[Prevalence of endometrial injury in asymptomatic obese women]

Obesity represents the most important risk factor for endometrial pathology. This study aimed to evaluate the prevalence of endometrial injuries, such as polyps, hyperplasia and endometrial cancer in asymptomatic obese women, as well as to recognize the associated risk factors .

A cross-sectional study was conducted between December 2004 and February 2006. Ninety-four obese (body mass index > or = 30 kg/m2) women were evaluated, divided in two groups of 47 participants each: pre-menopausal and postmenopausal women. Clinical characteristics, physical exams (anthropometric and gynecological), blood count and endometrial assessment by vaginal ultrasonography, biopsy, and hysteroscopy (only for confirmed endometrial pathology), were the variables appraised.

In pre-menopausal women, 12.8% of cases had endometrial pathology statistically associated to age, hypertension, hypercholesterolemia and LDL-c increase. In the post-menopausal women, 40.4% of cases had a pathology identified as statistically associated with hypertension, LDL-c and estrone increase. Two cases of endometrial cancer were identified, one in each group.

The increased incidence of obesity over recent years has increased risk factors of endometrial cancer. In pre-menopausal women only a small number of cases with endometrial alterations was observed. Therefore, it is suggested that greater attention be given to those over 40 years of age, associated with hypertension and/or higher LDL-c . The menopausal status increases risk of endometrial injury, and when associated with hypertension, LDL-c and/or estrone increase, women become candidates to biopsy aiming for an early diagnosis of cancer, a decisive factor for a favorable prognosis.