Hysterectomy before age 50 raises risk for type 2 diabetes
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Women who had a hysterectomy before age 50 years had an increased risk for developing type 2 diabetes, according to data presented at the European Association for the Study of Diabetes annual meeting.
“Hysterectomies could be associated with some consequences in women: increased risk of cardiovascular disease and increased risk of incident hypertension,” Fabrice Bonnet, MD, PhD, professor at CHU de Rennes, Rennes, and the Centre for Research in Epidemiology and Population Health in Villejuif, France, said during a presentation. “So, when it comes to hysterectomy and incident diabetes, we are limited with mixed results.”
The large, prospective French cohort included 83,582 women from the E3N prospective cohort born between 1925 and 1950. Women did not have diabetes, and hysterectomies were performed for benign gynecologic conditions. Researchers assessed diet and physical activity through questionnaires.
Overall, 16,426 women had a hysterectomy (mean age, 52.6 years), and during a mean of 16.4 years of follow-up, 2,672 women had incident diabetes (P < .0001 for both). Hysterectomy was associated with an increased risk for diabetes in the model adjusted for age and stratified by birth generation (HR = 1.3; 95% CI, 1.17-1.43; P < .0001), the model adjusted for smoking, physical activity, diabetes history, BMI, Mediterranean diet adherence (HR = 1.27; 95% CI, 1.02-1.25; P = .02) and the model adjusted for age at menarche, menopausal status, age at menopause, oral contraceptive use, hormone therapy use and pregnancies (HR = 1.2; 95% CI, 1.09-1.33; P = .0003).
In addition, age at hysterectomy also influenced risk for diabetes with women younger than 40 years (HR = 1.38; 95% CI, 1.1-1.74; P= .005) and women younger than 45 years (HR = 1.52; 95% CI, 1.31-1.78; P < .0001) having an increased risk compared with women aged 45 years and older (HR = 1.07; 95% CI, 0.95-1.21; P = .23).
Women with both a hysterectomy and oophorectomy had a greater increased risk for developing diabetes (HR =1.26; 95% CI, 1.11-1.42; P = .0003) compared with women with hysterectomy alone (HR = 1.13; 95% CI, 0.99-1.3; P = .06).
“Hysterectomy is a risk marker for future diabetes, and we should target women with early hysterectomy before 40 and the age of even 45 years because they are at higher risk independently of lifestyle or reproductive factors and any hormonal therapy,” Bonnet said. “Ovarian preservation may be beneficial with regard to the risk for diabetes and depression could be an underlying factor [that] needs to be further addressed.
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Bonnet F, et al. Abstract #151. Presented at: European Association for the Study of Diabetes Annual Meeting; Sept. 19-23, 2022; Stockholm (hybrid meeting).
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