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体重指数(BMI)在绝经前异常子宫出血妇女子宫内膜增生诊断中的预测价值及最佳切点的确定

Predictive value of body mass index (BMI) and determination of optimum cut-off point in the diagnosis of endometrial hyperplasia in pre-menopausal women with abnormal uterine bleeding.

作者信息

Alizadeh Garna Sara, Yazdani Shahla, Musavi Hadis, Ranaei Mohammad, Hajian Karimollah, Bouzari Zinatossadat

机构信息

Student Research Committee, Babol University of Medical Sciences, Babol, Iran.

Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.

出版信息

Caspian J Intern Med. 2024 Winter;15(1):87-95. doi: 10.22088/cjim.15.1.9.

Abstract

BACKGROUND

The suitable BMI cut-off point in persons with endometrial cancer or hyperplasia with abnormal uterine bleeding was investigated in this study.

METHODS

This case-control research was conducted on 1470 women with abnormal uterine bleeding in Ayatollah Rouhani Hospital,Babol between 2010 and 2012, with 312 participants included in the study. In terms of uterine biopsy results, patients were split into six groups: simple hyperplasia without atypia, simple hyperplasia with atypia, complicated hyperplasia with atypia, complex hyperplasia without atypia, endometrial cancer, and normal persons.

RESULTS

The mean age and BMI of patients in these three groups were not significantly different (P equal to 0.081 and 0.435, respectively). The kind of disease exhibited a strong relationship with menstruation (P 0.001). The body mass index (BMI) values ​​did not have significant levels under the curve to determine the appropriate cut-off point in the diagnosis of hyperplasia plus endometrial cancer and endometrial cancer alone (P 0.380 and 0.124, respectively) and hyperplasia alone (P = 0.920). Based on logistic regression, age 50 years and older and irregular menstruation were significant with OR equal to 2.36 and 2.09 (P = 0.011) and HTN with OR equal to 0.44 (P = 0.026), respectively.

CONCLUSION

BMI has little predictive value in the detection of endometrial cancer or hyperplasia, according to the findings, and other diagnostic and screening modalities should be utilized instead. The findings backed up the theory that old age and irregular menstruation are linked to an increased risk of endometrial cancer.

摘要

背景

本研究调查了子宫内膜癌或伴有异常子宫出血的增生患者的合适体重指数(BMI)切点。

方法

本病例对照研究于2010年至2012年在巴博勒的阿亚图拉·鲁哈尼医院对1470名有异常子宫出血的女性进行,其中312名参与者纳入研究。根据子宫活检结果,患者被分为六组:单纯性不典型增生、单纯性非典型增生、复杂性非典型增生、复杂性不典型增生、子宫内膜癌和正常人。

结果

这三组患者的平均年龄和BMI无显著差异(P分别为0.081和0.435)。疾病类型与月经有密切关系(P<0.001)。体重指数(BMI)值在确定增生加子宫内膜癌和单独子宫内膜癌诊断的合适切点时,曲线下无显著水平(P分别为0.380和0.124),单独增生时(P = 0.920)也是如此。基于逻辑回归,50岁及以上、月经不规律以及高血压的比值比(OR)分别为2.36、2.09(P = 0.011)和0.44(P = 0.026),差异有统计学意义。

结论

根据研究结果,BMI在子宫内膜癌或增生的检测中预测价值不大,应采用其他诊断和筛查方式。研究结果支持了老年和月经不规律与子宫内膜癌风险增加有关的理论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/29f4/10921111/dd9b2150c34d/cjim-15-87-g001.jpg

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