Systemic inflammation and menstrual cycle length in a prospective cohort study - 24/01/23
, Anne Z. Steiner, MD, MPH a, Keturah R. Faurot, PhD b, Anneliese Long, MA c, Anne Marie Jukic, PhD dAbstract |
Background |
Local inflammation plays an important role in normal folliculogenesis and ovulation, and conditions of chronic systemic inflammation, such as obesity and polycystic ovarian syndrome, can disrupt normal follicular dynamics.
Objective |
This study aimed to determine the association between systemic inflammation, as measured by C-reactive protein levels, and menstrual cycle length.
Study Design |
This study was a secondary analysis using data from Time to Conceive, a prospective time-to-pregnancy cohort study. The association between cycle length and C-reactive protein was analyzed using multivariable linear mixed and marginal models adjusted for age, race, education, body mass index, time since oral contraceptive use, alcohol, smoking, caffeine consumption, and exercise. Time to Conceive enrolled women aged 30 to 44 years with no history of infertility who were attempting to conceive for <3 months. Serum C-reactive protein levels were measured on cycle day 2, 3, or 4. Participants recorded daily menstrual cycle data for ≤4 months.
Results |
Main outcome measures included menstrual cycle length and follicular and luteal phase lengths. Multivariable analysis included 1409 cycles from 414 women. There was no linear association between C-reactive protein levels and menstrual cycle length. However, compared with <1 mg/L, a C-reactive protein level >10 mg/L was associated with >3 times the odds (adjusted odds ratio, 3.7; 95% confidence interval, 1.67–8.11) of long cycles (defined as ≥35 days). When evaluating follicular phase length, a C-reactive protein level of >10 mg/L was associated both with follicular phases that were 1.7 (95% confidence interval, 0.23–3.09) days longer and with >2 times the odds of a long follicular phase (adjusted odds ratio, 2.2; 95% confidence interval, 1.05–4.74).
Conclusion |
There is a potential pathophysiological association between systemic inflammation and menstrual cycle changes. Further studies are needed to determine if systemic inflammation alters the menstrual cycle or if long menstrual cycles are a marker for elevated systemic inflammation.
Le texte complet de cet article est disponible en PDF.Key words : C-reactive protein, chronic inflammation, follicular phase, luteal phase, ovulation
Plan
| A.Z.S. had financial support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development/National Institutes of Health for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years; and no other relationships or activities that could appear to have influenced the submitted work. A.Z.S. has previously consulted for Prima-Temp and Seikagaku Corporation outside the submitted work. The remaining authors report no conflict of interest. |
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| Grants were received from the National Institutes of Health (NIH)/Eunice Kennedy Shriver National Institute of Child Health and Human Development (R21 HD060229-01 and R01 HD067683-01) and the NIH Intramural Research Program of the National Institute of Environmental Health Sciences (Z01ES103333). Support for this investigation was provided in part by the Office of Research on Women’s Health, NIH. |
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| Data availability: Some or all datasets generated during and/or analyzed during the current study are not publicly available but are available from the senior author on reasonable request. |
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| Cite this article as: Harris BS, Steiner AZ, Faurot KR, et al. Systemic inflammation and menstrual cycle length in a prospective cohort study. Am J Obstet Gynecol 2023;228:215.e1-17. |
Vol 228 - N° 2
P. 215.e1-215.e17 - février 2023 Retour au numéro
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