Impaired Muscle Parameters in Individuals With Premature Ovarian Insufficiency: A Pilot Study

Abstract

Context: Although bone loss is a recognized consequence of premature ovarian insufficiency (POI), the impact on skeletal muscle health is less well-defined.

Objective: To compare muscle mass and function parameters between women with POI and controls.

Methods: Cross-sectional study from a tertiary health network and community between 2017 and 2023. Participants were women aged 20 to 40 years with POI associated with Turner syndrome (TS; n = 11) and spontaneous normal karyotype POI (s-POI; n = 7) compared with age- and body mass index (BMI)-matched controls (n = 45).

Results: All women with POI (mean age 28.70 ± 5.58) were using hormone therapy. Appendicular lean mass (ALM)/total fat mass and ALM/ BMI was lower in the POI group. Height-adjusted muscle mass parameters did not differ between groups. Compared with controls, women with TS and s-POI had lower muscle strength (TS 19.72 ± 4.89; s-POI 22.73 ± 5.35; controls 28.67 ± 5.65 kg; P < .001) and muscle quality (TS 11.09 ± 2.06; s-POI 10.89 ± 2.01; controls 14.10 ± 1.99 kg/kg; P < .001). Higher C-reactive protein levels, higher depression scores, and lower sex-steroid and physical activity levels were observed in women with POI (P < .05). Creatinine/cystatin C ratio, insulin-like growth factor-1, and transthyretin did not differ between groups.

Conclusion: Despite hormone therapy usage, women with POI exhibited compromised muscle parameters compared with age-matched controls. Potential contributory factors were identified. Further research is required to clarify pathophysiology and inform management strategies.

Keywords: Turner syndrome; appendicular lean mass; body composition; handgrip strength; muscle; premature ovarian insufficiency.

Figure 1.

(A) Prevalence of low muscle mass and (B) prevalence of low muscle strength in control, TS, and s-POI groups. The prevalence of low muscle strength differed significantly between the 3 groups (P < .001). Low muscle mass and strength was defined as values falling below 1 SD and 2 SD below the GOS-established threshold for normative data Australian young adult women [18, 23].

Figure 2.

Prevalence of low vitamin D levels in controls, TS, and s-POI women. The prevalence of vitamin D was significantly different between the 3 groups (P < .001). Fifty-six percent of women in the POI group were taking vitamin D supplements compared with 14% in the control group.