Bone mineral density in Jamaican black women after hysterectomy and bilateral oophorectomy: an observational study.
OBJECTIVE
To see if black Jamaican postmenopausal women who had hysterectomy were at increased risk of osteoporosis. To assess the risk of osteoporosis in hysterectomized Jamaican postmenopausal patients.


METHODS
We reviewed 809 women (403 hysterectomized and 406 controls) for cardiovascular disease risk. We did a demographic history and examination looking at blood pressure, waist hip ratio and body mass index and investigations done included fasting blood glucose and total and high density lipoprotein (HDL) cholesterol. We also measured bone density at the heel in all women using the Achilles ultrasound bone densitometer looking at T-score and Z-score.


RESULTS
There was a significant association of hysterectomy status and bone mineral density (BMD) status with a smaller than expected proportion of women with osteoporosis in the hysterectomy group (χ2 = 18.4; p = 0.001). The mean T-score was significantly higher in the hysterectomized women, adjusting for age, waist circumference and sociodemographic factors. The relationship between the various predictors and BMD was explored by stepwise regression modelling. The factors that were significantly related to low BMD were hysterectomy status, age, waist circumference and being employed.


CONCLUSIONS
Hysterectomy was not found to be a significant risk factor for osteoporosis. The osteoporosis risk among menopausal women in Jamaica appears to be due to other risk factors which probably existed prior to the operation.
Department of Obstetrics and Gynaecology, The University of the West Indies, Kingston 7, Jamaica, West Indies. horace.fletcher@uwimona.edu.jm.
H M
HM
Fletcher
Department of Pathology, The University of the West Indies, Kingston 7, Jamaica, West Indies.
F
F
Bennett
Department of Obstetrics and Gynaecology, The University of the West Indies, Kingston 7, Jamaica, West Indies.
D
D
Simms-Stewart
Tropical Metabolism Research Unit, The University of the West Indies, Kingston 7, Jamaica, West Indies.
M
M
Reid
Department of Pathology, The University of the West Indies, Kingston 7, Jamaica, West Indies.
N P
NP
Williams
Department of Pathology, The University of the West Indies, Kingston 7, Jamaica, West Indies.
G H
GH
Wharfe
D000328:Adult; D000368:Aged; D044383:Black People; D015519:Bone Density; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D007563:Jamaica / Q000453:epidemiology; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology; D010052:Ovariectomy / Q000009:adverse effects*; D012307:Risk Factors