Does hysterectomy with ovarian conservation affect bone metabolism and density?

We evaluated whether hysterectomy with ovarian conservation (HYX) has an effect on bone metabolism and density in 176 healthy Caucasian postmenopausal women aged 48-59 years. Bone properties of the hip, spine, radius, tibia, and calcaneus were measured using different bone assessment modalities. In addition, bone turnover was assessed using serum bone-specific alkaline phosphatase (BAP), osteocalcin (OC), and tartrate-resistant acid phosphatase (TRAP) 5b as biomarkers. Our results showed that women having HYX had a significantly lower level of OC (P = 0.017) and a marginally lower level of TRAP 5b (P = 0.051) and higher bone mineral density (BMD) of the femoral neck (P = 0.037) and lumbar spine (P = 0.001) than women with no history of HYX. In addition, the cortical BMD and bone strength index (I-polar) of the tibia also showed higher values at different sections in women having HYX than women with no history of HYX (P = 0.055 to P < 0.005). These results suggest that the uterus may have a role in regulating bone metabolism that has not been detected previously.