Advertisement

Trajectories of metabolic parameters after bilateral oophorectomy in premenopausal women

  • Ekta Kapoor
    Correspondence
    Corresponding author at: Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States.
    Affiliations
    Menopause and Women's Sexual Health Clinic, Division of General Internal Medicine, Mayo Clinic, Rochester, MN, United States

    Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, United States

    Center for Women's Health, Mayo Clinic, Rochester, MN, United States

    Mayo Clinic Specialized Center of Research Excellence (SCORE) on Sex Differences, Mayo Clinic, Rochester, MN, United States
    Search for articles by this author
  • Stephanie S. Faubion
    Affiliations
    Center for Women's Health, Mayo Clinic, Rochester, MN, United States

    Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, United States
    Search for articles by this author
  • Liliana Gazzuola Rocca
    Affiliations
    Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States
    Search for articles by this author
  • Michelle M. Mielke
    Affiliations
    Mayo Clinic Specialized Center of Research Excellence (SCORE) on Sex Differences, Mayo Clinic, Rochester, MN, United States

    Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States

    Department of Neurology, Mayo Clinic, Rochester, MN, United States
    Search for articles by this author
  • Carin Y. Smith
    Affiliations
    Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States
    Search for articles by this author
  • Walter A. Rocca
    Affiliations
    Mayo Clinic Specialized Center of Research Excellence (SCORE) on Sex Differences, Mayo Clinic, Rochester, MN, United States

    Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States

    Department of Neurology, Mayo Clinic, Rochester, MN, United States
    Search for articles by this author

      Highlights

      • The trajectories of metabolic parameters after bilateral oophorectomy remain unknown.
      • Weight, body mass index (BMI), and high-density lipoprotein cholesterol (HDL-C) changed significantly over a 10-year period after surgery.
      • The unfavorable changes in metabolic parameters occurred primarily within 4–5 years after surgery.
      • Some of these changes can be reduced in magnitude by estrogen therapy.
      • Our findings may inform the clinical management of women after bilateral oophorectomy.

      Abstract

      Objective

      To study the trajectories of metabolic parameters after bilateral oophorectomy.

      Study design

      This population-based cohort study included a random sample of all premenopausal women who underwent bilateral oophorectomy at or before age 45 years from 1988 to 2007 in Olmsted County, Minnesota, and their age-matched (±1 year) referent women who did not undergo bilateral oophorectomy.

      Main outcome measures

      The medical records of all women were reviewed to collect the metabolic parameters over a 10-year period. We compared three groups of women: 1) referent women (n = 270), 2) women who underwent bilateral oophorectomy and received estrogen therapy (n = 163), and 3) women who underwent bilateral oophorectomy and did not receive estrogen therapy (n = 107).

      Results

      Over 10 years of follow-up, the three groups had significantly different mean values of diastolic blood pressure, weight, body mass index (BMI), total cholesterol, triglycerides, and high-density lipoprotein cholesterol (HDL-C). However, women with and without bilateral oophorectomy were already different at baseline for hyperlipidemia, systolic blood pressure, weight, and BMI. Nevertheless, the trajectories of change over 10 years were significant for weight (group by time interaction p = 0.03), BMI (p = 0.03), and HDL-C (p = 0.004). The changes occurred primarily in the initial 4–5 years. Women who received estrogen therapy after bilateral oophorectomy were comparable to the referent women with respect to the weight and BMI trends, and they experienced an increase in HDL-C over time.

      Conclusion

      Women who underwent bilateral oophorectomy before menopause experienced unfavorable changes in some metabolic parameters possibly increasing their cardiovascular risk.

      Abbreviations:

      CAD (coronary artery disease), ET (estrogen therapy), MOA-2 (Mayo Clinic Cohort Study of Oophorectomy and Aging-2), REP (Rochester Epidemiology Project), LDL-C (low-density lipoprotein cholesterol), HDL-C (high-density lipoprotein cholesterol), BMI (body mass index), GEE (generalized estimating equation)

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Maturitas
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Rocca W.A.
        • et al.
        Accelerated accumulation of multimorbidity after bilateral oophorectomy: a population-based cohort study.
        Mayo Clin. Proc. 2016; 91: 1577-1589
        • Rivera C.M.
        • et al.
        Increased cardiovascular mortality after early bilateral oophorectomy.
        Menopause. 2009; 16: 15-23
        • Honigberg M.C.
        • et al.
        Association of premature natural and surgical menopause with incident cardiovascular disease.
        JAMA. 2019; 322: 2411-2421
        • Panay N.
        • et al.
        Premature ovarian insufficiency: an International Menopause Society white paper.
        Climacteric. 2020; 23: 426-446
        • Ley S.H.
        • et al.
        Duration of reproductive life span, age at menarche, and age at menopause are associated with risk of cardiovascular disease in women.
        J. Am. Heart Assoc. 2017; 6
        • Muka T.
        • et al.
        Association of age at onset of menopause and time since onset of menopause with cardiovascular outcomes, intermediate vascular traits, and all-cause mortality: a systematic review and meta-analysis.
        JAMA Cardiol. 2016; 1: 767-776
        • Michelsen T.M.
        • et al.
        Metabolic syndrome after risk-reducing salpingo-oophorectomy in women at high risk for hereditary breast ovarian cancer: a controlled observational study.
        Eur. J. Cancer. 2009; 45: 82-89
        • Franklin R.M.
        • Ploutz-Snyder L.
        • Kanaley J.A.
        Longitudinal changes in abdominal fat distribution with menopause.
        Metabolism. 2009; 58: 311-315
        • Rocca W.A.
        • et al.
        Bilateral oophorectomy and accelerated aging: cause or effect?.
        J. Gerontol. A Biol. Sci. Med. Sci. 2017; 72: 1213-1217
        • Rocca W.A.
        • et al.
        Cohort profile: the Mayo Clinic Cohort Study of Oophorectomy and Aging-2 (MOA-2) in Olmsted County, Minnesota (USA).
        BMJ Open. 2017; 7e018861
        • Rocca W.A.
        • et al.
        Personal, reproductive, and familial characteristics associated with bilateral oophorectomy in premenopausal women: a population-based case-control study.
        Maturitas. 2018; 117: 64-77
        • Rocca W.A.
        • et al.
        History of the Rochester Epidemiology Project: half a century of medical records linkage in a US population.
        Mayo Clin. Proc. 2012; 87: 1202-1213
        • St Sauver J.L.
        • et al.
        Generalizability of epidemiological findings and public health decisions: an illustration from the Rochester Epidemiology Project.
        Mayo Clin. Proc. 2012; 87: 151-160
        • St Sauver J.L.
        • et al.
        Data resource profile: the Rochester Epidemiology Project (REP) medical records-linkage system.
        Int. J. Epidemiol. 2012; 41: 1614-1624
        • St Sauver J.L.
        • et al.
        Use of a medical records linkage system to enumerate a dynamic population over time: the Rochester Epidemiology Project.
        Am. J. Epidemiol. 2011; 173: 1059-1068
        • Lee K.J.
        • et al.
        Framework for the treatment and reporting of missing data in observational studies: the Treatment And Reporting of Missing data in Observational Studies framework.
        J. Clin. Epidemiol. 2021; 134: 79-88
        • Zhu D.
        • et al.
        Age at natural menopause and risk of incident cardiovascular disease: a pooled analysis of individual patient data.
        Lancet Public Health. 2019; 4: e553-e564
        • Roeters van Lennep J.E.
        • et al.
        Cardiovascular disease risk in women with premature ovarian insufficiency: A systematic review and meta-analysis.
        Eur J Prev Cardiol. 2016; 23: 178-186
        • Arnett D.K.
        • et al.
        2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines.
        Circulation. 2019; 140: e596-e646
        • Elder P.
        • et al.
        Identification of female-specific risk enhancers throughout the lifespan of women to improve cardiovascular disease prevention.
        Am. J. Prev. Cardiol. 2020; 2100028
        • Young L.
        • Cho L.
        Unique cardiovascular risk factors in women.
        Heart. 2019; 105: 1656-1660
        • Tsiligiannis S.
        • Panay N.
        • Stevenson J.C.
        Premature ovarian insufficiency and long-term health consequences.
        Curr. Vasc. Pharmacol. 2019; 17: 604-609
        • Archer D.F.
        • et al.
        Long-term safety of drospirenone-estradiol for hormone therapy: a randomized, double-blind, multicenter trial.
        Menopause. 2005; 12: 716-727
        • Guttmann H.
        • et al.
        Choosing an oestrogen replacement therapy in young adult women with Turner syndrome.
        Clin. Endocrinol. 2001; 54: 159-164
        • Kalantaridou S.N.
        • et al.
        Impaired endothelial function in young women with premature ovarian failure: normalization with hormone therapy.
        J. Clin. Endocrinol. Metab. 2004; 89: 3907-3913