Hysterectomy accelerates sarcopenia risk in US women and mouse models.

BACKGROUND

Sarcopenia represents a clinical condition with particular prevalence among postmenopausal women. Hysterectomy is a common gynecological surgical procedure associated with various complications. However, the relationship between hysterectomy and sarcopenia remains poorly investigated. This study aimed to explore the association between hysterectomy and sarcopenia risk.

METHOD: Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES, 2001-2018) was utilized for analysis. Sarcopenia was defined using the Foundation for the National Institutes of Health (FNIH) criteria based on ALM/BMI < 0.512 in women. Multivariable logistic regression and propensity score matching were applied to assess the association between hysterectomy and sarcopenia. In parallel, a senescence-accelerated mouse model (SAMP8) was used to examine the effects of hysterectomy on muscle function and related molecular pathways, including markers of protein degradation and ferroptosis.

RESULTS

In the NHANES cohort, hysterectomy was associated with an increased risk of sarcopenia after adjustment for covariates (OR = 1.35; 95% CI: 1.00-1.82; p = 0.049). The association was stronger in women who had undergone both hysterectomy and oophorectomy (OR = 2.06; 95% CI: 1.45-2.93; p < 0.001). In SAMP8 mice, hysterectomy was associated with reduced grip strength, shorter endurance time, and decreased muscle fiber size. Molecular analyses suggested activation of the FOXO1-MuRF-1/Atrogin-1 pathway and changes consistent with ferroptosis-related signaling.

CONCLUSION

Hysterectomy appears to be associated with an increased risk of sarcopenia in women, and this association is supported by findings from an experimental mouse model. These results suggest potential involvement of muscle protein degradation and ferroptosis-related pathways, although further studies are needed to clarify causality.