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目的探讨职业性体力活动、体质指数(BMI)与中老年女性子宫肌瘤(UL)危险性之间的关系。方法采用以医院为基础的病例对照研究方法,抽取辽宁医学院附属第一医院、附属第三医院和锦州市妇婴医院,临床诊断为UL的353例患者为病例组,对照为同期入院并按年龄进行1∶1匹配未患UL的女性患者353例,采用自行设计的健康状况调查表和国际体力活动调查表进行问卷调查,同时测量其身高和体重;应用多因素logistic回归分析估计职业性体力活动、BMI与UL关联的比值比(OR)及其相应的95%可信区间(CI)。结果病例组与对照组年龄、婚姻状况、文化程度及家庭经济收入差异均无统计学意义(P>0.05);而病例组产次≥2的比例(34.28%)低于对照组(44.19%)(P=0.026)。进行适度的职业性体力活动可使发生UL的危险性降低(OR=0.679,95%CI=0.480~0.925,P=0.007)。与BMI正常者比较,超重或肥胖者发生UL的危险性均升高(OR=1.571,95%CI=1.053~2.182,P=0.001;OR=1.875,95%CI=1.191~2.774,P=0.002)。BMI正常者(18.50~23.99 kg/m2)进行适度职业性体力活动可降低发生UL的危险性(OR=0.455,95%CI=0.215~0.960,P=0.039)。与代谢当量(MET)最低四分位数者比较,MET为第三个四分位数的超重者(BMI:24.00~27.99 kg/m2)发生UL的危险性下降(OR=0.389,95%CI=0.182~0.832,P=0.015)。结论进行适度的体力活动,维持正常的BMI,可能有助于预防UL的发生和发展。
Objective To explore the relationship between occupational physical activity, body mass index (BMI) and the risk of uterine fibroids (UL) in middle-aged and elderly women. Methods A hospital-based case-control study was conducted. The first affiliated hospital of Affiliated Hospital of Liaoning Medical University, the third affiliated hospital of Jinhua City and Maternal and Infant Hospital of Jinzhou City were selected. 353 patients with clinical diagnosis of UL were selected as case group, 351 female patients without UL were matched by 1: 1 age. The questionnaire was conducted by using self-designed questionnaire of health status and international physical activity questionnaire, meanwhile height and weight were measured. Multivariate logistic regression analysis was used to estimate occupational physical strength Activity, odds ratios (ORs) associated with BMI and UL, and their corresponding 95% confidence intervals (CIs). Results There were no significant differences in age, marital status, educational level and family income between the case and control groups (P> 0.05), while the incidence of cases with ≥2 in the case group (34.28%) was lower than that in the control group (44.19%) (P = 0.026). Moderate occupational physical activity reduced the risk of developing UL (OR = 0.679; 95% CI = 0.480-0.925, P = 0.007). Compared with those with normal BMI, the risk of UL was higher in overweight or obese people (OR = 1.571, 95% CI = 1.053-2.182, P = 0.001; OR = 1.875,95% CI = 1.191-2.774, P = 0.002 ). Moderate occupational physical activity with normal BMI (18.50-23.99 kg / m2) reduced the risk of developing UL (OR = 0.455, 95% CI = 0.215-0.960, P = 0.039). MET was associated with a decreased risk of UL in the third tertile of overweight (BMI: 24.00-27.99 kg / m2) compared with the lowest quartile of MET (OR = 0.389, 95% CI = 0.182 ~ 0.832, P = 0.015). Conclusion Appropriate physical activity and maintaining normal BMI may help prevent the occurrence and development of UL.