Climacteric Status at the Age of 46: Impact on Metabolic Outcomes in Population-Based Study

Savukoski, Susanna; Mäkelä, Hannele; Auvinen, Juha; Jokelainen, Jari; Puukka, Katri; Ebeling, Tapani; Suvanto, Eila; Niinimäki, Maarit

doi:10.1210/jc.2018-02025

Cited by 8 publications

(15 citation statements)

References 61 publications

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“…It is possible, however, that women ever using HRT have underlying hormonal differences from women never using HRT, which drive their need for HRT use. In accordance with the latter, women from the Northern Finland Birth Cohort 1966 experiencing earlier climacterium at age 46 years were more likely to use HRT and had fewer pregnancies but more metabolic disturbances, higher fat and lower muscle mass compared to pre-climacteric women at the same age, and additionally had lower testosterone levels even at age 31 years 39 . In our study, post-menopausal women with past or current HRT use had experienced menopause at a younger age compared to those never using HRT.…”

Section: Discussionmentioning

confidence: 53%

Associations of body shape phenotypes with sex steroids and their binding proteins in the UK Biobank cohort

Christakoudi

Riboli

Εvangelou

et al. 2022

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Associations of sex steroids and their binding proteins with body shape are unclear, because waist and hip circumference are correlated strongly with body size. We defined body shape using “a body shape index” (ABSI) and hip index (HI), which are independent of weight and height by design, and examined associations in multivariable generalised linear models for the UK Biobank cohort (179,902 men, 207,444 women). Total testosterone was associated inversely with ABSI, especially in men. Free testosterone was lowest for large-ABSI-large-HI (“wide”) and highest for small-ABSI-small-HI (“slim”) in men, but lowest for small-ABSI-large-HI (“pear”) and highest for large-ABSI-small-HI (“apple”) in women. Oestradiol was associated inversely with ABSI in obese pre-menopausal women but positively with HI in obese men and post-menopausal women not using hormone replacement therapy. Sex-hormone binding globulin (SHBG) was associated inversely with ABSI but positively with HI and was lowest for “apple” and highest for “pear” phenotype in both sexes. Albumin was associated inversely with HI in women, but matched the pattern of free testosterone in obese men (lowest for “wide”, highest for “slim” phenotype). In conclusion, sex steroids and their binding proteins are associated with body shape, including hip as well as waist size, independent of body size.

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Section: Discussionmentioning

confidence: 53%

Associations of body shape phenotypes with sex steroids and their binding proteins in the UK Biobank cohort

Christakoudi

Riboli

Εvangelou

et al. 2022

Sci Rep

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“…The duration of amenorrhea was less than 24 months for two-thirds of climacteric women, whose exact menstrual anamnesis was available. 39 A total of 76 of the climacteric women used HT. The background and clinical characteristics of climacteric and preclimacteric women at age 46 are shown in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…Our earlier study with this population found that earlieronset of the climacteric phase is associated with unfavorable changes in cardiovascular risk profile. 39 Studies have suggested that HT use might protect postmenopausal women against cardiovascular diseases. 50,51 In addition, some evidence suggests that adequate 25(OH)D concentrations may have an atheroprotective function.…”

Section: Discussionmentioning

confidence: 99%

Early-onset climacterium is not associated with impaired vitamin D status: a population-based study

et al. 2021

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Objective:To investigate vitamin D status in women with the onset of the climacteric phase by age 46 as both early menopause and inadequate vitamin D status may increase the risk of adverse health outcomes.Methods:A cross-sectional study included 2,544, 46-year-old women from a birth cohort. Women were divided into the following two groups according to their menstrual history and follicle-stimulating hormone (FSH) concentration: 1) climacteric (FSH ≥25 IU/L and amenorrhea ≥4 mo, n = 351) and 2) preclimacteric women (FSH <25 IU/L and having regular/irregular menstrual cycles, n = 2,193). Serum 25-hydroxyvitamin D (25(OH)D) concentrations were compared between the groups. A linear regression model was performed to investigate which factors are associated with 25(OH)D status.Results:Mean serum 25(OH)D concentrations were higher in climacteric compared with preclimacteric women (68.1 ± 19.8 nmol/L vs 65.2 ± 19.3 nmol/L, P = 0.01). However, in the linear regression model, climacteric status was not associated with 25(OH)D status (multivariable adjusted mean difference 4.5 nmol/L, 95% confidence interval −1.4 to 10.4, P = 0.137). A total of 76 of the climacteric women were using systemic estrogen hormone therapy (HT). In a subanalysis, including only climacteric women, the use of HT was associated with higher 25(OH)D status (multivariable adjusted mean difference 5.9 nmol/L, 95% confidence interval 1.3-10.5, P = 0.013).Conclusions:The onset of the climacteric phase by age 46 was not associated with inadequate 25(OH)D concentrations, whereas HT use was associated with higher 25(OH)D status in women with early-onset climacterium.

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“…This division has been described in detail in our earlier studies. 17,18 As there are no general criteria for climacterium, the European Society of Human Reproduction and Embryology (ESHRE) criteria for POI and Stages of Reproductive Aging Workshop (STRAW þ10) criteria for menopausal transition were applied. 4,21 The group of climacteric women included women in the late perimenopausal and postmenopausal stages with FSH !…”

Section: Study Groupsmentioning

confidence: 99%

Is climacterium by the mid-40s associated with thyroid dysfunction or autoimmunity? A population-based study

et al. 2021

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Objective: We investigated whether more advanced climacteric stage in the mid-40s is associated with thyroid autoimmunity and dysfunction. Methods:This cross-sectional cohort study included 2569 46-year-old women. Thyroid hormone, thyroid peroxidase antibodies, and follicle stimulating hormone levels were determined. Using menstrual history and follicle stimulating hormone levels, the participants were divided into climacteric (n = 340) and preclimacteric (n = 2229) groups. Women diagnosed with premature ovarian insufficiency (menopause by 40 years of age) were excluded. The use of thyroid medication was evaluated from the medication reimbursement register. The prevalence of thyroid medication use, laboratory-based thyroid dysfunction, and thyroid peroxidase antibody positivity was compared between the two groups. The association between climacteric status and thyroid disorders was investigated using a logistic regression model including smoking and thyroid antibody status.Results: At 46 years old, climacteric women used thyroid medication more often than preclimacteric women (9.1% vs. 6.1%; P = 0.04). There was no difference in the prevalence of subclinical or clinical hypothyroidism and hyperthyroidism in non-medicated participants (5.5% vs. 5.0%; P = 0.7) or thyroid peroxidase antibody positivity (14.0% vs. 15.0%, P = 0.7). In the regression model, being climacteric (OR = 1.6; 95% CI 1.1 to 2.3; P = 0.02) and antibody positivity (OR 4.9; 95% CI 3.6 to 6.6; P < 0.001) were associated with a higher prevalence of thyroid dysfunction.Conclusions: More advanced climacteric stage in the mid-40s was slightly associated with thyroid dysfunction but not thyroid autoimmunity.

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Climacteric Status at the Age of 46: Impact on Metabolic Outcomes in Population-Based Study

Cited by 8 publications

References 61 publications

Associations of body shape phenotypes with sex steroids and their binding proteins in the UK Biobank cohort

Associations of body shape phenotypes with sex steroids and their binding proteins in the UK Biobank cohort

Early-onset climacterium is not associated with impaired vitamin D status: a population-based study

Is climacterium by the mid-40s associated with thyroid dysfunction or autoimmunity? A population-based study

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