Ovarian Reserve and Endothelial Health in Healthy Reproductive Age Women.

Abstract

While literature suggests women with diminished ovarian reserve may have increased metabolic risk, implications for long-term health are unknown. To investigate the relationship between ovarian reserve markers at baseline with a subsequent measure of endothelial dysfunction, as a proxy for cardiovascular risk. Prospective cohort study. Community-based setting. 322 subjects from the Ovarian Aging Study (OVA), an NIH-funded study of ovarian aging (average 35.4 years old at the time of baseline ovarian reserve measurements, and 45.1 years old at the time of endothelial dysfunction measurement). This study investigated the association of ovarian reserve markers at baseline with a subsequent (average of 9.7 years) assessment of cardiovascular risk using the EndoPAT reactive hyperemia index (RHI) score of endothelial function. Secondary outcomes including the American Heart Association PREVENT score, metabolic syndrome, telomere length, and mitochondrial DNA were evaluated. RHI as a continuous outcome was significantly positively associated with both anti-Müllerian hormone (AMH) and antral follicle count (AFC) on fully adjusted models (AMH Coeff 0.052 95% CI 0.008 to 0.096, p = 0.02; AFC Coeff 0.017, 95% CI 0.001 to 0.032, p = 0.04). For secondary outcomes, the only result that was significant was the association of fully adjusted AFC with metabolic syndrome (OR 0.92, 95% CI 0.86-0.99, p = 0.02). A sensitivity analysis of the premenopausal cohort (N = 246) had similar findings. In this longitudinal cohort of women with normal ovarian aging, baseline ovarian reserve markers of AMH and AFC were positively associated with endothelial function as a continuous outcome. Baseline ovarian reserve markers were not related to most secondary outcomes of cellular aging and metabolic risk.