Huang Hung-Kai, Kor Chew-Teng, Chen Ching-Pei, Chen Hung-Te, Yang Po-Ta, Tsai Chen-Dao, Huang Ching-Hui
Division of Cardiology, Department of Internal Medicine.
Internal Medicine Research Center, Changhua Christian Hospital.
Acta Cardiol Sin. 2018 Jan;34(1):66-76. doi: 10.6515/ACS.201801_34(1).20170901B.
Venous thromboembolism (VTE) is a sex-specific disease that has different presentations between men and women. Women with uterine leiomyoma can present with VTE without exhibiting the traditional risk factors. We investigated the relationship between a history of uterine leiomyoma and the risk of VTE using the National Health Insurance Research Database (NHIRD).
We conducted a retrospective, nationwide, population-based case-control study using the NHIRD. We identified 2,282 patients with diagnosed VTE and 392,635 subjects without VTE from 2000 to 2013. After development of an age and index diagnosis year frequency-matched model and propensity score-matched model, 2 models with a case-to-control ratio of 1 to 4 were established. Using the diagnosis of uterine leiomyoma as the exposure factor, conditional logistic regression was performed to examine the association between uterine leiomyoma and VTE. Multiple logistic regression analysis was used to investigate the joint effect of uterine leiomyoma and comorbid diseases on the risk of VTE.
A strong association was observed between uterine leiomyoma and VTE in the overall patient model, frequency-matched model and propensity score-matched model [p < 0.0001, odds ratio (OR): 1.547; p = 0.0005, OR: 1.486; p = 0.0405, OR: 1.26, respectively]. In the subgroup analyses, women with uterine leiomyoma who were ≥ 45 years old were less likely to experience VTE, but women with uterine leiomyoma and anemia, cancer, coronary artery disease or heart failure were more likely to experience VTE.
Women with uterine leiomyomas have an increased risk of developing VTE, especially during reproductive periods or in the presence of specific diseases.
静脉血栓栓塞症（VTE）是一种具有性别差异的疾病，在男性和女性中表现不同。患有子宫肌瘤的女性可能出现VTE，却无传统的风险因素。我们使用国民健康保险研究数据库（NHIRD）调查了子宫肌瘤病史与VTE风险之间的关系。
我们利用NHIRD进行了一项基于全国人群的回顾性病例对照研究。我们从2000年至2013年确定了2282例确诊为VTE的患者和392635例无VTE的受试者。在建立年龄和索引诊断年份频率匹配模型以及倾向得分匹配模型后，建立了两个病例对照比为1比4的模型。以子宫肌瘤诊断作为暴露因素，进行条件逻辑回归以检验子宫肌瘤与VTE之间的关联。采用多元逻辑回归分析研究子宫肌瘤和合并症对VTE风险的联合作用。
在总体患者模型、频率匹配模型和倾向得分匹配模型中，均观察到子宫肌瘤与VTE之间存在强关联[p < 0.0001，比值比（OR）：1.547；p = 0.0005，OR：1.486；p = 0.0405，OR：1.26]。在亚组分析中，年龄≥45岁的子宫肌瘤女性发生VTE的可能性较小，但患有子宫肌瘤且合并贫血、癌症、冠状动脉疾病或心力衰竭的女性发生VTE的可能性较大。
患有子宫肌瘤的女性发生VTE的风险增加，尤其是在生育期或存在特定疾病时。
