Indicators of lifetime endogenous estrogen exposure and risk of venous thromboembolism.
BACKGROUND
Lifetime estrogen exposure has been related to breast cancer risk, osteoporosis, and cardiovascular disease but data on venous thromboembolism (VTE) risk are limited.


METHODS
Data from a hospital-based case-control study among 608 postmenopausal women (191 with a first episode of idiopathic VTE and 417 age-matched controls) were used to determine whether estrogen exposure, as assessed by age at menopause [classified as early (< or = 45 years), normal (46-54 years) and late menopause (> or = 55 years)] and parity, was associated with the risk of VTE.


RESULTS
After adjustment for potential confounding variables, the risk of VTE was increased with each year's delay in the menopause [odds ratio (OR) = 1.06, 95% confidence interval (CI) = 1.02-1.10, P < 0.0075]. When compared with women with normal menopause used as a reference, the adjusted OR for VTE was 0.59 (95% CI = 0.36-0.97) and 2.53 (95% CI = 1.28-4.99) for women with early menopause and late menopause, respectively (P = 0.001). Adjusted OR for VTE was also higher for women with more than two children when compared with those with less than or equal to two children (1.56, 95% CI = 1.03-2.34, P = 0.03). The lowest risk of VTE was observed in women with early menopause and lower parity (adjusted OR = 0.60, 95% CI = 0.30-1.24), the highest risk was among women with late menopause who have had more than two children (adjusted OR = 3.41, 95% CI = 1.46-9.25).


CONCLUSIONS
These results show that the longer exposure to endogenous estrogen is associated with an increased VTE risk.
Simon
T
T
Cardiovascular Epidemiology, Villejuif, France.
Beau Yon de Jonage-Canonico
M
M
Oger
E
E
Wahl
D
D
Conard
J
J
Meyer
G
G
Emmerich
J
J
Barrellier
M-T
MT
Guiraud
A
A
Scarabin
P-Y
PY
D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D004967:Estrogens / Q000097:blood*; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D016017:Odds Ratio; D010298:Parity; D011247:Pregnancy; D011655:Pulmonary Embolism / Q000453:epidemiology / Q000209:etiology; D012306:Risk; D013923:Thromboembolism / Q000453:epidemiology / Q000209:etiology; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology*
D004967:Estrogens