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Publications

Journal Article Epublish

PubMed: 42741715 DOI: 10.2147/IJWH.S631294

Endogenous Estrogen Exposure and All-Cause Mortality Among Women with Overweight or Obesity According to Metabolic Health Status: Insights from an 18-Year Prospective Cohort Study.

Int J Womens Health 18:631294

Authors: Sara Sadeghi, Maryam Barzin, Maryam Mahdavi, Majid Valizadeh, Fahimeh Ramezani Tehrani, Maryam Farahmand, Fereidoun Azizi, Farhad Hosseinpanah

Affiliations

  • Obesity Research Center, Research Institute for Metabolic and Obesity Disorders, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Reproductive Endocrinology Research Center, Research Institute for Endocrine Molecular Biology, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Endocrine Research Center, Research Institute for Endocrine Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

BACKGROUND

Despite extensive research on estrogen and its implications, there remains a gap in understanding the relationship between the duration of endogenous estrogen exposure (EEE) and all-cause mortality among women with overweight or obesity according to their metabolic health status. Therefore, this study examined the association between EEE duration and all-cause mortality over an 18-year follow-up period, separately among women with metabolically healthy overweight/obesity (MHO) and those with metabolically unhealthy overweight/obesity (MUO).

METHODS

In this large population-based cohort, 1162 post-menarcheal women aged ≥20 years with a body mass index (BMI) ≥25 kg/m 2 from the Tehran Lipid and Glucose Study were included. Participants were classified into MHO and MUO phenotypes, and each phenotype was further divided into tertiles of EEE. Cox proportional hazards models were then applied to estimate incidence rates and hazard ratios (HRs) for all-cause mortality across EEE tertiles.

RESULTS

During the follow-up, 62 deaths occurred (2.2 per 1000 person-years; 95% CI: 1.7-2.8), including 20 in the MHO group and 42 in the MUO group. Among individuals with MHO, incidence rates per 1000 person-years (95% CI) were 0.94 (0.42-2.11), 1.50 (0.81-2.79), and 0.60 (0.22-1.60) across the first, second, and third EEE tertiles, respectively. Corresponding rates for MUO were 6.46 (4.02-10.40), 3.42 (1.78-6.58), and 6.05 (3.71-9.88). After adjusting for confounders, the highest EEE tertile in MHO was associated with a significantly lower hazard of all-cause mortality (HR: 0.19; 95% CI: 0.05-0.76).

CONCLUSION

Longer EEE durations appear to reduce the risk of all-cause mortality among women with overweight/obesity who are metabolically healthy.

MeSH

Mortality, Estrogens, Incidence, Phenotype, Cohort Studies, Health Status, Obesity, Overweight