{"paper_id":"bb803f0f-b979-4e70-9fdd-1cf318ddbb6f","body_text":"Hysterectomy during the menopausal transition as a predictor of metabolic disorders\nDOI:\nhttps://doi.org/10.15574/PP.2023.95.43Keywords:\nuterine fibroids, climacteric syndrome, metabolic syndrome, hysterectomy, estrogen-dependent conditions of the female body, perinatal losses in history, body mass indexAbstract\nAlthough data on the decrease in ovarian function after hysterectomy (GE) are found in literature sources, the nature of changes in the hormonal and metabolic profile, its chronological sequence, the issue of the relationship with the development of metabolic syndrome (MS), even in the case of preservation of ovarian tissue, remain controversial and fragmented, which served as an impetus for conducting this study.\nPurpose - to assess the risk of metabolic disorders after GE during the menopausal transition.\nMaterials and methods. A comprehensive assessment of the long-term consequences of GE was carried out in 160 women of the menopausal transition age. Metabolic homeostasis parameters were evaluated before surgery and in dynamics after surgical intervention (after 12 months). Risk factors were identified during a general clinical examination, based on anamnestic data. Indicators of carbohydrate and lipid metabolism were evaluated in the examined women. Inclusion criteria: the age of the menopausal transition, GE due to benign uterine pathology, the patient's consent to participate in the research.\nResults. Analysis of carbohydrate metabolism indicators showed an increase in the HOMA-IR index and postprandial glucose level, changes in the lipid profile. When comparing clinical symptoms and laboratory research methods, in 34.37% of cases, the formation of MS was noted one year after GE. Based on multivariate analysis using binary logistic regression, the following risk factors for metabolic disorders were found to be statistically significant: high body mass index, waist circumference above 80 cm, age older than 45, climacteric syndrome, GE.\nConclusions. A high body mass index, a waist circumference greater than 80 cm, the presence of signs of the climacteric syndrome, GE and age older than 45 years show the association with the development of metabolic disorders in the distant postoperative period, and their combined effect increases the risk of their development. These factors at the preoperative stage can serve as prognostic markers of metabolic disorders in the distant postoperative period.\nThe research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.\nNo conflict of interests was declared by the authors.\nReferences\nAltman D, Falconer C, Cnattingius S, Granath F. (2008). Pelvic organ prolapse surgery following hysterectomy on benign indications. Am J Obstet Gynecol. 198 (5): 572.e1-572.e6. https://doi.org/10.1016/j.ajog.2008.01.012; PMid:18355787\nAraujo JA, Romano EL, Brito BE et al. (1995). Iron overload augments the development of atherosclerotic lesions in rabbits. Arterioscler Thromb Vasc Biol. 15 (8): 1172-1180. https://doi.org/10.1161/01.ATV.15.8.1172; PMid:7542998\nBhattacharya S, Middleton LJ, Tsourapas A, Lee AJ, Champaneria R, Daniels JP et al. (2011). Hysterectomy, endometrial ablation and Mirena® for heavy menstrual bleeding: a systematic review of clinical effectiveness and cost-effectiveness analysis. Health Technol Assess. 15 (19): III-XVI, 1-252. https://doi.org/10.3310/hta15190; PMid:21535970 PMCid:PMC4781434\nCho SW, Kim BG, Kim BO et al. (2016). Hemorheological and glycemic parameters and HDL cholesterol for the prediction of cardiovascular events. Arq Bras Cardiol. 106 (1): 56-61.\nCorrigan KE, Vargas MV, Robinson HN, Gu A, Wei C, Tyan P et al. (2019). Impact of Diabetes Mellitus on Postoperative Complications Following Laparoscopic Hysterectomy for Benign Indications. Gynecol Obstet Invest. 84 (6): 583-590. Epub 2019 Jun 18. https://doi.org/10.1159/000501034; PMid:31212286\nDronova V, Dronov O, Teslyuk R. (2017). The psychological status of patients in pre- and postoperative periods with gynаecological and surgical pathology, and methods of its determination (a literary review). Perinatologiya i pediatriya. 1 (69): 65-69. https://doi.org/10.15574/PP.2017.69.65\nEshtehardi P, Brown AJ, Bhargava A et al. (2017). High wall shear stress and high-risk plaque: an emerging concept. Int J Cardiovasc Imaging. 33 (7): 1089-1099. https://doi.org/10.1007/s10554-016-1055-1; PMid:28074425 PMCid:PMC5496586\nFernandez H. (2009, Jan-Feb). Rate, type, and cost of invasive interventions for uterine myomas in Germany, France, and England. J Minim Invasive Gynecol. 16 (1): 40-46. https://doi.org/10.1016/j.jmig.2008.09.581; PMid:18996060\nFindley AD, Siedhoff MT, Hobbs KA et al. (2013). Short-term effects of salpingectomy during laparoscopic hysterectomy on ovarian reserve: a pilot randomized controlled trial. Fertil Steril. 100 (6): 1704-1708. https://doi.org/10.1016/j.fertnstert.2013.07.1997; PMid:23993887 PMCid:PMC3844119\nHavryliuk HM, Makarchuk OM. (2016). Osoblyvosti otsinky yakosti zhyttia ta poshuk shliakhiv reabilitatsii u zhinok, yaki perenesly operatsiiu na mattsi. Halytskyi likarskyi visnyk. 23; 3 (1): 40-43.\nHehenkamp WJ, Volkers NA, Broekmans FJ et al. (2007). Loss of ovarian reserve after uterine artery embolization: a randomized comparison with hysterectomy. Hum Reprod. 22 (7): 1996-2005. https://doi.org/10.1093/humrep/dem105; PMid:17582145\nHladchuk IZ, Rozhkovska NM, Kosei TV. (2016). Suchasni khirurhichni tekhnolohii v likuvanni miomy matky (ohliad literatury i vlasni dani). Zbirnyk naukovykh prats Asotsiatsii akusheriv-hinekolohiv Ukrainy. 2 (38): 123-129.\nIngelsson E, Lundholm C, Johansson AL, Altman D. (2011). Hysterectomy and risk of cardiovascular disease: a population-based cohort study. Eur Heart J. 32 (6): 745-750. https://doi.org/10.1093/eurheartj/ehq477; PMid:21186237\nKim C, Nan B, Kong S, Harlow S. (2012). Changes in iron measures over menopause and associations with insulin resistance. J Womens Health (Larchmt). 21 (8): 872-877. https://doi.org/10.1089/jwh.2012.3549; PMid:22731657 PMCid:PMC3411341\nLaughlin-Tommaso SK, Khan Z, Weaver AL et al. (2018). Cardiovascular and metabolic morbidity after hysterectomy with ovarian conservation: a cohort study. Menopause. 25: 483-492. https://doi.org/10.1097/GME.0000000000001043; PMid:29286988 PMCid:PMC5898981\nMakarchuk OM, Havryliuk HM. (2013). Osoblyvosti lipidnoho profiliu ta hormonalnoho fonu u zhinok z posthisterektomichnym syndromom. Zdorove zhenshchyni. 6 (82): 113-115.\nMakris N, Vomvolaki E, Partsinevelos G et al. (2006). The effect of hysterectomy on sexuality and psychological changes. The European Journal of Contraception and Reproductive Health Care March. 11 (1): 23-27. https://doi.org/10.1080/13625180500430200; PMid:16546813\nMatsuo K, Mandelbaum RS, Nusbaum DJ, Matsuzaki S, Klar M, Roman LD, Wright JD. (2021, Mar). National trends and outcomes of morbidly obese women who underwent inpatient hysterectomy for benign gynecological disease in the USA. Acta Obstet Gynecol Scand. 100 (3): 459-470. https://doi.org/10.1111/aogs.14034; PMid:33111335\nMisiura AH. (2014). Dynamika metabolichnykh porushen pislia histerektomii u perymenopauzalnomu periodi. Aktualni pytannia pediatrii, akusherstva ta hinekolohii. 2: 103-105.\nMustafa A. (2023, Apr 20). Association between hysterectomy and hypertension among Indian middle-aged and older women: a cross-sectional study. BMJ Open. 13 (4): e070830. doi: 10.1136/bmjopen-2022-070830. Erratum in: BMJ Open. 2023 Jun 19; 13 (6): e070830corr1. PMID: 37080618; PMCID: PMC10124308. https://doi.org/10.1136/bmjopen-2022-070830corr1; PMid:37336544 PMCid:PMC10314587\nNahás EAP, Pontes A, Nahas-Neto J et al. (2005). Effect of Total Abdominal Hysterectomy on Ovarian Blood Supply in Women of Reproductive Age. J. Ultrasound. Med. 24: 169-174. https://doi.org/10.7863/jum.2005.24.2.169; PMid:15661947\nRead MD, Edey KA, Hapeshi J et al. (2010). The age of ovarian failure following premenopausal hysterectomy with ovarian conservation. Menopause Int. 16; 2: 56-59. https://doi.org/10.1258/mi.2010.010022; PMid:20729494\nVenturella R, Lico D, Borelli M et al. (2017). 3 To 5 years later: long-term effects of prophylactic bilateral salpingectomy on ovarian function. J Minim Invasive Gynecol. 24 (1): 145-150. https://doi.org/10.1016/j.jmig.2016.08.833; PMid:27621194\nVermeulen CKM, Veen J, Adang C et al. (2023). Long-term pelvic floor symptoms and urogenital prolapse after hysterectomy. BMC Women's Health. 23. Article number: 115. https://doi.org/10.1186/s12905-023-02286-3; PMid:36944980 PMCid:PMC10029236\nWhiteman MK, Hillis SD, Jamieson DJ, Morrow B, Podgornik MN, Brett KM et al. (2008, Jan). Inpatient hysterectomy surveillance in the United States, 2000-2004. Am J Obstet Gynecol. 198 (1): 34 e1-7. https://doi.org/10.1016/j.ajog.2007.05.039; PMid:17981254\nYeh JS, Cheng HM, Hsu PF et al. (2013). Hysterectomy in young women associates with higher risk of stroke: a nationwide cohort study. Int J Cardiol. 168 (3): 2616-2621. https://doi.org/10.1016/j.ijcard.2013.03.042; PMid:23587399\nYuan Z, Cao D, Bi X, Yu M, Yang J, Shen K. (2019). The effects of hysterectomy with bilateral salpingectomy on ovarian reserve. Int J Gynaecol Obstet. 145 (2): 233-238. https://doi.org/10.1002/ijgo.12798; PMid:30805925\nYuk J, Kim BG, Lee BK et al. (2023). Association of Early Hysterectomy With Risk of Cardiovascular Disease in Korean Women. JAMA Netw Open. 6 (6): e2317145. https://doi.org/10.1001/jamanetworkopen.2023.17145; PMid:37307002 PMCid:PMC10261994\nDownloads\nPublished\nIssue\nSection\nLicense\nCopyright (c) 2023 Ukrainian Journal of Perinatology and Pediatrics\nThis work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.\nThe policy of the Journal “Ukrainian Journal of Perinatology and Pediatrics” is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license(СС BY-NC).\nAuthors transfer the copyright to the Journal “MODERN PEDIATRICS. UKRAINE” when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.\nReaders have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.\nThe use of published materials for commercial purposes is strongly prohibited.","source_license":"CC0","license_restricted":false}