Rocca Walter A, Gazzuola Rocca Liliana, Smith Carin Y, Grossardt Brandon R, Faubion Stephanie S, Shuster Lynne T, Kirkland James L, Stewart Elizabeth A, Miller Virginia M
Division of Epidemiology, Department of Health Sciences Research.
Department of Neurology.
J Gerontol A Biol Sci Med Sci. 2017 Sep 1;72(9):1213-1217. doi: 10.1093/gerona/glx026.
The cause-effect relationship between bilateral oophorectomy and accelerated aging remains controversial. We conducted new analyses to further address this controversy.
The Rochester Epidemiology Project records-linkage system was used to identify all premenopausal women who underwent bilateral oophorectomy for a noncancerous condition before age 50 years between 1988 and 2007 in Olmsted County, MN. Each woman was randomly matched to a referent woman born in the same year (±1 year) who had not undergone bilateral oophorectomy. We studied the rate of accumulation of 18 common chronic conditions over a median of approximately 14 years of follow-up (historical cohort study). Analyses were restricted to women free of any of the 18 chronic conditions at the time of oophorectomy (or index date).
After adjustments for race/ethnicity, education, body mass index, smoking, and age and calendar year at the index date, women who underwent oophorectomy before age 46 years experienced an accelerated rate of accumulation of the 18 chronic conditions considered together (hazard ratio = 1.24; 95% confidence interval: 1.12, 1.37; p < .001). The single-year incidence rate of new conditions was most different in the first 6 years after oophorectomy but the difference attenuated thereafter. Findings did not vary by surgical indication for the oophorectomy.
Bilateral oophorectomy is associated with a higher risk of multimorbidity among women who did not have any of the 18 selected conditions at baseline. The association did not vary by surgical indication for oophorectomy. Our findings suggest that bilateral oophorectomy is causally linked to accelerated aging.
双侧卵巢切除术与加速衰老之间的因果关系仍存在争议。我们进行了新的分析以进一步解决这一争议。
利用罗切斯特流行病学项目记录链接系统，在明尼苏达州奥尔姆斯特德县确定了1988年至2007年间所有在50岁之前因非癌性疾病接受双侧卵巢切除术的绝经前女性。将每位女性随机匹配至同年（±1岁）未接受双侧卵巢切除术的对照女性。我们研究了在约14年的中位随访期内18种常见慢性病的累积发生率（历史性队列研究）。分析仅限于在卵巢切除术时（或索引日期）无这18种慢性病中的任何一种的女性。
在对种族/民族、教育程度、体重指数、吸烟情况以及索引日期时年龄和日历年进行调整后，46岁之前接受卵巢切除术的女性，18种慢性病综合累积发生率加快（风险比=1.24；95%置信区间：1.12，1.37；P<0.001）。新发病例的单年发病率在卵巢切除术后的前6年差异最大，但此后差异减弱。研究结果不因卵巢切除术的手术指征而异。
对于基线时无18种选定疾病中任何一种的女性，双侧卵巢切除术与患多种疾病的较高风险相关。该关联不因卵巢切除术的手术指征而异。我们的研究结果表明双侧卵巢切除术与加速衰老存在因果联系。
