Gouveia Daniela Alves da Cruz, Bahamondes Luis, Aldrighi José Mendes, Tamanaha Sonia, Ribeiro Alessandra Lorenti, Aoki Tsutomu
Faculdade de Ciências Médicas, Santa Casa de São Paulo.
Rev Assoc Med Bras (1992). 2007 Jul-Aug;53(4):344-8. doi: 10.1590/s0104-42302007000400021.
Obesity represents the most important risk factor for endometrial pathology. This study aimed to evaluate the prevalence of endometrial injuries, such as polyps, hyperplasia and endometrial cancer in asymptomatic obese women, as well as to recognize the associated risk factors .
A cross-sectional study was conducted between December 2004 and February 2006. Ninety-four obese (body mass index > or = 30 kg/m2) women were evaluated, divided in two groups of 47 participants each: pre-menopausal and postmenopausal women. Clinical characteristics, physical exams (anthropometric and gynecological), blood count and endometrial assessment by vaginal ultrasonography, biopsy, and hysteroscopy (only for confirmed endometrial pathology), were the variables appraised.
In pre-menopausal women, 12.8% of cases had endometrial pathology statistically associated to age, hypertension, hypercholesterolemia and LDL-c increase. In the post-menopausal women, 40.4% of cases had a pathology identified as statistically associated with hypertension, LDL-c and estrone increase. Two cases of endometrial cancer were identified, one in each group.
The increased incidence of obesity over recent years has increased risk factors of endometrial cancer. In pre-menopausal women only a small number of cases with endometrial alterations was observed. Therefore, it is suggested that greater attention be given to those over 40 years of age, associated with hypertension and/or higher LDL-c . The menopausal status increases risk of endometrial injury, and when associated with hypertension, LDL-c and/or estrone increase, women become candidates to biopsy aiming for an early diagnosis of cancer, a decisive factor for a favorable prognosis.
肥胖是子宫内膜病变最重要的危险因素。本研究旨在评估无症状肥胖女性子宫内膜损伤（如息肉、增生和子宫内膜癌）的患病率，并识别相关危险因素。
于2004年12月至2006年2月进行了一项横断面研究。对94名肥胖（体重指数≥30kg/m²）女性进行了评估，分为两组，每组47名参与者：绝经前和绝经后女性。评估的变量包括临床特征、体格检查（人体测量和妇科检查）、血常规以及通过阴道超声、活检和宫腔镜检查（仅用于确诊的子宫内膜病变）进行的子宫内膜评估。
在绝经前女性中，12.8%的病例存在与年龄、高血压、高胆固醇血症和低密度脂蛋白胆固醇升高有统计学关联的子宫内膜病变。在绝经后女性中，40.4%的病例被确定存在与高血压、低密度脂蛋白胆固醇和雌酮升高有统计学关联的病变。发现两例子宫内膜癌，每组各一例。
近年来肥胖发生率的增加提高了子宫内膜癌的危险因素。在绝经前女性中，仅观察到少数子宫内膜改变病例。因此，建议对40岁以上、伴有高血压和/或较高低密度脂蛋白胆固醇的女性给予更多关注。绝经状态会增加子宫内膜损伤的风险，当与高血压、低密度脂蛋白胆固醇和/或雌酮升高相关时，女性应进行活检以早期诊断癌症，这是预后良好的决定性因素。
