Li Pei-Chen, Yang Yu-Cih, Wang Jen-Hung, Lin Shinn-Zong, Ding Dah-Ching
Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 970, Taiwan.
Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan.
J Clin Med. 2021 Sep 15;10(18):4173. doi: 10.3390/jcm10184173.
Endometriosis is a common systemic chronic inflammatory disease. Inflammation is the key mechanism responsible for the development of endothelial dysfunction and atherosclerosis. We aimed to investigate the risk of coronary artery disease (CAD) among Asian women with endometriosis. This retrospective population-based cohort study included patients with endometriosis diagnosed from 2000 to 2012 and registered in the Longitudinal Health Insurance Database, Taiwan. The comparison cohort (those without endometriosis) were selected (1:4) by matching the age frequency and the index year. We followed up the patients until the diagnosis of CAD (ICD-9-CM codes: 410-414, A270, and A279), withdrawal from the National Health Insurance system, death, or the end of the study. We used a multivariable-adjusted Cox proportional hazard model for evaluating the risk of CAD. We included 19,454 patients with endometriosis and 77,816 women as a comparison group. The mean age of the women at the diagnosis of endometriosis was 37.4 years. A total of 3245 women developed CAD in both groups during a median follow-up of 7 years. The incidence of CAD was higher in women with endometriosis than in those without (5.96 vs. 4.38 per 10,000 person-years; adjusted hazard ratio [95% confidence interval], 1.34 [1.22-1.47]). In conclusion, Asian women with endometriosis had a significantly higher risk of CAD. Further large-scale studies are needed to elucidate the cause-effect relationship between endometriosis and CAD.
子宫内膜异位症是一种常见的全身性慢性炎症性疾病。炎症是导致内皮功能障碍和动脉粥样硬化发展的关键机制。我们旨在调查患有子宫内膜异位症的亚洲女性患冠状动脉疾病（CAD）的风险。这项基于人群的回顾性队列研究纳入了2000年至2012年期间诊断为子宫内膜异位症并登记在台湾纵向健康保险数据库中的患者。通过匹配年龄频率和索引年份选择比较队列（无子宫内膜异位症者）（1:4）。我们对患者进行随访，直至诊断出CAD（国际疾病分类第九版临床修正本编码：410 - 414、A270和A279）、退出国民健康保险系统、死亡或研究结束。我们使用多变量调整的Cox比例风险模型来评估CAD的风险。我们纳入了19454例子宫内膜异位症患者和77816名女性作为比较组。女性诊断为子宫内膜异位症时的平均年龄为37.4岁。在中位随访7年期间，两组共有3245名女性患CAD。子宫内膜异位症女性的CAD发病率高于无子宫内膜异位症的女性（每10000人年5.96例对4.38例；调整后的风险比[95%置信区间]，1.34[1.22 - 1.47]）。总之，患有子宫内膜异位症的亚洲女性患CAD的风险显著更高。需要进一步的大规模研究来阐明子宫内膜异位症与CAD之间的因果关系。
