Jacob P Christ1, Marlise N Gunning2, Giulia Palla3, Marinus J C Eijkemans4, Cornelis B Lambalk5, Joop S E Laven6, Bart C J M Fauser2. 1. Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, the Netherlands; Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio. Electronic address: J.P.Christ@umcutrecht.nl. 2. Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, the Netherlands. 3. Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, the Netherlands; University of Pisa Medical Center, Pisa, Italy. 4. Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands. 5. Department of Obstetrics and Gynecology, VU Medical Center, Amsterdam, the Netherlands. 6. Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, the Netherlands.
Abstract
OBJECTIVE: To evaluate the association between estrogen (E) exposure and deficiency and cardiovascular disease (CVD) risk among women with primary ovarian insufficiency (POI). DESIGN: Cross-sectional study conducted between 1996 and 2016. SETTING: Tertiary referral centers. PATIENT(S): A total of 385 women with POI, defined by amenorrhea and FSH levels ≥40 IU/L before 40 years of age, were recruited. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Women underwent a standardized intake questionnaire including data on menstrual cyclicity. Lifetime E exposure and E-free period were assessed. Serum was analyzed for endocrine and CVD profiles. The Framingham 30-year risk of CVD was calculated. RESULT(S): Lifetime E exposure (mean ± SD) was 19.3 ± 7.0 years, E-free period was 3.1 ± 4.1 years, and age at screening was 34.8 ± 7.4 years. In multivariate models E-free interval associated positively with estimated risk of hard and general CVD events (β 0.18 [95% confidence interval 0.08, 0.29]; 0.20 [0.05, 0.35], respectively), and lifetime E exposure associated negatively with estimated risk of hard and general CVD events (-0.15 [-0.24, -0.05]; -0.16 [-0.29, -0.03], respectively), as well as low density lipoprotein cholesterol (-0.03 [-0.06, 0.00]) and non-high density lipoprotein cholesterol (-0.04 [-0.07, 0.00]). CONCLUSION(S): Prolonged E deprivation is associated with an increased estimated risk of CVD, whereas prolonged E exposure is associated with a reduced estimated risk. These results support the policy of early and continued use of E replacement therapy in women with POI. CLINICAL TRIAL REGISTRATION NUMBER: NCT0230904.
OBJECTIVE: To evaluate the association between estrogen (E) exposure and deficiency and cardiovascular disease (CVD) risk among women with primary ovarian insufficiency (POI). DESIGN: Cross-sectional study conducted between 1996 and 2016. SETTING: Tertiary referral centers. PATIENT(S): A total of 385 women with POI, defined by amenorrhea and FSH levels ≥40 IU/L before 40 years of age, were recruited. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Women underwent a standardized intake questionnaire including data on menstrual cyclicity. Lifetime E exposure and E-free period were assessed. Serum was analyzed for endocrine and CVD profiles. The Framingham 30-year risk of CVD was calculated. RESULT(S): Lifetime E exposure (mean ± SD) was 19.3 ± 7.0 years, E-free period was 3.1 ± 4.1 years, and age at screening was 34.8 ± 7.4 years. In multivariate models E-free interval associated positively with estimated risk of hard and general CVD events (β 0.18 [95% confidence interval 0.08, 0.29]; 0.20 [0.05, 0.35], respectively), and lifetime E exposure associated negatively with estimated risk of hard and general CVD events (-0.15 [-0.24, -0.05]; -0.16 [-0.29, -0.03], respectively), as well as low density lipoprotein cholesterol (-0.03 [-0.06, 0.00]) and non-high density lipoprotein cholesterol (-0.04 [-0.07, 0.00]). CONCLUSION(S): Prolonged E deprivation is associated with an increased estimated risk of CVD, whereas prolonged E exposure is associated with a reduced estimated risk. These results support the policy of early and continued use of E replacement therapy in women with POI. CLINICAL TRIAL REGISTRATION NUMBER: NCT0230904.
Authors: Sybil L Crawford; Carolyn J Crandall; Carol A Derby; Samar R El Khoudary; L Elaine Waetjen; Mary Fischer; Hadine Joffe Journal: Menopause Date: 2018-12-21 Impact factor: 2.953
Authors: Nicholas S Wilcox; Seth J Rotz; McKay Mullen; Evelyn J Song; Betty Ky Hamilton; Javid Moslehi; Saro H Armenian; Joseph C Wu; June-Wha Rhee; Bonnie Ky Journal: Circ Res Date: 2022-02-17 Impact factor: 17.367
Authors: Angela H E M Maas; Giuseppe Rosano; Renata Cifkova; Alaide Chieffo; Dorenda van Dijken; Haitham Hamoda; Vijay Kunadian; Ellen Laan; Irene Lambrinoudaki; Kate Maclaran; Nick Panay; John C Stevenson; Mick van Trotsenburg; Peter Collins Journal: Eur Heart J Date: 2021-03-07 Impact factor: 29.983
Authors: Marlise N Gunning; Cindy Meun; Bas B van Rijn; Nadine M P Daan; Jeanine E Roeters van Lennep; Yolande Appelman; Eric Boersma; Leonard Hofstra; Clemens G K M Fauser; Oscar L Rueda-Ochoa; Mohammad A Ikram; Maryam Kavousi; Cornelis B Lambalk; Marinus J C Eijkemans; Joop S E Laven; Bart C J M Fauser Journal: PLoS One Date: 2020-03-05 Impact factor: 3.240
Authors: Santiago Palacios; John C Stevenson; Katrin Schaudig; Monika Lukasiewicz; Alessandra Graziottin Journal: Womens Health (Lond) Date: 2019 Jan-Dec