Gynecology World Conference 2026

Abstract

Objective: Menopause is commonly accompanied by an increase in body mass index (BMI) and a shift in fat distribution toward central abdominal adiposity. This central fat accumulation, together with estrogen deficiency, significantly elevates the risk of metabolic and cardiovascular diseases. Estrogen plays a protective role through its antioxidant properties and vasodilatory effects on the cardiovascular system, and it has also been shown to reduce total cholesterol and low-density lipoprotein (LDL) cholesterol levels. Therefore, the decline in estrogen during menopause—or in conditions such as premature ovarian insufficiency—may predispose women to adverse metabolic and cardiovascular outcomes .We designed a prospective cross-sectional study in order to evaluate the prevalence of metabolic syndrome in patients with POI referred to Royan Institute

Methods: In this study, all women diagnosed with POI who were referred to Royan Institute from 2020 onward were investigated. The control group consisted of women with regular menstrual cycles who had participated in the institute’s occupational health evaluations. Data were collected using questionnaires completed as part of the study. Inclusion criteria were the presence of POI diagnostic criteria. Exclusion criteria included malignancies, systemic diseases (e.g., hepatic or renal failure), metabolic disorders, thyroid dysfunction, and the use of medications known to influence lipid, glucose, or hormonal profiles. To compare metabolic abnormalities between the POI and control groups, the chi-square test and independent t-test were used. Logistic regression analysis was performed to evaluate the effect of risk factors on metabolic syndrome in both groups.

Results: This study included 238 women with POI (case group) and 158 women from the health study of Royan persone (control group). The mean age in the POI group was 33.34 ± 3.84 years and in the control group 38.86 ± 5.67 years. Serum triglyceride (TG) levels did not differ significantly between the two groups. Low-density lipoprotein (LDL) levels were higher in women with POI. Waist circumference, body mass index (BMI), and blood pressure showed no significant differences between the groups. The risk of cardiovascular disease was below 10% in 97.7% (127 individuals) of the POI group, and this risk was not significantly different between the POI and control groups (p-value = 0.70).
The prevalence of metabolic syndrome was 10.9% (26 individuals) in the POI group and 11.4% (18 individuals) in the control group, with no statistically significant difference (p-value = 0.88). Based on multivariable logistic regression in the overall study population, fasting blood glucose (FBS, p-value < 0.001) and triglycerides (TG, p-value < 0.001) were significant predictors of metabolic syndrome.
In the POI group, multivariable logistic regression showed that elevated FBS (p-value = 0.020), increased waist circumference (p-value < 0.001), and elevated TG (p-value < 0.001) were significant contributors to metabolic syndrome. In the control group, FBS (p-value = 0.001) and TG (p-value < 0.001) were also significant predictors.

Discussion: This study found no significant difference in the prevalence of metabolic syndrome between women with POI and those with regular menstrual cycles after adjusting for age. However, predictors differed in the POI group, with elevated fasting blood glucose, triglycerides, and increased waist circumference identified as significant contributors. These findings underscore the importance of monitoring metabolic parameters in women with POI and may facilitate early detection of cardiovascular risk factors.