Coronary artery calcification in middle-aged women with premature ovarian insufficiency

Marlise N. Gunning, Cindy Meun, Bas B. van Rijn, Angela H.E.M. Maas, Laura Benschop, Arie Franx, Eric Boersma, Ricardo P.J. Budde, Yolande Appelman, Cornelis B. Lambalk, Marinus J.C. Eijkemans, Birgitta K. Velthuis, Joop S.E. Laven, Bart C.J.M. Fauser, Erik Koffijberg,

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objective: Women with premature ovarian insufficiency (POI) enter menopause before age 40. Early menopause was associated with increased risk for coronary artery disease (CAD), death from cardiovascular disease and all-cause mortality. We compared the prevalence of CAD between middle-aged women on average 10 years following the initial POI diagnosis, with a population-based cohort. Design: Cross-sectional case-control study. Participants: Women from two Dutch University Medical Centers above 45 years of age previously diagnosed with POI (n = 98) were selected and compared with age- and race-matched controls from the Multi-Ethnic Study of Atherosclerosis (MESA). Measurements: The primary outcome was detectable coronary artery calcium (CAC) determined by coronary computed tomography (CCT). Results: Women with POI had significantly higher blood pressure, cholesterol and glucose, despite lower BMI compared to controls. Similar proportions of detectable CAC (CAC score >0 Agatston Units) were observed in women with POI and controls (POI n = 16 (16%), controls n = 52 (18%), P = 0.40 and Padj = 0.93). In women with POI separately, we were not able to identify associations between CVD risk factors and CAC. The following CVD risk factors in controls were positively associated with CAC: age, diabetes mellitus, hypertension and LDL cholesterol. HRT use was negatively associated with CAC in controls. Conclusions: The presence of CAC did not differ significantly in women with POI around 50 years of age, compared to an age- and race-matched control group. We observe no increased calcified coronary disease in POI patients, despite the presence of unfavourable cardiovascular risk factors in these women.

Original languageEnglish
Pages (from-to)314-322
Number of pages9
JournalClinical Endocrinology
Volume91
Issue number2
DOIs
Publication statusPublished - 1 Aug 2019

Fingerprint

Coronary Vessels
Calcium
Menopause
Coronary Artery Disease
Hypertension
LDL Cholesterol
Coronary Disease
Blood Glucose
Case-Control Studies
Atherosclerosis
Diabetes Mellitus
Research Design
Cardiovascular Diseases
Cholesterol
Tomography
Control Groups
Mortality
Population

Keywords

  • UT-Hybrid-D
  • coronary artery calcium score
  • menopause
  • POI
  • reproductive disorder
  • risk factor
  • cardiovascular

Cite this

Gunning, M. N., Meun, C., van Rijn, B. B., Maas, A. H. E. M., Benschop, L., Franx, A. (2019). Coronary artery calcification in middle-aged women with premature ovarian insufficiency. Clinical Endocrinology, 91(2), 314-322. https://doi.org/10.1111/cen.14003
Gunning, Marlise N. ; Meun, Cindy ; van Rijn, Bas B. ; Maas, Angela H.E.M. ; Benschop, Laura ; Franx, Arie ; Boersma, Eric ; Budde, Ricardo P.J. ; Appelman, Yolande ; Lambalk, Cornelis B. ; Eijkemans, Marinus J.C. ; Velthuis, Birgitta K. ; Laven, Joop S.E. ; Fauser, Bart C.J.M. ; Koffijberg, Erik. / Coronary artery calcification in middle-aged women with premature ovarian insufficiency. In: Clinical Endocrinology. 2019 ; Vol. 91, No. 2. pp. 314-322.
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abstract = "Objective: Women with premature ovarian insufficiency (POI) enter menopause before age 40. Early menopause was associated with increased risk for coronary artery disease (CAD), death from cardiovascular disease and all-cause mortality. We compared the prevalence of CAD between middle-aged women on average 10 years following the initial POI diagnosis, with a population-based cohort. Design: Cross-sectional case-control study. Participants: Women from two Dutch University Medical Centers above 45 years of age previously diagnosed with POI (n = 98) were selected and compared with age- and race-matched controls from the Multi-Ethnic Study of Atherosclerosis (MESA). Measurements: The primary outcome was detectable coronary artery calcium (CAC) determined by coronary computed tomography (CCT). Results: Women with POI had significantly higher blood pressure, cholesterol and glucose, despite lower BMI compared to controls. Similar proportions of detectable CAC (CAC score >0 Agatston Units) were observed in women with POI and controls (POI n = 16 (16{\%}), controls n = 52 (18{\%}), P = 0.40 and Padj = 0.93). In women with POI separately, we were not able to identify associations between CVD risk factors and CAC. The following CVD risk factors in controls were positively associated with CAC: age, diabetes mellitus, hypertension and LDL cholesterol. HRT use was negatively associated with CAC in controls. Conclusions: The presence of CAC did not differ significantly in women with POI around 50 years of age, compared to an age- and race-matched control group. We observe no increased calcified coronary disease in POI patients, despite the presence of unfavourable cardiovascular risk factors in these women.",
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author = "Gunning, {Marlise N.} and Cindy Meun and {van Rijn}, {Bas B.} and Maas, {Angela H.E.M.} and Laura Benschop and Arie Franx and Eric Boersma and Budde, {Ricardo P.J.} and Yolande Appelman and Lambalk, {Cornelis B.} and Eijkemans, {Marinus J.C.} and Velthuis, {Birgitta K.} and Laven, {Joop S.E.} and Fauser, {Bart C.J.M.} and Sara Baart and Laura Brouwers and Suzanne Cannegieter and Veerle Dam and Nadine Daan and Rene Eijkemans and Michel Ferrari and {de Groot}, Christianne and Annemieke Hoek and Erik Koffijberg and Wendy Koster and Mark Kruit and Giske Lagerweij and Nils Lambalk and Katie Linstra and {van der Lugt}, Aad and {van den Brink}, {Antoinette Maassen} and Saskia Middeldorp and Karel Moons and {van Lennep}, {Jeanine Roeters} and Jolien Roos-Hesselink and Luuk Scheres and {van der Schouw}, Yvonne and Eric Steegers and Regine Steegers and Gisela Terwindt and Marieke Wermer and Bart Zick and Gerbrand Zoet",
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Gunning, MN, Meun, C, van Rijn, BB, Maas, AHEM, Benschop, L, Franx, A, Boersma, E, Budde, RPJ, Appelman, Y, Lambalk, CB, Eijkemans, MJC, Velthuis, BK, Laven, JSE, Fauser, BCJM, Koffijberg, E 2019, 'Coronary artery calcification in middle-aged women with premature ovarian insufficiency' Clinical Endocrinology, vol. 91, no. 2, pp. 314-322. https://doi.org/10.1111/cen.14003

Coronary artery calcification in middle-aged women with premature ovarian insufficiency. / Gunning, Marlise N.; Meun, Cindy; van Rijn, Bas B.; Maas, Angela H.E.M.; Benschop, Laura; Franx, Arie; Boersma, Eric; Budde, Ricardo P.J.; Appelman, Yolande; Lambalk, Cornelis B.; Eijkemans, Marinus J.C.; Velthuis, Birgitta K.; Laven, Joop S.E.; Fauser, Bart C.J.M.; Koffijberg, Erik.

In: Clinical Endocrinology, Vol. 91, No. 2, 01.08.2019, p. 314-322.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Coronary artery calcification in middle-aged women with premature ovarian insufficiency

AU - Gunning, Marlise N.

AU - Meun, Cindy

AU - van Rijn, Bas B.

AU - Maas, Angela H.E.M.

AU - Benschop, Laura

AU - Franx, Arie

AU - Boersma, Eric

AU - Budde, Ricardo P.J.

AU - Appelman, Yolande

AU - Lambalk, Cornelis B.

AU - Eijkemans, Marinus J.C.

AU - Velthuis, Birgitta K.

AU - Laven, Joop S.E.

AU - Fauser, Bart C.J.M.

AU - Baart, Sara

AU - Brouwers, Laura

AU - Cannegieter, Suzanne

AU - Dam, Veerle

AU - Daan, Nadine

AU - Eijkemans, Rene

AU - Ferrari, Michel

AU - de Groot, Christianne

AU - Hoek, Annemieke

AU - Koffijberg, Erik

AU - Koster, Wendy

AU - Kruit, Mark

AU - Lagerweij, Giske

AU - Lambalk, Nils

AU - Linstra, Katie

AU - van der Lugt, Aad

AU - van den Brink, Antoinette Maassen

AU - Middeldorp, Saskia

AU - Moons, Karel

AU - van Lennep, Jeanine Roeters

AU - Roos-Hesselink, Jolien

AU - Scheres, Luuk

AU - van der Schouw, Yvonne

AU - Steegers, Eric

AU - Steegers, Regine

AU - Terwindt, Gisela

AU - Wermer, Marieke

AU - Zick, Bart

AU - Zoet, Gerbrand

N1 - Wiley deal

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Objective: Women with premature ovarian insufficiency (POI) enter menopause before age 40. Early menopause was associated with increased risk for coronary artery disease (CAD), death from cardiovascular disease and all-cause mortality. We compared the prevalence of CAD between middle-aged women on average 10 years following the initial POI diagnosis, with a population-based cohort. Design: Cross-sectional case-control study. Participants: Women from two Dutch University Medical Centers above 45 years of age previously diagnosed with POI (n = 98) were selected and compared with age- and race-matched controls from the Multi-Ethnic Study of Atherosclerosis (MESA). Measurements: The primary outcome was detectable coronary artery calcium (CAC) determined by coronary computed tomography (CCT). Results: Women with POI had significantly higher blood pressure, cholesterol and glucose, despite lower BMI compared to controls. Similar proportions of detectable CAC (CAC score >0 Agatston Units) were observed in women with POI and controls (POI n = 16 (16%), controls n = 52 (18%), P = 0.40 and Padj = 0.93). In women with POI separately, we were not able to identify associations between CVD risk factors and CAC. The following CVD risk factors in controls were positively associated with CAC: age, diabetes mellitus, hypertension and LDL cholesterol. HRT use was negatively associated with CAC in controls. Conclusions: The presence of CAC did not differ significantly in women with POI around 50 years of age, compared to an age- and race-matched control group. We observe no increased calcified coronary disease in POI patients, despite the presence of unfavourable cardiovascular risk factors in these women.

AB - Objective: Women with premature ovarian insufficiency (POI) enter menopause before age 40. Early menopause was associated with increased risk for coronary artery disease (CAD), death from cardiovascular disease and all-cause mortality. We compared the prevalence of CAD between middle-aged women on average 10 years following the initial POI diagnosis, with a population-based cohort. Design: Cross-sectional case-control study. Participants: Women from two Dutch University Medical Centers above 45 years of age previously diagnosed with POI (n = 98) were selected and compared with age- and race-matched controls from the Multi-Ethnic Study of Atherosclerosis (MESA). Measurements: The primary outcome was detectable coronary artery calcium (CAC) determined by coronary computed tomography (CCT). Results: Women with POI had significantly higher blood pressure, cholesterol and glucose, despite lower BMI compared to controls. Similar proportions of detectable CAC (CAC score >0 Agatston Units) were observed in women with POI and controls (POI n = 16 (16%), controls n = 52 (18%), P = 0.40 and Padj = 0.93). In women with POI separately, we were not able to identify associations between CVD risk factors and CAC. The following CVD risk factors in controls were positively associated with CAC: age, diabetes mellitus, hypertension and LDL cholesterol. HRT use was negatively associated with CAC in controls. Conclusions: The presence of CAC did not differ significantly in women with POI around 50 years of age, compared to an age- and race-matched control group. We observe no increased calcified coronary disease in POI patients, despite the presence of unfavourable cardiovascular risk factors in these women.

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KW - coronary artery calcium score

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KW - POI

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DO - 10.1111/cen.14003

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Gunning MN, Meun C, van Rijn BB, Maas AHEM, Benschop L, Franx A et al. Coronary artery calcification in middle-aged women with premature ovarian insufficiency. Clinical Endocrinology. 2019 Aug 1;91(2):314-322. https://doi.org/10.1111/cen.14003