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    Additional file 2 of Estrogen metabolites in premenopausal women living in China, Mongolia, and the United Kingdom
    (Figshare (United Kingdom), 2026-06-10)
    Lauren C. Houghton
    ;
    ;
    Isabel Dos Santos Silva
    ;
    Roni Falk
    ;
    Michelle L. Lui
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Additional file 3 of Estrogen metabolites in premenopausal women living in China, Mongolia, and the United Kingdom
    (Figshare (United Kingdom), 2026-06-10)
    Lauren C. Houghton
    ;
    ;
    Isabel Dos Santos Silva
    ;
    Roni Falk
    ;
    Michelle L. Lui
    Supplementary Material 3. Supplemental Table 1. Adjusted least square means for selected metabolites (pg/mL per mg of creatinine).
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Additional file 3 of Estrogen metabolites in premenopausal women living in China, Mongolia, and the United Kingdom
    (Figshare (United Kingdom), 2026-06-10)
    Lauren C. Houghton
    ;
    ;
    Isabel Dos Santos Silva
    ;
    Roni Falk
    ;
    Michelle L. Lui
    Supplementary Material 3. Supplemental Table 1. Adjusted least square means for selected metabolites (pg/mL per mg of creatinine).
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Additional file 1 of Estrogen metabolites in premenopausal women living in China, Mongolia, and the United Kingdom
    (Figshare (United Kingdom), 2026-06-10)
    Lauren C. Houghton
    ;
    ;
    Isabel Dos Santos Silva
    ;
    Roni Falk
    ;
    Michelle L. Lui
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Additional file 2 of Estrogen metabolites in premenopausal women living in China, Mongolia, and the United Kingdom
    (Figshare (United Kingdom), 2026-06-10)
    Lauren C. Houghton
    ;
    ;
    Isabel Dos Santos Silva
    ;
    Roni Falk
    ;
    Michelle L. Lui
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Additional file 1 of Estrogen metabolites in premenopausal women living in China, Mongolia, and the United Kingdom
    (Figshare (United Kingdom), 2026-06-10)
    Lauren C. Houghton
    ;
    ;
    Isabel Dos Santos Silva
    ;
    Roni Falk
    ;
    Michelle L. Lui
  • Some of the metrics are blocked by your 
    Item type:Publication,
    Risk factors for active tuberculosis in 938 QuantiFERON-positive schoolchildren in Mongolia: a community-based cross-sectional study
    (BioMed Central, 2019-06-17) ;
    Polyna Khudyakov
    ;
    Uyanga Buyanjargal
    ;
    Delgerekh Baigal
    ;
    BACKGROUND: There is controversy regarding the relative influence of 'exogenous' versus 'endogenous' factors on the risk of progression from latent tuberculosis infection to active tuberculosis (TB) disease in children. METHODS: We conducted a cross-sectional analysis to identify risk factors for active tuberculosis in QuantiFERON®-TB Gold (QFT-G)-positive children aged 6-13 years attending 18 schools in Ulaanbaatar, Mongolia. Children underwent clinical and radiological screening for active tuberculosis, and data relating to potential risk factors for disease progression were collected by questionnaire and determination of serum 25-hydroxyvitamin D (25[OH]D) concentrations. Risk ratios were calculated using generalized estimating equations with adjustment for potential confounders. RESULTS: 129/938 (13.8%) QFT-positive children were diagnosed with active tuberculosis. Risk of active tuberculosis was independently associated with household exposure to pulmonary TB (adjusted risk ratio [aRR] 2.40, 95% CI 1.74 to 3.30, P < 0.001), month of sampling (adjusted risk ratio [aRR] for March-May vs. June-November 3.31, 95% CI 1.63 to 6.74, P < 0.001; aRR for December-February vs. June-November 2.53, 95% CI 1.23 to 5.19, P = 0.01) and active smoking by the child (aRR 5.23, 95% CI 2.70 to 10.12, P < 0.001). No statistically significant independent association was seen for age, sex, socio-economic factors, presence of a Bacillus Calmette-Guérin (BCG) scar, tobacco exposure or vitamin D status. CONCLUSIONS: Household exposure to active TB, winter or spring season and active smoking were independently associated with risk of active tuberculosis in QFT-positive children. Our findings highlight the potentially high yield of screening child household contacts of infectious index cases for active tuberculosis in low- and middle-income countries.
    Scopus© Citations 14
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    Item type:Publication,
    Estrogen metabolites in premenopausal women living in China, Mongolia, and the United Kingdom
    (2026-06)
    Houghton, Lauren C
    ;
    ;
    Dos Santos Silva, Isabel
    ;
    Falk, Roni
    ;
    Lui, Michelle L
    BACKGROUND: Breast cancer incidence is lower in women living in Asia than women living in North America and Northern Europe. However, large differences exist within Asia, for example, Mongolia's breast cancer rate is even lower than China's. Endogenous estrogens in Asian populations have been hypothesized to explain the disparity because of their strong positive correlations with breast cancer, though few studies have compared estrogen metabolites (EM) within Asia or between Asia and higher breast cancer risk countries. METHODS: We measured urinary concentrations of estradiol and estrone (parent estrogens) and 13 EM (non-parent estrogens) formed by irreversible hydroxylation at the C-2, C-4, or C-16 positions of the steroid ring in premenopausal women living in Ulaanbaatar, Mongolia (n = 282), Shanghai, China (n = 121), and the United Kingdom (n = 125). We performed analysis of variance (ANOVA) using a generalized linear model procedure to assess differences in hormone concentrations between British and Asian (Chinese and Mongolian), and Chinese and Mongolian. Exponentiated least square means were used to calculate percent differences. We compared differences in overall means adjusted for age, body mass index, and parity by country during the follicular, peri-ovulatory, and luteal phases. RESULTS: Total, parent, and non-parent estrogen concentrations were generally higher in British than Asian women, while the non-parent to parent ratio was lower. While parent estrogens appeared higher in Chinese compared with Mongolian women, differences did not reach statistical significance except for peri-ovulatory estrone; total estrogen metabolites in the 2-, 4-, and 16-pathways were higher in Mongolian than Chinese women. The non-parent to parent ratio was highest in Mongolian women followed by Chinese women, with British women having the lowest ratio. CONCLUSION: Total urinary estrogens, both parent and their metabolites, were higher in British compared with Asian women. Our data showing the ratio of non-parent to parent estrogens, possibility reflecting greater estrogen metabolism, in women living in Mongolia, with one of the lowest breast cancer rates globally, than in women living in China, and in Chinese compared with British women, are consistent with their relative breast cancer risks and suggestive of a potentially protective metabolic profile.
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    Item type:Publication,
    Prevalence and Determinants of QuantiFERON-Diagnosed Tuberculosis Infection in 9810 Mongolian Schoolchildren
    (Oxford University Press, 2018-11-26) ;
    Polyna Khudyakov
    ;
    Uyanga Buyanjargal
    ;
    ;
    Delgerekh Baigal
    BACKGROUND: There is controversy regarding the potential influence of vitamin D deficiency, exposure to environmental tobacco smoke, BCG vaccination, season, and body habitus on susceptibility to Mycobacterium tuberculosis (MTB) infection. METHODS: We conducted a cross-sectional analysis to identify determinants of a positive QuantiFERON-TB Gold (QFT) assay result in children aged 6-13 years attending 18 schools in Ulaanbaatar, Mongolia. Data relating to potential risk factors for MTB infection were collected by questionnaire, physical examination, and determination of serum 25-hydroxyvitamin D (25[OH]D) concentrations. Risk ratios (RRs) were calculated with adjustment for potential confounders, and population attributable fractions (PAFs) were calculated for modifiable risk factors identified. RESULTS: Nine hundred forty-six of 9810 (9.6%) participants had a positive QFT result. QFT positivity was independently associated with household exposure to pulmonary tuberculosis (adjusted RR [aRR], 4.75 [95% confidence interval {CI}, 4.13-5.46, P < .001]; PAF, 13.1% [95% CI, 11.1%-15.0%]), vitamin D deficiency (aRR, 1.23 [95% CI, 1.08-1.40], P = .002; PAF, 5.7% [95% CI, 1.9%-9.3%]), exposure to environmental tobacco smoke (1 indoor smoker, aRR, 1.19 [95% CI, 1.04-1.35]; ≥2 indoor smokers, aRR, 1.30 [95% CI, 1.02-1.64]; P for trend = .006; PAF, 7.2% [95% CI, 2.2%-12.0%]), and increasing age (aRR per additional year, 1.14 [95% CI, 1.10-1.19], P < .001). No statistically significant independent association was seen for presence of a BCG scar, season of sampling, or body mass index. CONCLUSIONS: Vitamin D deficiency and exposure to environmental tobacco smoke are potentially modifiable risk factors for MTB infection.
    Scopus© Citations 35
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    Prevalence and Determinants of Vitamin D Deficiency in 9595 Mongolian Schoolchildren: A Cross-Sectional Study
    (2021-11)
    Bater, Jorick
    ;
    Bromage, Sabri
    ;
    Jambal, Tuyatsetseg
    ;
    Tsendjav, Enkhjargal
    ;
    Population-based data relating to vitamin D status of children in Northeast Asia are lacking. We conducted a cross-sectional study to determine the prevalence and determinants of vitamin D deficiency in 9595 schoolchildren aged 6-13 years in Ulaanbaatar (UB), the capital city of Mongolia. Risk factors for vitamin D deficiency were collected by questionnaire, and serum 25-hydroxyvitamin D (25[OH]D) concentrations were measured using an enzyme-linked fluorescent assay, standardized and categorized as deficient (25[OH]D <10 ng/mL) or not. Odds ratios for associations between independent variables and risk of vitamin D deficiency were calculated using multivariate analysis with adjustment for potential confounders. The prevalence of vitamins D deficiency was 40.6% (95% CI 39.7% to 41.6%). It was independently associated with female gender (adjusted odds ratio [aOR] for girls vs. boys 1.23, 95% CI 1.11-1.35), month of sampling (aORs for December-February vs. June-November 5.28 [4.53-6.15], March-May vs. June-November 14.85 [12.46-17.74]), lower levels of parental education (P for trend <0.001), lower frequency of egg consumption (P for trend <0.001), active tuberculosis (aOR 1.40 [1.03-1.94]), household smoking (aOR 1.13 [1.02 to1.25]), and shorter time outdoors (P for trend <0.001). We report a very high prevalence of vitamin D deficiency among Mongolian schoolchildren, which requires addressing as a public health priority.
    Scopus© Citations 11