Ott Johannes, Kurz Christine, Braun Ronald, Promberger Regina, Seemann Rudolf, Vytiska-Binstorfer Elisabeth, Walch Katharina
Department of Gynecological Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna, Austria.
Department of Surgery, Medical University of Vienna, Vienna, Austria.
Eur J Obstet Gynecol Reprod Biol. 2014 Jun;177:19-22. doi: 10.1016/j.ejogrb.2014.03.003. Epub 2014 Mar 13.
A possible correlation between uterine leiomyoma and thyroid disease was reported decades ago. We aimed to evaluate the possible associations between the presence of uterine leiomyomas and (i) the presence of overt hypothyroidism, (ii) the level of anti-thyroid peroxidase antibodies (TPO-Ab) and thyroglobulin antibodies (TG-Ab), and (iii) thyroid stimulating hormone (TSH) levels.
In a retrospective study, all 215 sterile women who underwent reproductive surgery (hysteroscopy and laparoscopy/laparotomy) at our department from January 2007 to January 2011 were included. All leiomyomas suspected on gynecologic ultrasound were verified during surgery. As risk factors for uterine leiomyomas, thyroid parameters, age, African heritage, age at menarche, parity, and body mass index were included.
One or more uterine leiomyomas were found in 51 cases (23.7%). After multivariate analysis, three parameters remained significant, with African heritage the most important (odds ratio, OR, 27.80), followed by overt hypothyroidism (OR 3.10) and increasing age (OR 1.23). Larger leiomyomas were found in women with overt hypothyroidism than in those without overt hypothyroidism (median, 70 mm; range, 5-88 vs. median, 30 mm; range, 2-93, respectively; p=0.007).
Overt hypothyroidism, but not autoantibodies against the thyroid gland, was associated with the presence of uterine leiomyoma in our study.
数十年前就有报道称子宫平滑肌瘤与甲状腺疾病之间可能存在关联。我们旨在评估子宫平滑肌瘤的存在与以下因素之间的可能关联：（i）显性甲状腺功能减退的存在；（ii）抗甲状腺过氧化物酶抗体（TPO-Ab）和甲状腺球蛋白抗体（TG-Ab）的水平；（iii）促甲状腺激素（TSH）水平。
在一项回顾性研究中，纳入了2007年1月至2011年1月在我院接受生殖手术（宫腔镜检查和腹腔镜检查/剖腹手术）的所有215名不育女性。所有经妇科超声怀疑的平滑肌瘤均在手术中得到证实。作为子宫平滑肌瘤的危险因素，纳入了甲状腺参数、年龄、非洲血统、初潮年龄、产次和体重指数。
51例（23.7%）发现一个或多个子宫平滑肌瘤。多因素分析后，三个参数仍具有显著性，其中非洲血统最为重要（比值比，OR，27.80），其次是显性甲状腺功能减退（OR 3.10）和年龄增长（OR 1.23）。显性甲状腺功能减退的女性比无显性甲状腺功能减退的女性发现的平滑肌瘤更大（中位数分别为70 mm；范围5 - 88 vs.中位数30 mm；范围2 - 93；p = 0.007）。
在我们的研究中，显性甲状腺功能减退而非针对甲状腺的自身抗体与子宫平滑肌瘤的存在有关。
