子宮内膜ポリープを合併した子宮内膜症患者における体組成の分析

Objective: To investigate the risk factors of endometrial polyps (EP) in patients with endometriosis (EM) and to analyze the predictive value of body composition measurement for EP. Methods: From January 1st, 2022 to June 30th, 2024, patients with EM who underwent hysteroscopy combined with laparoscopy in Chongqing Health Center for Women and Children due to "infertility" were enrolled. According to whether they had EP or not, they were divided into EP group and non-EP group. The general data and body composition (including skeletal muscle mass, body fat mass, body fat percentage and visceral fat level, waist-to-hip ratio, neck circumference, chest circumference, arm circumference, thigh circumference, etc.) of the two groups were compared. Univariate and multivariate logistic regression were used to analyze the high-risk factors of EP in infertile patients with EM. Body type was classified according to body fat percentage combined with lean body mass index. Body type classification and normal weight obesity rate were compared between the EP group and the non-EP group. Results: (1) A total of 180 patients with EM were enrolled, including 77 patients (42.8%, 77/180) in the EP group and 103 (57.2%, 103/180) patients in the non-EP group. There were no significant differences in body mass index (BMI), fasting blood glucose and blood lipid levels between the two groups (all P>0.05). The incidence of primary infertility, body fat mass, body fat percentage, visceral fat level, and thigh circumference in the EP group were higher than those in the non-EP group, and the differences were statistically significant (all P<0.05). (2) Multivariate logistic regression analysis showed that age≥30 years old (OR=3.079, 95%CI: 1.594-5.947), primary infertility (OR=2.914, 95%CI: 1.482-5.729), visceral fat level ≥10 grade (OR=2.838, 95%CI: 1.584-5.729) were the risk factors of EP in infertile patients with EM (all P<0.05). (3) In the EP group, there were no significant differences in BMI and body composition between single and multiple polyps, and between the largest polyp diameter <1 cm and ≥1 cm (all P>0.05). (4) The proportion of obese and puffy type in the EP group was higher than that in the non-EP group, and the difference in body type classification between the two groups was statistically significant (P=0.026). The proportion of patients with normal weight obesity in the EP group was significantly higher than that in the non-EP group [92.1% (35/38) vs 64.3% (36/56); χ²=9.480, P=0.002]. Conclusions: The occurrence of EP in infertile patients with EM is closely related to the increase of body fat mass, body fat percentage and visceral fat level, but not to BMI. The measurement of body composition is of great value for assessing the hidden obesity in infertile patients with EM.