研究子宫内膜异位症和多囊卵巢综合征的共现情况。

Examining the co-occurrence of endometriosis and polycystic ovarian syndrome.

作者信息

Schliep Karen C, Ghabayen Lina, Shaaban May, Hughes Felicity R, Pollack Anna Z, Stanford Joseph B, Brady Kristy Allen, Kiser Amber, Peterson C Matthew

机构信息

Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT (Dr Schliep, Mses Ghabayen, Shaaban, and Hughes, and Dr Stanford).

College of Health and Human Services, George Mason University, Fairfax, VA (Dr Pollack).

出版信息

AJOG Glob Rep. 2023 Aug 28;3(3):100259. doi: 10.1016/j.xagr.2023.100259. eCollection 2023 Aug.

DOI:10.1016/j.xagr.2023.100259

PMID:37663310

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10472311/

Abstract

BACKGROUND

Polycystic ovarian syndrome and endometriosis are 2 of the most common reproductive disorders among women but are thought to be unrelated.

OBJECTIVE

This study aimed to examine the overlap and common symptoms of polycystic ovarian syndrome and endometriosis.

STUDY DESIGN

The study population included the Endometriosis, Natural History, Diagnosis, and Outcomes Study (2007-2009) operative cohort: 473 women, aged 18 to 44 years, who underwent a diagnostic and/or therapeutic laparoscopy or laparotomy at 1 of 14 surgical centers located in Salt Lake City, Utah, or San Francisco, California, in addition to a population cohort composed of 127 women from the surgical centers' catchment areas. Age and site-adjusted multinomial regression models were used to estimate adjusted prevalence ratios and 95% confidence intervals of reproductive history characteristics among women with endometriosis only, women with polycystic ovarian syndrome only, and women with both endometriosis and polycystic ovarian syndrome.

RESULTS

Among the operative cohort, 35% had endometriosis only, 9% had polycystic ovarian syndrome only, and 5% had endometriosis and polycystic ovarian syndrome. Among the population cohort, 10% had endometriosis only, 8% had polycystic ovarian syndrome only, and 2% had endometriosis and polycystic ovarian syndrome. In the operative cohort, a history of subfertility was associated with a higher adjusted probability of having both conditions (adjusted prevalence ratio, 10.33; 95% confidence interval, 3.94-27.08), followed by having endometriosis only (adjusted prevalence ratio, 2.45; 95% confidence interval, 1.56-3.84) or polycystic ovarian syndrome only (adjusted prevalence ratio, 1.15; 95% confidence interval, 0.51-2.61), than having neither condition. In addition, experiencing chronic pelvic pain within the past 12 months was associated with a higher probability of having both conditions (adjusted prevalence ratio, 2.53; 95% confidence interval, 1.07-6.00) than having neither condition.

CONCLUSION

Among a cohort of women undergoing gynecologic laparoscopy or laparotomy, our study found that nearly 1 in 20 women had both an incident endometriosis diagnosis and symptoms consistent with polycystic ovarian syndrome. Among a population cohort of women not seeking gynecologic care, polycystic ovarian syndrome and endometriosis overlap prevalence was approximately 1 in 50 women.

摘要

背景

多囊卵巢综合征和子宫内膜异位症是女性中最常见的两种生殖系统疾病，但一般认为二者并无关联。

目的

本研究旨在探讨多囊卵巢综合征与子宫内膜异位症的重叠情况及共同症状。

研究设计

研究人群包括子宫内膜异位症自然病史、诊断与转归研究（2007 - 2009年）手术队列：473名年龄在18至44岁之间的女性，她们在位于犹他州盐湖城或加利福尼亚州旧金山的14个手术中心之一接受了诊断性和/或治疗性腹腔镜检查或剖腹手术，此外还包括一个由来自手术中心服务区域的127名女性组成的人群队列。采用年龄和地点调整的多项回归模型来估计仅患有子宫内膜异位症、仅患有多囊卵巢综合征以及同时患有子宫内膜异位症和多囊卵巢综合征的女性生殖史特征的调整患病率比值及95%置信区间。

结果

在手术队列中，35%的女性仅患有子宫内膜异位症，9%的女性仅患有多囊卵巢综合征，5%的女性同时患有子宫内膜异位症和多囊卵巢综合征。在人群队列中，10%的女性仅患有子宫内膜异位症，8%的女性仅患有多囊卵巢综合征，2%的女性同时患有子宫内膜异位症和多囊卵巢综合征。在手术队列中，有不孕史的女性同时患有这两种疾病的调整概率更高（调整患病率比值为10.33；95%置信区间为3.94 - 27.08），其次是仅患有子宫内膜异位症（调整患病率比值为2.45；95%置信区间为1.56 - 3.84）或仅患有多囊卵巢综合征（调整患病率比值为1.15；95%置信区间为0.51 - 2.61），高于两种疾病都没有的女性。此外，在过去12个月内经历慢性盆腔疼痛的女性同时患有这两种疾病的概率（调整患病率比值为2.53；95%置信区间为1.07 - 6.00）高于两种疾病都没有的女性。