HONOLULU – Women with greater ovarian reserve had lower cardiovascular risk in a prospective study of 1,092 healthy, ovulating women aged 25-45 years, 250 of whom were followed for 3-5 years.
Measures of ovarian aging at baseline were inversely correlated with measures of systemic cellular aging. At the follow-up assessment, women who’d had lower ovarian reserve at baseline were more likely to have higher Framingham Heart Study assessment scores predicting increased risk for cardiovascular events.
“The ovary may be particularly sensitive to cellular aging” and could provide a relatively simple, objective way to identify long-term cardiovascular risk earlier in some women, Dr. Marcelle I. Cedars said at the annual meeting of the American Society for Reproductive Medicine.
She and her associates tested the women for anti-Müllerian hormone levels (AMH) and antral follicle counts (AFC) as markers of ovarian reserve. They assessed cellular aging by examining telomere length and mitochondrial DNA copy numbers in circulating white blood cells as biomarkers of cellular senescence. Shorter telomere length has been associated with worse cardiovascular risk in previous studies, she noted. The current study also measured lipid levels, fasting glucose, insulin levels, body mass index, waist circumference, and blood pressure.
Sherry Boschert/Frontline Medical Media
Dr. Marcelle I. Cedars speaks at the ASRM meeting.
Women with higher AFC and AMH at baseline had healthier lipid profiles at follow-up 3-5 years later, reported Dr. Cedars, director of the division of reproductive endocrinology and of the Center for Reproductive Health at the University of California, San Francisco. The upper 10th percentile of AFC levels were associated with significantly longer telomeres and significantly lower numbers of mitochondrial DNA copies, compared with the lowest 10th percentile of AFC.
Women with higher AFC or AMH at baseline had significantly lower Framingham risk scores at follow-up, compared with women with low AFC or average AFC, she said. The Framingham scores at follow-up showed a 10-year risk of MI of 2.1% in women in the low AFC tertiles, 1.3% in women in middle AFC tertiles, and 1.1% in women in high AFC tertiles.
The difference in cardiovascular risk level was statistically significant between the high and low tertiles for AFC and between the middle and low tertiles for AFC. For AMH levels, the difference in cardiovascular risk was significant between high and low tertiles, between high and middle tertiles, and between middle and low tertiles.