Available online 15 April 2024

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Early ovarian cessation even in young women play a role in development of unfavorably altered lipid profile.

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Women with newly diagnosed POI exhibited adverse lipid profile along with higher fasting glucose level in contrary to age-matched healthy controls.

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Women with non-idiopathic POI present unfavorably altered lipid profile when compared to women with unknown cause of POI.

AbstractBackground

Hypoestrogenism related to the cessation of ovarian function increases the risk of metabolic disorders in postmenopausal women. Women with primary ovarian insufficiency (POI) are exposed to longer period of estrogen deficiency together with a subsequently higher risk of long-term comorbidities.

Objective

To compare metabolic along with hormonal status among newly diagnosed women with POI with pre- and postmenopausal women. To investigate the impact of POI etiology on both metabolic and hormonal profiles.

Methods

A case-control study with women assigned to one of the groups: 1) POI (n=216), 2) age-matched premenopausal (n=216), 3) postmenopausal (n=227). Lipid profile, fasting glucose and insulin levels together with insulin resistance were determined among all participants.

Results

POI women exhibited increased both total cholesterol (TC, p=0.04) and low-density lipoprotein cholesterol (LDL-C, p<0.01) compared to the premenopausal women and higher triglycerides (TG, p<0.001) than postmenopausal women. POI group showed higher fasting glucose level (p=0.04) differently to premenopausal women. The idiopathic POI group showed both lower SHBG (p=0.02) and DHEA-s (p=0.04) along with reduced TC (p=0.03) and TG (p=0.01) together with increased HDL-C (p=0.04) levels than non-idiopathic POI women.

Conclusion

Women with newly diagnosed POI exhibited less favorable lipid profile than pre- or postmenopausal women. The association of negatively changed lipid profile in POI women is mostly mediated by women with unknown cause of premature ovarian cessation.

Section snippetsINTRODUCTION

Premature ovarian insufficiency (POI) is defined as the cessation of ovarian function before the age of 40 along with elevated levels of follicle-stimulating hormone (FSH) >25 IU/L1. POI is diagnosed among 1-2% of women worldwide and may be caused by chromosomal and genetic defects, autoimmune processes, chemotherapy, radiation, infections and surgery, however, majority of cases remain unidentified2.

Ovarian estradiol is known to exert important anti-obesity effects in human and animal models3.

Study participants

In this case-control study, conducted from Jan 2015 – Jan 2020, women from the Department of Gynaecological Endocrinology of the University Hospital were enrolled to one of the following groups:

1)

POI women (n=216) with normal karyotype,

2)

premenopausal participants age-matched to POI women (n=216),

3)

postmenopausal women (n=227).

Women with POI were diagnosed based on meeting two of the following criteria both: menstrual disorders either oligomenorrhoea or amenorrhea for at least 4 months and elevated

Hormonal profile in POI versus pre-and postmenopausal women

Among POI women one hundred thirty-three (61.6%) had irregular menstrual bleeding. However, eighty-three (38.4%) of newly diagnosed POI women complained about amenorrhea for more than 4 months. In postmenopausal group the mean time since menopause was 15± 2 months.

POI women showed higher SBP, remaining within the ranges, than premenopausal ones (p=0.04). There were no differences in BP and MAP between POI and postmenopausal women. Eleven postmenopausal (4.8%) and three POI women (1.4%) were

DISCUSSION

The present study showed that women with newly diagnosed POI exhibited unfavorable lipid profile along with negatively changed glucose and insulin status than pre- or postmenopausal women. The association of negatively changed lipid profile in POI women is mostly mediated by women with unknown cause of POI. This study provides new insights into the etiology-dependent POI pathophysiology.

We showed that women with POI had significantly higher testosterone and DHEA-s levels when compared to the

CONCLUSSION

Women with newly diagnosed POI exhibited less favorable lipid profile than pre- or postmenopausal women. The association of negatively changed lipid profile in POI women is mostly mediated by women with unknown cause of POI. These findings suggest that further larger research would be warranted to confirm our findings. Future studies could also expand the knowledge whether an early POI diagnosis may improve health condition in POI women.

CRediT authorship contribution statement

Piróg Magdalena: Conceptualization, Data curation, Formal analysis, Writing – original draft, Writing – review & editing. Kacalska-Janssen Olga: Data curation, Formal analysis. Pulka Anna: Data curation, Formal analysis, Writing – original draft, Writing – review & editing. Jach Robert: Methodology, Validation, Project administration.

Declaration of competing interest

No.

Data availability

The data underlying this article will be shared on reasonable request to the corresponding author and after permission of the relevant medical ethical committees.

Funding

None.

Ethical Approval

The Jagiellonian University Medical College Ethical Committee approved the study [No. KBET/292/B/2017], and participants provided informed consent in accordance with the Declaration of Helsinki.

Use of AI and AI-assisted Technologies Statement

We have not used AI and AI-assisted Technologies.

Provenance and peer review

This article was not commissioned and was externally peer reviewed.

Acknowledgement

None.

Supplementary materials

None.

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© 2024 Published by Elsevier Inc. on behalf of National Lipid Association.