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Premature menopause and autoimmune primary ovarian insufficiency in two international multi-center cohorts

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-s...

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Detalles Bibliográficos
Autores principales: Vogt, Elinor Chelsom, Real, Francisco Gómez, Husebye, Eystein Sverre, Björnsdottir, Sigridur, Benediktsdottir, Bryndis, Bertelsen, Randi Jacobsen, Demoly, Pascal, Franklin, Karl Anders, de Aja Gallastegui, Leire Sainz, González, Francisco Javier Callejas, Heinrich, Joachim, Holm, Mathias, Jogi, Nils Oscar, Leynaert, Benedicte, Lindberg, Eva, Malinovschi, Andrei, Martínez-Moratalla, Jesús, Mayoral, Raúl Godoy, Oudin, Anna, Pereira-Vega, Antonio, Semjen, Chantal Raherison, Schlünssen, Vivi, Triebner, Kai, Øksnes, Marianne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Bioscientifica Ltd 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9175594/
https://www.ncbi.nlm.nih.gov/pubmed/35521804
http://dx.doi.org/10.1530/EC-22-0024
Descripción
Sumario: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.