title: Biochemical evaluation of the supporting structure of pelvic organs in selected numbers of premenopausal and postmenopausal Malaysian women.
abstract: BACKGROUND
  Pelvic organ prolapse (POP) is associated with menopause and changes in the proteins of the pelvic supporting system, but there is scant data on the precise alterations in Malaysian women.
  
  
  OBJECTIVE
  The aim of this study is to determine the differences in the extracellular matrices (ECM) of uterosacral ligaments in premenopausal and postmenopausal Malaysian women with or without POP.
  
  
  METHODS
  The observational study was conducted for 9 months in three general hospitals involving 30 women who underwent hysterectomies for various indications except for carcinoma of pelvic organs.
  
  
  METHODS
  Three groups were identified: Premenopausal women (Group 1), postmenopausal women without POP (Group 2), and postmenopausal women with POP (Group 3). Age, duration of menopause, body mass index (BMI), parity, and vaginal deliveries were documented. Only 21 samples of the uterosacral ligaments were stained immunohistochemically for collagen I and III, matrix metalloproteinases (MMPs) 1 and 2, elastin, and tenascin.
  
  
  METHODS
  Image J software analysis was utilized for quantification, while non-parametric statistics (Kruskal-Wallis with post-hoc Dunns Multiple Comparison test) was used for result analysis.
  
  
  RESULTS
  The profile parameters were not significantly different except for mean age and duration of menopause in Group 3. Samples from Group 2 showed lower expression of almost all proteins except MMP1 and tenascin (higher) as compared to Group 1. The changes appeared to be exaggerated in Group 3, though statistically insignificant.
  
  
  CONCLUSIONS
  A significant difference in the expression of ECM was apparent in postmenopausal subjects as compared to premenopausal (P=0.05), compromising the uterosacral ligament tensile strength. The findings are proven similar as those changes in women from other studies.
authors: Department of Obstetrics and Gynaecology and Pathology, International Medical University, Malaysia.
authors: Sharifah Sulaiha Syed
authors: SS
authors: Aznal
authors: Fong Guan
authors: FG
authors: Meng
authors: Sivalingam
authors: S
authors: Nalliah
authors: Annie
authors: A
authors: Tay
authors: Kathires
authors: K
authors: Chinniah
authors: Mohd Faiz
authors: MF
authors: Jamli
mesh_terms: D000368:Aged; D016326:Extracellular Matrix Proteins / Q000032:analysis*; D005260:Female; D005836:Genitalia, Female / Q000502:physiology*; D006801:Humans; D007150:Immunohistochemistry; D008022:Ligaments / Q000737:chemistry / Q000473:pathology*; D008296:Malaysia; D008853:Microscopy; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000473:pathology*; D017698:Postmenopause; D017697:Premenopause
chemical_list: D016326:Extracellular Matrix Proteins