Could body mass index be an indicator for endometrial biopsy in premenopausal women with heavy menstrual bleeding?

GÜRASLAN, Hakan; DOĞAN, Keziban; Kaya, Cihan; Senturk, Mehmet; Guraslan, Birgul; Helvacioglu, Caglar; Akbayir, Ozgur; YAŞAR, Levent

doi:10.1007/s00404-016-4043-8

Could body mass index be an indicator for endometrial biopsy in premenopausal women with heavy menstrual bleeding?

GÜRASLAN H., DOĞAN K., Kaya C., Senturk M. B., Guraslan B., Helvacioglu C., ...Daha Fazla

Archives of Gynecology and Obstetrics, cilt.294, sa.2, ss.395-402, 2016 (SCI-Expanded, Scopus)

Yayın Türü: Makale / Tam Makale
Cilt numarası: 294 Sayı: 2
Basım Tarihi: 2016
Doi Numarası: 10.1007/s00404-016-4043-8
Dergi Adı: Archives of Gynecology and Obstetrics
Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
Sayfa Sayıları: ss.395-402
Anahtar Kelimeler: Body mass index, Endometrial carcinoma, Endometrial hyperplasia, Endometrial sampling, Premenopausal bleeding
Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Purpose: To evaluate the role of body mass index (BMI) in women with premenopausal heavy menstrual bleeding (HMB) to identify patients who should undergo endometrial biopsy. Methods: This prospective cohort study included 1120 premenopausal women who presented to the Gynecology Clinic, Bakirkoy Dr. Sadi Konuk Training and Research Hospital in Istanbul, Turkey, due to HMB and who underwent endometrial sampling. The abnormal endometrial histopathological results were analyzed by separating patients into groups of all abnormal findings (hyperplasia without atypia + hyperplasia with atypia + carcinoma) and hyperplasia with atypia + carcinoma. Sensitivity and specificity of the abnormal histopathological results were calculated in both groups using BMI cut-off values as 25, 30 and 35 and age cut-offs as 40 and 45 years. Results: The rate of hyperplasia with atypia and carcinoma was sevenfold higher in women with a BMI ≥30 compared to those with a BMI ≤30 (95 % CI 2.4–17.9). In the analyses, BMI was a stronger risk factor in women younger than 45 years of age. The risk of endometrial carcinoma and atypical hyperplasia was twofold higher in patients older than 45 years when compared with patients younger than 45 years (95 % CI 1.1–5.1). Conclusions: All women with a BMI ≥30 and presenting premenopausal HMB should undergo endometrial biopsy regardless of age.