Association of Oophorectomy and Fat and Lean Body Mass: Evidence from a Population-Based Sample of U.S. Women.

BACKGROUND: Bilateral oophorectomy during a nonmalignant 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 affect body composition. We examined the relationship between oophorectomy and whole-body composition.
METHODS: Our study population included cancer-free women 35 to 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, and 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% confidence interval (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 with no surgery. Results were stronger in women with a normal body mass index (BMI) and those <45 years at surgery. All body regions were significantly affected for women with oophorectomy, whereas 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. ©2021 American Association for Cancer Research.