J Obstet Gynaecol Res. 2026 Sep;52(9):e70497. doi: 10.1111/jog.70497.
ABSTRACT
AIM: Menopause is associated with increased cardiovascular risk due to estrogen depletion. This study aimed to compare carotid intima-media thickness (CIMT) and serum endocan levels in women with natural menopause, surgical menopause, and premenopausal status, and to evaluate their potential roles as biomarkers for cardiovascular risk stratification.
METHODS: This prospective observational study included 88 healthy women aged 45-60 years: 32 with surgical menopause, 30 with natural menopause, and 26 who were premenopausal. Serum endocan concentrations were measured using an enzyme-linked immunosorbent assay, and bilateral CIMT was assessed ultrasonographically. Between-group comparisons were performed using appropriate parametric or non-parametric tests. Multivariable linear regression analyses adjusted for age and body mass index (BMI) were performed. Serum endocan was natural-log transformed before multivariable analysis because of its skewed distribution.
RESULTS: Serum endocan concentrations differed significantly among the three groups (overall p < 0.001), with the highest levels in surgical menopause, followed by natural menopause and premenopause. The association between menopausal group and log-transformed endocan remained significant after adjustment for age and BMI (overall p < 0.001). Overall mean CIMT did not differ significantly among the groups in either unadjusted (p = 0.913) or adjusted analyses (p = 0.703). Age, but not menopausal group or BMI, was independently associated with overall mean CIMT (p = 0.003).
CONCLUSIONS: Serum endocan levels were independently associated with menopausal status after adjustment for age and BMI, with the highest concentrations observed in women with surgical menopause. In contrast, CIMT was not independently associated with menopausal status. These findings support further investigation of endocan as a potential marker of menopause-associated endothelial alterations. However, prospective longitudinal studies are strictly required to validate this indirect hypothesis and establish causality.
PMID:42733277 | DOI:10.1111/jog.70497