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Premature menopause and autoimmune primary ovarian insufficiency in two international multi-center cohorts

Premature menopause and autoimmune primary ovarian insufficiency in two international multi-center cohorts


Title: Premature menopause and autoimmune primary ovarian insufficiency in two international multi-center cohorts
Author: Vogt, Elinor Chelsom
Real, Francisco Gómez
Husebye, Eystein Sverre
Björnsdottir, Sigridur
Benediktsdóttir, Bryndís
Bertelsen, Randi Jacobsen
Demoly, Pascal
Franklin, Karl Anders
Gallastegui, Leire Sainz de Aja
González, Francisco Javier Callejas
... 14 more authors Show all authors
Date: 2022-05
Language: English
Scope:
University/Institute: Landspitali - The National University Hospital of Iceland
School: Health Sciences
Series: Endocrine Connections; 11(5)
ISSN: 2049-3614
DOI: https://doi.org/10.1530/EC-22-0024
Subject: autoimmune; premature menopause; premature ovarian failure; premature ovarian insufficiency; primary ovarian insufficiency; Internal Medicine; Endocrinology, Diabetes and Metabolism; Endocrinology
URI: https://hdl.handle.net/20.500.11815/3903

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Citation:

Vogt , E C , Real , F G , Husebye , E S , Björnsdottir , S , Benediktsdóttir , B , Bertelsen , R J , Demoly , P , Franklin , K A , Gallastegui , L S D A , González , F J C , Heinrich , J , Holm , M , Jogi , N O , Leynaert , B , Lindberg , E , Malinovschi , A , Martínez-Moratalla , J , Mayoral , R G , Oudin , A , Pereira-Vega , A , Semjen , C R , Schlünssen , V , Triebner , K & Øksnes , M 2022 , ' Premature menopause and autoimmune primary ovarian insufficiency in two international multi-center cohorts ' , Endocrine Connections , vol. 11 , no. 5 , e220024 . https://doi.org/10.1530/EC-22-0024

Abstract:

Objective: To investigate markers of premature menopause (<40 years) and specifically the prevalence of autoimmune primary ovarian insufficiency (POI) in European women. Design: Postmenopausal women were categorized according to age at menopause and self-reported reason for menopause in a cross-sectional analysis of 6870 women. Methods: Variables associated with the timing of menopause and hormone measurements of 17β-estradiol and follicle-stimulating hormone were explored using multivariable logistic regression analysis. Specific immunoprecipitating assays of steroidogenic autoantibodies against 21-hydroxylase (21-OH), side-chain cleavage enzyme (anti-SCC) and 17alpha-hydroxylase (17 OH), as well as NACHT leucine-rich-repeat protein 5 were used to identify women with likely autoimmune POI. Results: Premature menopause was identified in 2.8% of women, and these women had higher frequencies of nulliparity (37.4% vs 19.7%), obesity (28.7% vs 21.4%), osteoporosis (17.1% vs 11.6%), hormone replacement therapy (59.1% vs 36.9%) and never smokers (60.1% vs 50.9%) (P < 0.05), compared to women with menopause ≥40 years. Iatrogenic causes were found in 91 (47%) and non-ovarian causes in 27 (14%) women, while 77 (39%) women were classified as POI of unknown cause, resulting in a 1.1% prevalence of idiopathic POI. After adjustments nulliparity was the only variable significantly associated with POI (odds ratio 2.46; 95% CI 1.63–3.42). Based on the presence of autoantibodies against 21 OH and SCC, 4.5% of POI cases were of likely autoimmune origin. Conclusion: Idiopathic POI affects 1.1% of all women and almost half of the women with premature menopause. Autoimmunity explains 4.5% of these cases judged by positive steroidogenic autoantibodies.

Description:

Funding Information: The study was supported by grants and fellowships from Stiftelsen Kristian Gerhard Jebsen, The Norwegian Research Council, University of Bergen, and The Regional Health Authorities of Western Norway. Publisher Copyright: © 2022 The authors Published by Bioscientifica Ltd.

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