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Gynecology Xagena

Postmenopausal women with and without diabetes: association of diabetes with cardiovascular disease is not reduced by bilateral salpingo oophorectomy


Diabetes mellitus elevates cardiovascular disease ( CVD ) risk more markedly in women than in men. Because the high risk of cardiovascular disease among women with type 2 diabetes mellitus ( DM2 ) may be partly due to increased ovarian androgen production, researchers investigated whether a history of bilateral salpingo oophorectomy ( BSO ) is inversely associated with CVD mortality among women with type 2 diabetes mellitus.

Data were obtained from 7,977 women ( 564 random subset had measurements of sex-steroid hormones ) enrolled in the Study of Osteoporotic Fractures ( SOF ), a community-based, multicenter study that monitored women aged greater than or equal to 65 for a mean of 15.1 years.

The average age at baseline was 71.5 years, with 6.3% and 18% of participants reporting a history of diabetes or bilateral salpingo oophorectomy, respectively.

In the subset of the SOF cohort with sex-steroid hormone measurements, those with type 2 diabetes mellitus had 43.6% significantly higher levels of free testosterone that were partly explained by age and adiposity, whereas total and free testosterone levels were lower in women with bilateral salpingo oophorectomy than in those with intact ovaries.

CVD mortality was elevated in women with type 2 diabetes mellitus without bilateral salpingo oophorectomy ( hazard ratio, HR=1.95, 95% CI 1.62–2.35 ) as well as in women with type 2 diabetes mellitus and bilateral salpingo oophorectomy ( HR=2.56, 95% CI 1.79–3.65; P = 0.190 for interaction ).

Overall, bilateral salpingo oophorectomy was not associated with CVD mortality ( HR=1.05, 95% CI 0.89–1.23 ).

In conclusion, the association of diabetes with cardiovascular disease was not reduced by bilateral salpingo oophorectomy, suggesting that ovarian hyperandrogenemia may not be a primary mechanism to explain the high risk for cardiovascular disease among women with type 2 diabetes mellitus. ( Xagena )

Appiah D et al, Diabetes Care 2015; Published online before print

XagenaMedicine_2015



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