Exploring the Link Between Hypoxia Inducible Factor 1A Expression and Neurodegenerative Risk in Postmenopausal Women

Abstract

Aim: Menopause involves the cessation of ovarian activity, follicular production, menstruation, and reproductive capacity, and may significantly affect women’s cognitive and emotional health. Estrogen receptors are highly expressed in brain regions such as the hippocampus, which are essential for learning and memory. The sharp decline in estrogen around age 50 may contribute to gray matter volume loss in dementia-vulnerable regions, potentially reflecting early neurodegenerative processes. This study investigated changes in cellular oxygenation capacity during menopause, their relationship with cognitive symptoms, and possible links to neurodegeneration.

Material and Methods: The study included 93 women: 53 postmenopausal and 40 premenopausal participants. Demographic data and cognitive assessments were collected using neurological tests, and blood samples were analyzed for HIF1A levels. Statistical analyses were performed using IBM SPSS Statistics 23.

Results: Compared with the premenopausal group, postmenopausal women showed significantly lower cognitive performance, particularly in MoCA scores (p=0.002; Holm p=0.006), and lower HIF1A levels (p=0.002; Holm p=0.006). QALY scores were lower before correction but became borderline after Holm adjustment, while EQ-VAS scores did not differ. Sensitivity analyses adjusted for age and EQ-VAS showed persistent MoCA differences, whereas HIF1A and QALY differences weakened.

Conclusion: Further studies should explore associations between HIF1A, neural atrophy, and estrogen-related molecular pathways.

Keywords

• HIF1A
• estrogen
• life quality
• menopause
• cognitive functions

Postmenopozal Kadınlarda HIF1A Ekspresyonu ve Nörodejeneratif Risk İlişkisi

Abstract

Amaç: Menopoz; over aktivitesinin, folikül üretiminin, menstruasyonun ve üreme kapasitesinin kalıcı olarak sona erdiği bir süreçtir ve kadınların bilişsel ile duygusal sağlığını önemli ölçüde etkileyebilir. Östrojen reseptörleri, öğrenme ve hafızada kritik rol oynayan hipokampus gibi beyin bölgelerinde yoğun olarak bulunur. Yaklaşık 50 yaşında görülen östrojen düşüşü, demansa duyarlı bölgelerde gri madde hacmi kaybına yol açarak erken nörodejeneratif süreçlerle ilişkili olabilir. Bu çalışmada menopoz sırasında hücresel oksijenlenme kapasitesindeki değişimlerin bilişsel semptomlar ve nörodejeneratif süreçlerle ilişkisi araştırıldı.

Gereç ve Yöntem: Çalışmaya 53 postmenopozal ve 40 premenopozal olmak üzere toplam 93 kadın dahil edildi. Katılımcıların demografik verileri ve nörolojik testlerle bilişsel değerlendirmeleri yapıldı, kan örneklerinde HIF1A düzeyleri analiz edildi. İstatistiksel analizlerde IBM SPSS Statistics 23 kullanıldı.

Bulgular: Premenopozal gruba kıyasla postmenopozal kadınlarda bilişsel performans, özellikle MoCA skorları, anlamlı derecede düşüktü (p=0.002; Holm p=0.006). HIF1A düzeyleri de postmenopozal grupta daha düşük bulundu (p=0.002; Holm p=0.006). QALY skorları düzeltme öncesinde düşük görünse de Holm düzeltmesi sonrası sınırda kaldı; EQ-VAS açısından fark saptanmadı. Yaş ve EQ-VAS için yapılan duyarlılık analizlerinde MoCA farkı devam ederken, HIF1A ve QALY farkları zayıfladı.

Sonuç: HIF1A düzeyleri, nöral atrofi ve östrojen ilişkili moleküler yolaklar arasındaki ilişkinin ileri çalışmalarla araştırılması gerekmektedir.

Keywords

• HIF1A
• östrojen
• yaşam kalitesi
• menopoz
• bilişsel işlevler

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