Is adiposity across life associated with subsequent hysterectomy risk? Findings from the 1946 British birth cohort study
Is adiposity across life associated with subsequent hysterectomy risk? Findings from the 1946 British birth cohort study
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DOI：
10.1111/j.1471-0528.2007.01569.x
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发表时间：
2008-01-01
影响因子：
5.8
通讯作者：
Kuh, D.
中科院分区：
文献类型：
--
作者：
Cooper, R.;Hardy, R.;Kuh, D.
目的探讨早期肥胖与子宫切除风险之间的关系。设计前瞻性出生队列研究。设置英格兰、苏格兰和威尔士。来自医学研究理事会国家健康与发展调查的人口妇女，有关于子宫切除状况的完整数据(n=1790)。方法采用生存分析方法，检验生命中各时间点的体重指数与随后的子宫切除率之间的关系。主要结果衡量自我报告的子宫切除加或不加卵巢切除。结果从20年开始，那些被归类为体重不足的妇女的子宫切除率较低，从36年起，那些超重的女性比那些正常体重的女性有更高的子宫切除率。青春期和成年早期肥胖的女性的子宫切除率低于正常体重的女性，尽管在这个年龄段被归类为肥胖的人数很少。成年后期肥胖的女性随后进行子宫切除术的比率更高。年龄在36岁到53岁之间的体重增加较多与成年后子宫切除的比率较高有关。结论这些结果表明，子宫切除率的差异可能部分是由肥胖的差异来解释的，因此，随着最近人群超重和肥胖水平的变化，未来对妇科治疗的需求可能会增加。
Objective To examine the associations between adiposity at time points from early life onwards and subsequent hysterectomy risk.Design Prospective birth cohort study.Setting England, Scotland and Wales.Population Women from the Medical Research Council National Survey of Health and Development study, with complete data on hysterectomy status (n = 1790).Methods Survival analysis methods were used to examine the associations between body mass index at time points across life and subsequent hysterectomy rates.Main outcome measure Self-reported hysterectomy with or without oophorectomy.Results From 20 years onwards, those women who were classified as underweight had lower hysterectomy rates, and from 36 years onwards, those women who were overweight had higher hysterectomy rates than those who were normal weight. Women who were obese in adolescence and early adulthood had lower rates of hysterectomy than those who were normal weight, although numbers categorised as obese at these ages were small. Women who were obese in later adulthood had higher subsequent rates of hysterectomy. Greater increases in weight between ages 36 and 53 years were associated with higher rates of hysterectomy in later adulthood. These results were not explained by parity, age at menarche or socio-economic position.Conclusions These results suggest that variation in hysterectomy rates may be partially explained by variation in adiposity, and so with the recent changes in levels of overweight and obesity in populations, there may be increasing demand for gynaecological treatments in the future.