bluuebunny/crossref_metadata_2025_split huggingface dataset:
ODP414 Incidence of Suicidal Events in Transgender Patients with Initiation of Gender Affirming Hormone Therapy
Authors: Elliott Karma-Jaya , Grotzke Marissa 
Published: November 2022

Abstract

Objectives
Our study aims to evaluate objective markers of suicidal events to further evaluate the relationship between incidence of suicidal events and initiation of gender affirming hormone therapy (HT).

Introduction
Transgender individuals are at higher risk for suicide compared with non-transgender individuals. Previous studies have revealed that a much higher percentage (18–45%) of transgender persons have attempted suicide in their lifetime, compared with the general population (4.6%).

Methods
We performed a retrospective chart review of adults at the local Veterans Administration (VA) from January 1, 2008 to December 31, 2020 of patient charts that include ICD-9 and ICD-10 code of F64. X, transgender, male-to-female transgender, female-to-male transgender, gender dysphoria, gender identity disorder, non-binary. Charts were reviewed for incidences of suicidal events defined as requiring hospitalizations, mental health crisis interventions, suicide attempts, and suicide completion. Charts were also reviewed for HT initiation, and mental health medication prescriptions. Data was compared using McNemar's Test or Chi Squared as appropriate.

Results
106 patients were found with the ICD codes with an average age of 50 years (standard deviation (SD) 15). Of those, 93 (88%) have previously been prescribed or are currently prescribed HT with an average age of initiation of 41 years (SD 14). Among all patients studied 98 (92%) were diagnosed with a mental health disorder, 57 (54%) had a history of suicidal event, and 50 (47%) had history of mental health medication prescription. Of persons on HT 49 (53%) had a suicidal event prior to the initiation of hormone therapy compared with 31 (33%) who had suicidal events after initiation of HT which was statistically significant (p&lt;0. 001). The most common suicidal event was hospitalization (41), followed by crisis interventions (27), suicide attempt (3), and suicide completion (1). Of all patients on HT: 39 (42%) had no suicidal events pre or post-HT, 5 (5%) had no suicidal events pre-HT but did have suicidal events post-HT, 23 (25%) had suicidal events pre-HT and no suicidal events post-HT, and 26 (28%) had suicidal events pre and post-HT (p&lt;0. 001).

Conclusions
Among transgender patients at our local VA on HT the incidence of suicidal event prior to initiation of HT was higher than that after initiation of HT. History of suicidal event prior to initiation of HT predicted future incidence of suicidal event after initiation of HT. Potential confounders include mental health evaluation and treatment prior to initiation of HT, limited duration of follow up, age at HT initiation, and initiation of new mental health medication prescriptions. References: Marshall E, Claes L, Bouman WP, et al. (2016). Non-suicidal self-injury and suicidality in trans people: A systematic review of the literature. Int Rev Psychiatry.28, 58–69
Presentation: No date and time listed
ODP416 Increased Ovarian Volume in Young Girls: A Marker of Impending Hyperandrogenism or Normal Variant?
Authors: Golob Laura , Chattha Asma , Pittock Siobhan 
Published: November 2022

Abstract
Ovarian volume increases with age in childhood with reported volumes from 0.6 cm 3 in neonates to approximately 6 cm 3 by 12 years old. There are no precise normal ranges defined based on age or Tanner stage in childhood; therefore, interpretation of ovarian volume can be challenging. The surgical and medical implications of ovarian enlargement are important as it can help predict ovarian torsion. It has been reported that a higher ovarian volume ratio (OVR) (ratio of larger to contralateral ovary) may be a strong predictor of ovarian torsion. A study evaluating premenarchal girls 3-14 years old showed OVR of 7.6 Vs 1.4 in those with and without torsion respectively. There is also an association between current or eventual development of hyperandrogenism and enlarged ovaries in adolescents. Seven girls, five to nine years old presented for care between 2013 and 2021 with at least one ovary large for pubertal status (volume ranging from 6 to 38 mL). Of these, 6 had bilateral enlargement. Presentation was for abdominal pain from ovarian torsion (5/7) or concerns for early puberty (2/7). Family history of PCOS was positive in 4/7. All girls were prepubertal or in early puberty (Tanner stage I-II for breast and pubic hair). All had normal body mass indices (BMI), none had reported hirsutism, acne or stigmata of Mc-Cune Albright syndrome. Pelvic ultrasound revealed large ovaries without discrete ovarian cysts or masses, 2/7 had decreased blood flow with one of these having heterogeneity related to prior torsion. Thyroid function tests, prolactin, gonadotropins, androgen levels and tumor markers were normal when measured. Bone age was checked and normal in five cases. Follow up ranged from 0-8 years, none required pubertal suppression for progressive precocious puberty. One case was diagnosed with PCOS at age 17 years after an initial presentation of ovarian torsion. PCOS is associated with oligo/anovulation and a risk for development of metabolic syndrome. Earlier detection of PCOS, particularly in the early pubertal age group may alter the trajectory of the complications with close monitoring potentially decreasing eventual metabolic risks. Since PCOS is associated with larger ovarian volumes (&gt;10mL in the adolescent population), detection of this enlargement in early puberty may portend later development of PCOS. It is also conceivable that premenarchal girls presenting with ovarian enlargement may signify a specific hyperandrogenic phenotype. While it is possible that larger ovarian volumes are variants of normal, larger retrospective studies and ideally, prospective, long term follow up investigations are required to determine a relationship between them and eventual hyperandrogenic and metabolic phenotypes.
Presentation: No date and time listed
ODP417 Kisspeptin directly stimulates estrogen and progesterone secretion from human granulosa cells.
Authors: Sitticharoon Chantacha , Sririwichitchai Rungnapa , Keadkraichaiwat Issarawan , Maikaew Pailin , Churintaraphan Malika 
Published: November 2022

Abstract
Kisspeptin is a peptide hormone that has a central role to stimulate gonadotropin-releasing hormone secretion from the hypothalamus. Furthermore, it was shown to have peripheral roles on enhancing CYP19 (aromatase) expression and aromatase secretion from human granulosa cells (1). The objectives of this study were to determine direct effects of kisspeptin treatment on estrogen and progesterone secretion from human granulosa-like tumor cell line (KGN). KGN cells (n=3) were treated with 10 nM follicle stimulating hormone (FSH); 100, 1,000, and 10,000 nM kisspeptin; and FSH together with different doses of kisspeptin for 24 hours. Estrogen and progesterone concentrations in supernatant were measured by enzyme immunoassay kits. The results showed that FSH treatment alone (P&lt;0. 05) and FSH together with 100 (P&lt;0. 01), 1,000 (P&lt;0. 001), and 10,000 (P&lt;0. 001) nM kisspeptin increased estrogen concentrations in supernatants when compared to control. Kisspeptin treatment alone did not increase estrogen concentrations in supernatant when compared to control. Interestingly, kisspeptin treatment at 1,000 (P&lt;0. 01) and 10,000 (P&lt;0. 01) nM together with FSH enhanced estrogen concentrations in supernatant when compared to FSH treatment alone. Furthermore, FSH treatment alone (P&lt;0. 05) and FSH together with kisspeptin at doses of 1,000 (P&lt;0. 001) and 10,000 (P&lt;0. 05) nM increased progesterone concentrations in supernatant when compared to control. All doses of kisspeptin did not increase progesterone concentrations in supernatant when compared to control. Only 1,000 nM kisspeptin together with FSH enhanced progesterone secretion in supernatant when compared to FSH alone (P&lt;0. 01). Taken together, FSH stimulated estrogen and progesterone secretion from human granulosa cells and kisspeptin enhanced these effects in addition to the effects of FSH alone. Further studies are required to determine whether kisspeptin treatment can restore the functions of unresponsive or partially responsive granulosa cells of aging humans to secrete estrogen and progesterone as well as kisspeptin is useful in augmenting infertility treatment. Reference: (1) Qin L, Sitticharoon C, Petyim S, Keadkraichaiwat I, Sririwichitchai R, Maikeaw P, et al. Exp Biol Med (Maywood). 2021;246(8): 996-1010.
Presentation: No date and time listed
ODP422 PCOS is Associated with Increased Incidence of Co-morbidities
Authors: Vine Donna , Ghosh Mahua , Wang Grace 
Published: November 2022

Abstract

Background
PCOS is the most common metabolic-endocrine disorder impacting women over their lifespan. It is important to understand the scope of health outcomes that impact the health and quality of life of those with PCOS in order to improve clinical and patient-centered health care in this population.

Aim
The aim of this study was to determine the incidence of co-morbidities in PCOS compared to age matched controls. We hypothesised that women with PCOS would have increased incidence of co-morbidities.

Methods
A retrospective observational case-control study in those diagnosed with PCOS and age-matched controls (&gt;12 yrs of age in a ratio of 1: 3) was undertaken using the Alberta Health Services Health Analytics database from 2002-2019 in Alberta, Canada. International classification codes (ICD9 and ICD10) were used to determine PCOS diagnosis including visits to a health care provider, Alberta ambulatory care reporting system and Discharge Abstract Data databases.

Results
The incidence of several co-morbidities were 20-40% higher in PCOS (n=16531) including hypertension, dyslipidemia, cardiovascular, cerebrovascular, gastrointestinal and renal disease, metabolic syndrome, eating disorders, mental illness, depression-anxiety, rheumatoid arthritis, respiratory infections and all cancers compared to controls (n=49335) (p&lt;0. 0001). Overweight-obesity, non-alcoholic liver disease, Type 1 diabetes and Type 2 Diabetes had a 3-fold greater incidence in PCOS compared to controls (p&lt;0. 0001).

Conclusion
These findings demonstrate PCOS is a major public health concern due to increased risk of co-morbidities and associated health-care costs. These findings provide evidence-based research to support the development of strategies to improve health care; screening, management and prevention of co-morbidities in high-risk PCOS populations.
Presentation: No date and time listed
ODP427 The Concomitant Existence of Turner Syndrome and Non-classic Congenital Adrenal Hyperplasia
Authors: Go Hanah , Joven Mark 
Published: November 2022

Abstract

Background
Turner syndrome and Congenital adrenal hyperplasia are distinct examples of disorders of sexual development. Because they share common clinical features, their coexistence is difficult to diagnose.1 Currently, only ten cases have been reported in the literature.2 Clinical Case: A 54-year-old, born and raised as a female, consulted a gynecologist because of ambiguous genitalia. Her late presentation was due to reluctance of medical care. During her teenage years, she had cyclic hypogastric cramps but never had menstrual bleeding. In her late 20s, she noted virilizing features such as receding hairline, hirsutism and deepening of voice. None of her parents and siblings presented the same features. She had a short stature (height: 147.32 cm), wide spaced nipples with absent breast bud and shortened 4th metatarsals. Genital examination showed a pair of labia without palpable mass and testes, and a prominent phallic structure measuring 3-4 cm (Prader Stage V). Hormonal assays revealed low normal FSH (4.58, &gt;3. 03 mIU/mL, low LH (0.48, &gt;1.8 mIU/mL), elevated testosterone (4.7, n&lt;0.75 ng/mL) and progesterone (14.47, &lt;1.4 ng/mL), and normal estradiol (66, n: 23-139 pg/mL). Tumor markers such as ß-hCG, ɑ-fetoprotein, LDH and CA-125, electrolyte analysis and thyroid function test showed no abnormalities. Both pelvic ultrasonography and abdominal MRI demonstrated a large abdominopelvic mass (14.7×17.1×8.4 cm) with no identifiable normal looking uterus, ovaries, or testes. She underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Histopathologic analysis of the specimen revealed submucous and intramural leiomyoma uteri, atrophic endometrium without abnormality on both ovaries and fallopian tubes. Karyotype analysis indicated 45×[2] / 46, XX [48], Mosaic 45,×/ 46 XX consistent with Turner's syndrome. Because virilization is not a typical feature, further evaluation using 17-hydroxyprogesterone was performed. The result yielded elevated basal (235, n&lt;6 nmol/L) and postsynacthen result (60 minutes) (241, n&lt;30 nmol/L), hence, the diagnosis of non-classic congenital adrenal hyperplasia was established.

Conclusion
The individual incidence of Turner syndrome and non-classic congenital adrenal hyperplasia is not uncommon, but their coexistence is rare. In the absence of Y chromosome in Turner syndrome, presence of virilization should warrant investigation for congenital adrenal hyperplasia.
Presentation: No date and time listed
ODP433 An increased in AIPB expression in Triple Negative (ER-/PR-/Her2-) Breast Tumors reduces estradiol synthesis
Authors: Downs William V , Perkins Edward L , Burak William E , Bose Himangshu S 
Published: November 2022

Abstract
Aromatase (estrogen synthetase) is a p450 family of enzymes that catalyzes testosterone to estradiol in presence of a cofactor NADPH. Aromatase is central for its role in reproduction and reproductive diseases for catalyzing the conversion of testosterone to estradiol by aromatase. Since aromatase is responsible for the synthesis of estrogens, it is essentially a rate limiting enzyme. Aromatase is expressed mainly in the ovaries of premenopausal women and placentas of pregnant women. Therapeutic approaches for controlling breast cancer proliferation include reducing estrogen by interfering with its production via ovarian ablation in premenopausal women and/or use of aromatase inhibitors or inactivators in postmenopausal women. The use of aromatase inhibitors can lead to rapid drug resistance and refractory disease. In triple negative breast cancers (TNBC) aromatase expression remains undetectable. Therefore, treatment of TNBC remains a challenge to the patients resulting in premature and very early death. Our laboratory is investigating the role of Aromatase Interacting Partner in Breast (AIPB), in TNBC cells (MDA-MB-231 cells). AIPB is a 22 kDa protein, present partially in the MAM (Mitochondria Associated-ER Membrane) but mainly in the endoplasmic reticulum associated with aromatase in the unaffected human breast tissue. The AIPB localization in the organelle was determined biochemically and visualized through scanning electron microscopy (SEM). We have cloned AIPB in a tetracycline inducible expression system (pTETOneAIPB) and created on demand expression of AIPB in MDA-MB-231 cells. In pTETOneAIPB engineered MDA-MB-231 cells addition of doxycycline resulted in a several fold increase in AIPB expression as compared to uninduced or MDA-MB-231 cells by quantitative PCR analysis. The growth rate of pTETOneAIPB is almost five-fold slower than the MBA-MB-231 cells. Interestingly estradiol synthesis was also decreased following doxycycline addition measured through radioimmuno assay (RIA). Therefore, our results suggest that restoration of AIPB expression may potentially reduce estradiol synthesis in TNBC patients and provide an additional therapeutic approached to treatment.
Presentation: No date and time listed
OR06-2 Paxillin and Androgen Receptor Interact to Modulate Female Fertility
Authors: Astapova Olga , Hammes Stephen , Vann Kenji , Walczyk Ariana , Weidner Adelaide 
Published: November 2022

Abstract
While androgens are traditionally associated with male physiology, recently it has become more apparent that balanced levels of androgens are crucial to maintaining female health and fertility as well. Specifically, androgens are necessary for granulosa cell proliferation and follicle survival and growth. Excess androgen levels in females are a hallmark in polycystic ovary syndrome (PCOS), whereas insufficient androgen signaling due to androgen receptor (AR) knockout leads to diminished ovarian reserve (DOR) – with both extremes resulting in anovulatory infertility. However, little is known about the factors regulating AR in granulosa cells. Our previous findings demonstrate that paxillin, a cytoplasmic adaptor protein, mediates AR signaling in prostate cancer cells. However, our current interest is whether this interaction is also found in granulosa cells. As such, our results show that paxillin indeed enhances AR protein expression in granulosa cells. We have also demonstrated through immunofluorescence and proximity ligation assays that paxillin colocalizes with AR, notably in membrane-bound complexes. Moreover, paxillin-null KGN and mouse granulosa cells express lower levels of AR, as demonstrated through Western blotting and immunofluorescence imaging. We then conducted mRNA and protein degradation experiments in paxillin-null KGN cells in order to determine the mechanism by which paxillin increases AR expression. These results suggest that paxillin acts by preventing AR mRNA and protein degradation, possibly by trafficking AR to focal adhesions, where it may be sequestered from degradation. Finally, to investigate the role of paxillin in female fertility, we developed a novel granulosa cell-specific paxillin knockout mouse model using an Amhr2-driven Cre/lox system. These knockout mice experience altered estrous cycles compared to controls, spending fewer days in estrus and more days in metestrus/diestrus. When bred continuously through 6 months of age, the paxillin KO mice produced significantly more litters compared to their littermate controls. Taken together, these results suggest that paxillin acts as a regulator of androgen-mediated female fertility in granulosa cells, and may serve as a potential target for therapeutics in fertility-related diseases such as PCOS and DOR.
Presentation: Saturday, June 11, 2022 11:45 a.m. - 12:00 p.m.
ODP064 Latrogenic Cushing Syndrome after Concomitant Oral Controlled-Release Budesonide and Famotidine Therapy
Authors: Salhah Hiba , Bowden Sasigarn 
Published: November 2022

Abstract

Introduction
It has been shown that complement factors are increased in polycystic ovary syndrome (PCOS) and that these may be affected by obesity and insulin resistance. Hypothetically, this may increase cardiometabolic risk but, paradoxically, increased clotting is not a feature of PCOS. To investigate this, proteomic analysis of the complement system was undertaken, including inhibitory proteins.

Methods
Plasma was collected from 244 women (147 with PCOS and all 3 diagnostic features and 97 controls). Somalogic proteomic analysis was undertaken for the following complement system proteins: C1q, C1r, C2, C3, C3a, iC3b, C3b, C3d, C3adesArg, C4, C4a, C4b, C5, C5a, C5b-6 complex, C8, properdin, Factor B, Factor D, Factor H, Factor I, Mannose-binding protein C (MBL), Mannan-binding lectin serine protease 1 (MASP3), Complement decay-accelerating factor (DAF) and Complement factor H-related protein 5 (CFHR5).

Results
The alternative pathway of the complement system was primarily activated in PCOS, with increased C3 (p&lt;0. 05), properdin and Factor B (p&lt;0. 01). In addition, inhibition of this pathway was also seen in PCOS, with increase in CFHR5, Factor H and Factor I (p&lt;0. 01). There were also increases in the downstream complement factors of iC3b and C3d, associated with an enhanced B cell response, and C5a, associated with inflammatory cytokine release (p&lt;0. 01).

Conclusion
This is the most comprehensive evaluation of the complement system in PCOS to date and reveals upregulation of the alternative complement system that appears to be offset by the concurrent upregulation of its inhibitors. However, any additional dysregulation of the system, such as occurs with COVID19 infection, may give rise to an increased risk for clotting in women with PCOS.
Presentation: No date and time listed
PMON257 Oral Ingestion of Macronutrients Selectively and Variably Decrease Circulating Testosterone Concentration in Healthy Men
Authors: Iranmanesh Ali , Johannes Veldhuis 
Published: November 2022

Abstract
We have previously reported acute suppression of testosterone in men after oral ingestion of dextrose. In the present study, we aimed to explore a potentially similar effect in response to other macronutrients.
Eleven healthy men (age: 33-70 yrs, BMI 20.4-31.5 kg/m2) were studied in random order after an overnight fast on 4 separate days, involving oral ingestion of 300 ml of either water (control), dextrose, protein, or lipid solutions. Sessions were 6.5 h long, starting at 0800-0900 hrs. Test meals were isocaloric (400 kcal) and were ingested after the 4th blood draw (30 min point). Blood was collected at 10-min intervals for testosterone (ng/dL), and LH (IU/L) measurements. Means of the 1st 4 pre-intervention measures were used as the first value in all the time series. Mean delta-serum (macronutrients-water) testosterone and LH concentrations sampled at 10-minute intervals over 6 hour period were adjusted to the corresponding 1st value to correct for among the sessions inconsistent baseline testosterone and LH measures.
Compared to the water day (control), mean (± SE) serum testosterone concentrations (ng/dL) in 11 subjects decreased from 415 ± 36 (control) to 370 ± 31 (dextrose: P=0.009), 340 ± 28 (protein: p=0.002), and 355 ± 30 (lipid: p=0.01). Corresponding LH (IU/L) values for dextrose (3.16 ± 0.29), protein (3.17 ± 0.39), and lipid (3.07 ± 0.29) were not significantly different from the control day (3.3 ± 0.29). Mean delta-testosterone time series revealed decreased testosterone of 63 ng/dL at 130 min after dextrose, 80 ng/dL at 200 min after protein, and 10 ng/dL at 70 min after lipid ingestion. Duration of suppression was variable among the 3 macronutrients, but most prolonged for protein lasting for 320 min. As oppose to testosterone, delta-LH concentrations were more positive rather than negative, suggestive of a potential testicular insult.
In conclusion, oral ingestion of all macronutrients decrease circulating testosterone concentration, which appear to be independent of LH secretion. The effect is more intense and prolonged after protein intake, and minimal with lipid ingestion. Future studies are required to define the etiology, and the macronutrient effect on more prolonged basis.
Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.