Place of endocrine-metabolic disorders in the development of endometrium pathology in climacteric women
Keywords:hyperproliferative endometrial diseases, extragenital morbidity, postmenopause
The results of a large number of studies indicate that the incidence of malignant transformation of hyperplasia endometrium increases significantly with age. Important in predicting the likelihood of hyperproliferative endometrial disease in postmenopausal women is a clear understanding of the causative factors that lead to pathological endometrium proliferation in the period of physiological decline of hormonal activity.
Purpose of the study. To investigate the frequency and structure of somatic morbidity in women with hyperproliferative endometrial diseases in postmenopause and to determine the place of endocrine and metabolic disorders in the hyperproliferative pathology of endometrium development in this category of women.
Materials and methods. Frequency and structure of extragenital morbidity, state of carbohydrate metabolism, lipid metabolism, leptin, estrone, prolactin, sex steroid binding protein, thyroid stimulating hormone and thyroxine levels we analyzed in 98 postmenopausal patients with morphologically confirmed forms of hyperproliferative pathology of endometrium (83 patients with endometrial polyps, 8 women with endometrial hyperplasia without atypia, 7 women with endometrial hypertension with atypia), and in 30 postmenopausal women with no changes in endometrium.
Study results. Patients with hyperproliferative diseases had a higher incidence of dyslipidemia (64.28 vs. 20%), obesity (43.87 vs. 6.6%), arterial hypertension (40.81 vs. 26.6%), hypothyroidism (34.69 vs. 10%), and type 2 diabetes mellitus (18.36 vs. 3.3%) than in the control group (р <0,05). Average levels of estrone, leptin, HOMA index were also higher, and sex hormone binding globulin level was lower.
Conclusions. Postmenopausal women with hyperproliferative endometrial diseases are characterized by elevated levels of extragenital morbidity and metabolic disturbances that are more common in women with endometrial hyperplasia with/without endometrial atypia than in women with endometrial polyps. Therefore timely diagnosis and treatment of endocrine-metabolic disorders will help to reduce the hyperproliferative pathology of endometrium in postmenopausal women.
- Vovk, I.B., Gorban, N.E., Borysiuk, O.Y. “Endometrial hyperplasia (clinical lecture).” Woman's health 5 (2016):10–8.
- Voronenko, N.Y. “The effect of adipose tissue dysfunction on the development of endometrial hyperplastic processes.” Medicine today and tomorrow 1 (2013):140–53.
- Gorin, V.S., Portnova, A.V., Resnichenko, E.V., Kalugin, S.A. “Endometrial hyperplastic processes in women of reproductive age with thyroid pathology.” Siberian Medical Review 55.1 (2009).
- Grebennikova, E.C., Tskhai, V.B., Nikolaev, V.G. “The constitutional characteristic of women with hyperplastic diseases of the uterus during the perimenopause.” Medicine and education in Siberia 1 (2012): 1–8.
- Dubossarskaya, Z.M., Dubossarskaya, Y.A. “Metabolic syndrome and gynecological diseases.” Medical aspects of woman's health 29 (2010): 27–38.
- Evstratova, O.R., Kharitonova, A.S., Lushchik, M.V. “The role of free radical oxidation processes in the development of pathologies.” International Student Science Herald 4 (2016): 146–7.
- Zanko, O.V. “Diagnosis, treatment and prevention of endometrial hyperproliferative diseases in postmenopausal women.” Thesis abstract for PhD degree. Kyiv (2018). Available from: [http://ipag-kiev.org.ua/wp-content/uploads/2018/12/Disertatsiya-2.12.2018.pdf].
- Zaporozhan, V.M., Tatarchuk, T.F., Dubinina, V.G., Kosei, N.V. “Modern diagnostics and treatment of endometrial hyperplastic processes.” Reproductive endocrinology 1.3 (2012): 5–12.
- Chestnova, G.P., Kulushina, E.A., Abashin, V.G., Efimenko, N.A. “Features of diagnosis of hyperplastic processes in the endometrium in women in the period of prolonged postmenopause.” Clinical Medicine 91 (2013): 46–7.
- Romantsova, T.I., Ostrovskaya, E.V. “Metabolically healthy obesity: definitions, protective factors, clinical significance.” Almanac of Clinical Medicine 1 (2015): 75–86.
- Occupation, death, demonstration of oncological service. Bulletin of National Cancer Registry of Ukraine (2017).
- Antypkin, Y.G., Vdovychenko, Y.P., Graziottin, A., et al. “Uterine bleedings of woman’s and quality of woman's life. Resolution of advisory board.” Reproductive endocrinology 3.47 (2019): 8–12.
- Baker, W.D., Pierce, S.R., Mills, A.M., et al. “Nonoperative management of atypical endometrial hyperplasia and grade 1 endometrial cancer with the levonorgestrel intrauterine device in medically ill post-menopausal women.” Gynecol Oncol 146.1 (2017): 34–8.
- Braun, S., Bitton-Worms, K., LeRoith, D. “The link between the metabolic syndrome and cancer.” Int J Biol Sci 7.7
- Brinton, L.A., Sakoda, L.C., Frederiksen, K., et al. “Relationships of uterine and ovarian tumors to pre-existing chronic conditions.” Anal Quant Cytol Histol 33.2 (2011): 61–7.
- Bueloni-Dias, F.N., Spadoto-Dias, D., Delmanto, L.R., et al.
- Chandran, J.R. “Advances in diagnosis of endometrial hyperplasia.” The Journal Of Obstetrics And Gynecology Of India 9.58 (2018): 1–7. DOI: 10.1007/s13224-018-1111-y
- Creutzberg, C.L., Fleming, G.F. “Endometrial Cancer.” Clinical Radiation Oncology 7 (2016): 1203–29. DOI: 10.1016/b978-0-323-24098-7.00059-9
- Hüsing, A., Dossus, L., Ferrari, P., et al. “An epidemiological model for prediction of endometrial cancer risk in Europe.” Eur J Epidemiol 31.1 (2016): 51–60.
- Jayanthi, R., Srinivasan, A.R., Hanifah, M., Maran, A.L. “Associations among Insulin resistance, triacylglycerol/high density lipoprotein (TAG/HDL ratio) and thyroid hormone levels – a study on type 2 diabetes mellitus in obese and overweight subjects.” Diabetes Metab Syndr 11.1 (2017): 121–6.
- Karmiris, K., Koutroubakis, I.E., Xidakis, C., et al. “Circulating levels of leptin, adiponectin, resistin, and ghrelin in inflammatory bowel disease.” Inflamm Bowel Dis 12.2 (2006): 100–5.
- Lai, Y., Sun, C. “Association of abnormal glucose metabolism and insulin resistance in patients with atypical and typical endometrial cancer.” Oncol Lett 15.2 (2018): 2173–8.
- Montgomery, B.E., Daum, G.S., Dunton, C.J. “Endometrial hyperplasia: a review.” Obstet Gynecol Surv 59.5 (2004): 368–78.
- Vicennati, V., Garelli, S., Rinaldi, E., Rosetti, S. “Obesity-related proliferative diseases: the interaction between adipose tissue and estrogens in post-menopausal women.” Horm Mol Biol Clin Invest 21.1 (2015): 75–87.
- Podzolkova, N., Tatarchuk, T., Doshchanova, A., et al. “Dydrogesterone treatment for menstrual-cycle regularization in routine clinical practice: a multicenter observational study.” Gynecological Endocrinology 32.3 (2016): 0246–9.
- Topcu, H.O., Erkaya, S., Guzel, A.I., et al. “Risk Factors For Endometrial Hyperplasia Concomitant Endometrial Polyps In Pre- And Post-Menopausal Women.” Asian Pac J Cancer Prev 15.13 (2014): 5423–5.
- Sanni, O.B., Kunzmann, A.T., Murray, L.J., et al. “Risk factors (excluding hormone replacement therapy) for endometrial hyperplasia: a systematic review.” Epidemiology 6.2 (2016): 229.
- Selva, D.M., Hammond, G.L. “Thyroid hormones act indirectly to increase sex hormone-binding globulin production by liver via hepatocyte nuclear factor-4a.” Journal of Molecular Endocrinology 43.1 (2009): 19–26.
- Shivappa, N., Hébert, J.R., Zucchetto, A., et al. “Dietary inflammatory index and endometrial cancer risk in an italian case-control study.” British Journal Of Nutrition 115.1 (2016): 138–46.
How to Cite
Copyright (c) 2019 Н. В. Косей, О. В. Занько, С. І. Регеда, О. О. Єфіменко
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.