Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea.
Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea.
Am J Obstet Gynecol. 2023 Jul;229(1):45.e1-45.e18. doi: 10.1016/j.ajog.2023.03.041. Epub 2023 Apr 5.
Uterine leiomyomas are the most common benign tumors in women of childbearing age. Although there are several studies reporting the positive association of drinking alcohol with the incidence of uterine leiomyomas, studies targeting Korean women are lacking.
This study aimed to investigate the association between alcohol consumption and the risk of new-onset uterine leiomyomas in Korean women of early reproductive-age.
This was a retrospective nationwide population-based cohort study using the Korean National Health Insurance Service database. Participants comprised 2,512,384 asymptomatic Korean women aged 20 to 39 years who underwent a national health examination from 2009 to 2012. The follow-up period was from the date of the first national health examination to the date of diagnosis of new-onset uterine leiomyomas or December 2018 if no uterine leiomyomas were detected. The diagnosis of uterine leiomyomas required 2 outpatient records within a year or 1 inpatient record of International Classification of Diseases, Tenth Revision (ICD-10) codes of uterine leiomyomas (D25) in the Korean National Health Insurance Service. Exclusion criteria were previously diagnosed uterine leiomyomas during the screening period (January 2002 to the date of first health examination) or uterine leiomyoma diagnosis within 1 year of baseline examination. The associations of alcohol consumption, amount drunk per drinking session, and sustained drinking over time with the risk of new-onset uterine leiomyomas were investigated.
Approximately 6.1% of women aged 20 to 39 years were diagnosed with uterine leiomyomas after an average of 4.3 years. Alcohol consumption was associated with an increased incidence of new-onset uterine leiomyomas of 12% to 16% (hazard ratio, 1.12; 95% confidence interval, 1.11-1.14 for mild-to-moderate drinkers; hazard ratio, 1.16; 95% confidence interval, 1.12-1.20 for heavy drinkers). Drinking ≥1 days per week was associated with increased risk of uterine leiomyomas (hazard ratio, 1.11; 95% confidence interval, 1.10-1.12 for drinking 1 day per week; hazard ratio, 1.15; 95% confidence interval, 1.12-1.17 for drinking ≥3 days per week), and the association increased proportionately to the amount of alcohol consumed per drinking session (hazard ratio, 1.17; 95% confidence interval, 1.15-1.19 for ≥7 glasses per drinking session). Women who also reported alcohol consumption in the questionnaire administered 2 years later (sustained drinkers) exhibited a 20% increased risk of new-onset uterine leiomyomas (hazard ratio, 1.20; 95% confidence interval, 1.17-1.22) compared with women who answered that they did not drink alcohol at both times (sustained nondrinkers). In women who discontinued drinking, the risk was 3% (hazard ratio, 1.03; 95% confidence interval, 1.01-1.06), whereas in women who became drinkers, the risk was 14% (hazard ratio, 1.14; 95% confidence interval, 1.11-1.16).
Having an alcohol drinking habit, the amount of alcohol consumed per drinking session, and sustained drinking over 2 years were significantly associated with the risk of new-onset uterine leiomyomas. Avoiding or discontinuing drinking could lower the risk of new-onset uterine leiomyomas in early reproductive-age women.
子宫肌瘤是育龄期妇女最常见的良性肿瘤。虽然有几项研究报告称饮酒与子宫肌瘤的发病率呈正相关，但针对韩国女性的研究还很少。
本研究旨在调查饮酒与韩国育龄期早期妇女新发子宫肌瘤风险之间的关系。
这是一项使用韩国国家健康保险服务数据库的回顾性全国人群队列研究。参与者包括 2512384 名年龄在 20 至 39 岁之间的无症状韩国女性，她们在 2009 年至 2012 年期间接受了国家健康检查。随访期从第一次国家健康检查的日期开始，到新发子宫肌瘤的诊断日期或 2018 年 12 月（如果未发现子宫肌瘤）结束。子宫肌瘤的诊断需要在韩国国家健康保险服务中，一年内有 2 次门诊记录或 1 次国际疾病分类第 10 版（ICD-10）子宫肌瘤代码（D25）的住院记录。排除标准为在筛查期（2002 年 1 月至首次健康检查日期）之前已诊断出子宫肌瘤或基线检查后 1 年内诊断出子宫肌瘤的患者。研究了饮酒、每次饮酒量和持续饮酒时间与新发子宫肌瘤风险之间的关系。
在平均随访 4.3 年后，约 6.1%的 20 至 39 岁女性被诊断为子宫肌瘤。饮酒与新发子宫肌瘤的发病率增加 12%至 16%相关（危险比，1.12；95%置信区间，1.11-1.14 轻度至中度饮酒者；危险比，1.16；95%置信区间，1.12-1.20 重度饮酒者）。每周饮酒≥1 天与子宫肌瘤风险增加相关（危险比，1.11；95%置信区间，1.10-1.12 每周饮酒 1 天；危险比，1.15；95%置信区间，1.12-1.17 每周饮酒≥3 天），并且与每次饮酒量呈比例增加（危险比，1.17；95%置信区间，1.15-1.19 每次饮酒≥7 杯）。在两年后（持续饮酒者）问卷调查中报告饮酒的女性新发子宫肌瘤的风险增加 20%（危险比，1.20；95%置信区间，1.17-1.22），而在两次都回答不饮酒的女性（持续非饮酒者）中，这一风险降低 20%。在停止饮酒的女性中，风险降低 3%（危险比，1.03；95%置信区间，1.01-1.06），而在开始饮酒的女性中，风险增加 14%（危险比，1.14；95%置信区间，1.11-1.16）。
有饮酒习惯、每次饮酒量和持续饮酒 2 年以上与新发子宫肌瘤的风险显著相关。避免或停止饮酒可能会降低早期生育期女性新发子宫肌瘤的风险。
