DOI: https://doi.org/10.18370/2309-4117.2018.42.28-33

Influence of obesity on the development of endometrial hyperplasia in women of all ages

О. О. Єфіменко, К. Д. Дейнюк

Abstract


Recent scientific studies show that fat tissue is not a passive metabolism depot, as previously thought, but manifests itself as an active endocrine organ. Pathological processes occurring in adipose tissue with its hypertrophy during weight gain are considered links in carcinogenesis in more than 20% of malignant tumors, including endometrial and breast cancer.

The aim of the research was to study the effect of excess weight (BMI >30) on the development of endometrial hyperplasia in women of reproductive age and in menopause.

The medical histories of 62 patients from 2016 to 2018 with diagnoses of endometrial hyperplasia without atypia and endometrial hyperplasia with atypia were reviewed in a retrospective study according to pathological histology after hysteroscopy. Depending on the reproductive status and body mass index, four groups of patients were formed.

Obtained data showed that in women with obesity, the percentage of atypical hyperplasia (65.9%) was significantly higher than in women with normal body weight (28.6%). In young women with overweight, the percentage of atypical hyperplasia was 57.9%, while for BMI <30 – 16.7%. In women of menopausal age with a BMI >30 percent of atypical hyperplasia, 68.2%, while with a BMI <30 – 33.3%. In women of menopausal age with a BMI >30 percent of atypical hyperplasia is 64.9%, while in young women with a BMI >30 – 48%.

The results of the study show that atypical hyperplasia of the endometrium is more often detected in the presence of excessive body weight, and the risk of its development among obese women of menopausal age is comparatively higher than in obese young women. Since the probability of progression of endometrial cancer is increased 45 times within 1 year if the diagnosis of endometrial hyperplasia is confirmed histologically, weight correction is a method of preventing the development of atypical changes in the endometrium at any age.


Keywords


endometrial hyperplasia; endometrial hyperplasia with atypia; obesity; adipocytokins; adiponectin; leptin

References


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Jayati Nath, Gagandeep Kaur. “A clinical study on post-hysterectomy sexual dysfunction.” International Journal of Scientific Research 7.2 (2018): 33–4.

Theunissen, M., et al. “Prevalence and predictors of depression and well-being after hysterectomy: An observational study.” European Journal of Obstetrics and Gynecology and Reproductive Biology 217 (2017): 94–100.

Kurman, R.J., Carcangiu, M.L., Herrington, C.S., Young, R.H. WHO Classification of Tumours of Female Reproductive Organs. Fourth Edition. IARC (2014): 307 p.

Lacey, J.V., Mutter, G.L., Nucci, M.R., et al.“Risk of subsequent endometrial carcinoma associated with endometrial intraepithelial neoplasia classification of endometrial biopsies.” Cancer 113 (2008b): 2073–81.

Sanderson, P.A., Hilary, O.D., Critchley, A., et al. “New concepts for an old problem: the diagnosis of endometrial hyperplasia.” Human Reproduction Update 23.2 (2017): 232–54.

Shang, C.-G., Liu, Z.-H., Wang, X.-H., et al. “Effect of High-fat Diet-induced Disorders on Rat with Endometrial Hyperplasia and Adiponectin System in Circulation and Uterus.” Chinese Medical Journal 130.15 (2017): 1831–7.

Merritt, M.A., Gunter, M.J. “Epidemiologic Evidence for the Obesity-Endometrial Cancer Relationship.” In: Focus on Gynecologic Malignancies. Berger, N., Klopp, A., Lu, K. (eds). Springer International Publishing (2018).

Divella, R., De Luca, R., Abbate, I., et al. “Obesity and cancer: the role of adipose tissue and adipo-cytokines-induced chronic inflammation.” J Cancer 7/15 (2016): 2346–59.

Linkov, F., et al. “Changes in inflammatory endometrial cancer risk biomarkers in individuals undergoing surgical weight loss.” Gynecologic Oncology 147.1 (2017): 133–8.


GOST Style Citations


1.       Бюлетень Національного канцер-реєстру України № 18. Київ, 2017.

2.       Jayati Nath, Gagandeep Kaur. “A clinical study on post-hysterectomy sexual dysfunction.” International Journal of Scientific Research 7.2 (2018): 33–4.

3.       Theunissen, M., et al. “Prevalence and predictors of depression and well-being after hysterectomy: An observational study.” European Journal of Obstetrics and Gynecology and Reproductive Biology 217 (2017): 94–100.

4.       Kurman, R.J., Carcangiu, M.L., Herrington, C.S., Young, R.H. WHO Classification of Tumours of Female Reproductive Organs. Fourth Edition. IARC (2014): 307 p.

5.       Lacey, J.V., Mutter, G.L., Nucci, M.R., et al.“Risk of subsequent endometrial carcinoma associated with endometrial intraepithelial neoplasia classification of endometrial biopsies.” Cancer 113 (2008b): 2073–81.

6.       Sanderson, P.A., Hilary, O.D., Critchley, A., et al. “New concepts for an old problem: the diagnosis of endometrial hyperplasia.” Human Reproduction Update 23.2 (2017): 232–54.

7.       Shang, C.-G., Liu, Z.-H., Wang, X.-H., et al. “Effect of High-fat Diet-induced Disorders on Rat with Endometrial Hyperplasia and Adiponectin System in Circulation and Uterus.” Chinese Medical Journal 130.15 (2017): 1831–7.

8.       Merritt, M.A., Gunter, M.J. “Epidemiologic Evidence for the Obesity-Endometrial Cancer Relationship.” In: Focus on Gynecologic Malignancies. Berger, N., Klopp, A., Lu, K. (eds).  Springer International Publishing (2018).

9.       Divella, R., De Luca, R., Abbate, I., et al. “Obesity and cancer: the role of adipose tissue and adipo-cytokines-induced chronic inflammation.” J Cancer 7/15 (2016): 2346–59.

10.     Linkov, F., et al. “Changes in inflammatory endometrial cancer risk biomarkers in individuals undergoing surgical weight loss.” Gynecologic Oncology 147.1 (2017): 133–8.





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ISSN 2411-1295 (Online), ISSN 2309-4117 (Print)