Abstract
PurposeIt is still not clear whether to screen women with primary premature ovarian insufficiency for autoimmunity. Moreover, a possible association of autoimmunity with decreased bone mass density in premature ovarian insufficiency patients has not been evaluated. Thus, the objectives of this study were to review our experience with the use of an autoimmune screening panel in premature ovarian insufficiency women and to focus on bone mass density.MethodsIn a retrospective cohort study, 76 chromosomally normal women with primary premature ovarian insufficiency were included. The main outcome parameters were the results of an autoimmune screening panel and of dual-energy X-ray absorptiometry.ResultsMedian age was 33 years. Sixty percent of premature ovarian insufficiency patients revealed abnormal dual-energy X-ray absorptiometry results (minimal T-score < −1.0). Any signs of autoimmunity were found in 21 women (36.2%). The most frequent abnormal results were increased thyroperoxidase antibodies (24.1%) and thyroglobulin antibodies (20.7%). A longer duration of amenorrhea (β = −0.015; p = 0.007), any abnormality during autoimmune screening (β = −0.940; p = 0.010), and a lower body mass index (β = −0.057; p = 0.036) were associated with a lower minimal T-score.ConclusionIn chromosomally normal women with primary premature ovarian insufficiency, the prevalence of autoimmunity and decreased bone mass density seem high. Our data highlight the association between autoimmune abnormalities and decreased dual-energy X-ray absorptiometry results.
Highlights
Premature ovarian insufficiency (POI) is defined as the cessation of ovarian function before the expected age of menopause [1, 2]
Since a decrease in estrogen is associated with a loss of trabecular and cortical bone departments in women, patients with POI show decreased bone mineral density (BMD) of the lumbar spine and the femoral neck assessed by dualenergy X-ray absorptiometry (DEXA) [6]
These results were confirmed by a later study: Popat et al demonstrated that POI patients had 2–3% lower BMD at L1–L4, femoral neck, and total hip
Summary
Premature ovarian insufficiency (POI) is defined as the cessation of ovarian function before the expected age of menopause [1, 2]. An unknown mechanism leads to irregular or absent menstrual cycles and sex steroid deficiency. It is characterized by oligo/amenorrhea for at. About two thirds of karyotypically normal women with spontaneous POI were reported to suffer from decreased femoral neck BMD [7]. These results were confirmed by a later study: Popat et al demonstrated that POI patients had 2–3% lower BMD at L1–L4, femoral neck, and total hip. Several risk factors were identified which included but were not limited to a delayed diagnosis of estrogen deficiency, low vitamin D
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