Department of Infectious Disease, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Wenzhou, 325027, China.
Lipids Health Dis. 2024 Jan 31;23(1):34. doi: 10.1186/s12944-024-02020-4.
A postmenopausal rise in the rates of nonalcoholic fatty liver disease (NAFLD) has been reported in women. This study thus sought to further probe the association of hysterectomy with NAFLD.
The data utilized in this investigation were attained from the 2017-March 2020 cycle of the National Health and Nutrition Examination Survey (NHANES), reflecting a strategic utilization of comprehensive health and nutrition information in the US population, to conduct a cross-sectional examination of the relationship between self-reported hysterectomy and NAFLD. Subjects included in this study were women aged 20 years or older. The multivariable logistic regression methodologies were utilized to determine the pertinent odds ratios (ORs) and their associated 95% confidence intervals (CIs).
Of the 2,868 subjects enrolled in this study (mean age: 51.3 years, 95%CI: 50.0-52.6 years), 22.1% (95%CI: 19.7-24.7%) reported having undergone a hysterectomy, while 31.1% (95%CI: 28.1-34.1%) exhibited elastographic evidence of NAFLD, and 3.8% (95%CI: 2.6-5.6%) exhibited clinically significant fibrosis (CSF). Relative to women with no history of hysterectomy, those that had undergone hysterectomy exhibited a higher odd of NAFLD (OR:1.66, 95%CI: 1.24-2.21) in a multivariable model fully adjusted for age, ethnicity, body mass index, female hormone use, oophorectomy, diabetes, hyperlipidemia, and smoking status. Subgroup analyses revealed a stronger association among women who were not obese (OR:2.23, 95%CI:1.61-3.11), women who were not affected by diabetes (OR:1.76, 95%CI: 1.25-2.46), and without hyperlipidemia (OR: 1.87, 95%CI: 1.10-3.16). No significant association of hysterectomy with NAFLD encompassing CSF was identified.
The results of the present nationally representative analysis suggested an association between hysterectomy and increased NAFLD prevalence among US women. Knowledge of this relationship may better aid clinical efforts to screen for and manage NAFLD.
据报道，绝经后女性中非酒精性脂肪性肝病（NAFLD）的发病率有所上升。因此，本研究旨在进一步探讨子宫切除术与 NAFLD 的关系。
本研究利用 2017 年至 2020 年 3 月期间的全国健康与营养调查（NHANES）数据，对美国人群的综合健康和营养信息进行了战略性利用，对自我报告的子宫切除术与 NAFLD 之间的关系进行了横断面研究。本研究的纳入对象为年龄在 20 岁及以上的女性。采用多变量逻辑回归方法确定相关优势比（OR）及其 95%置信区间（CI）。
在纳入本研究的 2868 名受试者中（平均年龄：51.3 岁，95%CI：50.0-52.6 岁），22.1%（95%CI：19.7-24.7%）报告曾接受过子宫切除术，31.1%（95%CI：28.1-34.1%）表现出弹性成像证据的 NAFLD，3.8%（95%CI：2.6-5.6%）表现出临床显著纤维化（CSF）。与没有子宫切除术史的女性相比，接受过子宫切除术的女性在多变量模型中表现出更高的 NAFLD 患病风险（OR：1.66，95%CI：1.24-2.21），该模型充分调整了年龄、种族、体重指数、女性激素使用、卵巢切除术、糖尿病、高血脂和吸烟状况。亚组分析显示，在非肥胖女性（OR：2.23，95%CI：1.61-3.11）、未患糖尿病的女性（OR：1.76，95%CI：1.25-2.46）和无高血脂的女性（OR：1.87，95%CI：1.10-3.16）中，这种关联更强。子宫切除术与涵盖 CSF 的 NAFLD 之间无显著关联。
本项具有全国代表性的分析结果表明，子宫切除术与美国女性 NAFLD 患病率增加有关。了解这种关系可能有助于临床努力筛查和管理 NAFLD。
