The evaluation of association between body mass index and clinical parameters in women underwent myomectomy

Abstract

ABSTRACT

Aim: To evaluate the association between body mass ındex and clinical parameters in women underwent abdominal myomectomy by using correlation analysis.

 

Material and Method: In this retrospective study a total of 273 women underwent abdominal myomectomy during the study period.  The patients were classified into two groups according to BMI (≤30 kg/m² and > 30 kg/m²). Risk factors recorded involved were; age, body mass index (BMI), gravidity, parity, diameter of the fibroid (DOF), preoperative and postoperative hemoglobin (hb) levels, white blood cell and trombocyte count, neutrophil-lymphocyte ratio (NLR), Ca125, Ca15-3, Ca19-9, CEA, AFP levels, duration of postoperative hospital stay and postoperative complications.  Pearson correlation analysis was used to evaluate the association between body mass index and clinical parameters.

 

Results: The obese group consisted of 64 patients and the nonobese group consisted of 209 patients. In obese group, DOF was larger postoperative hb was lower, length of hospital stay was longer, level of AFP and the presence of complications was higher than in nonobese group. According to the correlation analysis, there were positive correlation between BMI and DOF  and AFP levels, while there were negative correlation between BMI and postoperative hb level and length of hospital stay.

Conclusion: We think that obesity adversely affects the clinical outcomes of patients underwent abdominal myomectomy.

Keywords

• Fibroid,abdominal myomectomy,obesity,correlation analysis

Myomektomi uygulanan kadınlarda vücut kitle indeksi ile klinik parametreler arasındaki ilişkinin değerlendirilmesi

Abstract

ÖZ

Amaç: Abdominal myomektomi uygulanan kadınlarda vücut kitle indeksi ile klinik parametreler arasındaki ilişkiyi korelasyon analizi kullanarak değerlendirmek.

 

Gereç ve Yöntem: Çalışmamıza abdominal myomektomi yapılan toplam 273 kadın dahil edildi. Hastalar vücut kitle indeksi (VKİ) ‘ne göre (≤30 kg / m² ve > 30 kg / m²) iki gruba ayrıldı. Yaş, VKİ, gravida, parite, myom çapı, preoperatif ve postoperatif hemoglobin (hb) düzeyleri, beyaz kan hücresi ve trombosit sayısı, nötrofil-lenfosit oranı (NLR), Ca125, Ca15-3 , Ca19-9, CEA, AFP düzeyleri, postoperatif hastanede kalış süresi ve postoperatif komplikasyonlar gibi değişkenler retrospektif olarak incelendi. Vücut kitle indeksi ve klinik parametreler arasındaki ilişkiyi değerlendirmek için Pearson korelasyon analizi kullanıldı.

 

Bulgular: Obez grup 64, obez olmayan grup 209 hastadan oluştu. Obez grupta myom boyutu, ameliyat sonrası hb daha düşük, hastanede yatış süresi daha uzun, AFP düzeyi ve komplikasyon varlığı obez olmayan gruba göre daha yüksekti. Korelasyon analizine göre, VKİ ile myom boyutu ve AFP düzeyleri arasında pozitif korelasyon varken; VKİ ile postoperatif hb düzeyi ve hastanede kalış süresi arasında negatif korelasyon vardı.

Sonuç: Obezitenin, abdominal myomektomi uygulanan hastaların klinik sonuçlarını olumsuz etkilediğini düşünüyoruz.

Keywords

• Myom,abdominal myomektomi,obezite,korelasyon analizi

References

1. Hong YH, Han SJ, Lee D, Kim SK, Jee BC. Adverse symptoms during short‐term use of ulipristal acetate in women with uterine myomas and/or adenomyosis. Journal of Obstetrics and Gynaecology Research. 2019;45:865-70.
2. Pokras R. Hysterectomy: past present and future. Statistical Bulletin of Metropolitan Life Insurance Company. October–December 1989:12.
3. Schorge J, Schaffer J, Halvorson L, Hoffman B, Bradshaw K, and Cunningham FG. Williams gynecology. New York: McGraw-Hill, 2008.
4. Christman GM, Marsh CA, Campbell EJ. Counseling the Patient with Uterine Fibroids. James H Segars, MD. 2013:134.
5. LaMote AI, Lalwani S, Diamond MP. Morbidity associated with abdominal myomectomy. Obstet Gynecol 1993;82:897–900.
6. Mukhopadhaya N, De Silva C, Manyonda IT. Conventional myomectomy. Best Pract Res Clin Obstet Gynaecol 2008;22:677–705.
7. Gavai M, Berkes E, Lazar L, Fekete T, Takacs ZF, Urbancsek J, Papp Z. Factors affecting reproductive outcome following abdominal myomectomy. J Assist Reprod Genet. 2007; 24:525-31.
8. Behera MA, Likes CE 3rd, Judd JP, Barnett JC, Havrilesky LJ, Wu JM. Cost analysis of abdominal, laparoscopic, and robotic-assisted myomectomies. J Minim Invasive Gynecol. 2012; 19:52-7.

9. Okolo S. Incidence, aetiology and epidemiology of uterine fibroids. Best Pract Res Clin Obstet Gynaecol. 2008 Aug;22:571-88.
10. Wise LA, Palmer JR, Spiegelman D, Harlow BL, Stewart EA, Adams-Campbell LL, Rosenberg L. Influence of body size and body fat distribution on risk of uterine leiomyomata in U.S. black women. Epidemiology. 2005 May;16:346-54.
11. Flegal KM, Carroll MD, Ogden CL, et al. Prevalence and trends in obesity among US adults, 1999– 2000. JAMA 2002:288.
12. Flake GP, Andersen J, Dixon D. Etiology and pathogenesis of uterine leiomyomas: a review. Environ Health Perspect. 2003;111:1037–54.
13. Rein MS. Advances in uterine leiomyoma research:the progesterone hypothesis. Environ Health Perspect 2000; 108(suppl 5):791–3.
14. Terry KL, De Vivo I, Hankinson SE, Spiegelman D, Wise LA, Missmer SA. Anthropometric characteristics and risk of uterine leiomyoma. Epidemiology. 2007 Nov;18:758-63.
15. Samadi AR, Lee NC, Flanders WD, et al. Risk factors for self-reported uterine fibroids: a case-control study. Am J Public Health. 1996;86:858–62.
16. Lumbiganon P, Rugpao S, Phandhu-fung S, et al. Protective effect of depot-medroxyprogesterone acetate on surgically treated uterine leiomyomas: a multicentre case-control study. Br J Obstet Gynaecol. 1996;103:909 –14.
17. Parazzini F, Negri E, La Vecchia C, et al. Reproductive factors and risk of uterine fibroids. Epidemiology. 1996;7:440–2.
18. Wise LA, Palmer JR, Spiegelman D, et al. Influence of body size and body fat distribution on risk of uterine leiomyomata in U.S. black women. Epidemiology. 2005;16:346 –54.
19. Wang D, DuBois RN. Pro-inflammatory prostaglandins and progression of colorectal cancer. Cancer Lett. 2008;267:197-203.
20. Willett, WC. Anthropometric measures and body composition. In: Willett, WC., editor. Nutritional Epidemiology. 2. New York: Oxford University Press; 1998. p. 244-72.
21. Schwartz SM, Marshall LM, Baird DD. Epidemiologic contributions to understanding the etiology of uterine leiomyomata. Environ Health Perspect 2000;108:821–7.
22. Dorgan JF, Reichman ME, Judd JT, et al. The relation of body size to plasma levels of estrogens and androgens in premenopausal women (Maryland, United States). Cancer Causes Control 1995;6:3–8.
23. Verkasalo PK, Thomas HV, Appleby PN, et al. Circulating levels of sex hormones and their relation to risk factors for breast cancer: a cross-sectional study in 1092 pre- and postmenopausal women (United Kingdom). Cancer Causes Control 2001;12:47–59.
24. Harmanli O, Esin S, Knee A, Jones K, Ayaz R, Tunitsky E. Effect of obesity on perioperative outcomes of laparoscopic hysterectomy. J Reprod Med. 2013;58:497-503.
25. Duchesne JC, Schmieg RE Jr, Simmons JD, Islam T, McGinness CL, McSwain NE Jr. Impact of obesity in damage control laparotomy patients. J Trauma. 2009;67:108-12.
26. Osler M, Daugbjerg S, Frederiksen BL, Ottesen B. Body mass and risk of complications after hysterectomy on benign indications. Hum Reprod. 2011;26:1512-8.
27. Mousa N, Gad Y, Abdel-Aziz A, Abd-Elaal I. Increased α-Fetoprotein Predicts Steatosis among Patients with Chronic Hepatitis C Genotype 4. Int J Hepatol. 2012;2012:636392.
28. Alkhouri N, Gornicka A, Berk MP, Thapaliya S, Dixon LJ, Kashyap S, et al. Adipocyte apoptosis, a link between obesity, insulin resistance, and hepatic steatosis.J Biol Chem. 2010;285:3428-38.