Background Estrogen influences susceptibility to migraine attacks and it has been suggested to affect jealousy in romantic relationships in women. Therefore, we hypothesized that migraine women may... Show moreBackground Estrogen influences susceptibility to migraine attacks and it has been suggested to affect jealousy in romantic relationships in women. Therefore, we hypothesized that migraine women may be more jealous. Methods Jealousy levels and hormonal status were determined based on a cross-sectional, web-based, questionnaire study among female migraine patients and controls. A random sample of participants was selected from a validated migraine database. Participants with a serious and intimate monogamous relationship were included (n = 498) and divided into the following subgroups: menstrual migraine (n = 167), non-menstrual migraine (n = 103), postmenopausal migraine (n = 117), and premenopausal (n = 57) and postmenopausal (n = 54) controls. The primary outcome was the difference in mean jealousy levels between patients with menstrual migraine, non-menstrual migraine and premenopausal controls. Results were analyzed with a generalized linear model adjusting for age, relationship duration and hormonal status (including oral contraceptive use). Additionally, the difference in jealousy levels between postmenopausal migraine patients and controls was assessed. Previous research was replicated by evaluating the effect of combined oral contraceptives on jealousy. Results Jealousy levels were higher in menstrual migraine patients compared to controls (mean difference +/- SE: 3.87 +/- 1.09, p = 0.001), and non-menstrual migraine patients compared to controls (4.98 +/- 1.18, p < 0.001). No difference in jealousy was found between postmenopausal migraine patients and controls (- 0.32 +/- 1.24, p = 0.798). Women using combined oral contraceptives were more jealous compared to non-users with a regular menstrual cycle (2.32 +/- 1.03, p = 0.025). Conclusion Young women with migraine are more jealous within a romantic partnership. Show less
Atrial fibrillation (AF) is the clinically most prevalent rhythm disorder with large impact on quality of life and increased risk for hospitalizations and mortality in both men and women. In recent... Show moreAtrial fibrillation (AF) is the clinically most prevalent rhythm disorder with large impact on quality of life and increased risk for hospitalizations and mortality in both men and women. In recent years, knowledge regarding epidemiology, risk factors, and patho-physiological mechanisms of AF has greatly increased. Sex differences have been identified in the prevalence, clinical presentation, associated comorbidities, and therapy outcomes of AF. Although it is known that age-related prevalence of AF is lower in women than in men, women have worse and often atypical symptoms and worse quality of life as well as a higher risk for adverse events such as stroke and death associated with AF. In this review, we evaluate what is known about sex differences in AF mechanisms-covering structural, electrophysiological, and hormonal factors-and underscore areas of knowledge gaps for future studies. Increasing our understanding of mechanisms accounting for these sex differences in AF is important both for prognostic purposes and the optimization of (targeted, mechanism-based, and sex-specific) therapeutic approaches. Show less
Growth disorders are a major concern for patients, their parents, and health care professionals. our understanding of growth failure in the presence of normal GH secretion remains primitive,... Show moreGrowth disorders are a major concern for patients, their parents, and health care professionals. our understanding of growth failure in the presence of normal GH secretion remains primitive, hampering the development of new treatment strategies for children with short stature. Final height gain in currently available therapeutic regimens is restricted by rapid progression of pubertal development and the associated acceleration of growth plate fusion. Both an intact GH-Insulin-like growth factor I (IGF-I) system and estrogen signaling are of pivotal importance for normal growth. Regulation of normal growth is presumably based on the coordinated interplay between these systems, but the underlying molecular mechanisms are poorly understood. The aims of the work described in this thesis were: (1) to increase the understanding of the roles of GH, IGF-I and estrogen in growth plate biology, using a model system of fetal human mesenchymal stem cells (fhMSC) that are able to differentiate along the chondrogenic lineage in a similar fashion as occurs in the growth plate during growth; (2) to explore potential growth-promoting treatment strategies for children with idiopathic short stature (ISS) as an alternative for currently used growth hormone treatment regimens. Show less
Estrogen is known to play an important role in longitudinal bone growth and growth plate maturation, but the mechanism by which estrogens exert their effect is not fully understood. In this thesis... Show moreEstrogen is known to play an important role in longitudinal bone growth and growth plate maturation, but the mechanism by which estrogens exert their effect is not fully understood. In this thesis this role is further explored. Chapter 1 contains a general introduction to longitudinal bone growth and the regulation of the growth plate in respect to relevant topics further studied in this thesis. Estrogen can act through a genomic or a nongenomic pathway. Both pathways are explored in rats at the onset of maturation in chapter 2. Estrogen stimulates VEGF expression in uterus and bone, which is an important growth factor for chondrocyte differentiation and chondrocytes survival in the growth plate. In chapter 3 the effect of estrogen on VEGF expression in the growth plate was studied in the rat and human growth plate. Another effect of estrogen is that it accelerates growth plate senescence. Senescence is one of the postulated intrinsic mechanisms by which the growth plate matures and finally fuses. In chapter 4 we investigated senescence in relation to proliferation, by investigating a cell cycle inhibitor p27Kip1. In animal models, catch-up growth is suggested to be caused by delayed growth plate senescence. In chapter 5 this hypothesis was further tested in humans. With puberty estrogen levels increase, the growth plate matures and at the end growth ceases with epiphyseal fusion through mechanisms not yet completely understood. In order to further explore growth plate maturation we subjected two growth plate tissues of the same patient, but with one year and one pubertal Tanner stage in between, to microarray analyses. Gene expression patterns and transcription factor binding sides in relation to pubertal maturation were studied in a longitudinal study within this single patient in chapter 6. In addition, we collected extra prepubertal and pubertal growth plate tissues and studied these samples with microarray techniques as well in chapter 7. In chapter 8 the process of epiphyseal fusion and apoptosis was studied in human growth plates. Animal models are frequently used but not fully representative for the human growth plate. Therefore we investigated a promising human in vitro model with multipotent mesenchymal stem cells (MSCs) that can differentiate into chondrocytes. MSCs can be isolated from various tissues. In chapter 9 we investigated the chondrogenic potential of MSCs from different origins and in chapter 10 we compared this model with the epiphyseal growth plate by analyzing gene expression patterns and pathways with micro-array analyses. Chapter 11 contains general conclusions and a discussion regarding the results. Show less
This thesis centers on the mechanisms of estrogen action and the effects on the development of atherosclerosis. We have focused on the liver as central organ in lipid and glucose metabolism and the... Show moreThis thesis centers on the mechanisms of estrogen action and the effects on the development of atherosclerosis. We have focused on the liver as central organ in lipid and glucose metabolism and the vessel wall as the actual site where the injury occurs. To gain insight in tissue-specific actions of estrogens, we have spent considerable effort to develop tools for liver and blood vessel specific modulation of the estrogen receptor (ER) signaling cascade. The generation, characterization and application of these tools in vitro and in vivo will be described in the different chapters of this thesis. Show less
