Selçuk AYAS, Akif ALKAN, Sadiye EREN, Mesut BAYRAKTAR, Ayşe GÜRBÜZ

Uterine junctional zone thickness, cervical length and bioelectrical impedance analysis of body composition in women with endometriosis

Amaç: Bu çalışmada ileri evre endometriozisli kadınlarda uterin subendometrial myometrial kalınlığının ölçümü, serviks boylarının ve vücut bioelektrik impedansı analizlerinin yapılması amaçlanmıştır. Gereç ve Yöntemler: Bu çalışma üçüncü basamak bir eğitim hastanesinde yapılan prospektif bir çalışmadır. Toplam 73 hasta çalışmaya dahil edilmiştir. Endometriozisin tanısı 36 hastanın olduğu çalışma grubunda cerrahi olarak konmuştur. Kontrol grubu 37 hastadan oluşmaktadır.Bioelektrik impedans analizleri ölçümleri vücut bileşenlerinin belirlenmesinde kullanıldı. Subendometrial myometrial kalınlığın ve servikal uzunluğun ölçümünde transvajinal ultrasonografi kullanıldı. Bulgular: İki hasta grubu arasında tanımlayıcı bilgileri (yaş, gravida, parite, yaşayan bebek sayısı, menarj yaşı, dismenoreli yasta yüzdesi, ailevi anamnezi positif hasta sayısı), vücut kitle indeksleri (kg/m2), vücuttaki yağ miktarları (kg) ve vücut yağ yüzdeleri arasında istatistiksel bir fark yoktur (p > 0.05). Menstürasyon süresi ve servikal uzunluk endometriozisli hastalarda daha uzun olarak saptandı. Benzer şekilde subendometrial myometrium kalınlığı çalışma grubunda daha kalındı. Sonuç: Yaş, gravida, parite, Vücut kitle indeksi, menstürasyon süresi, menarj yaşı gibi demografik özellikler ve endometriozis arasındaki ilişki tartışmalıdır. Uzun servikal boy ve kalın subendometrial myometrium kalınlığı endometriozis etyopatogenezinde önemli olabilir.

Endometriosisli kadınlarda uterin myometrial kalınlık, servikal uzunluk ölçümü ve vücut bioelektrik impedansı analizleri

Objective: We aimed to evaluate uterine junctional zone thickness, cervical length and bioelectrical impedance analysis of body composition in women with endometriosis. Material and Methods: This is a prospective study conducted in a tertiary teaching hospital. A total of 73 patients were included in the study. Endometriosis was surgically diagnosed in 36 patients (study group). The control group included 37 patients. Main outcome measure(s): Bioelectrical impedance analysis was used to measure body composition. Uterine junctional zone thickness and cervical length were measured by transvaginal ultrasonography. Results: Patients' characteristics (age, gravida, parity, live baby, age of menarche, lengths of menstrual cycle , percentage of patients with dysmenorrhea, positive family history), body mass index (BMI) (kg/m2), amount of body fat (kg), percentage of body fat were not statistically different between the two groups (p>0.05). The length of menstruation and cervical length were longer in women with endometriosis. Similarly, the inner myometrium was thicker in women with endometriosis than the control group. Conclusion: The relation between endometriosis and demographic features such as age, gravida, parity, gravida, BMI, lengths of the menstrual cycle, age of menarche are controversial. Longer cervical length and thicker inner myometrial layer may be important in the etiopathogenesis of endometriosis.

PDF

___

1. Bohler HJ, Mokshagundam S, Winters S. Adipose tissue and reproduction in women. Fertil Steril 2010;94:795-825. [CrossRef]
2. Ferrero S, Anserini P, Remorgida V, Ragni N. Body mass index in endometriosis. Eur J Obstet Gynecol Reprod Biol 2005;121:94-8. [CrossRef]
3. Hediger M, Hartnett H, Louis G. Association of endometriosis with body size and figure. Fertil Steril 2005;84:1366-74. [CrossRef]
4. McCann S, Freudenheim J, Darrow S, Batt R, Zielezny M. Endometriosis and body fat distribution. Obstet Gynecol 1993;82:545-9. [CrossRef]
5. Yi K, Shin J, Park M, Kim T, Kim S, Hur J. Association of body mass index with severity of endometriosis in Korean women. Int J Gynaecol Obstet 2009;105:39-42. [CrossRef]
6. Bulletti C, Montini A, Setti P, Palagiano A, Ubaldi F, Borini A. Vaginal parturition decreases recurrence of endometriosis. Fertil Steril 2010;94:850-5. [CrossRef]
7. Brosens JJ, Barker FG, de Souza NM. Myometrial zonal differentiation and uterine junctional zone hyperplasia in the non-pregnant uterus. Hum Reprod Update 1998;4:496-502. [CrossRef]
8. Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertil Steril 1997;67:817-21. [CrossRef]
9. Nunez C, Gallagher D, Visser M, Pi-Sunyer FX, Wang Z, Heymsfield SB. Bioimpedance analysis: evaluation of leg-to-leg system based on pressure contact foot-pad electrodes. Med Sci Sports Exerc 1997;29:524-31. [CrossRef]
10. Utter AC, Nieman DC, Ward AN, Butterworth DE. Use of leg-toleg bioelectrical impedance method in assessing body-composition change in obese women. Am J Clin Nutr 1999;69:603-7.
11. Jebb SA, Cole TJ, Doman D, Murgatroyd PR, Prentice AM. Evaluation of the novel Tanita body-fat analyser to measure body composition by comparison with a four-compartment model. Br J Nutr 2000;83:115-22.
12. Kushner RF, Roxe DM. Bipedal bioelectrical impedance analysis reproducibly estimates total body water in hemodialysis patients. Am J Kidney Dis 2002;39:154-9. [CrossRef]
13. Sung RY, Lau P, Yu CW, Lam PK, Nelson EA. Measurement of body fat using leg to leg bioimpedance. Arch Dis Child 2001;85:263-7. [CrossRef]
14. Templeman C, Marshall S, Ursin G, Horn-Ross P, Clarke C, Allen M, et al. Adenomyosis and endometriosis in the California Teachers Study. Fertil Steril 2008;90:415-24. [CrossRef]
15. Yi KW, Shin JH, Park MS, Kim T, Kim SH, Hur JY. Association of body mass index with severity of endometriosis in Korean women. Int J Gynaecol Obstet 2009;105:39-42. [CrossRef]
16. Hediger ML, Hartnett HJ, Louis GM. Association of endometriosis with body size and figure. Fertil Steril 2005;84:1366-74. [CrossRef]
17. Vitonis AF, Baer HJ, Hankinson SE, Laufer MR, Missmer SA. A prospective study of body size during childhood and early adulthood and the incidence of endometriosis. Hum Reprod 2010;25:1325-34. [CrossRef]
18. Leyendecker G, Wildt L, Mall G. The pathophysiology of endometriosis and adenomyosis: tissue injury and repair. Arch Gynecol Obstet 2009;280:529-38. [CrossRef]
19. Salamanca A, Beltran E. Subendometrial contractility in menstrual phase visualized by transvaginal sonography in patients with endometriosis. Fertil Steril 1995;64:193-5.
20. Leyendecker G, Kunz G, Wildt L, Beil D, Deininger H. Uterine hyperperistalsis and dysperistalsis as dysfunctions of the mechanism of rapid sperm transport in patients with endometriosis and infertility. Hum Reprod 1996;11:1542-51. [CrossRef]
21. IJland MM, Evers JL, Dunselman GA, Volovics L, Hoogland HJ. Relation between endometrial wavelike activity and fecundability in spontaneous cycles. Fertil Steril 1997;67:492-6. [CrossRef]
22. Nawroth F, Rahimi G, Nawroth C, Foth D, Ludwig M, Schmidt T. Is there an association between septate uterus and endometriosis? Hum Reprod 2006;21:542-4. [CrossRef]
23. Mark AS, Hricak H, Heinrichs LW, Hendrickson MR, Winkler ML, Bachica JA, et al. Adenomyosis and leiomyoma: differential diagnosis with MR imaging. Radiology 1987;163:527-9.