Estrogen deprivation and cardiovascular disease risk in primary ovarian insufficiency
Open accessAbstract
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.
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From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [330]
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From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [330]
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- Authors
- Christ, J. P., Gunning, M. N., Palla, G., Eijkemans, M. J. C., Lambalk, C. B., Laven, J. S. E., & Fauser, B. C. J. M.
- Affiliations
- University Medical Center Utrecht (NL)
- University of Pisa (IT)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Erasmus MC (NL)
- Corresponding author
- Christ, Jacob P.
- ORCID
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2018-04
- Volume
- 109
- Issue
- 4
- Pages
- 594-600.e1
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2794655584
- Cited by
- 102
- References
- 27
- Citations by year
- 2026: 8 · 2025: 7 · 2024: 8 · 2023: 7 · 2022: 33 · 2021: 10 · 2020: 12 · 2019: 13 · 2018: 4
- FWCI
- 7.75
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Pure Amsterdam UMC (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Danone
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Estrogen and related hormone effects
- Keywords
- primary ovarian insufficiency, estrogen deprivation, cardiovascular risk, estrogen replacement therapy, lipid profile, LDL cholesterol, non-HDL cholesterol
- MeSH terms
- Adult, Cardiovascular Diseases, Cross-Sectional Studies, Estradiol, Female, Humans, Netherlands, Prognosis, Risk Factors, Time Factors, Biomarkers, Estrogen Replacement Therapy, Primary Ovarian Insufficiency, Risk Assessment, Protective Factors
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