LACK OF INFLUENCE OF SIMPLE PREMENOPAUSAL HYSTERECTOMY ON BONE MASS AND BONE METABOLISM

OBJECTIVE: Our purpose was to investigate the influence of premenopaus al hysterectomy on bone mass. STUDY DESIGN: A cross-sectional study wa s performed on 69 women who had premenopausal hysterectomy and 427 wom en with natural menopause 50 to 59 years old. Bone mineral density was measured in the distal forearm by single-energy x-ray absorptiometry. Body composition and bone mineral density in the anteroposterior spin e, proximal femur, and total body was measured by dual-energy x-ray ab sorptiometry. Bone turnover was determined by plasma osteocalcin, seru m alkaline phosphatase, and fasting urinary calcium corrected for crea tinine excretion, RESULTS: Women who had undergone premenopausal hyste rectomy had similar bone mineral densities compared with women with an intact uterus in all compartments, apart from a 6% to 11% higher bone mineral density (p < 0.05 to 0.001) in the proximal femur. The women who had undergone premenopausal hysterectomy had 2% to 11% more fat (s ignificant for arm fat, p < 0.05), 9% to 13% lower serum follicle-stim ulating hormone levels (p < 0.01), 10% to 13% higher serum estradiol l evels (not significant), and 8% to 9% lower osteocalcin levels (p < 0. 05 to 0.07). This bone mineral density difference could thus be explai ned by extragonadal sex hormone production. CONCLUSION: Premenopausal hysterectomy did not reduce ovarian function acid increase bone turnov er and bone loss.