Correlation Analysis Of Metabolic Syndrome Index And Endometrial Disease

ObjectivesRetrospectively analyzed the metabolic syndrome（MS）indexes（lipid,coagulation,etc.）of endometrioid adenocarcinoma（EC）,atypical hyperplasia（AH）,endometrial hyperplasia without atypia（EH）,and preliminarily studied the metabolism-related influencing factors of endometrial lesions.MethodsA total of 369 patients with endometrial lesions diagnosed by pathology after preoperative diagnostic curettage or total hysterectomy were selected from Fujian Provincial Hospital from January 2013 to December 2020,including 184 cases in EC group,32 cases in AH group,and 153 cases in EH group.The general clinical data of the patients were collected,including age,gestational order,birth order,past medical history,pathology,blood lipid,coagulation/fibrinolysis indexes.The independent sample t test was used to compare the data groups with normal distribution.Nonparametric Kruskal-Wallis test was used for comparison between non-normal data groups,and chi-square test was used for comparison between classification data groups.Spearman rank correlation was used to analyze the correlation between EC pathology and general clinical data and laboratory examination.The predictive factors of EC were analyzed by multivariate Logistic regression,and a regression equation model was established to predict EC.Receiver operating characteristic curve（ROC）was plotted according to the predictive probability,and the area under the curve（AUC）was calculated.Results1.In general,the age of EC group was significantly higher than that of AH and EH group,and the proportion of hypertension and diabetes combined with EC group was higher than that of AH and EH group（P<0.05）;The levels of triglycerides（TG）,total cholesterol（TC）,low density lipoprotein-cholesterol（LDL-C）and high density lipoprotein-cholesterol（HDL-C）in EC group were significantly higher than those in AH and EH groups（P<0.05）.The HDL-C of EC group was lower than that of EH group（P<0.05）.In terms of blood coagulation/fibrinolysis,fibrinogen（Fib）levels in EC group were significantly higher than those in AH and EH groups,but differences in D-dimer（D-D）and fibrinogen degradation products（FDP）were only found in EC and EH groups,and those in EC group were higher than those in EH group（P<0.05）.2.In correlation analysis,deep muscle infiltration of EC was positively correlated with age（r=0.352,P<0.001）,D-D（r=0.188,P=0.011）and Fib（r=0.233,P=0.001）.EC low differentiation with age（r=0.194,p=0.008）and antithrombinⅢ（antithrombinⅢ,atsⅢ）（r=0.155,P=0.035）were positively correlated.3.Multiple Logistic regression analysis showed that age,diabetes,LDL-C,Fib,TG/HDL-C were independent risk factors for EC,and a regression model was constructed to predict EC:P=e ^Z/（1+e ^Z）,Z=-9.144+0.113X₁+2.205X₂+1.355X₃+0.571X₄+1.233X₅,in which X₁represented age,X₂represented diabetes,X₃represented LDL-C,X₄represented Fib,X₅represented TG/HDL-C,and e was the natural logarithm.At this point,the area under the ROC curve AUC=0.840.When the Cutoff value is 0.434 and Youden index is 0.518,the sensitivity and specificity are the best,which are 79.9%and 71.9%,respectively.Conclusions1.Hyperlipidemia may increase the risk of EC in women.2.The indexes of coagulation/fibrinolysis are related to the depth of EC infiltration and the degree of differentiation.Patients with newly diagnosed endometrial lesions with abnormal coagulation/fibrinolysis may have poor pathological outcomes.3.Age,diabetes mellitus,and elevated LDL-C,Fib and TG/HDL-C indexes are high risk factors for developing EC.