Research and Clinical Studies

U.K. Scientists Find New Genes Linked to Hormonal Breast Cancer

U.K. scientists looked at the DNA of more than 100 women with estrogen receptor positive breast cancer and found three new genes—C6ORF96, C6ORF97 and C6ORF211—that appear to play a role in the disease. The study's lead author noted that the study in the journal PLoS Genetics could help shed light on hormonal breast cancer and lead to treatments for the condition. 

Brain Activity Linked to Food Addiction

Women with compulsive eating habits show brain activity patterns typically associated with drug or alcohol addiction, according to a study published in the Archives of General Psychiatry. The study included women who were lean, overweight, or obese, however, food addiction symptoms and brain responses to food were observed independent of weight.

Estrogen-only Therapy Less Risky Than First Thought

New research should help women better navigate the risks and benefits of hormone replacement therapy. The Women's Health Initiative had followed over 10,000 post-menopausal women with prior hysterectomy on either estrogen-only therapy or placebo, and was stopped early due to an increased risk of stroke. A study published in the Journal of the American Medical Association evaluated these women four years after they had ended therapy and found that the increased stroke risk disappeared after women stopped the estrogen pills. 

Like High Cholesterol, Overtime Work Boosts Heart Disease

A study of British civil service workers linked long work hours to a greater risk of coronary heart disease. The study suggests that the calculation of a person's risk for heart disease which currently involves age, gender, blood pressure, blood sugar, cholesterol and cigarette smoking might be more accurate if work hours are considered. Heart disease prevention should include a psychosocial component like stress management to minimize an individual's risk of heart disease. 

Graduate School Can Lower Your Blood Pressure

An analysis of nearly 4,000 patient records, published recently in BMC Public Health, shows that people with advanced degrees are more likely to have lower blood pressure than those who don't, and that this benefit is greater for women than men. Systolic blood pressure for women with 17 or more years of schooling was 3.26 mm Hg lower than in age-matched women who did not finish high school. A pronounced gender difference also suggested that education may have a greater impact on women's health over their lifetime, compared with the impact on men's health.

Clinical Research Still Neglects Some Gender Differences

Heart disease and other medical conditions vary greatly between women and men, but clinical research may not do enough to study these gender differences. Published in BMC Medicine, a research team examined almost 9000 medical research articles using a text-mining approach and showed a steady increase in clinical research incorporating gender-specific design and analysis, especially since the 1990s. However, the literature largely ignored gender-specific disparity in the area of clinical management, including potential differences in symptoms, diagnostic accuracy, referral practices, and therapy choices. The authors fear this research gap may lead to inequalities in health care and outcomes, if uncorrected.

Mouse Models Connect HRT and the Pill to Breast Cancer, and Suggest Possible Treatment

New research published in Nature points to why the synthetic sex hormones used in hormone replacement therapy and contraceptives increase the risk of breast cancer. A protein called RANKL, which regulates bone mass, is also expressed in mammary cells. Experiments in mice found that synthetic progestins bind to RANKL, triggering mammary cell division and inhibiting cell death, ultimately leading to breast tumors. A second Nature study demonstrated a potential 'antidote' to reduce the cancer risk associated with synthetic hormone use. Blocking RANKL with a monoclonal antibody, currently approved for treating osteoporosis, delayed mammary tumor formation and also reduced lung metastasis in mouse models.

Research Efforts Lessen the Burden of Disease and Reduces Deaths Among Women

A new progress report on women's health research from an Institute of Medicine panel found that, "A concerted effort to boost research on women's health over the last two decades has lessened the burden of disease and reduced deaths among women due to cardiovascular disease, breast cancer, and cervical cancer." The panel also found that "Overall, fewer gains have been made on chronic and debilitating conditions that cause significant suffering but have lower death rates, pointing to the need for researchers to give quality of life similar consideration as mortality for research attention. Moreover, barriers such as socio-economic and cultural influences still limit the potential reach and impact of research developments, especially among disadvantaged women."

Cardiac risk from calcium supplements

Calcium supplements\ are often prescribed for skeletal health, but a recent trial suggests they might increase rates of heart attack and cardiovascular events in otherwise healthy older women. According to a study published in the British Medical Journal which analyzed the results of eleven randomized controlled trials involving 12,000 patients, calcium supplements were associated with about a 30 percent increased risk of heart attack. Although the increase in risk is modest, the widespread use of calcium supplements may still translate that risk into a large disease burden in the population. Because calcium supplements only provide modest benefit on bone density and fracture prevention, the researchers argue that the role of calcium supplements in osteoporosis management should be reassessed.  

Severe Angina Triples Coronary Artery Disease Risk for Women

Coronary artery disease (CAD) is the leading cause of death in developed countries, but is still often viewed as a man's disease. Because women and men show different symptoms and risk factors for CAD, physicians need to decipher the most predictive factors to guide diagnosis and treatment. A retrospective Canadian study, published in the Journal of Internal Medicine, followed nearly 24,000 patients over six years and found that although chest pain is more common in men,  severe angina poses three times the risk for developing CAD in women. The study also showed that women at risk for CAD were more likely than men to have high blood pressure or diabetes, and less likely to smoke. 

Study of Early Ovarian Cancers May Lead to Screening Test

New research into the characteristics of early ovarian cancer may allow for screening tests to detect the disease sooner in women without symptoms. The study, published in PLoS ONE, examined ovaries removed from women with BRCA gene mutations, who have an increased risk of ovarian cancer. Researchers used microdissection and genetic assays to identify early tumors and precancerous cells, mainly located in ovarian surface structures called inclusion cysts. Knowing where to look and what to look for should help clinicians track down ovarian cancer at earlier stages, when treatments would be more effective.

New Way HIV Infects Women Discovered

Scientists have uncovered a mechanism to explain how HIV may cross through the lining of a woman's genital tract to establish infection without direct access to the blood stream. In a study published in PLoS Pathogens, researchers exposed cultures of mucosal epithelial cells to various strains of HIV-1, and observed an increase in the "leakiness" of the cell layers. Exposure to the virus's envelope glycoprotein alone also lowered the integrity of the epithelial lining by turning off gene expression of tight junction proteins. The virus could then squeeze through the "cracks" in the genital lining and infect target cells in the blood. As women are the fastest growing group of new HIV infections, understanding this unique transmission method may provide new drug targets for preventing HIV infection in women. 

Study Questions Whether Screening Really Cuts Breast Cancer Deaths

The British Medical Journal reported a study evaluating the success of mammography screening programs introduced in two regions of Denmark in the 1990's. Surprisingly, when compared with Danish regions without an organized breast cancer screening program, the screened regions showed no difference in mortality from breast cancer over a ten year period. The researchers suggest that improvements in breast cancer mortality are due to better treatments options, rather than increased use of mammograms.

Further Evidence Links Severity of H1N1 Influenza Symptoms to Pregnancy

A new study that followed the epidemiology the 2009 influenza pandemic in Australia and New Zealand confirmed that pregnancy was a significant risk factor for influenza-related complications. This population-based study was published in the British Medical Journal and supported reports from the U.S. that pregnant women, especially those in the second half of their pregnancy, were at a significantly greater risk of developing respiratory complications requiring hospitalization compared with their nonpregnant counterparts. None of the women who developed complications had been vaccinated against H1N1, so the protective effects of this vaccine could not be assessed. These findings once again remind pregnant women that they should seek immediate medical attention if they think they may have the flu.

Osteoporosis Drugs May Decrease Breast Cancer Risk

Women taking common bisphosphonate drugs like Fosamax or Boniva for osteoporosis may also be reducing their risk for breast cancer. In a population case-controlled study published in the British Journal of Cancer, researchers interviewed nearly 6,000 women and observed a 30 percent reduction in breast cancer risk in women taking osteoporosis medications. Bisphosphonates may exert their protective effects by promoting tumor cell death, inhibiting blood supply to tumors, or preventing the ability of cancer cells to stick to each other. The benefit appeared limited to women who were not obese, perhaps due to the elevated estrogen levels associated with a higher body mass index.  

NIH Panel Recommends Revised VBAC Guidelines

Women who have previously delivered a baby by cesarean may now have more choices for subsequent births. Since their peak in 1996, rates of VBAC (vaginal birth after cesarean) have declined by 15 percent, with fewer health care providers supporting the option due to risk of uterine rupture and medical malpractice concerns. This trend prompted an NIH panel to examine the risks and benefits of VBAC, versus planned repeat cesarean births, for women and their babies. Because trial of labor was relatively safe and is successful in nearly 75 percent of cases, the panel recommended that VBAC guidelines be revised to support the preferences of women at low risk for complications.

Keeping an Eye on Your Eggs

Many women are aware that the production and release of viable eggs, which develop from follicles, from their ovaries diminishes with age, further supported by a new mathematical model calculating ovarian follicle reserves. This model, published recently in PloS ONE, was developed through analysis of several histological studies of human ovaries, and included ovarian specimens that spanned a large age range from several weeks postconception to 51 years. This model showed that women have lost almost 90 percent of their prebirth follicles by age 30 and 97 percent by age 40, and the number of follicles recruited for maturation into eggs started to decline by age 14. This study is unique in its attempt to measure the number of follicles in ovaries from conception to menopause, and may support a deeper understanding of underlying causes of infertility.

Maternal Age May Be A Significant Factor in Likelihood of Autistic Offspring

Researchers at the University of California, Davis have conducted a 10-year study evaluating nearly 5 million births in California during the 1990s, and found evidence linking the mother's age at conception to the risk of developing autism in the child. The study found that mothers over the age of 40 had a 51 percent greater risk of having an autistic child compared with mothers between the ages of 25-29, and a 71 percent higher risk compared with mothers under 25 years old. An earlier study performed by Kaiser Permanente found that both the father and mother's ages correlated to the risk of autism. The current study provides evidence that having an older father plays a stronger role in increasing the odds of having an autistic child only when the mother is under 30 years old. The study states that in the past twenty years rates of autism have increased by 600 percent, however only 5 percent of that increase is due to older women having children. The researchers also point out that there are many other factors which may contribute to the development of autism, including exposure to potential environmental toxins.

Walking Your Way to Better Heart Health

Good news for those of us who enjoy a walk after a meal; even a slow walk can significantly reduce potentially dangerous increases in blood glucose. A Norwegian group reports this month in Applied Physiology, Nutrition, and Metabolism that even 15 minutes of slow walking can make a difference.  They had 14 healthy women over the age of 50 eat a bowl of cornflakes and then either do office work, or walk slowly for 15 or 40 minutes.  Blood glucose levels were measured before, during, and after the exercise. Walking after the meal lowered the blood glucose level and delayed the peak value, compared with remaining sedentary.  Since postprandial blood glucose elevation is a risk factor for development of cardiovascular disease and diabetes, this study gives scientific evidence for the health benefits of post-meal walking.  Another thing to add to our list of New Year's resolutions!  

Mass Media Portrayal of Heart Disease in Women

Heart disease has often been considered to be a more common threat to men than to women, which has lead to a skewed reporting of the disease by the mass media.  A recent review in Maturitas suggests that not only does the media play a part in pubic health care, but that dangerous consequences can occur when the public is ill-informed.  More women than men in the UK die from circulatory system diseases, and 37 percent of female deaths in the USA are due to coronary heart disease, stroke, or other cardiovascular diseases. However, women often do not seek immediate help when facing the symptoms of a heart attack because the symptoms are misunderstood, and women are more likely than men to die within a year of having a heart attack.  Research into cardiovascular disease has tended to focus on men, and this has lead to a gendered portrayal of the disease in the mass media.  The review concludes that there is a need for continued research into the causes and treatments of heart disease in women, and for increased media advocacy by organizations involved in women's heart disease such as the Red Dress Campaign

Extra Attention to Cholesterol During Menopause

Women going through menopause were studied and found that LDL cholesterol can increase by nearly 9 percent during this time. Vera Bittner MD, MSPH of the University of Alabama at Birmingham, noted that this change over time is cumulative. At risk women starting in higher range cholesterol levels may be severely affected and want to monitor their levels closely.