Associations of Endometriosis and Hormone Therapy With Risk of Hyperlipidemia

Cherry Yin-Yi Chang, Cherry Yin‐Yi Chang, Chang CY, Muo CH, Chih-Hsin Muo, Chih‐Hsin Muo, Yi‐Chun Yeh, Yeh YC, Yi-Chun Yeh, Chung‐Yen Lu, Chung-Yen Lu, Lu CY, William W. Lin, William Wu-Chou Lin, Lin WW, Pei-Chun Chen, Pei‐Chun Chen
American Journal of Epidemiology · 2020 · vol. 190(2) , pp. 277–287 · doi:10.1093/aje/kwaa173 · PMID:32803257 · W3056649988
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Women with endometriosis have an increased risk of hyperlipidemia, particularly those over 35, with hysterectomy/oophorectomy accounting for much of this association, and hormone therapy use showing no independent link to hyperlipidemia risk.

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Abstract

Using claims data from the universal health insurance program of Taiwan, we conducted a retrospective cohort study to investigate whether endometriosis and hormone therapy are associated with the risk of developing hyperlipidemia. We selected 9,155 women aged 20-55 years with endometriosis diagnosed during the period 2000-2013 and 212,641 women without endometriosis with a median follow-up time of 7 years. Among patients with endometriosis, 86% of cases were identified on the basis of diagnosis codes with an ultrasound claim, and 14% were defined by diagnostic laparoscopy or surgical treatments. In a Cox proportional hazards model, the adjusted hazard ratio was 1.30 (95% confidence interval (CI): 1.19, 1.41) for all women, 1.04 (95% CI: 0.81, 1.32) for women under 35 years of age, 1.17 (95% CI: 1.03, 1.32) for women aged 35-44 years, and 1.34 (95% CI: 1.18, 1.52) for women aged 45-54 years. Hysterectomy and/or bilateral oophorectomy accounted for 46.9% of the association between endometriosis and hyperlipidemia, and hormone therapy accounted for 21.6%. Among women with endometriosis, the marginal structural model approach adjusting for time-varying hysterectomy/bilateral oophorectomy showed no association between use of hormone medications and risk of hyperlipidemia. We concluded that women with endometriosis are at increased risk of hyperlipidemia; use of hormone therapy by these women was not independently associated with the development of hyperlipidemia.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Estrogen Replacement Therapy Hyperlipidemias Adult Age Factors Endometriosis Endometriosis Estrogen Replacement Therapy Female Humans Hyperlipidemias Hysterectomy Hysterectomy Middle Aged Ovariectomy Ovariectomy Proportional Hazards Models Retrospective Studies Taiwan

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