Ashley M Geczik, Kara A Michels, Garnet L Anderson, Roni T Falk, Leslie V Farland, JoAnn E Manson, Aladdin H Shadyab, Ruth M Pfeiffer, Xia Xu, Britton Trabert
{"title":"妇女健康倡议观察研究》中绝经后妇女输卵管结扎和子宫切除与血清雄激素和雌激素代谢物的关系。","authors":"Ashley M Geczik, Kara A Michels, Garnet L Anderson, Roni T Falk, Leslie V Farland, JoAnn E Manson, Aladdin H Shadyab, Ruth M Pfeiffer, Xia Xu, Britton Trabert","doi":"10.1007/s10552-024-01882-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Hysterectomy is associated with subsequent changes in circulating hormone levels, but the evidence of an association for tubal ligation is unclear. We evaluated whether circulating concentrations of androgens and estrogens differ by tubal ligation or hysterectomy status in postmenopausal women from the Women's Health Initiative (WHI)-Observational Study (OS).</p><p><strong>Methods: </strong>Serum androgens and estrogens were measured in 920 postmenopausal women who did not use menopausal hormone therapy at the time of blood draw, of whom 139 self-reported a history of tubal ligation and 102 reported hysterectomy (with intact ovaries). Geometric mean hormone concentrations (GMs) and 95% confidence intervals (CIs) associated with a history of tubal ligation or hysterectomy (ever/never), as well as time since procedures, were estimated using adjusted linear regression with inverse probability of sampling weights to account for selection.</p><p><strong>Results: </strong>Circulating levels of 12 androgen/androgen metabolites and 20 estrogen/estrogen metabolites did not differ by tubal ligation status. Among women reporting prior hysterectomy compared to women without hysterectomy, we observed lower levels of several androgens (e.g., testosterone (nmol/L): GM<sub>yes</sub> 0.46 [95% CI:0.37-0.57] vs. GM<sub>no</sub> 0.62 [95% CI:0.53-0.72]) and higher levels of estrogen metabolites, for example, 2-hydroxyestrone-3-methyl ether (GM<sub>yes</sub> 11.1 [95% CI:8.95-13.9] pmol/L vs. GM<sub>no</sub> 8.70 [95% CI:7.38-10.3]) and 4-methoxyestrone (GM<sub>yes</sub> 6.50 [95% CI:5.05-8.37] vs. GM<sub>no</sub> 4.92 [95% CI:4.00-6.05]).</p><p><strong>Conclusion: </strong>While we did not observe associations between prior tubal ligation and postmenopausal circulating hormone levels, our findings support that prior hysterectomy was associated with lower circulating testosterone levels and higher levels of some estrogen metabolites, which may have implications for future hormone-related disease risks.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":" ","pages":"1283-1295"},"PeriodicalIF":2.2000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11441446/pdf/","citationCount":"0","resultStr":"{\"title\":\"Associations of tubal ligation and hysterectomy with serum androgen and estrogen metabolites among postmenopausal women in the Women's Health Initiative Observational Study.\",\"authors\":\"Ashley M Geczik, Kara A Michels, Garnet L Anderson, Roni T Falk, Leslie V Farland, JoAnn E Manson, Aladdin H Shadyab, Ruth M Pfeiffer, Xia Xu, Britton Trabert\",\"doi\":\"10.1007/s10552-024-01882-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Hysterectomy is associated with subsequent changes in circulating hormone levels, but the evidence of an association for tubal ligation is unclear. We evaluated whether circulating concentrations of androgens and estrogens differ by tubal ligation or hysterectomy status in postmenopausal women from the Women's Health Initiative (WHI)-Observational Study (OS).</p><p><strong>Methods: </strong>Serum androgens and estrogens were measured in 920 postmenopausal women who did not use menopausal hormone therapy at the time of blood draw, of whom 139 self-reported a history of tubal ligation and 102 reported hysterectomy (with intact ovaries). Geometric mean hormone concentrations (GMs) and 95% confidence intervals (CIs) associated with a history of tubal ligation or hysterectomy (ever/never), as well as time since procedures, were estimated using adjusted linear regression with inverse probability of sampling weights to account for selection.</p><p><strong>Results: </strong>Circulating levels of 12 androgen/androgen metabolites and 20 estrogen/estrogen metabolites did not differ by tubal ligation status. Among women reporting prior hysterectomy compared to women without hysterectomy, we observed lower levels of several androgens (e.g., testosterone (nmol/L): GM<sub>yes</sub> 0.46 [95% CI:0.37-0.57] vs. GM<sub>no</sub> 0.62 [95% CI:0.53-0.72]) and higher levels of estrogen metabolites, for example, 2-hydroxyestrone-3-methyl ether (GM<sub>yes</sub> 11.1 [95% CI:8.95-13.9] pmol/L vs. GM<sub>no</sub> 8.70 [95% CI:7.38-10.3]) and 4-methoxyestrone (GM<sub>yes</sub> 6.50 [95% CI:5.05-8.37] vs. GM<sub>no</sub> 4.92 [95% CI:4.00-6.05]).</p><p><strong>Conclusion: </strong>While we did not observe associations between prior tubal ligation and postmenopausal circulating hormone levels, our findings support that prior hysterectomy was associated with lower circulating testosterone levels and higher levels of some estrogen metabolites, which may have implications for future hormone-related disease risks.</p>\",\"PeriodicalId\":9432,\"journal\":{\"name\":\"Cancer Causes & Control\",\"volume\":\" \",\"pages\":\"1283-1295\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11441446/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cancer Causes & Control\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10552-024-01882-4\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/5/21 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer Causes & Control","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10552-024-01882-4","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/21 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：子宫切除术与循环激素水平的后续变化有关，但与输卵管结扎有关的证据尚不明确。我们评估了妇女健康倡议（WHI）-观察研究（OS）中绝经后妇女体内雄激素和雌激素的循环浓度是否因输卵管结扎或子宫切除状态而不同：对抽血时未使用绝经激素治疗的920名绝经后妇女的血清雄激素和雌激素进行了测定，其中139名妇女自述有输卵管结扎史，102名妇女自述有子宫切除史（卵巢完整）。采用调整线性回归法估算了与输卵管结扎史或子宫切除术史（曾经/从未）以及手术后时间相关的几何平均激素浓度（GMs）和 95% 置信区间（CIs），并使用反向概率抽样权重来考虑选择因素：结果：12种雄激素/雄激素代谢物和20种雌激素/雌激素代谢物的循环水平不因输卵管结扎状况而异。与未接受子宫切除术的妇女相比，我们观察到在接受过子宫切除术的妇女中，几种雄激素的水平较低（如睾酮（nmol/L）：GMyes：0.46 [95% CI：0.37-0.57] vs. GMno：0.62 [95% CI：0.53-0.72]），雌激素代谢物水平较高，例如 2-羟基雌酮-3-甲醚（GMyes：11.1 [95% CI:8.95-13.9] pmol/L vs. GMno 8.70 [95% CI:7.38-10.3]) 和 4-甲氧基雌酮（GMyes 6.50 [95% CI:5.05-8.37] vs. GMno 4.92 [95% CI:4.00-6.05] ）：虽然我们没有观察到既往输卵管结扎与绝经后循环激素水平之间的关联，但我们的研究结果表明，既往子宫切除术与循环睾酮水平较低和某些雌激素代谢物水平较高有关，这可能会对未来与激素相关的疾病风险产生影响。
Associations of tubal ligation and hysterectomy with serum androgen and estrogen metabolites among postmenopausal women in the Women's Health Initiative Observational Study.
Purpose: Hysterectomy is associated with subsequent changes in circulating hormone levels, but the evidence of an association for tubal ligation is unclear. We evaluated whether circulating concentrations of androgens and estrogens differ by tubal ligation or hysterectomy status in postmenopausal women from the Women's Health Initiative (WHI)-Observational Study (OS).
Methods: Serum androgens and estrogens were measured in 920 postmenopausal women who did not use menopausal hormone therapy at the time of blood draw, of whom 139 self-reported a history of tubal ligation and 102 reported hysterectomy (with intact ovaries). Geometric mean hormone concentrations (GMs) and 95% confidence intervals (CIs) associated with a history of tubal ligation or hysterectomy (ever/never), as well as time since procedures, were estimated using adjusted linear regression with inverse probability of sampling weights to account for selection.
Results: Circulating levels of 12 androgen/androgen metabolites and 20 estrogen/estrogen metabolites did not differ by tubal ligation status. Among women reporting prior hysterectomy compared to women without hysterectomy, we observed lower levels of several androgens (e.g., testosterone (nmol/L): GMyes 0.46 [95% CI:0.37-0.57] vs. GMno 0.62 [95% CI:0.53-0.72]) and higher levels of estrogen metabolites, for example, 2-hydroxyestrone-3-methyl ether (GMyes 11.1 [95% CI:8.95-13.9] pmol/L vs. GMno 8.70 [95% CI:7.38-10.3]) and 4-methoxyestrone (GMyes 6.50 [95% CI:5.05-8.37] vs. GMno 4.92 [95% CI:4.00-6.05]).
Conclusion: While we did not observe associations between prior tubal ligation and postmenopausal circulating hormone levels, our findings support that prior hysterectomy was associated with lower circulating testosterone levels and higher levels of some estrogen metabolites, which may have implications for future hormone-related disease risks.
期刊介绍：
Cancer Causes & Control is an international refereed journal that both reports and stimulates new avenues of investigation into the causes, control, and subsequent prevention of cancer. By drawing together related information published currently in a diverse range of biological and medical journals, it has a multidisciplinary and multinational approach.
The scope of the journal includes: variation in cancer distribution within and between populations; factors associated with cancer risk; preventive and therapeutic interventions on a population scale; economic, demographic, and health-policy implications of cancer; and related methodological issues.
The emphasis is on speed of publication. The journal will normally publish within 30 to 60 days of acceptance of manuscripts.
Cancer Causes & Control publishes Original Articles, Reviews, Commentaries, Opinions, Short Communications and Letters to the Editor which will have direct relevance to researchers and practitioners working in epidemiology, medical statistics, cancer biology, health education, medical economics and related fields. The journal also contains significant information for government agencies concerned with cancer research, control and policy.
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