代谢综合征作为绝经后女性子宫内膜息肉的预测指标
Metabolic syndrome as a predictor of endometrial polyps in postmenopausal women.
作者信息
Bueloni-Dias Flavia Neves, Spadoto-Dias Daniel, Delmanto Lucia R M G, Nahas-Neto Jorge, Nahas Eliana A P
机构信息
Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Sao Paulo, Brazil.
出版信息
Menopause. 2016 Jul;23(7):759-64. doi: 10.1097/GME.0000000000000616.
OBJECTIVE
The aim of the study was to evaluate clinical predictive factors for endometrial polyps in postmenopausal women compared with postmenopausal women without polyps.
METHODS
In this cross-sectional study, 132 Brazilian women with a histopathological diagnosis of endometrial polyps were compared with 264 women without endometrial alterations (control). The study group included women aged at least 45 years with amenorrhea for at least 12 months, who underwent hysteroscopic polypectomy. The control group consisted of women aged at least 45 years with amenorrhea for at least 12 months, without postmenopausal bleeding and endometrial thickness less than 5 mm by transvaginal ultrasonography. Clinical, anthropometric (body mass index and waist circumference), laboratory, and ultrasonographic data were collected to evaluate predictive factors for endometrial polyps. The Student's t test, χ test, and logistic regression (odds ratio [OR]) were used for statistical analysis.
RESULTS
A higher percentage of women with polyps were obese (72%) when compared with control (39%) (P < 0.0001). Waist circumference was greater among women with polyps (P = 0.0001). The incidence of diabetes, hypertension, and dyslipidemia was higher among women with endometrial polyps (P < 0.0001). According to the diagnostic criteria of the US National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III), 48.5% of the women with polyps and 33.3% of the controls were classified as having metabolic syndrome (MetS) (P = 0.004). The risk of endometrial polyps was higher in women with body mass index at least 25 kg/m (OR = 4.66; 95% CI 2.16-10.05); glucose at least 100 mg/dL (OR = 2.83; 95% CI 1.36-5.90); dyslipidemia (OR = 7.02; 95% CI 3.70-13.32); diabetes (OR = 2.58; 95% CI 1.05-6.32); and MetS (OR = 2.76; 95% CI 1.18-6.46) when compared with control, adjusted for age, and time since menopause.
CONCLUSIONS
In postmenopausal women, obesity, dyslipidemia, hyperglycemia, and the presence of MetS were predictive factors for endometrial polyps.
目的
本研究旨在评估绝经后子宫内膜息肉患者相较于无息肉的绝经后女性的临床预测因素。
方法
在这项横断面研究中，将132例经组织病理学诊断为子宫内膜息肉的巴西女性与264例无子宫内膜病变的女性（对照组）进行比较。研究组包括年龄至少45岁、闭经至少12个月且接受宫腔镜息肉切除术的女性。对照组由年龄至少45岁、闭经至少12个月、无绝经后出血且经阴道超声检查子宫内膜厚度小于5毫米的女性组成。收集临床、人体测量学（体重指数和腰围）、实验室及超声数据，以评估子宫内膜息肉的预测因素。采用Student's t检验、χ检验和逻辑回归（比值比[OR]）进行统计分析。
结果
与对照组（39%）相比，息肉患者中肥胖女性的比例更高（72%）（P<0.0001）。息肉患者的腰围更大（P = 0.0001）。子宫内膜息肉患者中糖尿病、高血压和血脂异常的发生率更高（P<0.0001）。根据美国国家胆固醇教育计划/成人治疗小组III（NCEP/ATP III）的诊断标准，48.5%的息肉患者和33.3%的对照组患者被归类为患有代谢综合征（MetS）（P = 0.004）。调整年龄和绝经时间后，体重指数至少25 kg/m²的女性（OR = 4.66；9
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