Association Between Endometriosis and Hypercholesterolemia or Hypertension.
Association Between Endometriosis and Hypercholesterolemia or Hypertension.
复制标题
子宫内膜异位和高胆固醇血症或高血压之间的关联。
DOI：
10.1161/hypertensionaha.117.09056
复制
发表时间：
2017-07
期刊：
影响因子：
--
通讯作者：
Missmer SA
中科院分区：
文献类型：
--
作者：
Mu F;Rich-Edwards J;Rimm EB;Spiegelman D;Forman JP;Missmer SA
子宫内膜异位症的特征性激素改变或慢性全身炎症环境可能导致高胆固醇血症和高血压的风险增加。相反，高胆固醇血症和高血压引起的慢性全身炎症中低密度脂蛋白升高可能增加子宫内膜异位症的风险。我们在一项大型前瞻性队列研究中评估了腹腔镜证实的子宫内膜异位症与高胆固醇血症和高血压的相关性。1989年，116，430名年龄在25-42岁之间的注册女护士完成了基线问卷，并被跟踪了20年。应用多变量考克斯比例风险模型。在1989年，有4，244名女性腹腔镜证实子宫内膜异位症，91，554名女性没有。在前瞻性调整人口统计学、人体测量学、家族史、生殖、饮食和生活方式风险因素后，比较腹腔镜证实的子宫内膜异位症妇女与无子宫内膜异位症妇女，发生高胆固醇血症的相对风险为1.25（95%置信区间=1.21-1.30），发生高血压的相对风险为1.14（1.09-1.18）。相反，腹腔镜检查证实的子宫内膜异位症的相对危险度为1.22（1.15-1.31），与无高胆固醇血症的女性相比，为1.29（1.18-1.41）。腹腔镜检查证实的子宫内膜异位症与高胆固醇血症或高血压的相关性在≤40岁的女性中最强，随着年龄的增加而减弱（相互作用的p值<0.001）。我们观察到，子宫内膜异位症与高胆固醇血症和高血压之间的相关性中，约45%可以由子宫内膜异位症诊断后的治疗因素解释，包括子宫切除术/卵巢切除术的频率更高和手术年龄更早。在这项大型队列研究中，腹腔镜证实的子宫内膜异位症与高胆固醇血症和高血压的风险增加前瞻性相关。相反，高胆固醇血症和高血压与腹腔镜证实的子宫内膜异位症的高风险相关。
An altered hormonal or chronic systemic inflammatory milieu characterizing endometriosis may result in a higher risk of hypercholesterolemia and hypertension. Conversely, elevated low-density lipoprotein in hypercholesterolemia and chronic systemic inflammation resulting from hypertension may increase the risk of endometriosis. We assessed the association of laparoscopically-confirmed endometriosis with hypercholesterolemia and hypertension in a large prospective cohort study. In 1989, 116,430 registered female nurses aged 25–42 completed the baseline questionnaire and were followed for 20 years. Multivariable Cox proportional hazards models were applied. In 1989, there were 4,244 women with laparoscopically-confirmed endometriosis and 91,554 women without. After adjusting for demographic, anthropometric, family history, reproductive, dietary, and lifestyle risk factors prospectively, comparing women with laparoscopically-confirmed endometriosis to women without, the relative risks were 1.25 (95% confidence interval=1.21–1.30) for development of hypercholesterolemia and 1.14 (1.09–1.18) for hypertension. Conversely, the relative risks of developing laparoscopically-confirmed endometriosis were 1.22 (1.15–1.31) comparing women with hypercholesterolemia to women without and 1.29 (1.18–1.41) comparing women with hypertension to women without. The strength of associations of laparoscopically-confirmed endometriosis with hypercholesterolemia or hypertension was strongest among women age ≤40 and weakened as age increased (p-values for interaction<0.001). We observed that ~45% of the associations between endometriosis and hypercholesterolemia and hypertension could be accounted for by treatment factors following endometriosis diagnosis, including greater frequency of hysterectomy/oophorectomy and earlier age for this surgery. In this large cohort study, laparoscopically-confirmed endometriosis was prospectively associated with increased risk of hypercholesterolemia and hypertension. Conversely, hypercholesterolemia and hypertension were prospectively associated with higher risk of laparoscopically-confirmed endometriosis.