{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:30:42Z","timestamp":1792801842323,"version":"4.5.0"},"reference-count":39,"publisher":"The Endocrine Society","issue":"1","license":[{"start":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T00:00:00Z","timestamp":1692748800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Louis B. Mayer Foundation","award":["K23 HL127262"],"award-info":[{"award-number":["K23 HL127262"]}],"id":[{"id":"https:\/\/ror.org\/01yx9sh34","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Louis B. Mayer Foundation","award":["R01 HD106096"],"award-info":[{"award-number":["R01 HD106096"]}],"id":[{"id":"https:\/\/ror.org\/01yx9sh34","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Edythe L. Broad Women's Heart Research"},{"name":"Barbra Streisand Women's Cardiovascular Research and Education Program"},{"name":"Smidt Heart Institute"},{"DOI":"10.13039\/100013015","name":"Cedars-Sinai Medical Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013015","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Endothelial dysfunction is a preclinical cardiovascular disease (CVD) marker. Due to various neuroendocrine aberrations, functional hypothalamic amenorrhea (FHA) may be a sex-specific risk factor for CVD in young women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate endothelial function in women with FHA, compared with eumenorrheic controls and recently menopausal women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a cross-sectional analysis among women with FHA (n = 30), eumenorrheic controls (n = 29), and recently menopausal women (n = 30). FHA was defined as amenorrhea \u22653 consecutive months, estradiol &amp;lt;50 pg\/mL, follicle-stimulating hormone (FSH) &amp;lt; 10 mIU\/mL, and luteinizing hormone (LH) &amp;lt; 10 mIU\/mL, excluding other etiologies. Participants were recruited through obstetrics and gynecology referrals, social media advertising, and review of electronic health records. Preclinical CVD was measured using EndoPAT 2000 to calculate reactive hyperemic index (RHI). RHI \u22641.67 indicates endothelial dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean estradiol levels in women with FHA, as compared with eumenorrheic controls and recently menopausal women, were 29.0 \u00b1 18.1, 46.4 \u00b1 15.7, and 10.9 \u00b1 14.4 pg\/mL (P &amp;lt; .0001), respectively. Women with FHA had lower insulin (P = .0095) and higher cortisol (P = .0004) compared with controls. RHI was significantly lower in women with FHA compared with eumenorrheic controls and recently menopausal women (1.8 \u00b1 0.5 vs 2.2 \u00b1 0.5 vs 2.2 \u00b1 0.6, respectively; P = .008), and 35% of women with FHA had RHI \u22641.67, consistent with endothelial dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These results demonstrate endothelial dysfunction in 1 out of 3 young women with FHA. FHA may be a contributor to preclinical CVD, and it is not explained by hypoestrogenemia alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgad498","type":"journal-article","created":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T11:26:33Z","timestamp":1692703593000},"page":"e51-e57","source":"Crossref","is-referenced-by-count":26,"title":["Functional Hypothalamic Amenorrhea and Preclinical Cardiovascular Disease"],"prefix":"10.1210","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6886-9210","authenticated-orcid":false,"given":"Chrisandra L","family":"Shufelt","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine, Mayo Clinic , Jacksonville, FL 32224 ,","place":["USA"]},{"name":"Mayo Clinic Center for Women's Health, Mayo Clinic , Rochester, MN 55902 ,","place":["USA"]},{"name":"Women's Health Research Center, Mayo Clinic , Rochester, MN 55902 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariam","family":"Saadedine","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Mayo Clinic , Jacksonville, FL 32224 ,","place":["USA"]},{"name":"Mayo Clinic Center for Women's Health, Mayo Clinic , Rochester, MN 55902 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Galen","family":"Cook-Wiens","sequence":"additional","affiliation":[{"name":"Biostatistics and Bioinformatics Research Center, Cedars-Sinai Medical Center , Los Angeles, CA 90048 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margareta D","family":"Pisarska","sequence":"additional","affiliation":[{"name":"Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center , Los Angeles, CA 90048 ,","place":["USA"]},{"name":"Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA , Los Angeles, CA 90048 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9426-7595","authenticated-orcid":false,"given":"JoAnn E","family":"Manson","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Harvard T.H. 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