Analysis of endometriosis associated risk factors in women with surgically diagnosed endometriosis

Endometriozes asociēto riska faktoru analīze sievietēm ar ķirurģiski diagnosticēto endometriozi Loading... Date Authors Advisor Journal Title Journal ISSN Volume Title Publisher Latvijas Universitāte Language lav Abstract Atslēgvārdi. Endometrioze, riska faktori, vecums, grūtniecību skaits, ķermeņa masas indekss Problēmas būtība. Endometrioze ir izplatīta ginekoloģiska slimība, tās prevalence globāli variē aptuveni no 2% līdz 10%, tomēr precīzi prevalences rādītāji nav zināmi. Slimības etioloģija ir sarežģīta un multifaktoriālā, pastāv vairākas endometriozes patoģenēzes teorijas. Tomēr nav unikālas teorijas, kas varētu izskaidrot visus slimības fenotipus, līdz ar to endometriozes riska faktori tiek plaši pētīti. Pētījuma mērķis. Izpētīt endometriozes asociētos riska faktorus un noskaidrot to saistību ar endometriozes attīstības risku. Pētījuma metodes. Tika veikts retrospektīvs, viena centra pētījums. Dati tika iegūti, analizējot pacienšu slimību vēstures. Pētījumam atlasītās pacientes tika sadalītas divās grupās. Pētāmo grupu veidoja pacientes, kurām ķirurģiskas procedūras veikšanas laikā tika apstiprināta endometriozes diagnoze. Kontroles grupu veidoja pacientes, kurām tika veikta ķirurģiska procedūra, sakarā ar dažādām mazā iegurņa slimībām un tās veikšanas laikā endometriozes perēkļi netika konstatēti. Datu analīze tika veikta izmantojot Pīrsona hī-kvadrāta testu un bināro loģistisko regresiju. Rezultāti. Pētījumā tika iekļautas 150 pacientes vecumā no 19 līdz 80 gadiem: 75 (50%) pacientes pētāmajā grupā un 75 (50%) pacientes kontroles grupā. Atšķirību analīzē starp grupām, statistiski nozīmīgs rezultāts tika iegūts vecuma grupu sadalījumā (x2=16,88, p=0,0003) un grūtniecību skaitā (x2=17,82, p=0,0001). ĶMI atšķirību analīzē tika noteikts būtiskuma līmenis, kas bija tuvu statistiski nozīmīgam (x2=6,55, p=0,088). Tāpēc, faktori – vecums, grūtniecību skaits un ĶMI tika iekļauti binārās loģistiskās regresijas modelī. Statistiski nozīmīga asociācija tika konstatēta vecuma grupā no 41 līdz 60 gadiem (OR 0,2; 95% TI: 0,094 – 0,462; p<0,001) un grūtniecību skaita grupās “1” (OR 3,4; 95% TI: 1,391 – 8,202; p=0,007) un “≥2” (OR 4,2; 95% TI: 1,868 – 9,629; p=0,001). Savukārt, ĶMI grupās “25,00-29,99 kg/m2” (OR 2,1; 95% TI: 0,877 – 5,047; p=0,096) un “>30,00 kg/m2” (OR 1,3; 95% TI: 0,430 – 3,724; p=0,669) netika konstatēta statistiski nozīmīga asociācija. Secinājumi. Pašreizējā pētījumā konstatēts, ka vecuma intervāls no 41 līdz 60 gadiem bija saistīts ar mazākām izredzēm slimības attīstībai. Viena un vairākas grūtniecības anamnēzē bija saistītas ar lielākam izredzēm slimības attīstībai. Lielāks ĶMI tika identificēts kā iespējamais endometriozes attīstību veicinošs faktors. Lai padziļināti izvērtēt endometriozes asociētos riska faktorus ir nepieciešami turpmāki pētījumi ar lielāku pacienšu skaitu. Keywords. Endometriosis, risk factors, age, number of pregnancies, body mass index Background. Endometriosis is a common gynaecological disease, with a global prevalence estimated to range from approximately 2% to 10%. However, the exact prevalence rates remain unknown. The etiology of the disease is complex and multifactorial, and several theories have been proposed to explain its pathogenesis. Nonetheless, no exclusive theory exists that can explain all its phenotypes. Therefore, the risk factors of endometriosis continue to be widely studied. Aim. To investigate endometriosis-associated risk factors in Latvia and to determine their relationship with the risk of developing endometriosis. Methods. A retrospective single-centre study was conducted. Data were obtained from patients’ medical records. The patients selected for the study were divided into two groups. The study group consisted of patients with surgically confirmed endometriosis. The control group included patients who underwent surgical procedures for various pelvic diseases, with no endometriotic lesions detected during surgery. Data analysis was performed using Pearson's chi-square test and binary logistic regression. Results. The study involved 150 patients aged 19 – 80 years: 75 (50%) patients in the study group and 75 (50%) patients in the control group. In the analysis of differences between groups, statistically significant results were found in age group distribution (x²=16,88, p=0,0003) and number of pregnancies (x²=17,82, p=0,0001). The analysis of differences in BMI showed a trend towards statistical significance (x²=6,55, p=0,088). Therefore, age, number of pregnancies, and BMI were included in the binary logistic regression model. A statistically significant association was found in the age group 41–60 years (OR 0,2; 95% CI: 0,094–0,462; p<0,001), as well as in the categories of number of pregnancies “1” (OR 3,4; 95% CI: 1,391–8,202, p=0,007) and “≥2” (OR 4,2; 95% CI: 1,868–9,629, p=0,001). In contrast, BMI categories “25,00–29,99 kg/m²” (OR 2,1; 95% CI: 0,877–5,047, p=0,096) and “>30,00 kg/m²” (OR 1,3; 95% CI: 0,430–3,724, p=0,669) did not show a statistically significant association. Conclusions. The results of the present study suggest that the age range of 41 to 60 years was associated with a lower risk of developing the disease. In contrast, having one or more pregnancies in anamnesis was associated with a higher risk of disease development. A higher BMI was identified as a potential risk factor promoting the development of endometriosis. Further studies with a larger sample size are needed for a deeper analysis of endometriosis associated risk factors. Keywords. Endometriosis, risk factors, age, number of pregnancies, body mass index Background. Endometriosis is a common gynaecological disease, with a global prevalence estimated to range from approximately 2% to 10%. However, the exact prevalence rates remain unknown. The etiology of the disease is complex and multifactorial, and several theories have been proposed to explain its pathogenesis. Nonetheless, no exclusive theory exists that can explain all its phenotypes. Therefore, the risk factors of endometriosis continue to be widely studied. Aim. To investigate endometriosis-associated risk factors in Latvia and to determine their relationship with the risk of developing endometriosis. Methods. A retrospective single-centre study was conducted. Data were obtained from patients’ medical records. The patients selected for the study were divided into two groups. The study group consisted of patients with surgically confirmed endometriosis. The control group included patients who underwent surgical procedures for various pelvic diseases, with no endometriotic lesions detected during surgery. Data analysis was performed using Pearson's chi-square test and binary logistic regression. Results. The study involved 150 patients aged 19 – 80 years: 75 (50%) patients in the study group and 75 (50%) patients in the control group. In the analysis of differences between groups, statistically significant results were found in age group distribution (x²=16,88, p=0,0003) and number of pregnancies (x²=17,82, p=0,0001). The analysis of differences in BMI showed a trend towards statistical significance (x²=6,55, p=0,088). Therefore, age, number of pregnancies, and BMI were included in the binary logistic regression model. A statistically significant association was found in the age group 41–60 years (OR 0,2; 95% CI: 0,094–0,462; p<0,001), as well as in the categories of number of pregnancies “1” (OR 3,4; 95% CI: 1,391–8,202, p=0,007) and “≥2” (OR 4,2; 95% CI: 1,868–9,629, p=0,001). In contrast, BMI categories “25,00–29,99 kg/m²” (OR 2,1; 95% CI: 0,877–5,047, p=0,096) and “>30,00 kg/m²” (OR 1,3; 95% CI: 0,430–3,724, p=0,669) did not show a statistically significant association. Conclusions. The results of the present study suggest that the age range of 41 to 60 years was associated with a lower risk of developing the disease. In contrast, having one or more pregnancies in anamnesis was associated with a higher risk of disease development. A higher BMI was identified as a potential risk factor promoting the development of endometriosis. Further studies with a larger sample size are needed for a deeper analysis of endometriosis associated risk factors.