Hemmert Rachael, Schliep Karen C, Willis Sydney, Peterson Charles Matthew, Louis Germaine Buck, Allen-Brady Kristina, Simonsen Sara E, Stanford Joseph B, Byun Jiyoung, Smith Ken R
Division of Public Health, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah.
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah.
Paediatr Perinat Epidemiol. 2019 Jan;33(1):19-25. doi: 10.1111/ppe.12516. Epub 2018 Oct 11.
Caffeine, alcohol, smoking and physical activity are known to alter sex steroid synthesis, which may affect hormone-dependent gynaecologic disease risk, such as endometriosis; however, few studies have assessed life style factors prior to endometriosis diagnosis.
Four hundred and seventy three women, ages 18-44 years, underwent laparoscopy or laparotomy, regardless of clinical indication, at 14 clinic sites, 2007-2009. Women with prior surgically confirmed endometriosis were excluded. Life style factors were assessed prior to surgery. Adjusted risk ratios (RR) of endometriosis by caffeine, alcohol, smoking (serum cotinine), and physical activity were estimated, adjusting for age, marital status, education, race/ethnicity, age at menarche, gravidity, BMI, study site, and other life style factors.
There were no associations between women with endometriosis and alcohol consumption (RR 0.9, 95% CI 0.7, 1.3), caffeine consumption (RR 1.1, 95% CI 0.8, 1.5), or smoking (serum cotinine <10 vs ≥10 ng/mL; RR 1.0, 95% CI 0.7, 1.6). Similar null findings were found between endometriosis and weekly occurrences of physical activity and total walking, moderate, and vigorous activity; a modest trend was found between total daily sitting time and increased endometriosis risk.
This study, which is unique in its capture of life style exposures prior to incident endometriosis diagnosis, largely found no association between alcohol, caffeine, smoking, and physical activity and risk of endometriosis.
已知咖啡因、酒精、吸烟和体育活动会改变性类固醇合成，这可能会影响激素依赖性妇科疾病的风险，如子宫内膜异位症；然而，很少有研究在子宫内膜异位症诊断之前评估生活方式因素。
2007年至2009年期间，473名年龄在18 - 44岁的女性在14个临床地点接受了腹腔镜检查或剖腹手术，无论临床指征如何。排除先前经手术确诊为子宫内膜异位症的女性。在手术前评估生活方式因素。估计咖啡因、酒精、吸烟（血清可替宁）和体育活动导致子宫内膜异位症的调整风险比（RR），并对年龄、婚姻状况、教育程度、种族/民族、初潮年龄、妊娠次数、体重指数、研究地点和其他生活方式因素进行调整。
子宫内膜异位症女性与饮酒（RR 0.9，95%可信区间0.7，1.3）、咖啡因摄入（RR 1.1，95%可信区间0.8，1.5）或吸烟（血清可替宁<10 vs≥10 ng/mL；RR 1.0，95%可信区间0.7，1.6）之间无关联。在子宫内膜异位症与每周体育活动次数以及总步行、中等强度和剧烈活动之间也发现了类似的阴性结果；在每日总久坐时间与子宫内膜异位症风险增加之间发现了适度的趋势。
这项研究在捕捉子宫内膜异位症发病诊断之前的生活方式暴露方面具有独特性，在很大程度上发现酒精、咖啡因、吸烟和体育活动与子宫内膜异位症风险之间无关联。
