Metabolic syndrome is an independent risk factor for time to complete remission of fertility-sparing treatment in atypical endometrial hyperplasia and early endometrial carcinoma patients

• Published in: Reproductive biology and endocrinology 2022-09, Vol.20 (1), p.1-134, Article 134
• Main Authors: Ding, Yingqiao, Fan, Yuan, Li, Xingchen, Wang, Yiqin, Wang, Jianliu, Tian, Li
• Format: Article
• Language: English
• Subjects: Accuracy; Biopsy; Blood pressure; Carcinoma; Complications and side effects; Diabetes; Diagnosis; Endometrial cancer; Endometrium; Fertility; High density lipoprotein; Hyperplasia; Infertility; Insulin; Menstruation; Metabolic syndrome; Metabolic syndrome X; Multivariate analysis; Ovaries; Patients; Polycystic ovary syndrome; Remission; Remission (Medicine); Risk factors; Uterine cancer
• ISSN: 1477-7827; 1477-7827
• DOI: 10.1186/s12958-022-01006-0

Objective Fertility-sparing treatment of atypical endometrial hyperplasia (AEH) and early endometrial carcinoma (EC) patients has recently emerged important social health topic. This study is designed to explore the risk factors for time to complete remission (CR) of fertility-sparing treatment in woman with AEH and early EC. Methods A retrospective study was designed with clinical data from 106 patients admitted between January 2012 to December 2019. Univariate and multivariate logistic analysis were used to explore independent risk factors for time to CR. These factors were employed in receiver operator characteristic (ROC) curve and the decision curve analysis (DCA) to evaluate predictive accuracy of time to CR. Stratified analysis and interactive analysis was also performed for more in-depth perspective. Results Univariate analysis showed that fasting blood glucose levels (FBG, OR = 1.6, 95%CI: 0.6-2.5, P = 0.020), metabolic syndrome (MetS, OR = 3.0, 95%CI: 1.1-5.0, P = 0.003), and polycystic ovary syndrome (PCOS, OR = 2.0, 95%CI: 0.5-3.4, P = 0.009) were associated with time to CR. Among these factors, multivariate analysis confirmed MetS (OR = 3.1, 95%CI: 1.0-5.2, P = 0.005) was an independent risk factor. The area under the ROC curve (AUC) of MetS was higher than FBG and PCOS (AUC = 0.723 vs 0.612 and 0.692). The AUC of FBG combined with PCOS was 0.779, and it was improved to 0.840 when MetS was included (P < 0.05). Additionally, MetS played different roles in time to CR in various groups. Moreover, we found high-density lipoprotein (HDL) and MetS had an interactive effect for time to CR. Conclusion MetS is an independent risk factor for time to CR and should be taken seriously in fertility-sparing management of AEH and early EC patients.