Abstract
This study investigated the risk of osteoporosis or bone fractures (vertebrae, hip and others) in hysterectomized women in Taiwan. This is a retrospective population-based cohort study from 2000 to 2013. Women aged ≥30 years who underwent hysterectomy between 2000 and 2012 were included in this study. The comparison group was randomly selected from the database with a 1:4 matching with age and index year. Incidence rate and hazard ratios of osteoporosis and bone fracture between hysterectomized women and the comparison group were calculated. Cox proportional hazard regressions were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). We identified 9,189 hysterectomized women and 33,942 age-matched women without a hysterectomy. All women were followed for a median time of about 7 years. The adjusted hazard ratio (aHR) of subsequent osteoporosis or bone fracture was higher in the hysterectomy women (2.26, 95% confidence interval [CI] = 2.09-2.44) than in the comparison group. In the subgroup analysis, oophorectomy and estrogen therapy increase the risk of osteoporosis or fracture in both groups. Regarding the fracture site, the aHR of vertebral fracture (4.92, 95% CI = 3.78-6.40) was higher in the hysterectomized women than in the comparison group. As follow-up time increasing, the aHR of vertebral fracture in hysterectomized women were 4.33 (95% CI = 2.99-6.28), 3.89 (95% CI = 2.60-5.82) and 5.42 (95% CI = 2.66-11.01) for <5, 5-9 and ≥9 years of follow-up, respectively. In conclusion, we found that hysterectomized women might be associated with increased risks of developing osteoporosis or bone fracture.
Highlights
Osteoporosis and its associated fragility fractures are a significant global issue with an impact on humans second only to cardiovascular disease [1,2]
The adjusted hazard ratio of subsequent osteoporosis or bone fracture was higher in the hysterectomy women (2.26, 95% confidence interval [CI] = 2.09–2.44) than in the comparison group
The adjusted hazard ratio (aHR) of vertebral fracture (4.92, 95% CI = 3.78–6.40) was higher in the hysterectomized women than in the comparison group
Summary
Osteoporosis and its associated fragility fractures are a significant global issue with an impact on humans second only to cardiovascular disease [1,2]. Osteoporosis is a skeletal system disease that reduces bony mass and disrupts the bone structure, causing decreased bone strength and leading to fragility fractures. Women were found to have double the risk for osteoporosis and triple the risk for fragility fractures compared with men at age 50 [3]. Fractures are notorious for increased mortality, morbidity, disabilities in daily living, social costs, and psychogenic problems [4]. Hysterectomy is thought to be related to multiple comorbidities because it might be related to earlier physiological menopause than in the general population, which results in earlier hormonal changes and may be related to osteoporosis and bone fractures [8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
