Evaluation of the Effect of Visceral / Truncal Fat Rate and Insulin Resistance on Myoma Uteri Formation Among Premenopausal Women
Abstract
Objectives: Within the scope of this study, we aimed to analyze the effect of visceral and truncal fat rate and insulin resistance on myoma uteri progression in premenopausal women.
Materials and Methods: 100 patients, who have been applied to the gynecology department with myoma diagnosis and 50 control patients who had no myomas and had similar properties with the patient group were included in the study. Anthropometric measures, pre-prandial serum glucose, HbA1c, insulin, LDL-cholesterol, triglyceride, HDL-cholesterol and total cholesterol levels were studied. All statistical analyses were performed with SPSS 16.0 statistical soft-ware and a level of p < 0.05 is accepted statistically significant.
Results: Truncal fat rate of the patient group is found higher than the control group (p=0.014). Mean HbA1c was higher and statistically significant (p< 0.001) in the patient group. Mean HDL-C was found significantly lower in the patient group (p= 0.001).
Conclusion: In our study, higher levels of truncal fat rate in the patient group can be inferred to the production of estrogen in truncal fat tissue due to increased aromatase activity and thus myoma frequency was increased. We have also determined in this study that higher HbA1c levels in patient group caused an increase in the risk of myoma up to 3.5 times. Normal values of HOMA-IR suggest that insulin resistance is not a risk factor for the development of myoma. It is believed that there is a negative correlation between hyperlipidemia and myoma.
References
- Sadlonova J, Kostal M, Smahelova A, Hendl J, Starkova J, Nachtigal P. Selected metabolic parameters and the risk for uterine fibroids. Int J Gynecol and Obstet 2008;102:50–4.
- Lepine LA, Hillis SD, Marchbanks PA, et al. Hysterectomy surveillance – United States, 1980–1993. MMWR CDC Surveill Summ 1997;46:1–15.
- Wilcox LS, Koonin LM, Pokras R, Strauss LT, Xia Z, Peterson HB. Hysterectomy in the United States, 1988–1990. Obstet Gynecol 1994;83:549–55.
- Marrshall LM, Spiegelman D, Manson JE, et al. Risk of uterine leiomyomata among premanopausal women in relation to body size and cigarette smoking. Epidemiology 1998;9:511-17.
- Chen W, Wang S, Tian T, et al. Phenotypes and genotypes of insulin-like growth factor 1, IGF- binding protein-3 and cancer risk: evidence from 96 studies. Eur J Hum Genet 2009;17(12):1668-75.
- Rinaldi S, Cleveland R, Norat T et al. Serum levels of IGF-I, IGFBP-3 and colorectal cancer risk: results from the EPIC cohort, plus a meta- analysis of prospective studies. Int J Cancer 2010;126 (7):1702-15.
- Hankinson SE, Willet WC, Manson JE, et al. Alcohol, height, and liposity in relation to estrogen and prolactin levels in postmenopausal women. J Natl Cancer Inst. 1995;87:1297-302.
- Terry KL, De vivo I, Hankinson SE, Spiegelman D, Wise LA, Missmer SA. Anthropometric characteristics and risk of uterine leiyomyoma. Epidemiology 2007;18:758-63.
- Sato F, Nishi M, Kudo R, Miyake H. Body Fat Distribution and Uterine Leiomyomas. J Epidemiol 1998;8:176-80.
- Coppini LZ, Waitzberg DL, Campos AC. Limitations and validation of bioelectrical impedance analysis in morbidly obese patients. Curr Opin Clin Nutr Metab Care 2005;8:329-32.
- Irigaray P, Newby JA, Lacomme S, Belpomme D. Overweight/Obesity And Cancer Genesis: More Than A Biological Link Biomed Pharmacother 2007;61:665-78.
- Dandolu V, Singh R, Lidicker J, Harmanli O. BMI and uterine size: is there any relationship? Int J Gynecol Pathol 2010;29:568–71.
- Faerstein E, Szklo M, Rosenshein N. Risk factors for uterine leiomyoma: a practice-based case-control study. I African-American heritage, reproductive history, body size, and smoking. Am J Epidemiol 2001; 153: 1–10.
- Parazzini F, Chiaffarino F, Polverino G, Chiantera V, Surace M, La Vecchia C. Uterine fibroids risk and history of selected medical conditions linked with female hormones. Eur J Epidemiol 2004;19:249–53.
- He Y, Zeng Q, Dong S, Qin L, Li G, Wang P. Associations between uterine fibroids and lifestyles including diet, physical activity and stress: a case-control study in China. Asia Pac J Clin Nutr 2013;22:109–17.
- Samadi AR, Lee NC, Flanders WD, Boring JR, Parris EB. Risk factors for self-reported uterine fibroids: a case-control study. Am J Public Health 1996;86:858–62.
- Sommer EM, Balkwill A, Reeves G, Green J, Beral DV, Coffey K. Effects of obesity and hormone therapy on surgically-confirmed fibroids in postmenopausal women. Eur J Epidemiol 2015;6:493-9.
- Seidell JC, Kahn HS, Williamson DF, Lissner L, Valdez R. Report from a Centers for Disease Control and Prevention Workshop on use of adult anthropometry for public health and primary health care. Am J Clin Nutr 2001;73:123-6.
- Takeda T, Sakata M, Isobe A, et al. Relationship between Metabolic Syndrome and Uterine Leiomyomas: A Case-Control Study. Gynecol Obstet Invest 2008;66:14–7.
- Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412- 9.
- Elliot TG, Viberti GC. Insulin Resistance and coronary Heart Disease. Bailliere’s clinical endocrinology and metabolism 1993;7:1079-103.
- Bosetti C, Tavani A, Negri E, Trichopoulos D, La Vecchia C. Reliability of data on medical conditions, menstrual and reproductive history provided by hospital controls. J Clin Epidemiol 2001;54:902–6.
- Brunero S, Lamont S, Fairbrother G. Prevalence and Predictors of Metabolic Syndrome Among Patients Attending an Outpatient Clozapin Clinic in Australia. Arch Psychiatr Nurs 2009;23:261-8.
- Lemieux I, Alme´ras N, Maurie`ge P, et al. Prevalence of “hypertriglyceridemic waist” in men who participated in the Quebec Health Survey: association with atherogenic and diabetogenic metabolic risk factors. Can J Cardiol 2002;18:725–32.
Premenapozal Kadınlarda Myoma Uteri Gelişimi Üzerine Visseral/Trunkal Yağ Oranının ve İnsülin Direncinin Etkisinin Değerlendirilmesi
Abstract
Amaç: Biz bu kesitsel çalışmada premenapozal kadınlarda myoma uteri gelişimi üzerinde visseral- trunkal yağ oranı ve insülin direncinin etkisini araştırmayı amaçladık.
Materyal ve Metot: Bu çalışmada, Ankara Atatürk Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Kliniği’ne Ocak-Mayıs 2012 tarihleri arasında başvuran, myoma uteri tanısı almış 100 hasta, kontrol grubu olarak hasta grubu ile benzer klinik özelliklere sahip myomu olmayan 50 kadın çalışmaya alındı. Hastaların antropometrik ölçümleri, açlık plazma glukozu, HbA1c, insulin, LDL-kolesterol, trigliserit, HDL-kolesterol ve total kolesterol seviyesi bakıldı. Tüm istatistiksel analizler için SPSS 16.0 programı kullanıldı ve anlamlılık düzeyi p < 0,05 olarak kabul edildi.
Bulgular: Hasta grubunun trunkal yağ oranı, kontrol grubundan istatistiksel olarak anlamlı derecede daha yüksek bulundu (p= 0,014). HbA1c ortalaması hasta grubunda istatistiksel olarak anlamlı derecede yüksek idi (p < 0,001). HDL-K ortalaması hasta grubunda istatistiksel olarak anlamlı düzeyde düşük bulundu (p= 0,001).
Sonuç: Çalışmamızda hasta grubunda trunkal yağ doku oranının yüksek bulunması trunkal yerleşimli yağ dokuda artmış aromataz aktivitesi nedeni ile östrojen üretiminin daha fazla olduğunu bu nedenle myoma sıklığının arttığını düşündürmüştür. Myoma uteri gelişimi üzerinde etkili metabolik parametrelerin değerlendirildiği ileri çalışmalara ihtiyaç vardır. Yine çalışmamızda hasta grubunda ki HbA1c yüksekliğinin myom olma olasılığını 3,5 kat arttırdığını tespit ettik. HOMA-IR değerinin normal saptanması üzerine insülin direncinin myom gelişimi için muhtemel bir risk faktörü olamayacağı sonucuna varılmıştır.
References
- Sadlonova J, Kostal M, Smahelova A, Hendl J, Starkova J, Nachtigal P. Selected metabolic parameters and the risk for uterine fibroids. Int J Gynecol and Obstet 2008;102:50–4.
- Lepine LA, Hillis SD, Marchbanks PA, et al. Hysterectomy surveillance – United States, 1980–1993. MMWR CDC Surveill Summ 1997;46:1–15.
- Wilcox LS, Koonin LM, Pokras R, Strauss LT, Xia Z, Peterson HB. Hysterectomy in the United States, 1988–1990. Obstet Gynecol 1994;83:549–55.
- Marrshall LM, Spiegelman D, Manson JE, et al. Risk of uterine leiomyomata among premanopausal women in relation to body size and cigarette smoking. Epidemiology 1998;9:511-17.
- Chen W, Wang S, Tian T, et al. Phenotypes and genotypes of insulin-like growth factor 1, IGF- binding protein-3 and cancer risk: evidence from 96 studies. Eur J Hum Genet 2009;17(12):1668-75.
- Rinaldi S, Cleveland R, Norat T et al. Serum levels of IGF-I, IGFBP-3 and colorectal cancer risk: results from the EPIC cohort, plus a meta- analysis of prospective studies. Int J Cancer 2010;126 (7):1702-15.
- Hankinson SE, Willet WC, Manson JE, et al. Alcohol, height, and liposity in relation to estrogen and prolactin levels in postmenopausal women. J Natl Cancer Inst. 1995;87:1297-302.
- Terry KL, De vivo I, Hankinson SE, Spiegelman D, Wise LA, Missmer SA. Anthropometric characteristics and risk of uterine leiyomyoma. Epidemiology 2007;18:758-63.
- Sato F, Nishi M, Kudo R, Miyake H. Body Fat Distribution and Uterine Leiomyomas. J Epidemiol 1998;8:176-80.
- Coppini LZ, Waitzberg DL, Campos AC. Limitations and validation of bioelectrical impedance analysis in morbidly obese patients. Curr Opin Clin Nutr Metab Care 2005;8:329-32.
- Irigaray P, Newby JA, Lacomme S, Belpomme D. Overweight/Obesity And Cancer Genesis: More Than A Biological Link Biomed Pharmacother 2007;61:665-78.
- Dandolu V, Singh R, Lidicker J, Harmanli O. BMI and uterine size: is there any relationship? Int J Gynecol Pathol 2010;29:568–71.
- Faerstein E, Szklo M, Rosenshein N. Risk factors for uterine leiomyoma: a practice-based case-control study. I African-American heritage, reproductive history, body size, and smoking. Am J Epidemiol 2001; 153: 1–10.
- Parazzini F, Chiaffarino F, Polverino G, Chiantera V, Surace M, La Vecchia C. Uterine fibroids risk and history of selected medical conditions linked with female hormones. Eur J Epidemiol 2004;19:249–53.
- He Y, Zeng Q, Dong S, Qin L, Li G, Wang P. Associations between uterine fibroids and lifestyles including diet, physical activity and stress: a case-control study in China. Asia Pac J Clin Nutr 2013;22:109–17.
- Samadi AR, Lee NC, Flanders WD, Boring JR, Parris EB. Risk factors for self-reported uterine fibroids: a case-control study. Am J Public Health 1996;86:858–62.
- Sommer EM, Balkwill A, Reeves G, Green J, Beral DV, Coffey K. Effects of obesity and hormone therapy on surgically-confirmed fibroids in postmenopausal women. Eur J Epidemiol 2015;6:493-9.
- Seidell JC, Kahn HS, Williamson DF, Lissner L, Valdez R. Report from a Centers for Disease Control and Prevention Workshop on use of adult anthropometry for public health and primary health care. Am J Clin Nutr 2001;73:123-6.
- Takeda T, Sakata M, Isobe A, et al. Relationship between Metabolic Syndrome and Uterine Leiomyomas: A Case-Control Study. Gynecol Obstet Invest 2008;66:14–7.
- Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412- 9.
- Elliot TG, Viberti GC. Insulin Resistance and coronary Heart Disease. Bailliere’s clinical endocrinology and metabolism 1993;7:1079-103.
- Bosetti C, Tavani A, Negri E, Trichopoulos D, La Vecchia C. Reliability of data on medical conditions, menstrual and reproductive history provided by hospital controls. J Clin Epidemiol 2001;54:902–6.
- Brunero S, Lamont S, Fairbrother G. Prevalence and Predictors of Metabolic Syndrome Among Patients Attending an Outpatient Clozapin Clinic in Australia. Arch Psychiatr Nurs 2009;23:261-8.
- Lemieux I, Alme´ras N, Maurie`ge P, et al. Prevalence of “hypertriglyceridemic waist” in men who participated in the Quebec Health Survey: association with atherogenic and diabetogenic metabolic risk factors. Can J Cardiol 2002;18:725–32.
Details
| Subjects | Health Care Administration |
|---|---|
| Journal Section | Research Articles |
| Authors | |
| Publication Date | March 30, 2017 |
| Published in Issue | Year 2017 Volume: 17 Issue: 1 |