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目的探讨代谢综合征(MS)对女性人群子宫内膜癌(EC)发病的影响。方法采用前瞻性队列研究方法,以参加2006年1月-2007年12月邯郸市285医院健康体检的女性(包括在职和离退休)作为研究对象,符合入选标准的19 941例组成观察队列。根据是否有MS,将观察对象分为MS组(5 862例)和非MS组(14 079例)。随访期间观察研究对象EC的发生情况,用多因素Cox比例风险回归模型分析影响EC发生的因素。结果 (1)MS组的绝经后女性、高体质指数(BMI)、高甘油三酯(TG)、低高密度蛋白胆固醇(HDL-C)、初中以下文化程度、吸烟者、高尿酸(UA)、高C反应蛋白(CRP)所占比例均高于非MS组,而高收缩压(SBP)、高舒张压(DBP)、高血糖、体育锻炼程度、饮酒者、结婚所占比例低于非MS组,差异有统计学意义(χ~2=1 624.90、1 760.33、3 904.55、936.72、439.85、45.57、434.88、719.24;3 957.30、2 268.89、2 608.89、163.99、97.42、215.85,P<0.001)。(2)随访时间为1~8(6.99±0.42)年,随访期内共发生EC 45例,MS组EC累积发病率(211/10万)高于非MS组(169/10万),差异有统计学意义(χ~2=5.42,均P<0.05)。校正其他危险因素后,多因素Cox比例风险回归模型分析显示MS组发生EC的风险是非MS组的2.36(95%CI:1.23~4.52)倍。结论 MS是女性人群发生EC的独立危险因素。
Objective To investigate the effect of metabolic syndrome (MS) on the incidence of endometrial cancer (EC) in female population. Methods A prospective cohort study was conducted to select 19 941 observational cohorts of women (including on-the-job and retired) who participated in the health examination of Handan 285 Hospital from January 2006 to December 2007. Subjects were divided into MS group (5 862 cases) and non-MS group (14 079 cases) according to the presence or absence of MS. The incidence of EC was observed during follow-up, and the factors influencing the occurrence of EC were analyzed by multivariate Cox proportional hazards regression model. Results The postmenopausal women with high body mass index (BMI), high triglyceride (TG), low HDL-C, junior high school education, smoker, high uric acid (UA) , High C-reactive protein (CRP) were higher than non-MS group, and high SBP, DBP, hyperglycemia, physical exercise, drinkers, the proportion of married less than non-MS MS group, the difference was statistically significant (χ ~ 2 = 1 624.90,1 760.33,3 904.55,936.72,439.85,45.57,434.88,719.24; 3 957.30,2 268.89,2 608.89,163.99,97.42,215.85, P <0.001 ). (2) The follow-up time ranged from 1 to 8 (6.99 ± 0.42) years. There were 45 EC cases during the follow-up period. The cumulative incidence of EC was higher in MS group (211/10) than in non-MS group (169/10) There was statistical significance (χ ~ 2 = 5.42, all P <0.05). After adjusting for other risk factors, multivariate Cox proportional hazards regression analysis showed that the risk of developing EC in MS group was 2.36 (95% CI: 1.23-4.52) times of that of non-MS group. Conclusion MS is an independent risk factor for EC in female population.