Associations Between BMI, Serum Hormone Levels, Time Since Ovarian Insufficiency Onset, Serologic Autoimmunity, and Prevalence of Common Parameters: A cross-sectional Retrospective Study of Premature Ovarian Insufficiency

Abstract

OBJECTIVE Premature ovarian insufficiency (POI) affects 1:100 women before the age of 40. The objectives include exploring correlations between body mass index, years since the onset of premature ovarian insufficiency, follicular stimulating hormone, and estradiol; and studying prevalence of five common serologic autoimmunologic parameters during POI diagnosis. METHODS The records of idiopathic POI patients presenting with secondary amenorrhea who visited the Gynecologic Endocrinology Unit, Siriraj Hospital, between January 1, 2000 and December 31, 2016 were reviewed. Extracted data included body mass index, years since premature ovarian insufficiency onset, levels of follicular stimulating hormone and estradiol. Five common serologic autoimmunologic parameters were also retrieved where available. RESULTS Among the 161 idiopathic POI patients analyzed, a significant reverse correlation was found between serum follicular stimulating hormone and estradiol (r=-0.209, p=0.008), while no correlations were identified between body mass index, years since the onset of premature ovarian insufficiency, and serum estradiol (p=0.141, p=0.240, respectively). After excluding cases with abnormal karyotypes which can potentially cause POI, the remaining 146 cases was comprised of 72 cases with a normal 46,XX karyotype (the first group) and 74 cases who declined karyotype investigation (the second group). At least one of the serologic autoimmunologic parameters was investigated in 43 cases in the first group and in 20 cases in the second group. Anti-nuclear antibody was the most prevalent in the first group (25.0%) while anti-thyroglobulin was the most prevalent in the second group (30.7%). CONCLUSIONS Only serum follicular stimulating hormone and estra-diol exhibited significant reverse correlation in POI cases with secondary amenorrhea. Baseline serologic autoimmunologic parameters were positive but didn’t indicate autoimmune diseases during POI diagnosis.