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Læknablaðið - 15.12.1999, Qupperneq 35

Læknablaðið - 15.12.1999, Qupperneq 35
LÆKNABLAÐIÐ 1999; 85 969 Brottnám eggjastokka fyrir tíðahvörf Áhrif á lífsgæði, fituefnaskipti og beinþéttni Eva Sigvaldadóttir1, Jens A. Guðmundsson2, Gunnar Sigurðsson3, Matthías Kjeld4 Sigvaldadóttir E, Guðmundsson JA, Sigurðsson G, Kjeld M Bilateral oophorectomy before mcnopause. Late effects on quaiity of life, lipid metabolism and bone mass Læknablaðið 1999; 85: 969-74 Objective: Oophorectomy in premenopausal women may profoundly affect health. This study was done to investigate whether it had influenced the quality of life, lipid metabolism and bone mass if removal of the ovaries in premenopausal women was performed more than 15 years ago. Material and methods: Operation records from the Department of Obstetrics and Gynecology at the National University Hospital, Reykjvík, were scruti- nized to fínd all women who during 1977-1984 had a bilateral oophorectomy performed at less than 47 years of age at the time of operation. A control group of age-matched women, who during the same period had undergone a hysterectomy with preservation of the ovaries, was chosen. Women with malignant and chronic disabling diseases were excluded. The parti- cipants answered 36 standardized questions relating to menopausal symptoms, hormonal use and smo- king. Mesurements of total serum cholesterol, HDL (high density lipoprotein) and LDL (low density lipoprotein) cholesterol, triglycerides and calcium and fasting urine calcium and creatinine, were per- Frá 'læknadeild Háskóla Islands, 2Kvennadeild Landspít- alans, 3lyflækningadeild Sjúkrahúss Reykjavíkur, “rann- sóknastofu Landspítalans í blóðmeinafræði. Fyrirspurnir, bréfaskipti: Jens A. Guðmundsson. Kvennadeild Land- spítalans, 101 Reykjavík. Sími: 560 1000, bréfsími: 560 1191, netfang: jens@rsp.is Lykilorð: brottnám eggjastokka, brottnám legs, tíðahvarfa- einkenni, beinþéttni. formed. Bone mineral density was assessed by dual energy X-ray absorptiometry in the lumbar spine, left hip and femoral neck. Results: Thirty-four patients and equally many con- trols were identified. Fifty women agreed to partici- pate, but two did not attend for the investigation, giving a total of 26 cases and 22 controls. Mean age at the time of operation was 43.3 years for cases and 43.5 and controls. The difference in the duration of hormone use (11.6 and 8.9 years) was not significant. Of the 36 questions on climacteric symptoms there was a signifícant difference between the groups in only one. Cases and controls were not different with regard to serum lipids and bone mineral density. Mean values of bone mineral density in both groups were within the normal limits for an age-matched general population. Conclusions: Women who underwent removal of the ovaries before 47 years of age, more than 15 years later, were not shown to have suffered more from longterm effects of estrogen defíciency than age- matched women who had undergone hysterectomy with preservation of the ovaries. A relatively long du- ration of estrogen use may be the main reason for this outcome. Keywords: oophorectomy, hysterectomy, climacteric symptoms, bone mass. Ágrip Markmið: Brottnám eggjastokka í konum, sem ekki hafa náð tíðahvörfum, getur haft nei- kvæð áhrif á heilsu þeirra. Tilgangur þessarar rannsóknar var að kanna hvort það hefði haft áhrif á lífsgæði, fituefnaskipti og beinþéttni, ef eggjastokkar voru fjarlægðir hjá konum fyrir tíðahvörf og fyrir meira en 15 árum. Efniviður og aðferðir: Kannaðar voru að- gerðabækur á Kvennadeild Landspítalans frá árunum 1977-1984 og fundnar allar aðgerðir þar sem eggjastokkar höfðu verið fjarlægðir hjá konum sem voru yngri en 47 ára. Til sam-
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