Department of Obstetrics and Gynaecology, Helsinki University Hospital, Helsinki, Finland.
Maturitas. 2011 Aug;69(4):354-8. doi: 10.1016/j.maturitas.2011.05.004.
To compare, whether women with menorrhagia, treated with either hysterectomy or LNG-IUS, differ in their cardiovascular risk profile during 10-year follow-up.
A total of 236 women were randomized to treatment by hysterectomy (n=117) or LNG-IUS (n=119). Their cardiovascular risk factors were analyzed at baseline, at 5 years, and at 10 years. As 55 originally randomized to the LNG-IUS group had hysterectomy during the follow-up, all analyzes were performed by actual treatment modality.
Waist circumference, body-mass index (BMI), blood pressure, and the levels of blood lipids, serum high-sensitivity CRP (hsCRP) and tumor necrosis factor alpha (TNF-α) were measured, and the use of medication for hypertension, diabetes, hypercholesterolemia, and ischemic heart disease was analyzed.
After 5 years, an increase in the use of diabetes medication during the follow-up was only detected in the hysterectomy group (from 1.7% to 6.7%, P=0.008 vs from 5.1% to 8.4%, P=0.08), as well as they had significantly higher serum levels of TNF-α (108.59 pg/ml vs 49.02 pg/ml, P=0.001) and hsCRP (1.55 μg/ml vs 0.78 μg/ml, P=0.038) at 5- and 10-years. There was no difference between the groups in the use of cardiovascular medication, neither was there difference in blood pressure, waist circumference, BMI, or concentrations of blood lipids.
Hysterectomy seems to be associated with increased levels of serum inflammatory markers and increased diabetes medication, which in turn, may predispose individual to future cardiovascular events.
比较月经过多的女性在接受子宫切除术或 LNG-IUS 治疗后，在 10 年随访期间心血管风险状况是否存在差异。
共有 236 名女性被随机分为子宫切除术组（n=117）或 LNG-IUS 组（n=119）。在基线、5 年和 10 年时分析了她们的心血管危险因素。由于最初随机分配到 LNG-IUS 组的 55 名女性在随访期间接受了子宫切除术，因此所有分析均按实际治疗方式进行。
测量腰围、体重指数（BMI）、血压以及血脂、血清高敏 C 反应蛋白（hsCRP）和肿瘤坏死因子-α（TNF-α）水平，并分析高血压、糖尿病、高脂血症和缺血性心脏病的药物治疗情况。
5 年后，仅在子宫切除术组中发现随访期间糖尿病药物的使用有所增加（从 1.7%增至 6.7%，P=0.008；而从 5.1%增至 8.4%，P=0.08），并且 TNF-α（108.59 pg/ml 比 49.02 pg/ml，P=0.001）和 hsCRP（1.55 μg/ml 比 0.78 μg/ml，P=0.038）的血清水平在 5 年和 10 年时也明显更高。两组间心血管药物的使用、血压、腰围、BMI 或血脂浓度均无差异。
子宫切除术似乎与血清炎症标志物水平升高和糖尿病药物使用增加有关，这反过来可能使个体易发生未来的心血管事件。
