Association Between Hepatic Steatosis Index and Endometrial Cancer Risk: A Cross-Sectional Study

Zheng L, Lei H, Tang X, Zheng Y, Wu Q, Chen P, Chen Y, Cai L
2025 · W7054753671
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This retrospective cross-sectional study compared hepatic steatosis index (HSI), along with related metabolic indicators, between 114 patients with pathologically diagnosed endometrial cancer and 175 patients with benign endometrial lesions (endometrial polyps and uterine submucosal fibroids) treated at a single hospital from 2016–2022. The authors used non-parametric tests, ROC curve analysis for cut-offs, and logistic regression to evaluate associations and diagnostic value. HSI was significantly higher in the endometrial cancer group, NAFLD was more prevalent in endometrial cancer patients (27.19% vs 12%), and multivariate regression identified CA125 elevation and HSI elevation as independent risk factors for endometrial cancer. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Lili Zheng,1,* Huifang Lei,1,* Xiaoyi Tang,2 Yuanyin Zheng,3 Qiuzhen Wu,3 Peixuan Chen,1 Yanhong Chen,1 Liangzhi Cai4,5 1Department of Gynecology, Mindong Hospital Affiliated to Fujian Medical University, Ningde, People’s Republic of China; 2Department of Laboratory, Mindong Hospital Affiliated to Fujian Medical University, Ningde, People’s Republic of China; 3Department of Pathology, Mindong Hospital Affiliated to Fujian Medical University, Ningde, People’s Republic of China; 4Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, People’s Republic of China; 5Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fuzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Liangzhi Cai, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Daoshan Road 18, Fuzhou, 350001, People’s Republic of China, Tel +86 1 348 910 2656, Fax +86 591 87551247, Email [email protected]: To investigate the relationship between hepatic steatosis index (HSI) and endometrial cancer (EC) and its diagnostic value for EC.Patients and Methods: A total of 114 patients with pathologically diagnosed EC in Mindong Hospital, Ningde City, Fujian Province from 2016 to 2022 were retrospectively included as the EC group. A total of 175 patients with pathologically confirmed benign endometrial lesions (endometrial polyps and uterine submucosal fibroids) in the same hospital during the same period were selected as the control group. Non-parametric test were used to compare the differences in HSI and non-alcoholic fatty liver disease (NAFLD) between the two groups, and the diagnostic value of HSI and NAFLD levels on EC was analysed. The cut-off point of continuous variables was determined by receiver operating characteristic (ROC) curve analysis. Logistic regression analysis was used to calculate odds ratios (ORs).Results: The results showed that compared with the control group, serum GGT, CA125, HDL-C and HSI were significantly increased in the EC group (P< 0.05). 27.19% of the EC patients (31/114) and 12% of the control group (21/175) had NAFLD, and the difference between the two groups was statistically significant (P< 0.05). The results of univariate logistic regression analysis showed that GGT, CA125, HDL-C, HSI and NAFLD were significantly correlated with the occurrence of EC (P< 0.05). Further multivariate logistic regression analysis showed that CA125 and HSI elevation were independent risk factors for EC (P< 0.05).Conclusion: NAFLD is closely associated with EC, and elevated HSI is an independent risk factor for EC.Keywords: nonalcoholic fatty liver disease, hepatic steatosis index, endometrial cancer
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International Journal of Women's Health (Mar 2025) Association Between Hepatic Steatosis Index and Endometrial Cancer Risk: A Cross-Sectional Study Abstract Lili Zheng,1,* Huifang Lei,1,* Xiaoyi Tang,2 Yuanyin Zheng,3 Qiuzhen Wu,3 Peixuan Chen,1 Yanhong Chen,1 Liangzhi Cai4,5 1Department of Gynecology, Mindong Hospital Affiliated to Fujian Medical University, Ningde, People’s Republic of China; 2Department of Laboratory, Mindong Hospital Affiliated to Fujian Medical University, Ningde, People’s Republic of China; 3Department of Pathology, Mindong Hospital Affiliated to Fujian Medical University, Ningde, People’s Republic of China; 4Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, People’s Republic of China; 5Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fuzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Liangzhi Cai, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Daoshan Road 18, Fuzhou, 350001, People’s Republic of China, Tel +86 1 348 910 2656, Fax +86 591 87551247, Email [email protected]: To investigate the relationship between hepatic steatosis index (HSI) and endometrial cancer (EC) and its diagnostic value for EC.Patients and Methods: A total of 114 patients with pathologically diagnosed EC in Mindong Hospital, Ningde City, Fujian Province from 2016 to 2022 were retrospectively included as the EC group. A total of 175 patients with pathologically confirmed benign endometrial lesions (endometrial polyps and uterine submucosal fibroids) in the same hospital during the same period were selected as the control group. Non-parametric test were used to compare the differences in HSI and non-alcoholic fatty liver disease (NAFLD) between the two groups, and the diagnostic value of HSI and NAFLD levels on EC was analysed. The cut-off point of continuous variables was determined by receiver operating characteristic (ROC) curve analysis. Logistic regression analysis was used to calculate odds ratios (ORs).Results: The results showed that compared with the control group, serum GGT, CA125, HDL-C and HSI were significantly increased in the EC group (P< 0.05). 27.19% of the EC patients (31/114) and 12% of the control group (21/175) had NAFLD, and the difference between the two groups was statistically significant (P< 0.05). The results of univariate logistic regression analysis showed that GGT, CA125, HDL-C, HSI and NAFLD were significantly correlated with the occurrence of EC (P< 0.05). Further multivariate logistic regression analysis showed that CA125 and HSI elevation were independent risk factors for EC (P< 0.05).Conclusion: NAFLD is closely associated with EC, and elevated HSI is an independent risk factor for EC.Keywords: nonalcoholic fatty liver disease, hepatic steatosis index, endometrial cancer

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