子宫内膜癌与代谢综合征的关系

摘要

Objective To study the association between endometrioid uterine carcinomas and metabolic syndrome (MS). Methods A retrospective study was conducted on 123 patients who were admitted in Department of Gynecology Oncology, Zhejiang Cancer Hospital (study group) and 90 healthy women (control group) with matching age from Jan. 2005 to Mar. 2009. The general conditions[including age, whether menopausal, body mass index (BMI)];the risk factors for MS [including waist circumference,fasting plasma glucose, triglycerides(TG), high-density lipoprotein (HDL) and systolic and diastolic blood pressure]were analyzed. The clinical stage, histological type, and pathology differentiated degree of study group with or without MS were also analyzed by univariate analysis and Cox proportional hazards models.Results (1) The univariate survival analysis shown that there were no significant difference with age in two groups[(54.3±0.6) vs. (54.2±0.9) years;P>0.05], while the rate of menopausal, BMI(≥25 kg/m~2), the cases coupled with MS, the size of waist circumference (> 80 cm), the level of fasting plasma glucose (≥5.6 mmol/L),TG(> 1.7 mmol/L)and abnormal systolic and diastolic blood pressure in study group were higher than those in control group (67.5% vs. 48. 9%, 45.5% vs. 23.3%, 43.9% vs.18.9%, 50.4% vs. 27.8%, 53.7% vs. 21.1%, 40.7% vs. 21.1% and 40.7% vs. 25.6%,respectively, all P <0.05). The percentage of HDL(< 1.30 mmol/L) was higher in study group than that in control granp(63. 4% vs. 32. 2%, P <0.05). (2) There were not significant difference for the clinical stage, pathological type, grades between patients with or without MS in study group (P > 0.05). (3) The Logistic multivariate survival analysis shown that central obesity, higher TG, lower HDL and abnormal plasma glucose were independent risk factors for endometrioid uterine carcinomas coupled with MS (P< 0.05). Conclusion Metabolic syndrome is marginally associated with an increased risk of endometrioid uterine carcinomas, which may be the new point to screen, prevention and treatment endometrioid uterine carcinomas.%目的 探讨子宫内膜癌与代谢综合征的关系.方法 对浙江省肿瘤医院妇瘤科2005年1月-2009年3月收治的123例原发性子宫内膜癌患者(病例组)和同期90例健康体检妇女(对照组)的临床资料进行回顾性分析,临床资料包括一般情况[年龄、绝经与否、体质指数(BMI)]及代谢综合征相关指标[腰隔、甘油三酯(TG)、高密度脂蛋白(HDL)、血压及空腹血糖],分别采用t检验和χ~2检验及logistic回归模型进行单因素及多因素分析,并对病例组内合并代谢综合征患者的病理情况进行分析.结果 (1)单因素分析结果显示,病例组与对照组比较,年龄相似[分别为(54.3±0.6)和(54.2±0.9)岁,P>0.05];绝经比例(分别为67.5%、48.9%)、BMI过大(≥25 kg/m~2)比例(分别为45.5%、23.3%)均升高,分别比较,差异均有统计学意义(P<0.05,P<0.01).病例组与对照组比较,合并代谢综合征比例(分别为43.9%和18.9%)、腰围过大(>80 cm)比例(分别为50.4%、27.8%)、高TG(>1.7 mmol/L)比例(分别为40.7%、21.1%)、血压异常[≥130/85 mm Hg(1 mm Hg=0.133 kPa)]比例(分别为40.7%、25.6%)、血糖异常(空腹血糖≥5.6 mmol/L)比例(分别为53.7%、21.1%)及低HDL(<1.30 mmol/L)比例(分别为63.4%、32.2%)均升高,分别比较,差异均有统计学意义(P<0.05).(2)病例组内是否合并代谢综合征患者的病理类型、手术病理分期、病理分级比较,差异均无统计学意义(P>0.05).(3)logistic多因素分析提示,中心性肥胖、高TG、低HDL、空腹血糖异常是子宫内膜癌合并代谢综合征的独立危险因素(P<0.05).结论 子宫内膜癌与代谢综合征关系密切,代谢综合征可能成为筛查和防治子宫内膜癌的新视点.