High-sensitivity troponin-T levels and associated health conditions in 3146 women aged 46

Abstract

Objective

The aim of the study was to investigate are there associations between common female sex-specific health conditions (oligo/amenorrhea, hyperandrogenism, menopause and polycystic ovary syndrome [PCOS]) and high-sensitivity troponin-T (hs-TnT) levels.

Methods

Cross-sectional and longitudinal analyses of a general population-based prospective cohort study were performed. The hs-TnT levels of 3146 women aged 46 were measured using an Elecsys® Troponin T high-sensitivity assay. Median hs-TnT levels and 25 and 75 percentiles of the cases and controls were compared. Also, a logistic regression analysis using a binary outcome – undetectable hs-TnT (< 3.0 ng/L) versus detectable hs-TnT (≥ 3.0 ng/L) – was performed.

Results

Women with oligo/amenorrhea at age 31 had significantly higher hs-TnT levels at age 46 than women without oligo/amenorrhea (4.06 [3.59; 4.86] vs 3.98 [3.44; 4.71] ng/L, p = .042). Menopausal women had significantly higher hs-TnT levels than premenopausal women (4.15 [3.54; 4.91] vs 3.95 [3.45; 4.68] ng/L, p = .012) at age 46. Women with PCOS or hyperandrogenism had comparable hs-TnT levels with their controls. In the adjusted logistic regression analysis, oligo/amenorrhea (odds ratio [OR] = 1.52 [0.90–2.57]), hyperandrogenism (OR = 1.20 [0.75–1.92]), PCOS (OR = 1.51 [0.81–2.84]) and menopause (OR = 1.05 [0.63–1.74]) were not significantly associated with detectable hs-TnT.

Conclusions

This study was the first to investigate how oligo/amenorrhea, hyperandrogenism, PCOS and menopause are associated with hs-TnT. Although women with oligo/amenorrhea and menopause had higher hs-TnT levels than women without these conditions, the difference was small. Larger studies are required to better understand the effects of oligo/amenorrhea on cardiovascular health.

KEY MESSAGES

• No previous studies have investigated the association between common female sex-specific health conditions, such as oligo/amenorrhea, hyperandrogenism and PCOS, and hs-TnT levels. Only one prior study has investigated the association between menopause and hs-TnT levels.

• Hs-TnT levels were significantly higher in women with oligo/amenorrhea and relatively early menopause at age 46 than women without these conditions, whereas women with hyperandrogenism or PCOS and their controls have comparable hs-TnT levels.

• The effect of oligo/amenorrhea on cardiovascular health should be further investigated. A simple question about the presence of oligo/amenorrhea might identify women at increased risk of cardiovascular disease.

Keywords:

• Troponin
• oligomenorrhea
• polycystic ovary syndrome
• hyperandrogenism
• menopause

Acknowledgements

We thank all the cohort members and researchers who participated in the study. We also acknowledge the work of the NFBC project centre. We thank the Roche Diagnostics International Ltd for providing the Elecsys® Troponin T-high sensitivity assay.

Authors contributions

All authors (M.-M.O., R.K.A., K.K., L.M.-P., J.J., T.T.P.) participated in the design of the study, planning the statistical analyses, the interpretation of the results and the drafting and finalization of the manuscript, and all accepted the manuscript for publication. In addition, R.K.A analysed the serum samples, K.K. performed the echocardiographic examination and M.-M.O. conducted the statistical analysis, made the tables and figures.

Disclosure statement

The authors have no competing interest to declare.

Data availability statement

NFBC data can be obtained from the University of Oulu, Infrastructure for Population Studies. Permission to use the data for research purposes can be requested via an electronic material request portal. When using the data, we followed the EU General Data Protection Regulation (679/2016) and the Finnish Data Protection Act. The use of personal data was based on the cohort participants’ written informed consent in their latest follow-up study, thus limiting its use. Please contact the NFBC project centre ([email protected]) or visit the cohort website (www.oulu.fi/nfbc) for more information.

Additional information

Funding

This work was supported by the Academy of Finland (315921, 321763, Profi6 336449), Sigrid Juselius Foundation, the Medical Research Center Oulu, the Novo Nordisk Foundation, Sakari Alhopuro Foundation, Finnish Diabetes Research Foundation and Roche Diagnostics International Ltd. The NFBC1966 31-year follow-up received financial support from the University of Oulu (Grant No. 65354); Oulu University Hospital (Grant No. 2/97, 8/97); Ministry of Health and Social Affairs (Grant No. 23/251/97, 160/97, 190/97); National Institute for Health and Welfare, Helsinki (Grant No. 54121) and Regional Institute of Occupational Health, Oulu, Finland (Grant No. 50621, 54231). The NFBC1966 46-year follow-up received financial support from the University of Oulu (Grant No. 24000692), the Oulu University Hospital (Grant No. 24301140) and the European Regional Development Fund (ERDF) (Grant No. 539/2010 A31592). Data generation, curation and labour were also supported by the following EU H2020 grants: DynaHEALTH (633595), LifeCycle (733206), LongITools (873749), EarlyCause, EDCMET (825762) and the Medical Research Council, UK, Grant MRC/BBSRC MR/S03658X/1 (JPI HDHL H2020).