Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang, Republic of Korea; Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Republic of Korea.
Division of Cardiology, Department of Obstetrics and Gynecology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea.
Maturitas. 2022 Mar;157:49-56. doi: 10.1016/j.maturitas.2021.10.009. Epub 2021 Oct 26.
Hysterectomy is one of the most commonly performed gynecological procedures. Several studies have reported an association between hysterectomy and coronary heart disease (CHD), but the conclusions are controversial. This study aimed to evaluate the association between hysterectomy and the occurrence of CHD using a national sample cohort from South Korea.
Using the national cohort from the Korean National Health Insurance Service, we extracted data on patients who had undergone hysterectomy (n = 8,642) and on controls matched at a ratio of 1:4 (n = 34,568) and then analyzed the occurrence of CHD from 2002 to 2013. Patients were matched according to age, income, region of residence, obesity, smoking, alcohol consumption, and medical history.
A Cox proportional hazards model was used to analyze the hazard ratios (HRs) and 95% confidence intervals (CIs). Subgroup analyses were performed based on both age and bilateral salpingo-oophorectomy (BSO) status. The age of the participants was defined as that at the time of hysterectomy.
The HR for CHD was 1.05 (95% CI = 0.96-1.16, p = 0.286) in the hysterectomy group. The HRs for CHD according to the different age subgroups were 1.19 (95% CI = 1.03-1.38, p = 0.018) for patients aged < 50 years, 1.05 (95% CI = 0.89-1.25, p = 0.561) for patients aged 50-59 years, and 0.88 (95% CI = 0.73-1.05, p = 0.147) for patients aged ≥ 60 years.
The incidence of CHD was statistically significantly higher in women who underwent hysterectomy when they were under 50 years of age than in the matched controls.
子宫切除术是最常见的妇科手术之一。多项研究报告了子宫切除术与冠心病（CHD）之间的关联，但结论存在争议。本研究旨在使用来自韩国的全国样本队列评估子宫切除术与 CHD 发生之间的关联。
我们使用韩国国家健康保险服务的全国队列，提取了接受子宫切除术（n=8642）的患者和按 1:4 比例匹配的对照组（n=34568）的数据，然后分析了 2002 年至 2013 年 CHD 的发生情况。患者根据年龄、收入、居住地、肥胖、吸烟、饮酒和病史进行匹配。
采用 Cox 比例风险模型分析危险比（HR）和 95%置信区间（CI）。根据年龄和双侧输卵管卵巢切除术（BSO）状态进行亚组分析。参与者的年龄定义为子宫切除术时的年龄。
子宫切除术组 CHD 的 HR 为 1.05（95%CI=0.96-1.16，p=0.286）。根据不同年龄亚组，CHD 的 HR 分别为<50 岁患者为 1.19（95%CI=1.03-1.38，p=0.018）、50-59 岁患者为 1.05（95%CI=0.89-1.25，p=0.561）和≥60 岁患者为 0.88（95%CI=0.73-1.05，p=0.147）。
与年龄匹配的对照组相比，50 岁以下接受子宫切除术的女性 CHD 发生率明显更高。
