Heller Debra S, Mosquera Claudia, Goldsmith Laura T, Cracchiolo Bernadette
Department of Pathology and Laboratory Medicine, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark 07103, USA.
J Reprod Med. 2011 Mar-Apr;56(3-4):110-2.
Endometrial hyperplasia is a known risk factor for the development of endometrial cancer, particularly atypical hyperplasia, with a subsequent risk of up to 30%. Of the known risk factors for endometrial hyperplasia, obesity is the most preventable, but there is a paucity of data addressing the association. We tested the hypothesis that patients with endometrial hyperplasia have a higher body mass index (BMI) than patients with abnormal bleeding who are found to have proliferative endometrium.
This was an Institutional Review Board-approved retrospective study using University Hospital Department of Pathology records. All patients who had endometrial sampling performed between January 1, 2001, and July 30, 2008, were included. The experimental group consisted of patients with endometrial hyperplasia including simple, complex and atypical hyperplasia. The control group consisted of patients who underwent endometrial sampling for abnormal bleeding during the same time period and were diagnosed with proliferative endometrium. BMI was calculated based on documented height and weight within 30 days of endometrial sampling.
Forty-two patients with hyperplasia and 103 patients with proliferative endometrium met inclusion criteria, including documented height and weight and nonexposure to hormones. The median BMI in the hyperplasia group was 38 kg/m2 (95% CI 34.8-42.4) and 30 kg/m2 (95% CI 29.9-33.3) in the proliferative group (p < 0.0001).
These data suggest that higher BMI is associated with endometrial hyperplasia as compared to women with lower BMIs and abnormal bleeding.
子宫内膜增生是子宫内膜癌发生的已知危险因素，尤其是不典型增生，后续风险高达30%。在已知的子宫内膜增生危险因素中，肥胖是最可预防的，但关于两者关联的数据较少。我们检验了这样一个假设，即与被发现有增生期子宫内膜的异常出血患者相比，子宫内膜增生患者的体重指数（BMI）更高。
这是一项经机构审查委员会批准的回顾性研究，使用大学医院病理科记录。纳入了2001年1月1日至2008年7月30日期间所有进行过子宫内膜取样的患者。实验组由患有子宫内膜增生（包括单纯性、复杂性和不典型增生）的患者组成。对照组由同期因异常出血接受子宫内膜取样并被诊断为增生期子宫内膜的患者组成。BMI根据子宫内膜取样后30天内记录的身高和体重计算得出。
42例增生患者和103例增生期子宫内膜患者符合纳入标准，包括记录的身高和体重以及未接触激素。增生组的BMI中位数为38kg/m²（95%可信区间34.8 - 42.4），增生期组为30kg/m²（95%可信区间29.9 - 33.3）（p < 0.0001）。
这些数据表明，与BMI较低且有异常出血的女性相比，较高的BMI与子宫内膜增生有关。
