Abstract
This cross-sectional study aimed to investigate the effect of premenopausal risk reducing salpingo-oophorectomy (RRSO) on the cholesterol profile of women at increased ovarian cancer risk and to assess possible effects of age at and time since RRSO. We included 207 women who underwent RRSO before menopausal age (52 years) attending the family cancer clinic of an academic hospital and 828 age-matched women from a general population cohort (PREVEND). Participants filled out a questionnaire on socio-demographic characteristics, lifestyle and medical history, had anthropometric measurements and provided blood samples for assessment of serum levels of total cholesterol, HDL-cholesterol and non-HDL-cholesterol. The correlation between RRSO and cholesterol profile was assessed with logistic regression. Furthermore, subgroup analyses were performed to explore a possible effect of age at and time since RRSO. At a median time of 5.9 years (range 2.3–25.2) after surgery, RRSO was associated with low (< 60 mg/dl) HDL-cholesterol (OR 9.74, 95% CI 5.19–18.26) and high (≥ 160 mg/dl) non-HDL-cholesterol (OR 1.85, 95% CI 1.21–2.82) when adjusting for body mass index, hormone therapy, participation on sports and previous chemotherapy. The observed association was not dependent on age or time since RRSO. The RRSO group had less smokers (19.3 vs. 25.8%) and more participation on sports (45.4 vs. 22.0%). Our results suggest that RRSO is associated with a more atherogenic cholesterol profile, despite a lower prevalence of smoking and higher prevalence of participation on sports as compared to controls. This observation can be useful for physicians involved in the counselling and follow-up of women having RRSO.
Highlights
Risk reducing salpingo-oophorectomy (RRSO) is the most effective strategy for preventing ovarian cancer (OC) in BRCA1/2 germline mutation carriers, reducing OC risk up to 96% [1, 2] RRSO is currently recommended to these women after child bearing is complete, at age 35–40 (BRCA1) and 40–45 years (BRCA2)
Pre-menopausal bilateral oophorectomy is associated with increased total cholesterol and reduced HDL-C [8, 12], a higher prevalence of metabolic syndrome and an increased risk of cardiovascular disease (CVD) and cardiovascular mortality when compared to natural menopause [13,14,15,16,17]
After adjusting for BMI, ever use of hormone replacement therapy (HRT), previous chemotherapy and participation on sports, RRSO was still significantly associated with increased non-HDL-C and with decreased HDL-C
Summary
Risk reducing salpingo-oophorectomy (RRSO) is the most effective strategy for preventing ovarian cancer (OC) in BRCA1/2 germline mutation carriers, reducing OC risk up to 96% [1, 2] RRSO is currently recommended to these women after child bearing is complete, at age 35–40 (BRCA1) and 40–45 years (BRCA2). At this age the majority of women are premenopausal. A recent study observed that women at increased risk of OC who underwent RRSO, presented a more favorable CVD risk profile than age-matched women [19]
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