代谢综合征与子宫内膜病变的相关性研究

Association between metabolic syndrome and endometrial disorders

目的探讨代谢综合征与子宫内膜病变的相关性。方法采用回顾性对照研究,将125例因异常子宫出血行诊断性刮宫的患者,按是否存在代谢综合症分为代谢综合征组(A组,60例)及非代谢综合征组(B组,65例),对比分析两组子宫内膜病理检查的结果及体重指数、腰围、高血压、性激素(FSH、LH、E_2、T)、空腹血糖、甘油三脂(TG)、高密度脂蛋白(HDL)、空腹胰岛素、胰岛素抵抗指数(HOMA-IR)与子宫内膜病变的相关性。结果 A组的异常子宫内膜(子宫内膜息肉,子宫内膜增生及癌变)明显高于B组,差异有统计学意义(P<0.05),A组的体重指数、腰同、T、空腹血糖、TG、空腹胰岛素的水平,HOMA-IR程度及高血压的发生率均高于B组,差异有统计学意义(P<0.05);A组的HDL水平低于B组,差异有统计学意义(P<0.05);A组的性激素(FSH、LH、E_2)水平稍高于B组,但差异无统计学意义(P>0.05)。结论代谢综合征与子宫内膜息肉、子宫内膜增生及癌变有明显的相关性,其长期持续的单一雌激素刺激、高雄激素血症、胰岛素抵抗-高胰岛素血症是子宫内膜息肉、子宫内膜增生及癌变的重要因素。临床上对代谢综合征患者应进行早期的干预,从而降低子宫内膜病变的发生率。

Objective. To study the association between metabolic syndrome（MS）and endometrial disorders. Methods： A total of 125 patients with abnormal uterine bleeding were divided into two groups after diagnostic curettage ： metabolic syndrome group （group A, n = 60） and non metabolic syndrome group （group B, n= 65）. The risk factors were retrospectively analyzed according to the results of endometrial pathology, which included body mass index（BMI）, waist circumference（WC）, hypertension,levels of sexual hormones （FSH, LH, E2. T）, triglycerides （TG）, high-density lipoprotein （HDL）, fasting plasma glucose, fasting insulin and homeostasis model assessment of insulin resistance（ HOMA-IR） between the two groups. Results. The abnormal endometrium rate including endometrial polyps, hyperplasia and carcinoma in group A was significantly higher than that in group B（P〈0.05）. The BMI,WC,levels of T,fasting plasma glucose, fasting insulin,TG,and HOMA-IR and the hypertension rate in group A were significantly higher than those in group B（P〈0.05）,while the HDL level in A group was significantly lower than that in group B（P〈0. 05）. The levels of FSH,LH and E2in but there were no significant changes（P〈0.05）. group A were slightly higher than those in group B, Conclusions： Metabolic syndrome is significantly associated with endometrial polyps, hyperplasia and carcinoma. The persistent and long-term estrogen stimulation, hyperandrogenism, insulin resistance and hyperinsulinism are the important factors for the endometrial pathological changes. Therefore,early clinicalintervention should be performed in the patients with metabolic syndrom, so that the incidence of endometrial disorders can be decreased.