Zhang Lijun, Xu Fan, Huang Yanyan, Xu Wei, Pu Yang, Chen Ke, Zhou Bingqian, Gong Ruoyan, Su Xueyao, Zhang Jiayuan, Shi Qiuling
School of Public Health, Chongqing Medical University, Chongqing, China.
Department of Obstetrics and Gynecology, Nanchong Central Hospital Affiliated to North Sichuan Medical College, Nanchong, Sichuan, China.
BMJ Open. 2025 Jan 7;15(1):e085671. doi: 10.1136/bmjopen-2024-085671.
To investigate uterine fibroid (UF)-associated imaging changes, and their prevalence, incidence and potential risk factors in the Chinese population.
This was a retrospective observational study using health examination data.
A physical examination centre in Nanchong, China, between October 2017 and December 2020.
A total of 33 915 Chinese women older than 15 years of age underwent uterine imaging during the study period.
This study identified entries of UF-associated imaging changes through a two-round expert consultation and calculated prevalence and incidence of UF-associated imaging changes. Logistic regression estimated the association (OR, 95% CI of body mass index, high blood pressure (HBP), blood lipid profile, and fasting blood glucose level) with UF-associated imaging changes. Age-stratified (≤40 years and >40 years) risks were ascertained.
Besides the entry 'Potential UF', 17 other entries of UF-associated imaging changes screened by the expert consultation were included, involving a total of 46 864 records (n=33 915), and crude prevalence=25.18%; crude incidence density/1000-woman-years=63.28. Incidence and prevalence increased with age during reproductive age (15-49 years) and decreased thereafter. The greatest burden was in women aged 40-54 years, the prevalence was 38.60%-45.38% and the incidence was 14.73%-17.96%. In the incident younger population (age ≤40 years), overweight (OR: 1.48, 95% CI 1.03 to 2.14) and HBP (OR: 2.16, 95% CI 1.10 to 4.24) were associated with a higher risk for UF-associated imaging changes; in the >40 years group, no association was observed.
UF incidence and prevalence in Asians were higher than previously reported, showed age-related increase in reproductive age, and UF incidence increased with overweight and HBP in ≤40-year-old participants. Variation in UF burden and factors with higher risk noted in different age ranges, and the correlations identified in younger women make it possible for early preventive measures for women with a higher risk of UF.
调查中国人群中子宫肌瘤(UF)相关的影像学变化及其患病率、发病率和潜在危险因素。
这是一项使用健康检查数据的回顾性观察研究。
2017年10月至2020年12月期间,中国南充的一家体检中心。
在研究期间,共有33915名15岁以上的中国女性接受了子宫成像检查。
本研究通过两轮专家咨询确定了UF相关影像学变化的条目,并计算了UF相关影像学变化的患病率和发病率。逻辑回归估计了体重指数、高血压(HBP)、血脂谱和空腹血糖水平与UF相关影像学变化的关联(OR,95%CI)。确定了年龄分层(≤40岁和>40岁)的风险。
除了“潜在UF”条目外,专家咨询筛选出的其他17条UF相关影像学变化条目被纳入,涉及总共46864条记录(n = 33915),粗患病率 = 25.18%;粗发病率密度/每1000妇女年 = 63.28。在生育年龄(15 - 49岁)期间,发病率和患病率随年龄增加,此后下降。最大负担出现在40 - 54岁的女性中,患病率为38.60% - 45.38%,发病率为14.73% - 17.96%。在年轻的发病群体(年龄≤40岁)中,超重(OR:1.48,95%CI 1.03至2.14)和HBP(OR:2.16,95%CI 1.10至4.24)与UF相关影像学变化的较高风险相关;在>40岁组中,未观察到关联。
亚洲人的UF发病率和患病率高于先前报道,在生育年龄呈现与年龄相关的增加,并且在≤40岁的参与者中,UF发病率随超重和HBP而增加。不同年龄范围的UF负担和较高风险因素存在差异,以及在年轻女性中确定的相关性使得对UF风险较高的女性采取早期预防措施成为可能。