Lipid profiles and ovarian reserve status: a longitudinal study

Abstract

STUDY QUESTION: Is there any association between ovarian reserve status and lipid profile changes? SUMMARY ANSWER: Women with lower ovarian reserve might be susceptible to higher cardiovascular risks, especially lipid disturbances, even during their reproductive life span. WHAT IS KNOWN ALREADY: The risk of developing cardiovascular disease (CVD) in women increases after menopause, but the association between ovarian reserve status and CVD is not known. STUDY DESIGN, SIZE AND DURATION: This longitudinal study was conducted on 1015 participants of Tehran Lipid and Glucose Study, an ongoing population based cohort study with 12 years follow-up. PARTICIPANTS/MATERIALS, SETTING, METHODS: There were 1015 women who were aged 20-50 years and met our eligibility criteria. Their ovarian reserve status was identified according to their age-specific AMH levels, calculated using the exponential-normal 3-parameter model. At the time of recruitment, 268, 233, 256 and 258 subjects were in the first, second, third and fourth quartiles of age-specific AMH, respectively. The cardiovascular risk factors of these groups were compared. MAIN RESULTS AND THE ROLE OF CHANCE: Anthropometric measurements, lipid profiles and mean systolic and diastolic blood pressures in the first and fourth AMH quartiles did not differ at the initiation of the study. Total cholesterol (TC) net changes per year were incremental in the first AMH quartile but not in the fourth quartile (P < 0.001). According to the generalized estimating equation (GEE), after adjustment for age, BMI, time interaction and menopause status, the changes across time in TC, LDL and HDL were varied according to the age-specific AMH status. LIMITATIONS, REASONS FOR CAUTION: A potential limitation is that development of cardiovascular risk is a major long-term event that needs decades of follow-up from birth to death; hence further studies with longer follow-up times are needed. WIDER IMPLICATIONS OF THE FINDINGS: We provide the insight that women with lower ovarian reserve might be susceptible to developing cardiovascular risk factors, particularly lipid disturbances, even during their reproductive life span. STUDY FUNDING/COMPETING INTERESTS: This study was funded by Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences. The authors report no conflict of interest. TRIAL REGISTRATION NUMBER: Not applicable.