Age at Natural Menopause; A Data Mining Approach (Data from the National Health and Nutrition Examination Survey 2013‑2014)

Tahereh Alinia, Soheila Khodakarim, Fahimeh Ramezani Tehrani, Siamak Sabour

Abstract


Background: The timing of the age at which menopause occurs varies among female populations. This variation is attributed to genetic and environmental factors. This study aims to investigate the determinants of early and late‑onset menopause. Methods: We used data from the National Health and Nutrition Examination Survey 2013‑2014 for 762 naturally menopause women. Data on sociodemographic, lifestyle, examination, and laboratory characteristics were examined. We used random forest (RF), support vector machine (SVM), and logistic regression (LR) to identify important determinants of early and late‑onset menopause. We compared the performance of models using sensitivity, specificity, Brier score, and area under the receiver operating characteristic (AUROC). The top determinants were assessed by using the best performing models, using the mean decease in Gini. Results: Random forest outperformed LR and SVM with overall AUROC 99% for identifying related factors of early and late‑onset menopause (Brier score: 0.051 for early and 0.005 for late‑onset menopause). Vitamin B12 and age at menarche were strongly related to early menopause. Also, methylmalonic acid (MMA), vitamin D, body mass index (BMI) were among the top highly ranked factors contributing to early menopause. Features such as age at menarche, MMA, sex hormone‑binding globulin (SHBG), BMI, vitamin B12 were the most important covariate for late‑onset menopause. Conclusions: Menarche age and BMI are among the important contributors of early and late‑onset menopause. More research on the association between vitamin D, vitamin B12, SHBG, and menopause timing is required which will produce invaluable information for better prediction of menopause timing.

Keywords


Data mining; menopause; nutrition surveys

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References


Amanvermez R, Tosun M. An update on ovarian aging and

ovarian reserve tests. Int J Fertil Steril 2016;9:411‑5.

Research on the menopause in the 1990s. Report of a WHO

Scientific Group. World Health Organization technical report

series. 1996;866:1‑107.

O’Connor KA, Holman DJ, Wood JW. Menstrual cycle variability

and the perimenopause. Am J Hum Biol 2001;13:465‑78.

Cagnacci A, Pansini FS, Bacchi‑Modena A, Giulini N,

Mollica G, De Aloysio D, et al. Season of birth influences the

timing of menopause. Hum Reprod 2005;20:2190‑3.

Pikwer M, Bergstrom U, Nilsson JA, Jacobsson L, Turesson C.

Early menopause is an independent predictor of rheumatoid

arthritis. Ann Rheum Dis 2012;71:378‑81.

Hong JS, Yi SW, Kang HC, Jee SH, Kang HG, Bayasgalan G,

et al. Age at menopause and cause‑specific mortality in

South Korean women: Kangwha Cohort Study. Maturitas

;56:411‑9.

Jacobsen BK, Heuch I, Kvåle G. Age at natural menopause and

all‑cause mortality: A 37‑year follow‑up of 19,731 Norwegian

women. Am J Epidemiol 2003;157:923‑9.

Ruth KS, Murray A. Lessons from genome‑wide association

studies in reproductive medicine: Menopause. Semin Reprod

Med 2016;34:215‑23.

Ahmed K, Jahan P, Nadia I, Ahmed F, Abdullah Al E.

Assessment of menopausal symptoms among early and late

menopausal midlife Bangladeshi women and their impact on the

quality of life. J Menopausal Med 2016;22:39‑46.

Kelsey TW, Anderson RA, Wright P, Nelson SM, Wallace WH.

Data‑driven assessment of the human ovarian reserve. Mol Hum

Reprod 2012;18:79‑87.

Malinowski J, Farber‑Eger E, Crawford DC. Development

of a data‑mining algorithm to identify ages at reproductive

milestones in electronic medical records. Pac Symp Biocomput

:376‑87.

Faubion SS, Kuhle CL, Shuster LT, Rocca WA. Long‑term

health consequences of premature or early menopause and

considerations for management. Climacteric 2015;18:483‑91.

Canonico M, Plu‑Bureau G, O’Sullivan MJ, Stefanick ML,

Cochrane B, Scarabin PY, et al. Age at menopause, reproductive history and venous thromboembolism risk among postmenopausal

women: The women’s health initiative hormone therapy clinical

trials. Menopause 2014;21:214‑20.

Statnikov A, Aliferis CF. Are random forests better than support

vector machines for microarray‑based cancer classification?

AMIA Annu Symp Proc 2007;2007:686‑90.

Mishra GD, Pandeya N, Dobson AJ, Chung HF, Anderson D,

Kuh D, et al. Early menarche, nulliparity and the risk

for premature and early natural menopause. Hum Reprod

;32:679‑86.

Rizvanovic M, Balic D, Begic Z, Babovic A, Bogadanovic G,

Kameric L. Parity and menarche as risk factors of time of

menopause occurrence. Med Arch 2013;67:336‑8.

Zsakai A, Mascie‑Taylor N, Bodzsar EB. Relationship between

some indicators of reproductive history, body fatness and the

menopausal transition in Hungarian women. J Physiol Anthropol

;34:35.

Bjelland EK, Hofvind S, Byberg L, Eskild A. The relation of age

at menarche with age at natural menopause: A population study

of 336 788 women in Norway. Hum Reprod 2018;33:1149‑57.

Hannibal L, Lysne V, Bjorke‑Monsen AL, Behringer S, Grunert SC,

Spiekerkoetter U, et al. Biomarkers and algorithms for the

diagnosis of vitamin B12 deficiency. Front Mol Biosci 2016;3:27.

Allen LH. Vitamin B‑12. Adv Nutr 2012;3:54‑5.

Carmel R, Howard JM, Green R, Jacobsen DW, Azen C.

Hormone replacement therapy and cobalamin status in elderly

women. Am J Clin Nutr 1996;64:856‑9.

Allen LH, Miller JW, de Groot L, Rosenberg IH,

Smith AD, Refsum H, et al. Biomarkers of Nutrition

for Development (BOND): Vitamin B‑12 review. J Nutr

;148:1995S‑2027S.

Maggio M, Lauretani F, Basaria S, Ceda GP, Bandinelli S,

Metter EJ, et al. Sex hormone binding globulin levels across

the adult lifespan in women‑‑The role of body mass index and

fasting insulin. J Endocrinol Invest 2008;31:597‑601.

Soman M, Huang LC, Cai WH, Xu JB, Chen JY, He RK, et al.

Serum androgen profiles in women with premature ovarian

insufficiency: A systematic review and meta‑analysis. Menopause

;26:78‑93.

Purdue‑Smithe AC, Whitcomb BW, Szegda KL, Boutot ME,

Manson JE, Hankinson SE, et al. Vitamin D and calcium

intake and risk of early menopause. Am J Clin Nutr

;105:1493‑501.

Hong SH, Lee JE, An SM, Shin YY, Hwang DY, Yang SY, et al.

Effect of vitamin D3 on biosynthesis of estrogen in porcine

granulosa cells via modulation of steroidogenic enzymes. Toxicol

Res 2017;33:49‑54.

Jukic AMZ, Steiner AZ, Baird DD. Association between serum

‑hydroxyvitamin D and ovarian reserve in premenopausal

women. Menopause (New York, NY) 2015;22:312‑6.

Ahuja M. Age of menopause and determinants of menopause age:

A PAN India survey by IMS. J Midlife Health 2016;7:126‑31.

Akahoshi M, Soda M, Nakashima E, Tominaga T, Ichimaru S,

Seto S, et al. The effects of body mass index on age at

menopause. Int J Obes Relat Metab Disord 2002;26:961‑8.

Tao X, Jiang A, Yin L, Li Y, Tao F, Hu H. Body mass index

and age at natural menopause: A meta‑analysis. Menopause

;22:469‑74.

McTiernan A, Wu L, Chen C, Chlebowski R,

Mossavar‑Rahmani Y, Modugno F, et al. Relation of BMI and

physical activity to sex hormones in postmenopausal women.

Obesity (Silver Spring) 2006;14:1662‑77.