OR19-5 Consistent Ovulation Is Not Enough to Make You Healthy when Approaching Menopause: An Update from SWAN

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: OR19-Female Reproductive Endocrinology
Sunday, June 16, 2013: 11:15 AM-12:45 PM
Presentation Start Time: 12:15 PM
Room 102 (Moscone Center)
Amanda Ashleigh Allshouse*1, Samar El Khoudary2, Alex Joel Polotsky3, Sybil Crawford4 and Hsiang-Yu Chen2
1University of Colorado Denver Colorado School of Public Health, Aurora, CO, 2University of Pittsburgh, Pittsburgh, PA, 3University of Colorado Denver, Aurora, CO, 4University of Massachusetts, Worcester, MA
Background: Persistent anovulation during the menopausal transition may reflect poor ovarian function and thus a lower level of systemic health.

Purpose: To test the hypothesis that consistently ovulatory women have a more favorable cardiometabolic profile (HDL, LDL, triglycerides, HOMA, SBP, DBP, CRP and fibrinogen) than anovulatory women during the menopausal transition. We used data from women enrolled in the Daily Hormone Study (DHS), a sub study of the Study of Women’s Health Across the Nation (SWAN).

Methods: Ovulatory cycles were identified using the standard SWAN algorithm for Evidence of Luteal Activity (ELA) from up to four (H4) annual DHS visits. Women were categorized as CELA (consistently-ELA with four annual ELA cycles, or two or three ELA cycles followed by Final Menstrual Period [FMP]) or NELA (at least one non-ELA cycle). Differences between CELA and NELA women at baseline, DHS-H4 (or earlier if menopause before H4), and longitudinally across FMP were compared. Categorical (frequency, %) and continuous (with mean +/-SD, or geometric mean [GM] 95%CI) variables were tested with Χ2 or t tests. Data up to 6 years before and 2 years after FMP were centered at FMP and analyzed on the log-scale with a linear mixed-effects regression model. Analyses were adjusted for BMI and age.

Results: Of 953 DHS participants, 627 women age 47.4 years ± 2.49, BMI 27.4± 7.12, Black (19%), Caucasian (30%), Chinese (21%), Hispanic (9%) and Japanese (21%) were included in this analysis; 36% classified as CELA. At DHS-H4 (or earlier due to menopause), CELA women had lower HDL 55.7 (54.0, 57.4) vs. 59.5 (57.9, 61.0), p=0.002, which persisted after adjustment (mean difference: 4.33 (1.86, 6.81) p<0.001). Among 380 women with FMP, 28% were CELA. CELA women were slightly older (52.9 vs. 52.0 p=0.002) and had a lower BMI (GM: 26.1 vs. 27.5, p=0.06) than NELA women at FMP. When compared annually over the course of menopause in this subset, differences in HDL were no longer significant. LDL, triglycerides, HOMA, SBP, DBP, fibrinogen, CRP and the HDL/LDL ratio did not significantly differ between CELA and NELA groups through the year after FMP.

Conclusions: Consistent ovulation across the menopausal transition does not reflect superior cardiometabolic health. The ovary may age apart from the circulatory system. When comparing women in the DHS, aligning observations by time to menopause/FMP may be a more appropriate way to analyze data, and can significantly impact results.

Disclosure: AJP: Principal Investigator, Bayer, Inc.. Nothing to Disclose: AAA, SE, SC, HYC

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm

Sources of Research Support: The Study of Women's Health Across the Nation (SWAN) has grant support from the National Institutes of Health (NIH), DHHS, through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR) and the NIH Office of Research on Women’s Health (ORWH) (Grants NR004061; AG012505, AG012535, AG012531, AG012539, AG012546, AG012553, AG012554, AG012495). The content of this article {OR: paper, manuscript, abstract, other – please specify} is solely the responsibility of the authors and does not necessarily represent the official views of the NIA, NINR, ORWH or the NIH.