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Association of oophorectomy and fat and lean body mass: evidence from a population-based sample of U.S. women

Pritesh S Karia  1 , Corinne E Joshu  1 , Kala Visvanathan  2

Cancer Epidemiol Biomarkers Prev. 2021 Apr 20;cebp.1849.2021.doi: 10.1158/1055-9965.EPI-20-1849. Online ahead of print.

Background: Bilateral oophorectomy during a non-malignant hysterectomy is frequently performed for ovarian cancer prevention in premenopausal women. Oophorectomy before menopause leads to an abrupt decline in ovarian hormones that could adversely impact body composition. We examined the relationship between oophorectomy and whole-body composition.

Methods: Our study population included cancer-free women 35-70 years old from the 1999-2006 National Health and Nutrition Examination Survey, a representative sample of the U.S.Population: A total of 4,209 women with dual-energy x-ray absorptiometry scans were identified, including 445 with hysterectomy, 552 with hysterectomy and oophorectomy, and 3,212 with no surgery. Linear regression was used to estimate the difference in total and regional (trunk, arms, legs) fat and lean body mass by surgery status.

Results: In multivariable models, hysterectomy with and without oophorectomy was associated with higher total fat mass (mean percent difference (β); βoophorectomy: 1.61%, 95% CI: 1.00, 2.28%; βhysterectomy: 0.88%, 95% CI: 0.12, 1.58) and lower total lean mass (βoophorectomy: -1.48%, 95% CI: -2.67, -1.15; βhysterectomy: -0.87%, 95% CI: -1.50, -0.24) compared to no surgery. Results were stronger in women with a normal BMI and those <45 years at surgery. All body regions were significantly affected for women with oophorectomy, while only the trunk was affected for women with hysterectomy alone.

Conclusions: Hysterectomy with oophorectomy, particularly in young women, may be associated with systemic changes in fat and lean body mass irrespective of BMI. Impact: Our results support prospective evaluation of body composition in women undergoing hysterectomy with oophorectomy at a young age.