Burghaus S, Klingsiek P, Fasching P A, Engel A, Häberle L, Strissel P L, Schmidt M, Jonas K, Strehl J D, Hartmann A, Lermann J, Boosz A, Thiel F C, Müller A, Beckmann M W, Renner S P
Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander University , Erlangen-Nuremberg, Erlangen.
Institute of Pathology, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen.
Geburtshilfe Frauenheilkd. 2011 Dec;71(12):1073-1079. doi: 10.1055/s-0031-1280436.
The etiology of endometriosis is still a research field in which few consistent data are available. Large case-control studies or even cohort studies are rare, and most of the published data are conflicting. The aim of the present study was therefore to examine common epidemiological and endometriosis-specific risk factors in a German case-control study. From 2001 to 2010, a pool of 595 laparoscopically confirmed cases and 475 controls were recruited in a hospital-based setting. After matching for age, 298 cases and 300 controls remained in the pool. Age at menarche, menstrual cycle length, duration of menstrual bleeding, number of pregnancies, live births, miscarriages, use of contraceptive pills, body mass index (BMI), and smoking status were analyzed with logistic regression models predicting endometriosis case-control status. Menstrual cycle length, duration of menstrual bleeding, number of pregnancies, number of miscarriages, and smoking status, as relevant predictors for endometriosis case-control status, were identified as risk factors for endometriosis. Other factors such as age at menarche, number of live births, ever having used contraceptive pills, and BMI were not predictive. This hospital-based case-control study reproduced most of the familiar risk factors. Comparison of this study with others reveals a wide variety of effect sizes and directions of association with risk factors and may increase the information available about the characteristics of the patient population being treated in the relevant hospital setting.
子宫内膜异位症的病因仍是一个研究领域，目前可获得的一致数据很少。大型病例对照研究甚至队列研究都很罕见，并且大多数已发表的数据相互矛盾。因此，本研究的目的是在一项德国病例对照研究中检验常见的流行病学和子宫内膜异位症特异性危险因素。2001年至2010年，在一家医院环境中招募了595例经腹腔镜确诊的病例和475例对照。在按年龄匹配后，样本中剩余298例病例和300例对照。使用逻辑回归模型分析初潮年龄、月经周期长度、月经出血持续时间、怀孕次数、活产数、流产数、避孕药使用情况、体重指数（BMI）和吸烟状况，以预测子宫内膜异位症的病例对照状态。月经周期长度、月经出血持续时间、怀孕次数、流产数和吸烟状况作为子宫内膜异位症病例对照状态的相关预测因素，被确定为子宫内膜异位症的危险因素。其他因素，如初潮年龄、活产数、是否曾使用避孕药和BMI，并无预测作用。这项基于医院的病例对照研究重现了大多数常见的危险因素。将本研究与其他研究进行比较，发现与危险因素的关联在效应大小和方向上存在很大差异，这可能会增加有关在相关医院环境中接受治疗的患者群体特征的可用信息。
