Risk of osteoporosis and fracture after hysterectomies without oophorectomies: a systematic review and pooled analysis

Education level is associated with the occurrence and timing of hysterectomy: A cohort study of Canadian women

INTRODUCTION

Hysterectomy is a common surgery with discernible practice variations that could be influenced by socioeconomic factors. We examined the association between level of educational attainment and the occurrence and timing of hysterectomy in Canadian women.

MATERIAL AND METHODS

We conducted a prospective cohort study of 30 496 females in the Alberta's Tomorrow Project (2000-2015) followed approximately every 4 years using self-report questionnaires. Educational attainment was defined as high school diploma or less, college degree, university degree (reference group), and postgraduate degree. We used logistic regression analyzing hysterectomy occurrence at any time and before menopause, separately, and flexible parametric survival models analyzing hysterectomy timing with age as the time scale. Multivariable models controlled for race/ethnicity, rural/urban residence, parity, oral contraceptive use, and smoking.

RESULTS

Overall, 39.1% of females reported a high school diploma or less, 28.9% reported a college degree, 23.5% reported a university degree, and 8.5% reported a postgraduate degree. A graded association was observed between lower education and higher odds of hysterectomy (high school or less: adjusted odds ratio [AOR] 1.68, 95% CI 1.55-1.82; college degree: AOR 1.58, 95% CI 1.45-1.72); results were similar for premenopausal hysterectomy. A graded association between lower education and earlier timing of hysterectomy was also observed up to approximately age 60 (eg at age 40: high school or less adjusted hazard ratio [AHR] 1.61, 95% CI 1.49-1.75; college degree AHR 1.53, 95% CI 1.40-1.67).

CONCLUSIONS

Women with lower levels of education were more likely to experience hysterectomy, including hysterectomy before menopause and at younger ages.

Prevalence of hysterectomy and its determinants in northern Iran: enrollment results of the Tabari cohort study

BACKGROUND

To the best of our knowledge, no population-based studies have provided insights into the prevalence of hysterectomy and its risk factors among northern Iranian females. Thus, the present study aimed to investigate the prevalence and sociodemographic determinants of hysterectomy in a large cohort of northern Iranian females.

METHODS

This cross-sectional study included data from the enrollment phase of the Tabari cohort study (TCS). The TCS consists of 10,255 adults (4,149 males and 6,106 females) aged 35-70 years who reside in Sari, Mazandaran, Iran, of which 6103 females were included in the study. Multiple logistic regression analysis was used to search for hysterectomy determinants.

RESULTS

Our results revealed that the prevalence of hysterectomy among northern Iranian females was 9.7% (595/6103). Additionally, 50-59 (OR: 4.63, 95% CI: 3.57-6.01) and 60-70 (OR: 5.83, 95% CI: 4.28-7.95) age groups, higher socioeconomic levels (OR: 1.66, 95% CI: 1.13-2.42), a history of tubectomy (OR: 1.27, 95% CI: 1.05-1.53), and more gravida (OR: 5.35, 95% CI: 1.62-17.63) were found to increase the odds of hysterectomy, whereas living in mountainous areas (OR: 0.57, 95% CI: 0.43-2.75) and having a job (OR: 0.62, 95% CI: 0.45-0.86) were found to decrease the odds of hysterectomy.

CONCLUSION

Older age groups, living in urban areas, higher socioeconomic levels, not having a job, a history of tubectomy, and more gravida were found to increase the odds of hysterectomy.

CircZNF367 promotes osteoclast differentiation and osteoporosis by interacting with FUS to maintain CRY2 mRNA stability

BACKGROUND

Osteoporosis, characterized by reduced bone mass and deterioration of bone quality, is a significant health concern for postmenopausal women. Considering that the specific role of circRNAs in osteoporosis and osteoclast differentiation remains poorly understood, this study aims to shed light on their involvement in these processes to enhance our understanding and potentially contribute to improved treatment strategies for osteoporosis.

METHODS

An osteoporotic model was constructed in vivo in ovariectomized mouse. In vitro, we induced osteoclast formation in bone marrow-derived macrophages (BMDMs) using M-CSF + RANKL. To assess osteoporosis in mice, we conducted HE staining. We used MTT and TRAP staining to measure cell viability and osteoclast formation, respectively, and also evaluated their mRNA and protein expression levels. In addition, RNA pull-down, RIP and luciferase reporter assays were performed to investigate interactions, and ChIP assay was used to examine the impact of circZNF367 knockdown on the binding between FUS and CRY2.

RESULTS

We observed increased expression of CircZNF367, FUS and CRY2 in osteoporotic mice and M-CSF + RANKL-induced BMDMs. Functionally, knocking down circZNF367 inhibited osteoporosis in vivo. Furthermore, interference with circZNF367 suppressed osteoclast proliferation and the expression of TRAP, NFATc1, and c-FOS. Mechanistically, circZNF367 interacted with FUS to maintain CRY2 mRNA stability. Additionally, knocking down CRY2 rescued M-CSF + RANKL-induced osteoclast differentiation in BMDMs promoted by circZNF367 and FUS.

CONCLUSION

This study reveals that the circZNF367/FUS axis may accelerate osteoclasts differentiation by upregulating CRY2 in osteoporosis and suggests that targeting circZNF367 may have potential therapeutic effects on osteoporosis.

The Biological Interaction of SARS-CoV-2 Infection and Osteoporosis: A Preliminary Study

The COVID-19 pandemic caused by the severe acute coronavirus disease 2 (SARS-CoV-2) virus represents an ongoing threat to human health and well-being. Notably, many COVID-19 patients suffer from complications consistent with osteoporosis (OP) following disease resolution yet the mechanistic links between SARS-CoV-2 infection and OP remain to be clarified. The present study was thus developed to explore the potential basis for this link by employing transcriptomic analyses to identify signaling pathways and biomarkers associated with OP and SARS-CoV-2. Specifically, a previously published RNA-sequencing dataset (GSE152418) from Gene Expression Omnibus (GEO) was used to identify the differentially expressed genes (DEGs) in OP patients and individuals infected with SARS-CoV-2 as a means of exploring the underlying molecular mechanisms linking these two conditions. In total, 2,885 DEGs were identified by analyzing the COVID-19 patient dataset, with shared DEGs then being identified by comparison of these DEGs with those derived from an OP patient dataset. Hub genes were identified through a series of bioinformatics approaches and protein-protein interaction analyses. Predictive analyses of transcription factor/gene interactions, protein/drug interactions, and DEG/miRNA networks associated with these DEGs were also conducted. Together, these data highlight promising candidate drugs with the potential to treat both COVID-19 and OP.

Osteoporosis and Related Health Status Among the Elderly Urban Residents in Elderly-Care Inns in Beijing, a Multicenter DXA Survey

BACKGROUND

Identification of the high risk population for osteoporosis and timely prevention are the best strategies at present. Detailed epidemiological investigation in a well-defined population is necessary to explore the population-based characteristics and risk factors of osteoporosis, thus to facilitate better prevention programs.

METHOD

In this prospective cross-sectional study, 1423 questionnaires were given out to the urban residents (female ≥ 40 years of age, male ≥50 years) who lived in the 27 Elderly-Care Inns interspersed among the seven central urban areas of Beijing. All participants were voluntary and underwent routine physical examination and spine and hip BMD measurements using the DXA instrument. The study protocols were approved by the Medical Ethics Committee of Dongzhimen Hospital, Beijing University of Chinese Medicine (JDZX2015079).

RESULTS

Altogether 1407 participants fulfilled the survey. Among 359 men, the prevalence of osteoporosis, osteopenia, and normal BMD were 18.1%, 56.6%, and 25.3%, respectively; among 1048 women, the corresponding figures were 40.3%, 42.8%, and 16.9%, respectively. After adjustment of age and BMI, both hands grip strength, height loss over 3 cm, serum levels of β-CTx, PINP, and OST were the independent risk factors for osteoporosis in both men and women; besides, familial Alzheimer's disease history in men; and history of steatohepatitis and fracture, serum levels of PTH and ALT, age of menarche, age of menopause, and duration of menstruation in women were also risk factors of osteoporosis. In both genders, the cost-effective method, which adopted both hands grip strength, height loss over 3 cm, and medical history, indicated a good predictive ability to evaluate the risk of osteoporosis (in men AUC=0.730, 95%CI=0.642~0.817; in women AUC=0.769, 95%CI=0.724~0.813).

CONCLUSIONS

In the population of elderly Beijing urban residents in Elderly-Care Inns, the prevalence of osteoporosis in women is higher than that in men and increases with aging more rapidly; the prevalence of osteopenia in men is higher than in women. The cost-effective method, including both hands grip strength, height loss over 3 cm, and familial Alzheimer's disease history in men; fracture and steatohepatitis history as well as menstrual history in women is recommended in identifying the high-risk subjects for osteoporosis.