Age and menopausal status are important factors influencing the serum human epididymis secretory protein 4 level:a prospective cross-sectional study in healthy Chinese people

Background::Human epididymis secretory protein 4(HE4)is a new ovarian cancer biomarker.The factors influencing HE4 levels are not clear,and the reference data in China are limited.Here,we aim to evaluate the effects of menopause and age on HE4 levels and to provide a possible reference value for HE4 in healthy Chinese people.Methods::A total of 2493 healthy females aged 40 years or older were recruited from March 2013 to March 2017 with the cooperation of four medical institutions across Beijing,China.The serum levels of HE4 and cancer antigen 125(CA125)were measured by enzyme-linked immunosorbent assay.The Wilcoxon rank-sum test of variance and a stratified analysis were used to analyze the relationships among age,menopausal status,and levels of HE4 or CA125.Confidence intervals(5%-95%)were determined for reference ranges in different populations.Results::There was a statistically significant difference in median HE4 levels between the post-menopausal(n=2168)and premenopausal groups(n=325)(36.46 vs.24.04 pmol/L,Z=-14.41,P<0.001).HE4 increased significantly with age in the post-menopausal groups(H=408.18,P<0.001)but not in the pre-menopausal subjects(Z=-0.43,P=0.67).The upper 95th percentile of HE4 levels were 44.63 pmol/L for pre-menopausal women,78.17 pmol/L for post-menopausal women,and 73.3 pmol/L for all women.In the post-menopausal population,the HE4 reference ranges were 13.15 to 47.31,14.31 to 58.04,17.06 to 73.51,24.50 to 115.25,and 35.71 to 212.37 pmol/L for different age groups from forty divided by decade.The CA125 level was affected mainly by menopausal status and not age.Conclusions::Menopausal status and age were both important factors influencing the level of HE4,and age affected HE4 levels mainly in post-menopausal women.The HE4 level was higher in the post-menopausal population than in the pre-menopausal population and increased with age.

Metabolic Abnormalities and Metabolic Syndrome among Cameroonian Women: Comparative Study between Pre- and Post-Menopausal Women

The high prevalence of non-communicable diseases is a challenging problem in the Cameroonian population and women are the most affected. The aim of the present study was to determine and compare the prevalence of metabolic abnormalities and metabolic syndrome (MetS) among pre- and post-men- opausal women living in urban areas in Cameroon. A total of 499 women were recruited during a mass health campaign in 2018. Metabolic abnormalities were diagnosed using International Diabetes Federation (IDF) criteria. MetS was defined using IDF criteria with slight modification (total cholesterol used instead of HDL cholesterol). Logistic regression was used to estimate the association between menopausal status and metabolic abnormalities and MetS in age control and non-control models. The prevalence of high waist- to-hip ratio (56.8% vs 36.3%, p < 0.001), elevated fasting blood glucose (glycemia ≥ 100 mg/dL) (38.7% vs 26.9%, p = 0.006);diabetes (14.6% vs 5.7%, p = 0.001);high triglycerides level (29.7% vs 17.1%, p = 0.002);hyperlipidemia (high total cholesterol and or triglycerides levels) (45.0% vs 30.8%, p = 0.002);and elevated blood pressure (67.9% vs 56.1%, p = 0.007) were higher among post-menopausal than pre-menopausal women. The overall prevalence of MetS was 30.1% and post-menopausal women were more affected (33.8% vs 25.0%;p = 0.034). The odds ratio of MetS was 1.888 (95% CI: 1.016 - 3.507) when age was covariate, but was slightly reduced without age control (OR = 1.532;95% CI: 1.031 - 2.275). Metabolic abnormalities seem to be a major health problem among Cameroonian women and menopausal status increased the risk of developing a cardiovascular event.