Vogt, Elinor ChelsomReal, Francisco GómezHusebye, Eystein SverreBjörnsdottir, SigridurBenediktsdóttir, BryndísBertelsen, Randi JacobsenDemoly, PascalFranklin, Karl AndersGallastegui, Leire Sainz de AjaGonzález, Francisco Javier CallejasHeinrich, JoachimHolm, MathiasJogi, Nils OscarLeynaert, BenedicteLindberg, EvaMalinovschi, AndreiMartínez-Moratalla, JesúsMayoral, Raúl GodoyOudin, AnnaPereira-Vega, AntonioSemjen, Chantal RaherisonSchlünssen, ViviTriebner, KaiØksnes, Marianne2025-11-202025-11-202022-05Vogt, 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-22-00242049-361479105115650c6cad-92b4-4426-963d-4de3d048a02885131700149https://hdl.handle.net/20.500.11815/7090Funding 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.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.1246524eninfo:eu-repo/semantics/openAccessautoimmunepremature menopausepremature ovarian failurepremature ovarian insufficiencyprimary ovarian insufficiencyInternal MedicineEndocrinology, Diabetes and MetabolismEndocrinologySDG 3 - Good Health and Well-being/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article10.1530/EC-22-0024