Missmer Stacey A, Hankinson Susan E, Spiegelman Donna, Barbieri Robert L, Marshall Lynn M, Hunter David J
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115-5804, USA.
Am J Epidemiol. 2004 Oct 15;160(8):784-96. doi: 10.1093/aje/kwh275.
The authors investigated the relations of demographic, anthropometric, and lifestyle factors with endometriosis in the Nurses' Health Study II prospective cohort. During 10 years of follow-up (1989-1999), 1,721 cases of laparoscopically confirmed endometriosis were reported among women with no past infertility. The incidence rate was greatest among women aged 25-29 years and lowest among women over 44 years (p(trend) < 0.0001). In multivariate Cox proportional hazards models, African-American women had a lower rate of disease compared with Caucasian women (rate ratio = 0.6, 95% confidence interval: 0.4, 0.9). The authors also observed an inverse relation with body mass index at age 18 years (for body mass index of >30 vs. 19-20.4 kg/m(2): rate ratio = 0.8, 95% confidence interval: 0.6, 1.1; p(trend) = 0.004) and with current alcohol intake (for >10 vs. 0 g/day: rate ratio = 0.7, 95% confidence interval: 0.6, 0.8; p(trend) < 0.0001) but no association with height, waist/hip ratio, or caffeine intake. An inverse relation with current body mass index and current cigarette smoking was observed only when cases were concurrently infertile. The authors conclude that age, race, body mass index, alcohol use, and cigarette smoking are associated with the incidence of endometriosis and that some of these relations may differ by infertility status at the time of laparoscopic diagnosis.
作者在护士健康研究II前瞻性队列中，调查了人口统计学、人体测量学和生活方式因素与子宫内膜异位症之间的关系。在10年随访期（1989 - 1999年）内，报告了1721例腹腔镜确诊的子宫内膜异位症病例，这些病例来自既往无不孕史的女性。发病率在25 - 29岁女性中最高，在44岁以上女性中最低（趋势p值<0.0001）。在多变量Cox比例风险模型中，非裔美国女性的疾病发生率低于白人女性（率比 = 0.6，95%置信区间：0.4，0.9）。作者还观察到18岁时的体重指数与之呈负相关（体重指数>30 vs. 19 - 20.4 kg/m²：率比 = 0.8，95%置信区间：0.6，1.1；趋势p值 = 0.004），以及与当前酒精摄入量呈负相关（>10 vs. 0 g/天：率比 = 0.7，95%置信区间：0.6，0.8；趋势p值<0.0001），但与身高、腰臀比或咖啡因摄入量无关。仅当病例同时存在不孕情况时，才观察到与当前体重指数和当前吸烟呈负相关。作者得出结论，年龄、种族、体重指数、饮酒和吸烟与子宫内膜异位症的发病率相关，并且其中一些关系可能因腹腔镜诊断时的不孕状况而异。
