Relationship between body mass index, endometrial thickness and histopathological diagnosis in women with post-menopausal bleeding
DOI:
https://doi.org/10.15218/zjms.2024.18Keywords:
BMI, Endometrial Thickness, PMB, TVSAbstract
Background and objective: Obesity is a worldwide epidemic and a public health concern. It is one of the most significant alterations occurring in the menopause. It is closely related to the development of endometrial bleeding, increase endometrial thickness and endometrial cancer. The main objectives of this study were to demonstrate the independent effects of obesity and its relationship with endometrial thickness and histopathological outcome in women experiencing vaginal bleeding after menopause.
Methods: The study included hundred women who were experiencing postmenopausal bleeding included in this study. Their obesity was calculated by BMI. Biopsy taken from them either through a Pipelle sampler as an outpatient, or hysteroscopy under general anesthesia, or with dilatation and curettage under general anesthesia for histopathology examination to decide endometrial thickness and related pathology.
Results: The mean age of the studied women was 57.2 ± 6.4 years, which ranged between48 – 83 years. The mean endometrial thickness (ET) of the whole sample was 10.64 mm. The highest was 13.36 mm among obese women with a BMI of ≥ 35 Kg/m2. There was a significant correlation between BMI and endometrial thickness. endometrial polyps were detected in 50% women who had normal weight. The highest mean of ET (13.95 mm) was detected among women with endometrial carcinoma. There was no any significant relationship between age of menopause with the histopathological diagnosis. The highest rate of endometrial carcinoma was detected among obese women of ≥ 35 Kg/m2.
Conclusion: According to the current study, obesity increases the risk of endometrial cancer and endometrial hyperplasia in postmenopausal women.
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References
Mendoza N, Sánchez-Borrego R, Cancelo MJ, Calvo A, Checa MA, Cortés J, et al. Position of the Spanish Menopause Society regarding the management of perimenopause. Maturitas 2013; 74(3):283–90. doi.org/10.1016/j.maturitas.2012.12.010
Campbell KE, Dennerstein L, Finch S, Szoeke CE. Impact of menopausal status on negative mood and depressive symptoms in a longitudinal sample spanning 20 years. Menopause 2017; 24(5):490–6. https://doi.org/10.1097/GME.0000000000000805
Kim MH, Jung-Choi K, Ko H, Song YM. Educational Inequality in Obesity-Related Mortality in Korea. Journal of Korean Medical Science 2017; 32(3):386–92. https://doi.org/10.3346/jkms.2017.32.3.386
Ko SH, Kim HS. Menopause-Associated Lipid Metabolic Disorders and Foods Beneficial for Postmenopausal Women. Nutrients 2020; 12(1):202. https://doi.org/10.3390/nu12010202
Otify M, Fuller J, Ross J, Shaikh H, Johns J. Endometrial pathology in the postmenopausal woman – an evidence-based approach to management. The Obstetrician & Gynaecologist 2015; 17(1):29–38. https://doi.org/10.1111/tog.12150
Schmandt RE, Iglesias DA, Co NN, Lu KH. Understanding obesity and endometrial cancer risk: opportunities for prevention. Am J Obstet Gynecol 2011; 205(6):518–25. https://doi.org/10.1016/j.ajog.2011.05.042
Junnare K, Desai G, Shekhawat G. Hysteroscopy: an effective tool in post-menopausal bleeding. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2018; 8:159. https://doi.org/10.18203/2320-1770.ijrcog20185415
Cho HJ, Lee ES, Lee JY, Hong SN, Ji YI, Kim HY, et al. Investigations for postmenopausal uterine bleeding: Special considerations for endometrial volume. Archives of Iranian Medicine 2013; 16(11):665–70. Scopus ID: 84887077733
Sedeq MG, Dawood SN, Farooq A, Alalaf SK. Can vaginal ultrasound replace diagnostic curettage in the detection of endometrial pathology in post-menopausal bleeding? Zanco J Med Sci 2019; 23(2):224–32. https://doi.org/10.15218/zjms.2019.029
Burbos N, Musonda P, Crocker SG, Morris EP, Nieto JJ, Duncan TJ. Management of postmenopausal women with vaginal bleeding when the endometrium can not be visualized. Acta Obstetricia et Gynecologica Scandinavica 2012; 91(6):686–91. https://doi.org/10.1111/j.1600-0412.2012.01407.x
Acmaz G, Aksoy H, Albayrak E, Baser M, Aksoy H, Aksoy Ü, et al. Evaluation of Endometrial Precancerous Lesions in Postmenopausal Obese Women - A High Risk Group? Asian Pacific journal of cancer prevention. APJCP 2014; 15:195–8. https://doi.org/10.7314/APJCP.2014.15.1.195
Bakour SH, Timmermans A, Mol BW, Khan KS. Management of women with postmenopausal bleeding: evidence-based review. The Obstetrician & Gynecologist 2012; 14(4):243–9. Doi:10.1111/j.1744-4667.2012.00129.x
Wong ASW, Lao TTH, Cheung CW, Yeung SW, Fan HL, Ng PS, et al. Reappraisal of endometrial thickness for the detection of endometrial cancer in postmenopausal bleeding: a retrospective cohort study. BJOG 2016; 123(3):439–46. https://doi.org/10.1111/1471-0528.13342
Behera B, Mohanty S, Patro M, Mishra D. Histopathological Evaluation of Endometrium in Cases of Abnormal Uterine Bleeding- An Institutional Experience in a Tertiary Care Center. Journal of Evidence Based Medicine and Healthcare 2020; 7:24–8. https://doi.org/10.18410/jebmh/2020/6
Zaki A, Gaber A, Ghanem E, Moemen M, Shehata G. Abdominal obesity and endometrial cancer in egyptian females with postmenopausal bleeding. Nutr Cancer 2011; 63(8):1272–8. doi.org/10.1080/01635581.2011.615973
Carugno J. Clinical management of vaginal bleeding in postmenopausal women. Climacteric 2020; 23(4):343–9. https://doi.org/10.1080/13697137.2020.1739642
Bhatta S, Sinha AK. Histopathological study of endometrium in abnormal uterine bleeding. Journal of Pathology of Nepal 2012; 2(4):297–300. https://doi.org/10.3126/jpn.v2i4.6882
Çetin B, Beyaz A, Türkgeldi L, Bahat P, köroğlu N. Diagnosis of endometrial pathologies: transvaginal sonography versus hysteroscopy. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2017; 6:544. https://dx.doi.org/10.18203/2320-1770.ijrcog20170378
Elgarhy I, Elboghdady A. Relationship Between Transvaginal Ultrasound Endometrial Thickness, Body Mass Index and Endometrial Pathology in Women with Post-Menopausal Bleeding. Al-Azhar International Medical Journal 2021; 2:33–40. https://doi.org/10.21608/aimj.2021.62095.1460
Van den Bosch T, Vandendael A, Van Schoubroeck D, Lombard CJ, Wranz PA. Age, weight, body mass index and endometrial thickness in post menopause. Acta Obstet Gynecol Scand 1996; 75(2):181–2. doi: 10.3109/00016349609033315.
Zhang Y, Liu H, Yang S, Zhang J, Qian L, Chen X. Overweight, obesity and endometrial cancer risk: results from a systematic review and meta-analysis. Int J Biol Markers 2014; 29(1): e21-9. https://doi.org/10.5301/JBM.5000047
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