Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, R3E 0T6, Canada.
Department of Epidemiology and Biostatistics, KLE University, Belgaum, Karnataka, 590010, India.
BMC Womens Health. 2020 Sep 23;20(1):211. doi: 10.1186/s12905-020-01075-6.
In recent years, the hysterectomy, a surgical removal of the uterus, has received increased attention in health policy debates in India. The trigger for this was a series of media reports that highlighted an unusual surge in the number of women undergoing hysterectomies with a significant number of cases involving young and early menopausal women from low-income families. When menopause occurs as a result of hysterectomy, then the hormones such as estrogen and progesterone affect how the body cells respond to insulin. To date, we have not come across a national study following blood glucose levels among women who undergo a hysterectomy.
The study used the Indian fourth round of National Family Health Survey data, which is a cross-sectional nationally representative sample of 699,686 women in the age group 15-49 years and conducted during 2015-16. Bivariate and multivariate logistic regressions were used to examine the effect of hysterectomy on blood glucose level of > 140 mg/dl among women of reproductive age groups.
The blood glucose level of > 140 mg/dl was much higher among women who had undergone a hysterectomy (12.2%) compared to non-hysterectomy women (5.7%). The pattern holds true among relevant background characteristics such as age, place of residence, education, caste, religion, wealth, marital status, body mass index (BMI), anaemia and consumption of tobacco. The adjusted odds after controlling for significant background factors, women who underwent hysterectomy experienced 15% higher odds of blood glucose level of > 140 mg/dl compared those who did not.
The results indicated increased blood glucose level among women post hysterectomy. Hence, the government of India should consider developing evidence-based policies and programming to provide effective targeted interventions for the better reproductive health of women.
近年来，子宫切除术作为一种切除子宫的手术，在印度的卫生政策辩论中受到了越来越多的关注。引发这一关注的是一系列媒体报道，这些报道强调了印度妇女接受子宫切除术的人数异常增加，其中大量病例涉及来自低收入家庭的年轻和早绝经妇女。当因子宫切除术而绝经时，雌激素和孕激素等激素会影响身体细胞对胰岛素的反应方式。迄今为止，我们还没有遇到过一项针对接受子宫切除术的妇女血糖水平的全国性研究。
该研究使用了印度第四轮全国家庭健康调查数据，这是一项针对 15-49 岁年龄组的 699686 名妇女的横断面全国代表性样本，于 2015-16 年进行。使用二变量和多变量逻辑回归来检查子宫切除术对生育年龄组妇女血糖水平>140mg/dl 的影响。
与未接受子宫切除术的妇女（5.7%）相比，接受过子宫切除术的妇女（12.2%）的血糖水平>140mg/dl 要高得多。这种模式在年龄、居住地、教育、种姓、宗教、财富、婚姻状况、体重指数（BMI）、贫血和烟草消费等相关背景特征中也是如此。在控制了重要背景因素后，调整后的比值比表明，接受子宫切除术的妇女血糖水平>140mg/dl 的几率比未接受手术的妇女高 15%。
结果表明，子宫切除术后妇女的血糖水平升高。因此，印度政府应考虑制定基于证据的政策和方案，为妇女提供更有效的有针对性的干预措施，以改善其生殖健康。
