Department of Obstetrics and Gynecology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea.
Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea.
Sci Rep. 2022 Apr 22;12(1):6620. doi: 10.1038/s41598-022-10625-x.
Uterine fibroid and benign thyroid disease are both common diseases in women. This study aimed to evaluate whether these diseases are related. We established the uterine fibroid group according to diagnosis and surgery codes using the Korea National Health Insurance data from 2009 to 2020. All women from 20 to 50 years old who underwent uterine myomectomy from 2009 to 2020 were identified. We selected the control group by performing a 1:1 propensity score matching on age at 5-year intervals, socioeconomic status (SES), region, Charlson comorbidity index (CCI), menopause, and year among women who visited a medical institution for a health check-up. Thyroid disease cases were selected using the thyroid disease diagnosis code and thyroid-associated laboratory tests. A total of 181,419 patients were included in the uterine fibroid and control groups. The median age of each group was 40 (range, 35 ~ 44) and 40 (range, 35 ~ 45) years old, respectively. Benign thyroid disease affected 1162 (0.6%) in the uterine fibroid group and 1137 (0.6%) in the control group. Among the benign thyroid diseases, hypothyroidism was the most common in both groups, followed by a nontoxic single thyroid nodule. The uterine fibroid group had a higher risk of thyroid goiter (hazard ratio (HR) 1.169, 95% confidence interval (CI) 1.022-1.338), nontoxic single thyroid nodule (HR 1.268, 95% CI 1.182-1.361), and total thyroid disease (HR 1.078, 95% CI 1.036-1.121) in stratified Cox regression analysis adjusted for age, SES, region, CCI, parity, menopause, hypertension, diabetes, dyslipidemia, systemic lupus erythematosus, irritable bowel syndrome, Crohn's disease, and endometriosis than the control group. The results suggest that women with uterine fibroids have an increased risk of thyroid goiters and thyroid nodules. Although the mechanism is not well known, estrogen and iodide might be a link between uterine fibroids and thyroid goiters and nodules. Future studies that prospectively follow women with uterine fibroids across a lifetime are needed.
子宫肌瘤和良性甲状腺疾病都是女性常见疾病。本研究旨在评估这两种疾病是否存在关联。我们根据韩国国家健康保险数据（2009 年至 2020 年）中的诊断和手术代码建立了子宫肌瘤组。所有在 2009 年至 2020 年间接受子宫肌瘤切除术的 20 至 50 岁女性均被纳入该组。我们通过年龄（每隔 5 年）、社会经济状况（SES）、地区、Charlson 合并症指数（CCI）、绝经和就诊年份进行 1:1 倾向评分匹配，在接受医疗机构健康检查的女性中选择对照组。甲状腺疾病病例使用甲状腺疾病诊断代码和甲状腺相关实验室检查进行选择。共纳入 181419 例子宫肌瘤患者和对照组患者。每组的中位年龄分别为 40 岁（范围：3544 岁）和 40 岁（范围：3545 岁）。在子宫肌瘤组中，有 1162 例（0.6%）和对照组中 1137 例（0.6%）患有良性甲状腺疾病。在良性甲状腺疾病中，两组均以甲状腺功能减退症最为常见，其次是非毒性单发甲状腺结节。在分层 Cox 回归分析中，与对照组相比，子宫肌瘤组的甲状腺肿（风险比[HR]1.169，95%置信区间[CI]1.022-1.338）、非毒性单发甲状腺结节（HR 1.268，95%CI 1.182-1.361）和总甲状腺疾病（HR 1.078，95%CI 1.036-1.121）的风险更高。这些结果表明，患有子宫肌瘤的女性患甲状腺肿和甲状腺结节的风险增加。尽管其机制尚不清楚，但雌激素和碘可能是子宫肌瘤与甲状腺肿和结节之间的联系。需要对患有子宫肌瘤的女性进行前瞻性终身随访的研究。
