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双侧卵巢切除术后绝经后女性激素水平的变化:一项荟萃分析。

Changes of hormone levels for postmenopausal women after bilateral oophorectomy: A meta-analysis.

作者信息

Wu Xiaoqin, Lin Yong, Long Yan, Yi Qinqin

机构信息

Luzhou Maternal and Child Health Hospital (Luzhou Second People's Hospital), Sichuan Province, China.

出版信息

Medicine (Baltimore). 2025 Aug 8;104(32):e43726. doi: 10.1097/MD.0000000000043726.

Abstract

BACKGROUND

Bilateral oophorectomy has a significant effect on changes in hormone levels in postmenopausal women. This meta-analysis aimed to evaluate the effects of bilateral oophorectomy on estradiol, testosterone, androstenedione, dehydroepiandrosterone sulfate (DHEAS), dehydroepiandrosterone (DHEA), sex hormone-binding globulin (SHBG), and estrone levels.

METHOD

We conducted a search for studies on focused ultrasound for cervical high-grade squamous intraepithelial lesions in PubMed, EMBASE, Web of Science, and Cochrane Library databases. This review included 7 studies related to bilateral ovariectomy or retention in postmenopausal women. Using Stata software version 12.0, we applied the random effect model, fixed effect model, and subgroup analysis to evaluate the change of different hormones.

RESULTS

After bilateral ovariectomy, estradiol levels decreased significantly (standardized mean difference [SMD] = -0.26, 95% confidence interval [CI] [-0.50, -0.02], P = .031). The overall analysis did not show significant differences (SMD = -0.10, 95% CI [-0.46, 0.26], P = .585), although significant differences were observed between subgroups (P = .025). Testosterone levels also decreased significantly after bilateral ovariectomy (SMD = -0.58, 95% CI [-0.86, -0.31], P < .001). The overall analysis indicated a significant difference between the 2 groups (SMD = -0.35, 95% CI [-0.63, -0.07], P = .014). DHEA levels decreased significantly after bilateral ovariectomy (SMD = -0.51, 95% CI [-0.93, -0.10], P = .015). In contrast, the hormone levels of androstenedione, DHEAS, SHBG, and estrone did not show significant differences between the 2 groups: androstenedione (SMD = -0.04, P = .682), DHEAS (SMD = -0.07, P = .489), SHBG (SMD = -0.02, P = .781), and estrone (SMD = -0.04, P = .587).

CONCLUSIONS

The present meta-analysis showed that bilateral ovariectomy had a significant effect on both estrogen and androgen levels in postmenopausal women, especially estradiol, testosterone, and DHEA. In contrast, the changes in androstenedione, DHEAS, SHBG, and estrone were not obvious. The findings of this study underscore the importance of monitoring hormone levels in postmenopausal women in clinical practice and considering the impact of oophorectomy on women's long-term health when developing individualized treatment options.

摘要

背景

双侧卵巢切除术对绝经后女性激素水平的变化有显著影响。本荟萃分析旨在评估双侧卵巢切除术对雌二醇、睾酮、雄烯二酮、硫酸脱氢表雄酮(DHEAS)、脱氢表雄酮(DHEA)、性激素结合球蛋白(SHBG)和雌酮水平的影响。

方法

我们在PubMed、EMBASE、科学引文索引和考克兰图书馆数据库中搜索有关聚焦超声治疗宫颈高级别鳞状上皮内病变的研究。本综述纳入了7项与绝经后女性双侧卵巢切除或保留相关的研究。使用Stata 12.0软件,我们应用随机效应模型、固定效应模型和亚组分析来评估不同激素的变化。

结果

双侧卵巢切除术后,雌二醇水平显著降低(标准化均数差[SMD]= -0.26,95%置信区间[CI][-0.50,-0.02],P = 0.031)。总体分析未显示出显著差异(SMD = -0.10,95% CI [-0.46,0.26],P = 0.585),尽管亚组间观察到显著差异(P = 0.025)。双侧卵巢切除术后睾酮水平也显著降低(SMD = -0.58,95% CI [-0.86,-0.31],P < 0.001)。总体分析表明两组间存在显著差异(SMD = -0.35,95% CI [-0.63,-0.07],P = 0.014)。双侧卵巢切除术后DHEA水平显著降低(SMD = -0.51,95% CI [-0.93,-0.10],P = 0.015)。相比之下,两组间雄烯二酮、DHEAS、SHBG和雌酮的激素水平未显示出显著差异:雄烯二酮(SMD = -0.04,P = 0.682)、DHEAS(SMD = -0.07,P = 0.489)、SHBG(SMD = -0.02,P = 0.781)和雌酮(SMD = -0.04,P = 0.587)。

结论

本荟萃分析表明,双侧卵巢切除术对绝经后女性的雌激素和雄激素水平均有显著影响,尤其是雌二醇、睾酮和DHEA。相比之下,雄烯二酮、DHEAS、SHBG和雌酮的变化不明显。本研究结果强调了在临床实践中监测绝经后女性激素水平的重要性,以及在制定个体化治疗方案时考虑卵巢切除术对女性长期健康的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4b6/12338285/f11ca39dfe39/medi-104-e43726-g001.jpg

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