Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Cancer Epidemiol Biomarkers Prev. 2021 Jul;30(7):1424-1432. doi: 10.1158/1055-9965.EPI-20-1849. Epub 2021 Apr 20.
Bilateral oophorectomy during a nonmalignant hysterectomy is frequently performed for ovarian cancer prevention in premenopausal women. Oophorectomy before menopause leads to an abrupt decline in ovarian hormones that could adversely affect body composition. We examined the relationship between oophorectomy and whole-body composition.
Our study population included cancer-free women 35 to 70 years old from the 1999-2006 National Health and Nutrition Examination Survey, a representative sample of the U.S.
A total of 4,209 women with dual-energy x-ray absorptiometry scans were identified, including 445 with hysterectomy, 552 with hysterectomy and oophorectomy, and 3,212 with no surgery. Linear regression was used to estimate the difference in total and regional (trunk, arms, and legs) fat and lean body mass by surgery status.
In multivariable models, hysterectomy with and without oophorectomy was associated with higher total fat mass [mean percent difference (β); β: 1.61%; 95% confidence interval (CI), 1.00-2.28; β: 0.88%; 95% CI, 0.12-1.58] and lower total lean mass [β: -1.48%; 95% CI, -2.67, -1.15; β: -0.87%; 95% CI, -1.50, -0.24) compared with no surgery. Results were stronger in women with a normal body mass index (BMI) and those <45 years at surgery. All body regions were significantly affected for women with oophorectomy, whereas only the trunk was affected for women with hysterectomy alone.
Hysterectomy with oophorectomy, particularly in young women, may be associated with systemic changes in fat and lean body mass irrespective of BMI.
Our results support prospective evaluation of body composition in women undergoing hysterectomy with oophorectomy at a young age.
在非恶性子宫切除术中对绝经前女性行双侧卵巢切除术常用于预防卵巢癌。绝经前的卵巢切除术会导致卵巢激素的急剧下降，从而对身体成分产生不利影响。我们研究了卵巢切除术与全身成分之间的关系。
我们的研究人群包括来自 1999-2006 年全国健康与营养调查的无癌症、年龄在 35 至 70 岁的女性，这是美国的代表性样本。
共确定了 4209 名接受双能 X 射线吸收法扫描的女性，其中 445 名接受了子宫切除术，552 名接受了子宫切除术和卵巢切除术，3212 名未接受手术。线性回归用于根据手术状态估计总脂肪量和区域脂肪量（躯干、手臂和腿部）以及瘦体重的差异。
在多变量模型中，行子宫切除术伴或不伴卵巢切除术与总脂肪量较高相关[平均百分比差异（β）；β：1.61%；95%置信区间（CI）：1.00-2.28；β：0.88%；95%CI：0.12-1.58]和总瘦体重较低[β：-1.48%；95%CI：-2.67，-1.15；β：-0.87%；95%CI：-1.50，-0.24]相比，未手术。在正常体重指数（BMI）和手术时年龄<45 岁的女性中，结果更强。对于卵巢切除术的女性，所有身体部位均受到显著影响，而对于仅行子宫切除术的女性，仅躯干受到影响。
卵巢切除术，尤其是在年轻女性中，与脂肪和瘦体重的全身变化有关，与 BMI 无关。
我们的结果支持对年轻女性行子宫切除术伴卵巢切除术时的身体成分进行前瞻性评估。
