Department of Medical Laboratory Science, Faculty of Medicine, Mbarara University of Science of Science and Technology, P.O. Box 1410, Mbarara, Uganda.
Department of Obstetrics and Gynaecology, Faculty of Medicine, Mbarara University of Science of Science and Technology, P.O. Box 1410, Mbarara, Uganda.
BMC Womens Health. 2023 Apr 4;23(1):159. doi: 10.1186/s12905-023-02315-1.
Though obesity has been said to be associated with a number of malignancies including cervical cancer, its association with cervical intraepithelial neoplasia (CIN) is still a contentious issue. This study was designed to determining the prevalence and association between obesity and CIN.
This was an unmatched case control study, involving women with cervical intraepithelial neoplasia (cases) and those negative for intraepithelial lesions or malignancy (controls) at the cervical cancer clinic of Mbarara Regional Referral Hospital, in south-western Uganda, between April and November 2022. Cases and controls provided written informed consent and were recruited in a ratio of 1:1. Cases were identified by visual inspection with acetic acid (VIA) and subsequent confirmation with cytology and/or histology. Demographic information was collected using an enrolment form and height, weight and waist circumference were recorded. We calculated body mass index (BMI) and identified obese women as those with body mass index of ≥ 30 kg/m from both case and control groups. Central obesity was defined as waist: height ration of ≥ 0.5. Data was analysed using STATA version 17. Categorical variables were analysed using proportions, chi-square and logistic regression analysis to determine association between obesity and CIN. Our level of statistical significance was set at ≤ 0.05.
The prevalence of general and central obesity among cases was 25.5% (24/94) and 0% (0/94) respectively while the prevalence of general and central obesity among controls was 33.3% (37/111) and 0% (0/111) respectively. There was an increased prevalence of general obesity among women with low grade squamous intraepithelial lesions (LSIL). However, there was no statistically significant association between general obesity and CIN. Factors associated with general obesity included residing in Mbarara city (AOR 2.156, 95%CI 1.085-4.282, P-value 0.028), age group of 31-45 years (AOR 2.421, 95%CI 1.577-9.705, P-value 0.003) and ≥ 46 years (AOR 1.971, 95%CI 1.022-11.157, P-value 0.046).
We observed an increased prevalence of general obesity among women with LSIL. However, there was no association between obesity and CIN. Factors associated with general obesity included residing in Mbarara city, and being in the age groups of 31-40 and ≥ 46 years. This highlights the need to rethink management of CIN to control other non-communicable diseases that could arise due to general obesity.
尽管肥胖与包括宫颈癌在内的多种恶性肿瘤有关，但肥胖与宫颈上皮内瘤变（CIN）的关系仍存在争议。本研究旨在确定肥胖与 CIN 之间的患病率和关联。
这是一项在乌干达西南部姆巴拉拉地区转诊医院的宫颈癌诊所进行的病例对照研究，纳入了宫颈上皮内瘤变（病例）和宫颈上皮内病变或恶性肿瘤阴性的女性（对照）。病例和对照均提供了书面知情同意书，并以 1:1 的比例招募。通过醋酸视觉检查（VIA）识别病例，随后通过细胞学和/或组织学进行确认。使用登记表收集人口统计学信息，并记录身高、体重和腰围。我们计算了体重指数（BMI），并将 BMI 大于等于 30kg/m2 的女性确定为肥胖者，包括病例组和对照组。中心性肥胖定义为腰围：身高比大于等于 0.5。使用 STATA 版本 17 分析数据。使用比例、卡方和逻辑回归分析分析分类变量，以确定肥胖与 CIN 之间的关联。我们的统计显著性水平设定为≤0.05。
病例组中普通肥胖和中心性肥胖的患病率分别为 25.5%（24/94）和 0%（0/94），对照组中普通肥胖和中心性肥胖的患病率分别为 33.3%（37/111）和 0%（0/111）。低度鳞状上皮内病变（LSIL）女性中普通肥胖的患病率较高。然而，普通肥胖与 CIN 之间没有统计学上的显著关联。与普通肥胖相关的因素包括居住在姆巴拉拉市（AOR 2.156，95%CI 1.085-4.282，P 值 0.028）、年龄在 31-45 岁（AOR 2.421，95%CI 1.577-9.705，P 值 0.003）和≥46 岁（AOR 1.971，95%CI 1.022-11.157，P 值 0.046）。
我们观察到 LSIL 女性中普通肥胖的患病率较高。然而，肥胖与 CIN 之间没有关联。与普通肥胖相关的因素包括居住在姆巴拉拉市，以及年龄在 31-40 岁和≥46 岁。这突显出需要重新考虑 CIN 的管理，以控制由于普通肥胖而可能出现的其他非传染性疾病。
