Gravidity is not associated with telomere length in a biracial cohort of middle-aged women: The Coronary Artery Risk Development in Young Adults (CARDIA) study

<div><p>Objective</p><p>Having experienced 2–3 births is associated with reduced mortality versus women with <2 or ≥4 births. The effect of 2–3 births on lifespan may be associated with delayed cellular aging. We hypothesized telomere length, a marker of cellular aging, would be longer in women who had 2–3 pregnancies.</p><p>Methods</p><p>Leukocyte telomere length was measured using quantitative real-time polymerase chain reaction in 620 women in CARDIA at the year 15 and 20 exams, expressed as the ratio of telomere repeat copy number to single-copy gene copy number (<i>T</i>/<i>S</i>). Number of pregnancies at the time of telomere length measurement was obtained (mean age = 41±0.1 years, average gravidity = 2.64±0.1 pregnancies). Participants were divided into 4 groups by number of pregnancies: 0, 1, 2–3, and ≥4, to test for differences in telomere length by gravidity group.</p><p>Results</p><p>The mean and SD for telomere length was 0.98 ± 0.20 <i>T/S</i> in the whole cohort. There were no differences in mean telomere length between groups; 0.98±0.02 <i>T/S</i> in women with 0 pregnancies, 1.01±0.02 <i>T/S</i> in women with 1 pregnancy, 0.97±0.01 <i>T/S</i> in women with 2–3 pregnancies, and 0.99±0.02 <i>T/S</i> in women with ≥4 pregnancies (p = 0.51). We defined high-risk (shorter) telomere length as ≤25^th percentile, and low-risk (longer) telomere length as ≥75 percentile. There were no differences in the prevalence of high-risk or low-risk telomere length between gravidity groups.</p><p>Conclusions</p><p>Gravidity was not associated with telomere length in early middle age; the protective association of 2–3 births may act through other mechanisms.</p></div

Association between Sleep Quality and C-Reactive Protein: Results from National Health and Nutrition Examination Survey, 2005-2008

<div><p>Objective</p><p>Our objective was to explore the association between poor sleep quality and hs_CRP in an adult U.S. population.</p><p>Methods</p><p>This study focused on 9,317 participants in the National Health and Nutrition Examination Survey (NHANES) from 2005–2008 who were aged 20–85 years, completed a sleep disorder questionnaire, and had available information on serum hs_CRP. Sleep quality was classified into three categories (good, moderate, poor) based on the responses of participants to the NHANES sleep disorder questionnaire. High CRP was defined as hs-CRP >1 md/dL. Linear regression model was applied to investigate the association between poor sleep quality and log-transformed hs_CRP. And logistic regression model was fitted to evaluate the association between sleep quality and the risk of high CRP.</p><p>Results</p><p>Females were more likely to report poor sleep quality than males (26% vs. 19%, p<0.0001). Each sleep disorder was significantly associated with increased hs_CRP and correlative to other sleep disorders. In fully-adjusted linear regression model, poor sleep quality was significantly associated with elevated hs_CRP (log transformed) among the overall sample and in females only (β = 0.10, se = 0.03, p<0.01 and β = 0.13, se = 0.04, p<0.01, respectively). In fully-adjusted logistics regression model, poor sleep quality was linked with risk of high CRP(OR: 1.42, 95%CI: 1.15–1.76 in overall sample and OR: 1.59, 95%CI: 1.18–2.14 in females, respectively).</p><p>Conclusion</p><p>We found that poor sleep quality was independently associated with elevated hs_CRP in females but not in males in a U.S. adult population.</p></div

Participant characteristics compared women not in sample.

<p>Participant characteristics compared women not in sample.</p

Telomere length (mean and 95% CI) by gravidity group in Caucasian and African-American women.

<p>There were no differences in unadjusted telomere length between gravidity groups in either race.</p

Association of sleep quality with hs-CRP stratified by gender and race/ethnicity.

<p>Model 1, adjusted for sex, age, smoking, drinking, estrogen/progestin use, statin use, education status, race/ethnicity, self-reported health status. Model 2, model 1 further adjusted for BMI. ^&p<0.001, ^#p<0.01.</p

Participant characteristics at time of telomere length measurement by gravidity group.

<p>Participant characteristics at time of telomere length measurement by gravidity group.</p

Selected adult population (20–85 yrs old) characteristics: NHANES, 2005–2008.

<p>Student's t-test was used to compare continuous variables, and x² was used to compare categorical variables between males and females. ^aweighted mean. ^bweighted percentage. ^cunderweight (BMI<18.5); normal weight (18.5≤BMI<25); overweight (25≤BMI<30); obese (BMI≥30).</p

Profile of sleep quality components in American Adults:NHANES 2005–2008.

<p>*score: 1 =  Never-4 times/month; 2 = 5–15 times/month; 3 = 16–30 times/month.</p><p>**Poor: at least one component meet scale 3; Moderate: at least one component meet scale 2; Good: no component meet scale 2 or 3.</p>#<p>chi-square test for frequency between genders.</p

Correlations of intraclass correlation coefficients (ICCs) with DNA methylation levels and genomic characteristics of the sequences analyzed.

<p>The panels show correlations of ICCs for each of the methylation biomarkers with content of guanosine and cytosine (G+C, panel A); ratio of observed/expected CpG dinucleotides (CpG o/e; panel B); distance of repeat elements from 3′ (panel C); distance of repeat elements from 5′ (panel D); DNA methylation mean on Day 1 (panel E); range of DNA methylation on Day 1 (panel F). The scatter plots use ICC values subtracted of pyrosequencing measurement errors (ICC₁) and estimated from models adjusted by PM₁₀ exposure levels, age, current smoking, and percent blood granulocytes. Each data point corresponds to the ICC₁ value for one biomarker, as indicated by the corresponding label.</p

Effect of cervical cancer education and provider recommendation for screening on screening rates: A systematic review and meta-analysis

<div><p>Background</p><p>Although cervical cancer is largely preventable through screening, detection and treatment of precancerous abnormalities, it remains one of the top causes of cancer-related morbidity and mortality globally.</p><p>Objectives</p><p>The objective of this systematic review is to understand the evidence of the effect of cervical cancer education compared to control conditions on cervical cancer screening rates in eligible women population at risk of cervical cancer. We also sought to understand the effect of provider recommendations for screening to eligible women on cervical cancer screening (CCS) rates compared to control conditions in eligible women population at risk of cervical cancer.</p><p>Methods</p><p>We used the PICO (Problem or Population, Interventions, Comparison and Outcome) framework as described in the Cochrane Collaboration Handbook to develop our search strategy. The details of our search strategy has been described in our systematic review protocol published in the International Prospective Register of systematic reviews (PROSPERO). The protocol registration number is CRD42016045605 available at: <a target="_blank">http://www.crd.york.ac.uk/prospero/display_record.asp?src=trip&ID=CRD42016045605</a>. The search string was used in Pubmed, Embase, Cochrane Systematic Reviews and Cochrane CENTRAL register of controlled trials to retrieve study reports that were screened for inclusion in this review. Our data synthesis and reporting was guided by the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). We did a qualitative synthesis of evidence and, where appropriate, individual study effects were pooled in meta-analyses using RevMan 5.3 Review Manager. The Higgins I² was used to assess for heterogeneity in studies pooled together for overall summary effects. We did assessment of risk of bias of individual studies included and assessed risk of publication bias across studies pooled together in meta-analysis by Funnel plot.</p><p>Results</p><p>Out of 3072 study reports screened, 28 articles were found to be eligible for inclusion in qualitative synthesis (5 of which were included in meta-analysis of educational interventions and 8 combined in meta-analysis of HPV self-sampling interventions), while 45 were excluded for various reasons. The use of theory-based educational interventions significantly increased CCS rates by more than double (OR, 2.46, 95% CI: 1.88, 3.21). Additionally, offering women the option of self-sampling for Human Papillomavirus (HPV) testing increased CCS rates by nearly 2-fold (OR = 1.71, 95% CI: 1.32, 2.22). We also found that invitation letters alone (or with a follow up phone contact), making an appointment, and sending reminders to patients who are due or overdue for screening had a significant effect on improving participation and CCS rates in populations at risk.</p><p>Conclusion</p><p>Our findings supports the implementation of theory-based cervical cancer educational interventions to increase women’s participation in cervical cancer screening programs, particularly when targeting communities with low literacy levels. Additionally, cervical cancer screening programs should consider the option of offering women the opportunity for self-sample collection particularly when such women have not responded to previous screening invitation or reminder letters for Pap smear collection as a method of screening.</p></div