Title: | Premature menopause and autoimmune primary ovarian insufficiency in two international multi-center cohorts |
Author: |
... 14 more authors Show all authors |
Date: | 2022-05 |
Language: | English |
Scope: | 1246524 |
School: | Health Sciences |
Department: | Other departments |
Series: | Endocrine Connections; 11(5) |
ISSN: | 2049-3614 |
DOI: | 10.1530/EC-22-0024 |
Subject: | Lungnalæknisfræði; 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 |
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
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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.
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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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