Xu Binkai, Wu Xian, Liu Zhiwei, Yu Bin
Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center of Nanjing Medical University, Changzhou, China.
Front Nutr. 2025 Aug 4;12:1623490. doi: 10.3389/fnut.2025.1623490. eCollection 2025.
The interplay between gynaecological surgeries and arthritis pathogenesis remains poorly understood. This study offers new insights into potential health risks associated with post-hysterectomy.
The cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018, which cannot establish the causation. The effects of five serum heavy metal and nine vitamin intakes were evaluated.
A total of 3,121 participants with complete data from NHANES (2007 ~ 2018) were included in this study. The prevalence of arthritis among participants having undergone hysterectomy was significantly increased (58.25% vs. 31.64%, < 0.001). Meanwhile, the levels of blood lead were significantly increased in women having undergone gynaecological surgery ( < 0.001) and women with arthritis ( < 0.001). After additionally adjusting, hysterectomy was still associated with an increased risk of arthritis (OR = 3.33, < 0.0001). A non-linear (L-shaped) relationship was observed in blood lead, mercury, and cadmium ( for non-linearity <0.001). Blood lead was the highest weighted quantile sum (WQS) weigh among five heavy metals, with the highest contributions of 0.72. Mediation analysis demonstrated that blood lead accounted for 6.02% of the observed association between hysterectomy and arthritis ( < 0.001). The RCS curves confirmed that there was a non-linear (L-shaped) relationship between vitamin K, vitamin D, and the risk of arthritis caused by hysterectomy ( < 0.001).
Hysterectomy is associated with an increased risk of arthritis, with a focus on blood lead as a mediating factor and vitamin intake as a potential protective factor. It will contribute to the long-term health management after hysterectomy.
妇科手术与关节炎发病机制之间的相互作用仍未得到充分理解。本研究为子宫切除术后潜在的健康风险提供了新的见解。
这项横断面研究利用了2007年至2018年美国国家健康与营养检查调查（NHANES）的数据，该研究无法确定因果关系。评估了五种血清重金属和九种维生素摄入量的影响。
本研究纳入了NHANES（2007~2018年）中共有3121名数据完整的参与者。接受子宫切除术的参与者中关节炎的患病率显著增加（58.25%对31.64%，<0.001）。同时，接受妇科手术的女性（<0.001）和患有关节炎的女性（<0.001）血铅水平显著升高。在进一步调整后，子宫切除术仍与关节炎风险增加相关（OR=3.33，<0.0001）。血铅、汞和镉呈现非线性（L形）关系（非线性检验P<0.001）。血铅是五种重金属中加权分位数和（WQS）权重最高的，贡献最大为0.72。中介分析表明，血铅占子宫切除术与关节炎之间观察到的关联的6.02%（<0.001）。限制立方样条（RCS）曲线证实，维生素K、维生素D与子宫切除术引起的关节炎风险之间存在非线性（L形）关系（<0.001）。
子宫切除术与关节炎风险增加相关，重点关注血铅作为中介因素以及维生素摄入作为潜在保护因素。这将有助于子宫切除术后的长期健康管理。
