title: Evaluation of menstrual cycle-related changes in 85 clinical laboratory analytes.
abstract: OBJECTIVE
  The menstrual cycle-related changes in clinical laboratory values were analysed by use of data obtained in the Asian multicentre study aimed at derivation of common reference intervals for 85 major clinical laboratory tests.
  
  
  METHODS
  Among 1876 healthy female volunteers, 893 had regular menstruation. They were classified into five groups according to dates between sample collection and the start of the last menstrual cycle: early follicular phase (1-6 days), late follicular phase (7-12 days), ovulatory phase (13-16 days), early luteal phase (17-22 days), and late luteal phase (23-31 days). Multiple linear regression analysis was performed to evaluate the menstrual cycle-related changes in test results. The magnitude was expressed as a standard deviation ratio of between-phase standard deviation to between-individual standard deviation based on nested ANOVA.
  
  
  RESULTS
  Aside from obvious changes for four sex hormones (oestradiol, progesterone, follicle-stimulating hormone, and luteinizing hormone), we observed statistically significant menstrual cycle-related changes in the following tests (standard deviation ratio >0.15): Na, Cl, creatine kinase, C-reactive protein, serum amyloid A, carbohydrate antigen 125, and parathyroid hormone were higher during the early follicular phase, while insulin, total cholesterol, and white blood cell were higher during the luteal phase. Significant associations of those test items with the four sex hormones were revealed.
  
  
  CONCLUSIONS
  The menstrual cycle-related changes in laboratory test results were revealed in some commonly tested items other than sex hormones. The findings are of interest in understanding female physiology in relation to hormonal changes, but the magnitude of changes is rather small and not very relevant in interpreting test results.
authors.affiliation: Department of Clinical Laboratory Medicine, Faculty of Medicine, Kindai University, Osakasayama, Japan shiori.masuda@sayama.med.kindai.ac.jp.
authors.forename: Shiori
authors.initials: S
authors.lastname: Masuda
authors.affiliation: Department of Clinical Laboratory Sciences, Faculty of Health Sciences, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Ichihara
authors.affiliation: Department of Clinical Laboratory Science, Faculty of Health Care, Tenri Health Care University, Tenri, Japan.
authors.forename: Hachiro
authors.initials: H
authors.lastname: Yamanishi
authors.affiliation: Division of Cardiology, Department of Medicine, Faculty of Medicine, Kindai University, Osakasayama, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hirano
authors.affiliation: Department of Clinical Laboratory Medicine, Faculty of Medicine, Kindai University, Osakasayama, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Department of Clinical Laboratory Medicine, Faculty of Medicine, Kindai University, Osakasayama, Japan.
authors.forename: Toshinori
authors.initials: T
authors.lastname: Kamisako
mesh_terms: D000328:Adult; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D007753:Laboratories; D008597:Menstrual Cycle
chemical_list: D012739:Gonadal Steroid Hormones
keywords: C-reactive protein; Sex hormones; multiple regression analysis; parathyroid hormone; serum amyloid A; three-level nested ANOVA; total cholesterol