Urinary Metals and Metal Mixtures and Timing of Natural Menopause in Midlife Women: the Study of Women’s Health Across the Nation

Details

• Alternative Title:
  Environ Int
• Personal Author:
  Wang, Xin ; Ding, Ning ; Harlow, Siobán D. ; Randolph, John F. ; Mukherjee, Bhramar ; Gold, Ellen B. ; Park, Sung Kyun
• Description:
  Background:
  
  Exposure to metals and metal mixtures may influence ovarian aging. However, epidemiologic evidence of their potential impact is lacking.
  
  Objective:
  
  We prospectively examined the associations of 15 urinary metal concentrations and their mixtures with natural menopause in the Study of Women’s Health Across the Nation Multi-Pollutant Study.
  
  Methods:
  
  The study population consisted of 1082 premenopausal women from multiple racial/ethnic groups, aged 45–56 years at baseline (1999–2000), with the median follow-up of 4.1 years. Urinary concentrations of 15 metals, including arsenic, barium, cadmium, cobalt, cesium, copper, mercury, manganese, molybdenum, nickel, lead, antimony, tin, thallium, and zinc, were measured at baseline. Natural menopause was defined as the final bleeding episode prior to at least 12 months of amenorrhea, not due to surgery or hormone therapy. Cox proportional hazards models were used to examine associations between individual metal concentrations and timing of natural menopause. The associations between metal mixtures and natural menopause were evaluated using elastic net penalized Cox regression, and an environmental risk score (ERS) was computed to represent individual risks of natural menopause related to metal mixtures.
  
  Results:
  
  The median age at natural menopause was 53.2 years. Using the Cox proportional hazards models, the adjusted hazard ratio (HR) (and its 95% confidence interval (CI)) for natural menopause was 1.32 (1.03, 1.67) for arsenic and 1.36 (1.05, 1.76) for lead, comparing the highest with the lowest quartiles of metal concentrations. The predicted ages at natural menopause in the highest and lowest quartiles were 52.7 and 53.5 years for arsenic; and 52.9 and 53.8 years for lead. A significant association between ERS and menopause was also observed. Women in the highest vs. the lowest quartiles of ERS had an HR of 1.71 (1.36, 2.15), equivalent to a 1.6 year earlier median time to natural menopause.
  
  Conclusion:
  
  This study suggests that arsenic, lead, and metal mixtures are associated with earlier natural menopause, a risk factor for adverse health outcomes in later life.
  
  
• Subjects:
  Arsenic Environmental Pollutants Female Humans Menopause Metals Women's Health
• Keywords:
  Aging Menopause Midlife Women Mixtures
• Source:
  Environ Int. 157:106781
• Pubmed ID:
  34311223
• Pubmed Central ID:
  PMC8490279
• Document Type:
  Journal Article
• Funding:
  T42 OH008455/OH/NIOSH CDC HHSUnited States/ ; R01 AG062622/AG/NIA NIH HHSUnited States/ ; U01 AG012554/AG/NIA NIH HHSUnited States/ ; T42OH008455/ACL/ACL HHSUnited States/ ; P30 ES017885/ES/NIEHS NIH HHSUnited States/ ; U01 AG012505/AG/NIA NIH HHSUnited States/ ; U01 AG012535/AG/NIA NIH HHSUnited States/ ; U01 AG012553/AG/NIA NIH HHSUnited States/ ; U01 NR004061/NR/NINR NIH HHSUnited States/ ; U01 AG012539/AG/NIA NIH HHSUnited States/ ; R01 ES026578/ES/NIEHS NIH HHSUnited States/ ; U01 AG012546/AG/NIA NIH HHSUnited States/ ; U19 AG063720/AG/NIA NIH HHSUnited States/ ; U01 AG012495/AG/NIA NIH HHSUnited States/ ; U01 AG012531/AG/NIA NIH HHSUnited States/ ; R01 ES026964/ES/NIEHS NIH HHSUnited States/ ; U01 AG017719/AG/NIA NIH HHSUnited States/
• Volume:
  157
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:a2110d88cc49edddae507413a46516faafd1646edb2e35cf4cd616a68d476ea4
• Download URL:
  https://stacks.cdc.gov/view/cdc/110383/cdc_110383_DS1.pdf
• File Type:
  [PDF - 562.57 KB ]