Lipid profile of women with premature ovarian failure.
OBJECTIVE
Earlier menopause is associated with a higher incidence of cardiovascular events later in life. Concurrent with the ages of menopausal transition, a shift in lipid profile takes place. Premature ovarian failure (POF) or premature menopause allows us to study the effect of cessation of ovarian function on the lipid profile independent of effects of advanced chronological age.


METHODS
Fasting triglycerides (TGs), total high-density lipoprotein (HDL), and low-density lipoprotein cholesterol levels were measured in 90 women with POF not using any hormone therapy and 198 population controls of the same age range not using oral contraceptives. Correlations between lipids and ovarian function parameters were assessed.


RESULTS
: After correction for age, body mass index, and smoking, women with POF presented with significantly higher TG levels (mean difference: 0.17 log mmol/L [95% CI: 0.06-0.29]). HDL cholesterol levels were borderline significantly lower in women with POF. No age-corrected correlation between triglycerides or other lipids and estradiol levels or time of estrogen deprivation could be identified. However, the free androgen index, sex hormone-binding globulin, and testosterone concentrations showed significant correlations with TGs and/or HDL cholesterol concentrations.


CONCLUSIONS
Loss of ovarian function at a very young age (POF) coincides with subtle changes in the lipid profile (higher TG levels and marginally lower HDL). Androgens (increased free androgen index and testosterone and decreased sex hormone-binding globulin) are better markers for unfavorable lipid changes compared with estrogen levels or duration of estrogen deprivation in women with POF. Elevated TG levels in combination with increased (free) androgens may be an early manifestation of reduced insulin sensitivity.
Knauff
Erik A H
EA
Department of Reproductive Medicine and Gynecology, University Medical Centre Utrecht, Utrecht, the Netherlands. knauff@gmail.com
Westerveld
Hendrika E
HE
Goverde
Angelique J
AJ
Eijkemans
Marinus J
MJ
Valkenburg
Olivier
O
van Santbrink
Evert J P
EJ
Fauser
Bart C J M
BC
van der Schouw
Yvonne T
YT
D000328:Adult; D000728:Androgens / Q000097:blood*; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D004967:Estrogens / Q000097:blood; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D008055:Lipids / Q000097:blood*; D008594:Menopause, Premature / Q000097:blood*; D009426:Netherlands; D016649:Primary Ovarian Insufficiency / Q000097:blood*; D012016:Reference Values; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D016387:Women's Health
D000728:Androgens; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004967:Estrogens; D012739:Gonadal Steroid Hormones; D008055:Lipids; D014280:Triglycerides