Abstract P4-10-01: Association of bilateral oophorectomy with sarcopenia and sarcopenic obesity in a diverse, nationally representative sample of U.S. women
Authors: Karia PS , Joshu CE , Visvanathan K 
Published: May 2019

Background: Sarcopenia (low muscle mass) and sarcopenic obesity (SO; low muscle mass with high body fat) have been linked to physical disability, poor quality of life, and mortality in older adults. We have previously demonstrated an association between early bilateral oophorectomy and increased body fat. Studies have also indicated that declines in circulating levels of estrogen and dehydroepiandrosterone during natural menopause are associated with loss of muscle mass. Therefore, we sought to evaluate the association between bilateral oophorectomy, sarcopenia, and SO among cancer-free women in the general population. We hypothesized that an abrupt decline in estrogen due to surgical menopause would be associated with sarcopenia and SO.

Methods: The study population included cancer-free women aged 35-70 years who underwent whole body dual-energy x-ray absorptiometry (DXA) scans as part of the U.S. National Health and Nutrition Examination Survey 1999-2006 (N=3,764). Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for sarcopenia and SO among women who had previously undergone hysterectomy and bilateral oophorectomy (n=552) compared to women with intact uterus and ovaries (n=3,212). Models accounted for complex survey design and were adjusted for age, race, education, weight at DXA scan, weight at age 25, physical activity, smoking, alcohol use, oral contraceptive use, and parity.

Results: The median age at DXA scan was 48 years (interquartile range, 41-56 years) and the median time since oophorectomy was 12 years (5-21 years). About 72.7% of women were non-Hispanic white, 10.8% were non-Hispanic black, 5.8% were Mexican American, and 10.7% other. Women who underwent oophorectomy had two-fold higher odds of sarcopenia (OR, 1.81 [95% CI, 1.12-2.95]) and SO (1.95 [1.17-3.25]) as compared to women with intact uterus and ovaries. The effect was stronger among women who underwent oophorectomy at age &lt;45 (sarcopenia: 2.38 [1.44-3.95]; SO: 2.32 [1.30-4.13]) as compared to women with intact uterus and ovaries, but no difference was observed among women who underwent oophorectomy at age ≥45 (sarcopenia: 1.08 [0.45, 2.58], SO: 1.40 [0.60, 3.28]; sarcopenia: pinteraction=0.031, SO: pinteraction=0.045). Of note, even women with normal BMI (18.5-24.9 kg/m2) at DXA scan who underwent oophorectomy at age &lt;45 years had significantly higher odds of sarcopenia (2.37 [1.15, 4.87]) and SO (2.89 [1.23, 6.75]) as compared to women with normal BMI and intact uterus and ovaries.

Conclusion: Women who undergo oophorectomy at a young age have an elevated risk of sarcopenia and SO even while maintaining normal weight. This novel finding, if confirmed in prospective studies, suggests that monitoring young women undergoing oophorectomy for sarcopenia and SO may improve long-term health outcomes.

Citation Format: Karia PS, Joshu CE, Visvanathan K. Association of bilateral oophorectomy with sarcopenia and sarcopenic obesity in a diverse, nationally representative sample of U.S. women [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-10-01.