Global DNA hypomethylation in hysterectomy: An 8-year follow-up study from Haryana, India

Abstract

Background Despite being a common gynecological surgery, epigenetic correlates of hysterectomy have not been much explored. Since epigenetic alterations are associated with several complex diseases, it is rather important to investigate the epigenetics of hysterectomy. To address this research gap, the present study aims to understand the interrelationship between hysterectomy and peripheral blood leucocyte global DNA methylation independently and in light of selected biochemicals (vitamin B12, folate, homocysteine). Method This study is a population-based follow-up study consisting of 616 women aged 30 to 70 years recruited from Palwal, Haryana (North India). Recruited participants underwent a baseline assessment, which included determination of menopausal and hysterectomy status, estimation of vitamin B12, folate, homocysteine, and global DNA methylation levels. Participants with no history of hysterectomy were followed up after 8 years and their follow-up menopausal and hysterectomy statuses were determined. Result Median global DNA methylation level of the group with hysterectomy was found to be significantly lower than that of those without hysterectomy in the baseline assessment. However, baseline median global methylation levels of women who eventually underwent hysterectomy and those who did not were comparable. Regardless of normal and abnormal levels of studied biochemicals, the median global DNA methylation level of the baseline hysterectomy group was found to be lower (statistically not significant) than that of pre- and post-menopausal groups. Conclusions Hysterectomy (or associated factors) appears to be a risk factor for global DNA hypomethylation. More studies should be taken up to understand the epigenetic implications of hysterectomy.