Hysterectomy during the menopausal transition as a predictor of metabolic disorders

In: UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS · 2023 · pp. 43–48 · doi:10.15574/pp.2023.95.43 · W4388269334
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Hysterectomy during the menopausal transition, along with high BMI, waist circumference, age over 45, and climacteric syndrome, increases the risk of metabolic disorders one year post-surgery.

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This study assessed long-term metabolic consequences of hysterectomy during the menopausal transition in 160 women with benign uterine pathology, measuring carbohydrate and lipid metabolism parameters before surgery and again 12 months afterward. The authors found worsened carbohydrate metabolism, including increased HOMA-IR and postprandial glucose, along with changes in the lipid profile, and in 34.37% of cases metabolic syndrome developed one year after hysterectomy. Multivariate binary logistic regression identified higher body mass index, waist circumference >80 cm, age >45, climacteric syndrome, and hysterectomy itself as statistically significant risk factors, with combined effects increasing risk. The paper’s limitation as stated is that the evidence base motivating the study is described as fragmented and controversial, reflecting ongoing uncertainty around hormonal/metabolic changes after hysterectomy. This paper relates to endometriosis and/or adenomyosis because hysterectomy is commonly performed for benign uterine conditions that can overlap with endometriosis- or adenomyosis-associated symptoms, though the paper does not explicitly discuss endometriosis or adenomyosis.

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Abstract

Although 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. Purpose - to assess the risk of metabolic disorders after GE during the menopausal transition. Materials 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. Results. 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. Conclusions. 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. The 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. No conflict of interests was declared by the authors.
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Materials

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. Results. 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. Conclusions. 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. The 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. No conflict of interests was declared by the authors.

References

Altman 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 Araujo 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 Bhattacharya 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 Cho 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. Corrigan 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 Dronova 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 Eshtehardi 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 Fernandez 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 Findley 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 Havryliuk 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. Hehenkamp 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 Hladchuk 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. Ingelsson 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 Kim 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 Laughlin-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 Makarchuk OM, Havryliuk HM. (2013). Osoblyvosti lipidnoho profiliu ta hormonalnoho fonu u zhinok z posthisterektomichnym syndromom. Zdorove zhenshchyni. 6 (82): 113-115. Makris 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 Matsuo 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 Misiura AH. (2014). Dynamika metabolichnykh porushen pislia histerektomii u perymenopauzalnomu periodi. Aktualni pytannia pediatrii, akusherstva ta hinekolohii. 2: 103-105. Mustafa 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 Nahás 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 Read 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 Venturella 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 Vermeulen 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 Whiteman 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 Yeh 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 Yuan 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 Yuk 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 Downloads Published Issue Section License Copyright (c) 2023 Ukrainian Journal of Perinatology and Pediatrics This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. The 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). Authors transfer the copyright to the Journal “MODERN PEDIATRICS. UKRAINE” when the manuscript is accepted for publication. 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