross-sectional data from the National Health and Nutrition Examination Survey 1999-2002. Multiple regression models with adjustments for relevant confounders were used to examine the associations between intake and serum levels of tocopherols, and serum bone-specific alkaline phosphatase (BAP), a biomarker of bone formation, and urinary N-telopeptides/creatinine (uNTx/Cr), a biomarker of bone resorption. The study sample included 497 postmenopausal women who were not taking estrogen, steroids, or osteoporosis medications, were free from kidney and liver disease, cancer, and rheumatoid arthritis, and were fasting >9 hours prior to examination. Participants had a mean age of 65.5 AE 0.6 years and over 45% used vitamin E (alpha-tocopherol) supplements in the past month. Vitamin E supplement users had significantly lower serum gamma-tocopherol, higher serum alpha-tocopherol levels, and higher ratio of serum alpha-tocopherol to gamma-tocopherol than nonusers. High serum gamma-tocopherol levels and low ratio of serum alpha-tocopherol to gamma-tocopherol were associated with increased BAP levels (p < 0.01 for both). There were no associations between any of the vitamin E variables and uNTx/Cr. In conclusion, we hypothesize that gamma-tocopherol may uncouple bone turnover, resulting in more bone formation than resorption. Vitamin E supplements in the form of alpha-tocopherol suppress serum gamma-tocopherol levels and may have negative effects on bone formation. Further research is needed to investigate the potential anabolic effect of gamma-tocopherol from food sources on bone. ß

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“…In addition, postmenopausal status was defined by amenorrheaforatleast12monthsbutnolongerthan5years,andplasma FSHlevelsgreaterthan30-40IU/l (NorthAmericanMenopauseSociety, 2000). In this regard, Henrich et al [23] have already shown the existenceofaconsiderableoverlapamongdistributionsofFSHbystageon arepresentativesampleof576USwomenaged35-60yearsexamined during the National Health and Nutrition Examination Survey (NHANES)1999-2000.Indeed,FSHcut-offpointsbetweenthereproductiveandmenopausetransitionstagesaswellasbetweenthemenopausetransitionandpostmenopausalstageswereneithersensitivenor veryspecific,thusemphasizingthatFSHlevelshadlimitedutilityindiscriminatingamongwomenindifferentstages.Althoughthephysiologicalandclinicalmanifestationsoftransitiontomenopausearestillnotwell understood, perimenopause, a time of menstrual irregularity lasting between2and8years [24][25][26],seemstooccurinstages.Duringperimenopause,FSHconcentrationsmayraisetothepostmenopauserangeduring some cycles, but return to premenopausal levels during subsequent cycles.AsFSHlevelsalsofluctuatefrommonthtomonthduringthisphase [24,25],theperimenopausalstatuscannotthusbeclearlyestablished.Itis the reason why perimenopausal women with irregular menses were excludedfromourstudy.AccordingtotheStagesofReproductiveAging Workshop (STRAW), late premenopausal (e.g. reproductive) stage referstowomenwithregularmenstrualcyclesassociatedwitheithernormalorslightlyincreasedplasmaFSHlevels [27].Finally,premenopausal women using oral contraceptives and postmenopausal women on HT wereexcludedfromthepresentstudy(table1).…”

Section: Subjectsmentioning

confidence: 99%

Impact of Walking on Adipose Tissue Lipoprotein Lipase Activity and Expression in Pre- and Postmenopausal Women

Tessier

Riesco²,

Lacaille³

et al. 2010

Obes Facts

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Objective: The aim of this study was to examine regional variation in adipose tissue lipoprotein lipase (AT-LPL) activity and expression in pre-and postmenopausal women, before and after training, once differences in chronological age or obesity degree are taken into account. Methods: Sixteen late pre- and 14 early postmenopausal (49 ± 2 vs. 52 ± 2 years; p < 0.001) moderately obese women (body mass index 29–35 kg/m²) were subjected to a 16-week walking program (3 sessions/week of 45 min at 60% heart rate reserve). Abdominal and femoral AT-LPL activity and expression, fasting lipidlipoprotein profile, body composition, and cardiorespiratory fitness (CRF) were measured before and after our intervention. Statistical analyses were performed using covariance analysis for age differences. Results: AT-LPL activity and expression, lipid-lipoprotein metabolism, body fatness, and CRF were similar at baseline, irrespective of the group considered. Slight reductions in plasma cholesterol and high-density lipoprotein (HDL) cholesterol levels, fat mass and waist girth reductions, CRF increases as well as femoral AT-LPL activity and expression decreases after our intervention were comparable, regardless of menopausal status (0.0001 < p < 0.05). Conclusions: Lipid storage is decreased in the femoral depot after walking, regardless of menopausal status. Reduction in AT-LPL activity or expression does not lead to a more deleterious lipid-lipoprotein profile, despite the modest decrease noted in HDL cholesterol concentrations.

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Limitations of follicle-stimulating hormone in assessing menopause status: findings from the National Health and Nutrition Examination Survey (NHANES 1999-2000)*

Abstract: Age and reproductive stage are the most important determinants of FSH levels in US women; however, FSH by itself has limited utility in distinguishing among women in different reproductive stages.

Cited by 40 publications

References 19 publications

The ReSTAGE Collaboration: defining optimal bleeding criteria for onset of early menopausal transition

The ReSTAGE Collaboration: defining optimal bleeding criteria for onset of early menopausal transition

Effects of vitamin E on bone turnover markers among US postmenopausal women

Impact of Walking on Adipose Tissue Lipoprotein Lipase Activity and Expression in Pre- and Postmenopausal Women

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