非绝经期女性子宫肌瘤检出率及其与代谢性指标的相关性研究-现代医学

非绝经期女性子宫肌瘤检出率及其与代谢性指标的相关性研究

单位：1. 西安交通大学第二附属医院健康管理部, 陕西西安 710016;
2. 西安红会医院消化科, 陕西西安 710054

分类号：R711

出版年·卷·期（页码）：2026·54·第七期（1064-1070）

摘要：

目的：探讨非绝经期女性子宫肌瘤检出率及其与代谢性指标的相关性，为该疾病的早期风险识别与干预提供临床依据。方法：本研究采用横断面研究设计，选取2025年1月至8月于西安交通大学第二附属医院健康管理部接受妇科超声检查的8 893名20~50岁非绝经期女性作为研究对象。根据妇科超声检查结果将研究对象分为子宫肌瘤组(n=1 278)与非子宫肌瘤组(n=7 615)；同时按年龄分为青年组(≤44岁，n=7 381)和中年组(45~50岁, n=1 512)。收集所有研究对象的一般资料及代谢相关指标，采用单因素分析比较组间代谢指标差异，Logistic回归模型分析代谢指标与子宫肌瘤的相关性。结果：子宫肌瘤总体检出率为14.4%，青年组检出率为11.4%，中年组检出率为29.0%。与非子宫肌瘤组相比，子宫肌瘤组的年龄、体质量指数、腰围、收缩压、舒张压、空腹血糖、总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平、高血压、高血糖及血脂异常的发生率均显著升高，差异均有统计学意义(均P＜0.05)。多因素Logistic回归分析显示，在青年组中，高血压(OR=3.807，95%CI:2.774~5.224)、高血糖(OR=2.284，95%CI:1.531~3.408)和血脂异常(OR=1.645，95%CI:1.337~2.022)均为子宫肌瘤的独立危险因素(均P＜0.001)；而在中年组中，仅高血压(OR=1.539，95%CI:1.078~2.198)和高血糖(OR=2.026，95%CI:1.406~2.919)为独立危险因素(均P＜0.05)。嵌套Logistic回归进一步表明，代谢综合征整体与子宫肌瘤无独立关联(P＞0.05)，其表观效应主要来源于各代谢组分的独立作用。结论：非绝经期女性子宫肌瘤检出率存在显著年龄差异，且危险因素亦随年龄不同而有所区别。青年女性应重视自身血压、血糖、血脂水平的监测与防控，而中年女性则优先注重血压、血糖的管理，这对子宫肌瘤的早期风险识别及干预具有重要意义。

Objective: To investigate the detection rate of uterine fibroids in non-menopausal women and its association with metabolic parameters, providing clinical evidence for early risk identification and intervention for this disease. Methods: This cross-sectional study included 8 893 non-menopausal women aged 20-50 years who underwent gynecological ultrasound examinations at the Department of Health Management, the Second Affiliated Hospital of Xi'an Jiaotong University, between January 2025 and August 2025. Based on ultrasound findings, participants were divided into the uterine fibroid group(n=1 278) and the non-uterine fibroid group(n=7 615). Additionally, participants were stratified by age into a young group(≤44 years, n=7 381) and a middle-aged group(45-50 years, n=1 512). General characteristics and metabolic parameters were collected for all participants. Univariate analysis was used to compare differences in metabolic indicators between groups, and Logistic regression models were applied to assess the association between metabolic parameters and uterine fibroids. Results: The overall detection rate of uterine fibroids was 14.4%, with rates of 11.4% in the young group and 29.0% in the middle-aged group. Compared with the non-uterine fibroid group, the uterine fibroid group had significantly higher levels of age, body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, triglycerides, and low-density lipoprotein cholesterol, as well as higher prevalence rates of hypertension, hyperglycemia, and dyslipidemia(all P<0.05). Multivariate Logistic regression analysis showed that in the young group, hypertension(OR=3.807,95%CI:2.774-5.224), hyperglycemia(OR=2.284,95%CI:1.531-3.408), and dyslipidemia(OR=1.645，95%CI:1.337-2.022) were independent risk factors for uterine fibroids(all P<0.001). In the middle-aged group, only hypertension(OR=1.539,95%CI:1.078-2.198) and hyperglycemia(OR=2.026，95%CI:1.406-2.919) were independent risk factors(both P<0.05). Nested Logistic regression further indicated that metabolic syndrome as a whole was not independently associated with uterine fibroids(P>0.05), and its apparent effect was primarily attributable to the independent contributions of individual metabolic components. Conclusion: The detection rate of uterine fibroids in non-menopausal women exhibits significant age-related differences, and the risk factors vary by age group. Young women should prioritize the monitoring and management of blood pressure, blood glucose and lipid levels, whereas middle-aged women should focus on the control of blood pressure and blood glucose. These findings have important implications for early risk identification and intervention of uterine fibroids.

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