Associations of Hysterectomy, Oophorectomy, and Hormone Replacement Therapy With the Risk of Type 2 Diabetes Mellitus in Postmenopausal Women

ABSTRACT Objective Female‐specific risk factors warrant attention in the prevention and control of type 2 diabetes mellitus (T2DM). The study aimed to investigate the relationships of hysterectomy, bilateral oophorectomy, and hormone replacement therapy (HRT) with the risk of T2DM in postmenopausal women. Design We included 127,514 postmenopausal women without T2DM at baseline from the UK Biobank. Measurements Hysterectomy, bilateral oophorectomy, and HRT were self‐reported at baseline, and incident T2DM was identified using ICD‐10 code E11 during the follow‐up period. Results Compared to no hysterectomy/bilateral oophorectomy, hysterectomy alone (HR, 1.20; 95%CI: 1.09, 1.32) and combined hysterectomy and bilateral oophorectomy (HR, 1.19; 95%CI: 1.08, 1.32) were associated with higher risks of incident T2DM. Independent of other factors, the history of HRT was associated with a higher risk of T2DM (HR, 1.08; 95%CI: 1.03, 1.14), but this positive association was observed only in women without no hysterectomy or bilateral oophorectomy. Within the women without surgical procedures, the association between HRT and T2DM existed only in those younger than 45 years (HR, 1.27; 95%CI: 1.14, 1.41), but not in the older (HR, 1.03; 95%CI: 0.96, 1.09). Conclusions Hysterectomy, regardless of bilateral oophorectomy status, was associated with a higher risk of T2DM. The HRT use, particularly early use in women without surgical interventions, was associated with a high risk. Our findings indicate that female‐specific risk factors such as hysterectomy and bilateral oophorectomy and HRT use should be incorporated into the assessments for potential risk of T2DM in postmenopausal women.