Maturitas最新文献

{"title":"Physical activity as an alternative or adjunct to menopausal hormone therapy for symptom management in women with primary ovarian insufficiency","authors":"Félix Ayala ,&nbsp;Juan E. Blümel ,&nbsp;María S. Vallejo ,&nbsp;Peter Chedraui ,&nbsp;Hugo Gutiérrez-Crespo ,&nbsp;Marcela López ,&nbsp;Juan Matzumura-Kasana ,&nbsp;Paolo Meza ,&nbsp;Álvaro Monterrosa-Castro ,&nbsp;Mónica Ñañez ,&nbsp;Eliana Ojeda ,&nbsp;Claudia Rey ,&nbsp;Ana Lucia Ribeiro Valadares ,&nbsp;Doris Rodríguez-Vidal ,&nbsp;Marcio A.H. Rodrigues ,&nbsp;Javier Saavedra ,&nbsp;Carlos Salinas ,&nbsp;Lida Sosa ,&nbsp;Konstantinos Tserotas ,&nbsp;Margot Acuña-San Martín ,&nbsp;Gustavo Gómez-Tabares","doi":"10.1016/j.maturitas.2026.108855","DOIUrl":"10.1016/j.maturitas.2026.108855","url":null,"abstract":"<div><h3>Background</h3><div>Physical activity alleviates menopausal symptoms in women whose menopause occurs after the age of 45; however, its effect in primary ovarian insufficiency, which occurs before the age of 40, remains unknown.</div></div><div><h3>Objective</h3><div>To examine the association between physical activity, menopausal symptoms, and the use of menopausal hormone therapy in women with primary ovarian insufficiency.</div></div><div><h3>Methods</h3><div>We analysed data from 4708 participants from two studies conducted in 12 Latin American countries. After applying eligibility criteria, 564 women with primary ovarian insufficiency (351 idiopathic and 213 surgical) were included. Menopausal symptoms were assessed using a validated scale, and severe symptoms were defined according to established cut-offs. Physical activity was classified according to international recommendations for moderate-intensity activity. Logistic regression models were adjusted for sociodemographic, clinical, and lifestyle variables.</div></div><div><h3>Results</h3><div>The prevalence of severe menopausal symptoms was 39.2%, with no significant difference between idiopathic and surgical primary ovarian insufficiency. Women with severe symptoms were less likely to meet recommended levels of physical activity or to be current users of menopausal hormone therapy. In adjusted models, regular physical activity (OR 0.65; 95% CI 0.45–0.94) and current use of menopausal hormone therapy (OR 0.27; 0.17–0.42) were associated with a lower likelihood of severe symptoms, whereas obesity and use of psychotropic medication were associated with a higher likelihood.</div></div><div><h3>Conclusions</h3><div>Women with primary ovarian insufficiency who engage in regular physical activity or currently use menopausal hormone therapy report less severe menopausal symptoms. Regular exercise may be an important non-hormonal option for women who cannot or prefer not to use hormone therapy.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108855"},"PeriodicalIF":3.6,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency and factors related to very early return of older persons to the emergency department: A separate analysis of men and women (EDEN-26 study)","authors":"Òscar Miró ,&nbsp;Natalia Miota ,&nbsp;Andrea Bellido ,&nbsp;Carolina Rangel ,&nbsp;Anette Arce ,&nbsp;Sira Aguiló ,&nbsp;Ana García-Martínez ,&nbsp;Effie Polyzogopoulou ,&nbsp;John Parissis ,&nbsp;Juan González del Castillo ,&nbsp;Blanca Coll-Vinent ,&nbsp;on behalf of the SIESTA Research Network","doi":"10.1016/j.maturitas.2026.108853","DOIUrl":"10.1016/j.maturitas.2026.108853","url":null,"abstract":"<div><h3>Objectives</h3><div>Discharge from acute care assumes adequate medical and social conditions. Very early return to the emergency department (i.e. within 72 h) may reflect a failure to ensure a safe discharge. Older persons are particularly vulnerable, yet sex-related disparities remain underexplored. We assessed the incidence and sex-specific predictors of very early returns to the emergency department.</div></div><div><h3>Methods</h3><div>We analyzed 23,962 consecutive individuals aged 65 years or more from the multicenter Spanish EDEN registry, including patients discharged home alive from 52 emergency departments, with post-discharge follow-up. The outcome was any emergency department return within 72 h after discharge either from the emergency department or following hospitalization. Candidate predictors included age, living arrangements, comorbidity, functional status, walking ability, previous falls, and prior diagnoses of depression, dementia, or delirium. Multivariable logistic regression models were stratified by sex, adjusted for all candidate predictors, and included interaction terms to assess sex-specific effects.</div></div><div><h3>Results</h3><div>The overall incidence of very early emergency department return was 6.6% (7.1% in men and 6.2% in women). In men, comorbidity was independently associated with return. In women, comorbidity, functional dependence, previous falls, and depression were independent predictors. Significant sex-by-predictor interactions indicated a stronger association for previous falls in women in the overall cohort, for depression in women discharged directly from the emergency department, and for prior delirium in women discharged after hospitalization. Male sex was independently associated with a higher adjusted risk of very early emergency department return (adjusted odds ratio 1.12).</div></div><div><h3>Conclusions</h3><div>Predictors of very early emergency department return differ by sex in older persons. Previous falls and depression have a stronger impact in women, while male sex is independently associated with a higher baseline risk. Sex-sensitive discharge planning may help reduce avoidable early revisits and improve transitional care.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108853"},"PeriodicalIF":3.6,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Independent and interaction effects of telomere length and life's essential 8 score on the risk of type 2 diabetes mellitus: Findings from a large prospective cohort study","authors":"Taifeng Chen ,&nbsp;Yaqin Su ,&nbsp;Li Yang ,&nbsp;Minqi Gu ,&nbsp;Jinliang Liang ,&nbsp;Kexin Li ,&nbsp;Yihao Shu ,&nbsp;Kaixin Chen ,&nbsp;Jinyuan Pang ,&nbsp;Dongsheng Hu ,&nbsp;Fulan Hu ,&nbsp;Ming Zhang","doi":"10.1016/j.maturitas.2026.108828","DOIUrl":"10.1016/j.maturitas.2026.108828","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the independent and joint effects of leukocyte telomere length and score on the Life's Essential 8 scale on type 2 diabetes mellitus risk using UK Biobank data.</div></div><div><h3>Methods</h3><div>A total of 309,288 participants without type 2 diabetes mellitus at baseline were included. Leukocyte telomere length was categorized into quartiles (Q1-Q4), and Life's Essential 8 scores into three groups: low (&lt; 50 points), intermediate (50–79 points) and high (≥ 80 points). Cox proportional-hazards models were used to estimate hazard ratios (HRs) for T2DM. Multiplicative and additive models assessed interactions between leukocyte telomere length and Life's Essential 8 score.</div></div><div><h3>Results</h3><div>Over a median follow-up of 13.33 years, 9830 participants developed T2DM. Compared with group Q1, the risk of T2DM was reduced by 7% (HR = 0.93, 95%CI: 0.88, 0.99) in the Q4 group. Compared with the low Life's Essential 8 score group, the risk of T2DM was reduced by 70% (HR = 0.30, 95%CI: 0.29, 0.31) and 93% (HR = 0.07, 95%CI: 0.06, 0.08) in the intermediate and high score groups, respectively. The group with long leukocyte telomere length and high Life's Essential 8 score had the most significant reduction in T2DM risk compared with the group with short leukocyte telomere length and low Life's Essential 8 score (HR = 0.07, 95%CI: 0.05, 0.08). Both multiplicative (<em>P</em>_interaction &lt; 0.001) and additive interactions (S = 1.12, 95%CI: 1.01, 1.25) were observed between the effects of leukocyte telomere length and Life's Essential 8 score on T2DM.</div></div><div><h3>Conclusion</h3><div>Elevated leukocyte telomere length and Life's Essential 8 scores synergistically reduce T2DM risk beyond their individual effects, underscoring the importance of integrated strategies that simultaneously target leukocyte telomere length maintenance and the optimization of cardiovascular-metabolic health in the prevention of T2DM.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108828"},"PeriodicalIF":3.6,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-traumatic stress disorder symptoms and sexual function among midlife women","authors":"Karen Jakubowski ,&nbsp;Holly N. Thomas ,&nbsp;Carolyn J. Gibson ,&nbsp;Karestan C. Koenen ,&nbsp;Pauline M. Maki ,&nbsp;Rebecca C. Thurston","doi":"10.1016/j.maturitas.2026.108839","DOIUrl":"10.1016/j.maturitas.2026.108839","url":null,"abstract":"<div><h3>Objectives</h3><div>Post-traumatic stress disorder (PTSD) is related to adverse mental and physical health outcomes and reduced wellbeing, yet limited work has examined associations between PTSD symptoms and sexual function among midlife women. We investigated whether PTSD symptoms were related to poorer sexual function among midlife women who reported past-month sexual activity (partnered or unpartnered).</div></div><div><h3>Study Design</h3><div>121 women aged 45–66 not taking hormone therapy self-reported PTSD symptom severity (PTSD Checklist-Civilian Version [DSM-IV]; yields a total score and symptom clusters: re-experiencing, avoidance/numbing, and hypervigilance), depressive symptoms (Center for Epidemiological Studies-Depression), alcohol use, medical history, and medication use; and completed physical measures (body mass index; BMI) and an actigraphy sleep protocol (total sleep time). Associations between PTSD symptom severity and sexual function were tested in linear regression models adjusted for age, race/ethnicity, education, partner status, vaginal estrogen use, alcohol use, years since final menstrual period, BMI, depressive symptoms, and total sleep time. Exploratory analyses examined associations between PTSD symptom clusters and sexual function.</div></div><div><h3>Main outcome measure</h3><div>Past-month sexual function (score on the 6-item Female Sexual Function Index; lower scores = poorer function).</div></div><div><h3>Results</h3><div>The average score on the PTSD Checklist was 23.91 (6.81). Women with greater PTSD symptoms reported poorer sexual function [B(95% CI) = −6.52 (−10.86, −2.17), <em>p</em> = .004]. Considering PTSD symptom clusters, avoidance/numbing related to poorer sexual function [B(95% CI) = −3.69 (−6.90, −0.48), <em>p</em> = .025].</div></div><div><h3>Conclusions</h3><div>Overall PTSD symptom burden and avoidance symptoms were related to poorer sexual function. Results suggest the importance of assessing and addressing PTSD symptoms among midlife women to improve women's sexual health as they age.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108839"},"PeriodicalIF":3.6,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of intrinsic capacity impairment and their longitudinal association with possible sarcopenia in older adults: A latent class analysis","authors":"Yilin Cheng ,&nbsp;Shuqin Xiao ,&nbsp;Yurun Cai ,&nbsp;Liwei Jing ,&nbsp;Weiyao Li ,&nbsp;Xue Liu","doi":"10.1016/j.maturitas.2026.108838","DOIUrl":"10.1016/j.maturitas.2026.108838","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the associations between different patterns of intrinsic capacity (IC) impairment and incident preclinical “possible sarcopenia”.</div></div><div><h3>Study design</h3><div>A longitudinal cohort study using data from the China Health and Retirement Longitudinal Study (CHARLS, 2011–2015). Latent class analysis (LCA) was applied to identify IC impairment patterns among 1667 adults aged ≥60 years, followed by Cox regression to examine longitudinal associations. Sensitivity analyses stratified by sex and age evaluated the robustness of findings.</div></div><div><h3>Main outcome measure</h3><div>Possible sarcopenia, defined according to AWGS 2019 criteria, assessed in 2013 and 2015.</div></div><div><h3>Results</h3><div>Four IC impairment patterns were identified. Compared with those with the “relatively healthy” pattern (Class 1), those with “locomotion decline” (Class 2) (3 years, HR = 1.64, 95% CI 1.27–2.11; 5 years, HR = 1.30, 95% CI 1.01–1.67), “locomotion and sensory decline” (Class 3) (3 years, HR = 1.39, 95% CI 1.06–1.82), and “locomotion, psychological, and sensory decline” (Class 4) (3 years, HR = 1.59, 95% CI 1.23–2.04; 5 years, HR = 1.60, 95% CI 1.25–2.03) showed higher risks of possible sarcopenia. Sensitivity analyses indicated stronger associations for Class 4 in women and those aged 60–70 years.</div></div><div><h3>Conclusions</h3><div>Distinct multidimensional IC impairment patterns, identified through LCA, significantly predicted possible sarcopenia. The results of Cox regression underscore the utility of IC profiles in identifying high-risk populations and support low-cost, community-based screening and interventions.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108838"},"PeriodicalIF":3.6,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of oral contraceptive use with mortality: Findings from NHANES","authors":"Dahong Zheng ,&nbsp;Xiaoxiao Li ,&nbsp;Jia Liu ,&nbsp;Jiaojiao Wang ,&nbsp;Jingya Jiao ,&nbsp;Liping Zheng ,&nbsp;Zhengbao Zhu ,&nbsp;Xiayan Xu ,&nbsp;Daoxia Guo","doi":"10.1016/j.maturitas.2026.108837","DOIUrl":"10.1016/j.maturitas.2026.108837","url":null,"abstract":"<div><h3>Background</h3><div>The formulations and usage patterns of oral contraceptives have evolved, necessitating updated evidence on their long-term safety.</div></div><div><h3>Objective</h3><div>To assess the associations between duration of oral contraceptive use and all-cause, cardiovascular, and cancer mortality.</div></div><div><h3>Methods</h3><div>We analyzed 19,275 women from the National Health and Nutrition Examination Survey with mortality follow-up through 2019. Use of oral contraceptives was classified by duration (≤1, 1–5, &gt;5 years). Weighted Cox models estimated hazard ratios with 95% CIs; restricted cubic splines examined dose–response relationships.</div></div><div><h3>Results</h3><div>Among 19,725 women (mean age 47.4 years), the median duration of oral contraceptive use was 3 years. Over a median follow-up of 12.2 years, compared with never-users, those using for &gt;5 years had adjusted hazard ratios of 0.53 (95% CI, 0.37–0.76) for all-cause, 0.50 (95% CI, 0.26–0.96) for cardiovascular, and 0.38 (95% CI, 0.17–0.86) for cancer mortality, with a trend toward lower risks for all three outcomes (all P for trend &lt;0.05). Restricted cubic splines revealed inverse linear associations with all-cause and cancer mortality, and a nonlinear association with cardiovascular mortality. Results remained consistent after propensity score matching.</div></div><div><h3>Conclusions</h3><div>The duration of oral contraceptive use was not associated with excess mortality risk and showed inverse linear or nonlinear associations with all-cause, cardiovascular, and cancer mortality, supporting their long-term safety.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108837"},"PeriodicalIF":3.6,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for acute kidney injury associated with intravenous acyclovir in older adults: ACICLOAGED study","authors":"Amandine André ,&nbsp;Olivier Brière ,&nbsp;Léa Bourreau ,&nbsp;Solène Tridon ,&nbsp;Mathilde Petit ,&nbsp;Cédric Annweiler ,&nbsp;Mathieu Corvaisier","doi":"10.1016/j.maturitas.2026.108836","DOIUrl":"10.1016/j.maturitas.2026.108836","url":null,"abstract":"<div><h3>Background</h3><div>Intravenous acyclovir is the recommended treatment for suspected viral meningoencephalitis, but it may induce acute kidney injury. Evidence in very old adults is limited, particularly regarding the role of frailty in renal vulnerability.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of adults aged 75 years or more who received intravenous acyclovir for suspected meningoencephalitis at a single university hospital between November 2021 and December 2024. Frailty was assessed using the 9-point Clinical Frailty Scale, with frailty defined as a score of 4 or higher. The primary outcome was acute kidney injury occurring within seven days of acyclovir initiation, identified according to international consensus criteria based on changes in serum creatinine levels. Logistic regression models were used to examine factors associated with acute kidney injury.</div></div><div><h3>Results</h3><div>Among 139 included patients (median age 83 years; 38% women), 31% developed acute kidney injury within seven days. Frailty was present in 60% of the cohort and was more frequent among those who developed acute kidney injury (79% vs. 52%, <em>p</em> = 0.004). Age, sex, comorbidity burden, baseline renal impairment, excessive acyclovir dosing, prolonged treatment, and use of three or more nephrotoxic medications were not significantly associated with the outcome.</div></div><div><h3>Conclusion</h3><div>In adults aged 75 years or more treated with intravenous acyclovir for suspected meningoencephalitis, frailty was a strong and independent predictor of acute kidney injury, whereas chronological age and baseline renal function were not. Incorporating frailty assessment into clinical decision-making may help identify patients at higher risk and guide preventive strategies.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108836"},"PeriodicalIF":3.6,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a digital voice assistant-delivered osteoporosis self-management program on diet in postmenopausal women with osteoporosis: A secondary analysis of a 12-month feasibility randomised controlled trial","authors":"Melkamu Tamir Hunegnaw ,&nbsp;Jakub Mesinovic ,&nbsp;Paul Jansons ,&nbsp;Elena S. George ,&nbsp;Belinda De Ross ,&nbsp;Nicole Kiss ,&nbsp;Peter R. Ebeling ,&nbsp;Robin M. Daly ,&nbsp;Eugene Gvozdenko ,&nbsp;David Scott","doi":"10.1016/j.maturitas.2026.108840","DOIUrl":"10.1016/j.maturitas.2026.108840","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the effects of a digital voice assistant-delivered self-management program on dietary behaviours for supporting musculoskeletal health in postmenopausal women with osteoporosis.</div></div><div><h3>Methods</h3><div>This was a secondary analysis of a 12-month randomised controlled feasibility trial evaluating the feasibility and effectiveness of a digital voice assistant intervention to support osteoporosis-related health behaviours, with 50 participants randomly assigned to a digital voice assistant intervention (<em>N</em> = 25) or control group (N = 25) for a 6-month intervention and an additional 6-month maintenance period. During the intervention period, the digital voice assistant group received videos focused on dairy foods, dairy alternatives, protein, calcium and vitamin D, via a digital voice assistant device located in their home. The control group received six emails with weblinks to osteoporosis information. Dietary intakes were assessed at baseline, 6 and 12 months via three-day food records.</div></div><div><h3>Results</h3><div>Participants (mean age 64.3 ± 6.1 years) accessed approximately 80% of prescribed videos during the intervention. There were no significant within- or between-group changes in protein or calcium intakes at 6 or 12 months. Daily low-fat milk and egg servings increased in the digital voice assistant group compared with controls from baseline to 12 months (<em>P</em> = 0.02).</div></div><div><h3>Conclusions</h3><div>A digital voice assistant-delivered intervention, including osteoporosis-related nutrition information, resulted in small increases in the consumption of low-fat milk and eggs, but did not increase habitual protein or calcium intake in women with osteoporosis. Adequately powered trials are required to determine whether similar digital health interventions are effective for improving dietary behaviours in this population.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108840"},"PeriodicalIF":3.6,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of frailty in the association between testosterone levels and mortality risk in older men","authors":"Panpan Zhang ,&nbsp;Wenzhen Hao ,&nbsp;Wen Ji ,&nbsp;Tangbin Yuan ,&nbsp;Jing Dai ,&nbsp;Li Ji ,&nbsp;Weiwei Sheng ,&nbsp;Shuying Li","doi":"10.1016/j.maturitas.2026.108834","DOIUrl":"10.1016/j.maturitas.2026.108834","url":null,"abstract":"<div><h3>Background</h3><div>Testosterone plays an important role in male aging, yet its impact on mortality remains unclear. Frailty, a syndrome of physiological decline, may mediate this relationship. This study investigates the mediating role of frailty in the association between testosterone levels and both all-cause and cardiovascular disease mortality in older men.</div></div><div><h3>Methods</h3><div>We analyzed data from 1478 men aged 60 years or more in the National Health and Nutrition Examination Survey (2011–2016). Cox proportional hazards models evaluated the direct association between testosterone and mortality. Mediation analysis on the log-hazard scale was conducted using the product-of-coefficients approach and Sobel tests to quantify indirect effects via the frailty index, and the proportion mediated was calculated as the ratio of the indirect to total effect.</div></div><div><h3>Results</h3><div>Higher testosterone levels were associated with lower risks of all-cause mortality (hazard ratio (HR) 0.892, 95% confidence interval (CI) 0.830–0.959; <em>P</em> = 0.002) and cardiovascular disease mortality (HR 0.820, 95% CI 0.716–0.939; <em>P</em> = 0.004). Frailty score was strongly associated with both all-cause (HR 1.648 per 0.1 increase) and cardiovascular disease mortality (HR 1.723 per 0.1 increase). Mediation analysis demonstrated that frailty substantially explained the association between testosterone and mortality. For all-cause mortality, the indirect pathway through frailty accounted for 35.9% of the total effect. After adjustment for frailty, the residual direct effect of testosterone was attenuated and no longer statistically significant, a pattern consistent with near-complete mediation. For cardiovascular disease mortality, frailty accounted for 21.7% of the association. Although the direct effect was reduced, its effect size and confidence interval indicated the possibility of remaining direct pathways, supporting a partial rather than complete mediation.</div></div><div><h3>Conclusion</h3><div>Frailty mediates the relationship between testosterone and mortality in older men. Targeting frailty may enhance the survival benefits associated with testosterone, offering potential strategies for aging-related health interventions.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108834"},"PeriodicalIF":3.6,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146014008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproductive factors and the risk of pelvic organ prolapse in postmenopausal women: A nationwide cohort study","authors":"Log Young Kim ,&nbsp;Jin-Sung Yuk","doi":"10.1016/j.maturitas.2026.108835","DOIUrl":"10.1016/j.maturitas.2026.108835","url":null,"abstract":"<div><h3>Objective</h3><div>To examine associations between reproductive factors and the risk of pelvic organ prolapse in postmenopausal women.</div></div><div><h3>Study design</h3><div>This nationwide retrospective cohort study included postmenopausal women aged 40 to 79 years who participated in a national health screening program in the period 2009–2012 in Korea. Participants were followed until 2022.</div></div><div><h3>Main outcome measures</h3><div>Clinically treated pelvic organ prolapse, defined by concurrent diagnosis and procedure codes (surgery or pessary).</div></div><div><h3>Results</h3><div>Among 3,743,520 women, 34,792 (0.9%) developed pelvic organ prolapse during a median follow-up of 10 years, corresponding to an incidence rate of 938 per 100,000 person-years. In fully adjusted models, having two or more births was the strongest predictor of pelvic organ prolapse (hazard ratio 1.751; 95% confidence interval 1.561–1.963). Breastfeeding ≥12 months (hazard ratio 1.297; 95% confidence interval 1.228–1.369), oral contraceptive use ≥1 year (hazard ratio 1.067; 95% confidence interval 1.024–1.112), menopausal hormone therapy for 2–4 years (hazard ratio 1.083; 95% confidence interval 1.022–1.147), age at menopause ≥55 years (hazard ratio 1.064; 95% confidence interval 1.031–1.098), and reproductive span ≥40 years (hazard ratio 1.169; 95% confidence interval 1.112–1.229) were each modestly associated with increased risk of pelvic organ prolapse. Age at menarche showed no association. Trends across exposure categories were significant for all factors except menarche. In women with parity 0 or 1, most reproductive factors were unrelated to pelvic organ prolapse, but prolonged breastfeeding (≥12 months) had a significant association (hazard ratio 1.348; 95% confidence interval 1.164–1.561).</div></div><div><h3>Conclusion</h3><div>Having multiple births and prolonged breastfeeding are key independent risk factors for pelvic organ prolapse in postmenopausal women. Other reproductive and hormonal factors have only minor effects.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108835"},"PeriodicalIF":3.6,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146032545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}