Fox K M, Cummings S R
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore.
Am J Obstet Gynecol. 1995 Jan;172(1 Pt 1):101-5. doi: 10.1016/0002-9378(95)90092-6.
Osteoporosis is a major women's health problem, because it is responsible for about 1.3 million fractures in the United States each year. Estrogen deficiency is a major risk factor in the pathogenesis of osteoporosis. Recent evidence has indicated that tubal ligation may cause menstrual dysfunction and estrogen deficiency. This study examined the association between tubal ligation and bone mass in a group of elderly postmenopausal women.
Subjects were 2215 white women > or = 65 years old participating in the Baltimore center of the Study of Osteoporotic Fractures. Bone mineral density of the proximal and distal radius and the calcaneus was measured by single photon absorptiometry. Multiple regression analysis was performed to determine whether tubal ligation had an independent effect on bone density. The effect of tubal ligation on the risk of hip and osteoporotic fractures was estimated by Cox proportional hazards model.
Women who reported a tubal ligation had lower, although not statistically significant, bone density of the radius and calcaneus. The relative risk of hip (1.05, 95% confidence limit 0.84 to 1.32) and osteoporotic fractures (1.01, 0.80 to 1.29) was not significantly increased in women with tubal ligation.
We conclude that elderly women who had a tubal ligation have small changes in bone density that are not of sufficient magnitude to increase their risk of osteoporotic fractures.
骨质疏松是一个主要的女性健康问题，因为在美国每年约有130万例骨折与之相关。雌激素缺乏是骨质疏松发病机制中的一个主要危险因素。最近有证据表明输卵管结扎可能导致月经功能紊乱和雌激素缺乏。本研究调查了一组老年绝经后妇女中输卵管结扎与骨量之间的关联。
研究对象为2215名年龄≥65岁的白人女性，她们参与了骨质疏松性骨折研究的巴尔的摩中心。采用单光子吸收法测量桡骨近端和远端以及跟骨的骨密度。进行多元回归分析以确定输卵管结扎是否对骨密度有独立影响。通过Cox比例风险模型估计输卵管结扎对髋部骨折和骨质疏松性骨折风险的影响。
报告有输卵管结扎的女性桡骨和跟骨的骨密度较低，尽管差异无统计学意义。输卵管结扎女性髋部骨折（相对风险1.05，95%可信区间0.84至1.32）和骨质疏松性骨折（相对风险1.01，0.80至1.29）的相对风险并未显著增加。
我们得出结论，进行过输卵管结扎的老年女性骨密度有微小变化，但不足以增加她们患骨质疏松性骨折的风险。
