ECE2024 Poster Presentations Late-Breaking (77 abstracts)
Long-term bone health in women with a premenopausal risk-reducing salpingo-oophorectomy (RRSO) compared with women who underwent
Maarten Beekman 1 , Lara Terra 1 , Anniek Stuursma 2 , Bernadette Heemskerk-Gerritsen 3 , Marc van Beurden 1 , Lena van Doorn 3 , Eleonora van Dorst 4 , Joanne de Hullu 5 , Stijn Mom 6 , Jeanine Roeters van Lennep 3 , Katja Gaarenstroom 7 , Tiny Korse 1 , Bart de Keizer 4 , Cristina Mitea 8 , Riemer Slart 2 , Snoeren Miranda 5 , Marcel Stokkel 1 , Hein Verberne 6 , Christi van Asperen 7 , Margreet Ausems 4 , Lieke Berger 2 , Truuske de Bock 2 , Collee Margriet 3 , Klaartje van Engelen 6 , Lizet van der Kolk 1 , Marijke Wevers 5 , Encarna Gomez Garcia 8 , Maartje Hooning 3 , Angela Maas 5 , Marian Mourits 2 , Flora van Leeuwen 1 & Carola Zillikens 3
1Netherlands Cancer Institute: Antoni van Leeuwenhoek; 2University Medical Center Groningen; 3Erasmus Medical Center Rotterdam; 4University Medical Center Utrecht; 5Radboud University Medical Center Nijmegen; 6Amsterdam University Medical Center; 7Leiden University Medical Center; 8Maastricht University Medical Center
Introduction: To prevent ovarian cancer, BRCA1/2 germline pathogenic variant carriers are recommended to undergo premenopausal risk-reducing salpingo-oophorectomy (RRSO). Premenopausal RRSO leads to immediate surgical menopause, which has been associated with an acute phase of rapid bone loss. However, data on long-term effects is scarce and inconclusive. Therefore, we investigated the long-term impact of premenopausal RRSO on bone mineral density (BMD).
Methods: We conducted a cross-sectional study nested in a nationwide cohort of women at high familial risk of ovarian cancer to assess long-term effects of a premenopausal RRSO compared with a postmenopausal RRSO on BMD. We included 500 women who underwent premenopausal RRSO (≤45 years) with 240 women who underwent postmenopausal RRSO (≥54 years). Participants underwent a Dual Energy X-ray absorptiometry (DXA) scan of the lumbar spine (LS) and femoral neck (FN) to asses BMD. Age differences between the pre- and postmenopausal RRSO groups were accounted for using Z-scores and subgroup analyses restricted to women aged 60-70 at study visit.
Results: Median age at study visit was 58.8 years in the premenopausal RRSO group and 69.0 years in the postmenopausal RRSO group (P<0.001), median time since RRSO was 16.1 years (IQR 15.3-21.3). Multivariable regression analyses showed that the Z-scores of both the LS and FN were significantly lower for the premenopausal RRSO group compared with the postmenopausal RRSO group (LS Z-score: 0.5 vs 1.2, P<0.001; FN Z-score: 0.1 vs 0.6, P<0.001). Furthermore, the relative risk (RR) of having a Z-score ≤-1.0 was higher in the premenopausal RRSO group compared with the postmenopausal RRSO group (LS RR: 2.35, 95% CI, 1.26-4.40; FN RR: 1.84, 95% CI, 1.08-3.13). Subgroup analyses in women aged 60-70 at study visit (n=320) showed that women in the premenopausal RRSO group had a higher prevalence of low BMD (T-score ≤-1.0) compared with the postmenopausal RRSO group (LS 52.0% vs 47.8%; FN 59.5% vs 56.9%; LS or FN 73.0% vs 66.4%), however, in multivariable regression analyses this difference was not statistically significant (LS P=0.58; FN P=0.45; LS or FN P=0.35).
Conclusion: Premenopausal RRSO appears to be associated with reduced BMD Z-scores more than 16 years after RRSO, however, in a subgroup of women of similar age we found no increased risk of low BMD based on T-score <-1.0.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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