Ma Yimin, Weng Jingjing, Zhu Yingying
Department of Gynecology, Ningbo Medical Center Lihuili Hospital, No.1111 Jiangnan Road, Yinzhou District, Ningbo, Zhejiang Province, 315040, China.
BMC Womens Health. 2024 Dec 31;24(1):677. doi: 10.1186/s12905-024-03530-0.
We aimed to analyze the correlation between serum lipid levels [total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)] and recurrence after uterine fibroids (UF) resection, and explore the predictive value of serum lipid levels in determining recurrence after myomectomy.
In this retrospective cohort study, 323 patients undergoing first myomectomy who came from Li Huili Hospital, Ningbo Medical Center between December 2019 and January 2023 were included. The primary endpoint was the recurrence of UF within 12 months following surgery. Univariate and multivariate logistic regression analyses were adopted to evaluate the association between four serum lipid parameters and the risk of UF recurrence. All included patients were randomly assigned to the training group for nomogram development and the testing group for nomogram validation, with a ratio of 7:3. Receiver operator characteristic, calibration curves, and decision curve analysis were used to assess the predicting performance of constructed nomograms.
Totally, 98 developed the recurrence of UF within 12 months following surgery. Multivariate logistic regression analyses indicated that high levels of TC [odds ratio (OR) = 9.98, 95% confidence interval (CI): 4.28-23.30], LDL-C (OR = 11.31, 95% CI: 4.66-27.47) and HDL-C (OR = 2.37, 95% CI: 1.21-4.64) were associated with recurrence of UF risk. The association between TG level and UF recurrence risk did not statistical significance (P > 0.05). Four online prediction nomograms by integrating serum lipid levels and clinical features for predicting the risk of recurrence of UF were developed (TC-model, TG-model, LDL-C-model and HDL-C-model). Through verification, these models may have good prediction performance for predicting the recurrence of UF risk.
This study developed and validated prediction nomograms for predicting the risk of UF recurrence. These nomograms can provide individual risk assessment for UF recurrence.
我们旨在分析血清脂质水平[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]与子宫肌瘤(UF)切除术后复发之间的相关性,并探讨血清脂质水平在确定肌瘤切除术后复发方面的预测价值。
在这项回顾性队列研究中,纳入了2019年12月至2023年1月期间来自宁波医疗中心李惠利医院的323例行首次肌瘤切除术的患者。主要终点是术后12个月内UF的复发情况。采用单因素和多因素逻辑回归分析来评估四个血清脂质参数与UF复发风险之间的关联。所有纳入患者按7:3的比例随机分配到用于列线图开发的训练组和用于列线图验证的测试组。采用受试者工作特征曲线、校准曲线和决策曲线分析来评估构建的列线图的预测性能。
共有98例患者在术后12个月内出现UF复发。多因素逻辑回归分析表明,高水平的TC[比值比(OR)=9.98,95%置信区间(CI):4.28 - 23.30]、LDL-C(OR = 11.31,95% CI:4.66 - 27.47)和HDL-C(OR = 2.37,95% CI:1.21 - 4.64)与UF复发风险相关。TG水平与UF复发风险之间的关联无统计学意义(P > 0.05)。通过整合血清脂质水平和临床特征,开发了四个用于预测UF复发风险的在线预测列线图(TC模型、TG模型、LDL-C模型和HDL-C模型)。经验证,这些模型在预测UF复发风险方面可能具有良好的预测性能。
本研究开发并验证了用于预测UF复发风险的预测列线图。这些列线图可为UF复发提供个体风险评估。