Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Division of Geriatric Medicine, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
BJOG. 2017 Sep;124(10):1525-1535. doi: 10.1111/1471-0528.14703. Epub 2017 Jun 26.
Oophorectomy is recommended for women at increased risk for ovarian cancer. When performed at premenopausal age oophorectomy induces acute surgical menopause, with unwanted consequences.
To investigate bone mineral density (BMD) and fracture prevalence after surgical menopause.
A literature search of PubMed, EMBASE and Cochrane library was performed with no date restriction. Date of last search was March 1st, 2016.
Primary studies reporting on BMD, T-scores or fracture prevalence in women with surgical menopause and age-matched control groups.
Data were extracted on BMD (g/cm ), T-scores and fracture prevalence in women with surgical menopause and control groups. Quality was assessed by an adaptation of the Downs and Black checklist. Random effects models were used to meta-analyse results of studies reporting on BMD or fracture rates.
Seventeen studies were included, comprising 43 386 women with surgical menopause. Ten studies provided sufficient data for meta-analysis. BMD after surgical menopause was significantly lower than in premenopausal age-matched women [mean difference lumbar spine, -0.15 g/cm (95% CI, -0.19 to -0.11 g/cm ); femoral neck, -0.17 g/cm (95% CI, -0.23 to -0.11 g/cm )] but not lower than in women with natural menopause [lumbar spine, -0.02 g/cm (95% CI, -0.04 to 0.00 g/cm ); femoral neck, 0.04 g/cm (95% CI, -0.09 to 0.16 g/cm )]. Hip fracture rate was not higher after surgical menopause compared with natural menopause [hazard ratio: 0.85 (95% CI, 0.70 to 1.04)].
AUTHOR'S CONCLUSIONS: No evident effect of surgical menopause was observed on BMD and fracture prevalence compared with natural menopause. However, available studies are prone to bias and need to be interpreted with caution.
Bone health after menopause: no evidence for additional effect of surgical menopause on BMD and fractures.
卵巢切除术被推荐用于患有卵巢癌风险增加的女性。在绝经前进行卵巢切除术会导致急性手术性绝经，带来不必要的后果。
研究手术性绝经后骨密度（BMD）和骨折发生率。
对 PubMed、EMBASE 和 Cochrane 图书馆进行了文献检索，没有时间限制。最后一次检索日期为 2016 年 3 月 1 日。
报告手术性绝经后妇女与年龄匹配的对照组的 BMD、T 评分或骨折发生率的原始研究。
提取手术性绝经后妇女和对照组的 BMD（g/cm）、T 评分和骨折发生率的数据。通过对 Downs 和 Black 清单的改编来评估质量。使用随机效应模型对报告 BMD 或骨折率的研究进行荟萃分析。
纳入了 17 项研究，共 43386 名接受手术性绝经的妇女。10 项研究提供了足够的数据进行荟萃分析。手术性绝经后的 BMD 明显低于绝经前年龄匹配的妇女[平均差异腰椎，-0.15 g/cm（95%CI，-0.19 至-0.11 g/cm）；股骨颈，-0.17 g/cm（95%CI，-0.23 至-0.11 g/cm）]，但与自然绝经的妇女相比并不低[腰椎，-0.02 g/cm（95%CI，-0.04 至 0.00 g/cm）；股骨颈，0.04 g/cm（95%CI，-0.09 至 0.16 g/cm）]。与自然绝经相比，手术性绝经后髋部骨折发生率并未升高[风险比：0.85（95%CI，0.70 至 1.04）]。
与自然绝经相比，手术性绝经对 BMD 和骨折发生率没有明显影响。然而，现有的研究容易出现偏倚，需要谨慎解释。
绝经后骨骼健康：手术性绝经对 BMD 和骨折无额外影响的证据。
