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Effects of obesity and hormone therapy on surgically-confirmed fibroids in postmenopausal women.

Abstract

To examine the association between body mass index (BMI), use of menopausal hormone therapy (HT), and incidence of uterine fibroids in postmenopausal women, 610,604 postmenopausal women without prior hysterectomy or diagnosis of fibroids were followed as part of a large United Kingdom prospective cohort study. We used Cox regression models to calculate adjusted relative risks (RRs) of surgically-confirmed fibroids (defined as a hospital admission with uterine fibroids as a primary diagnosis with a related surgical procedure), in relation to BMI and use of HT. During an average of 11.4 years of follow-up, 3561 women were admitted to hospital with surgically-confirmed fibroids. Five-year incidence rates decreased with age, from 0.50% (1 in 200 women) at age 50-54, to 0.11% (1 in 1000 women) at age 75-79. The 5-year rate in postmenopausal women aged 50-54 was about a quarter that seen in premenopausal women of the same age (1 in 200 vs. 1 in 50). Compared with normal weight women, obese women had a RR of surgically-detected fibroids of 1.46 (95% CI 1.33-1.59; p < 0.0001). HT use was associated with a RR of 2.33 (95% CI 2.18-2.49; p < 0.0001) in ever versus never users. When we analysed HT use and BMI together, obese vs. normal weight never users had a RR of 2.00 (95% CI 1.77-2.26): the highest risks were seen in women who were obese and had ever used HT, RR = 3.30 (95% CI 2.88-3.79). Uterine fibroids continue to occur in postmenopausal women; obesity and hormone therapy use are important modifiable risk factors.

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  • Authors+Show Affiliations

    ,

    Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Old Road Campus, Oxford, OX3 7LF, UK, eva.sommer@btinternet.com.

    , , , , ,

    Source

    European journal of epidemiology 30:6 2015 Jun pg 493-9

    MeSH

    Body Mass Index
    Cohort Studies
    Female
    Gynecologic Surgical Procedures
    Hormone Replacement Therapy
    Humans
    Incidence
    Leiomyoma
    Middle Aged
    Multivariate Analysis
    Obesity
    Postmenopause
    Proportional Hazards Models
    Prospective Studies
    Reproductive History
    Risk Factors
    United Kingdom
    Uterine Neoplasms

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    25784364

    Citation

    Sommer, Eva M., et al. "Effects of Obesity and Hormone Therapy On Surgically-confirmed Fibroids in Postmenopausal Women." European Journal of Epidemiology, vol. 30, no. 6, 2015, pp. 493-9.
    Sommer EM, Balkwill A, Reeves G, et al. Effects of obesity and hormone therapy on surgically-confirmed fibroids in postmenopausal women. Eur J Epidemiol. 2015;30(6):493-9.
    Sommer, E. M., Balkwill, A., Reeves, G., Green, J., Beral, D. V., & Coffey, K. (2015). Effects of obesity and hormone therapy on surgically-confirmed fibroids in postmenopausal women. European Journal of Epidemiology, 30(6), pp. 493-9. doi:10.1007/s10654-015-0016-7.
    Sommer EM, et al. Effects of Obesity and Hormone Therapy On Surgically-confirmed Fibroids in Postmenopausal Women. Eur J Epidemiol. 2015;30(6):493-9. PubMed PMID: 25784364.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effects of obesity and hormone therapy on surgically-confirmed fibroids in postmenopausal women. AU - Sommer,Eva M, AU - Balkwill,Angela, AU - Reeves,Gillian, AU - Green,Jane, AU - Beral,Dame Valerie, AU - Coffey,Kate, AU - ,, Y1 - 2015/03/18/ PY - 2014/09/26/received PY - 2015/03/04/accepted PY - 2015/3/19/entrez PY - 2015/3/19/pubmed PY - 2015/12/31/medline SP - 493 EP - 9 JF - European journal of epidemiology JO - Eur. J. Epidemiol. VL - 30 IS - 6 N2 - To examine the association between body mass index (BMI), use of menopausal hormone therapy (HT), and incidence of uterine fibroids in postmenopausal women, 610,604 postmenopausal women without prior hysterectomy or diagnosis of fibroids were followed as part of a large United Kingdom prospective cohort study. We used Cox regression models to calculate adjusted relative risks (RRs) of surgically-confirmed fibroids (defined as a hospital admission with uterine fibroids as a primary diagnosis with a related surgical procedure), in relation to BMI and use of HT. During an average of 11.4 years of follow-up, 3561 women were admitted to hospital with surgically-confirmed fibroids. Five-year incidence rates decreased with age, from 0.50% (1 in 200 women) at age 50-54, to 0.11% (1 in 1000 women) at age 75-79. The 5-year rate in postmenopausal women aged 50-54 was about a quarter that seen in premenopausal women of the same age (1 in 200 vs. 1 in 50). Compared with normal weight women, obese women had a RR of surgically-detected fibroids of 1.46 (95% CI 1.33-1.59; p < 0.0001). HT use was associated with a RR of 2.33 (95% CI 2.18-2.49; p < 0.0001) in ever versus never users. When we analysed HT use and BMI together, obese vs. normal weight never users had a RR of 2.00 (95% CI 1.77-2.26): the highest risks were seen in women who were obese and had ever used HT, RR = 3.30 (95% CI 2.88-3.79). Uterine fibroids continue to occur in postmenopausal women; obesity and hormone therapy use are important modifiable risk factors. SN - 1573-7284 UR - https://www.unboundmedicine.com/medline/citation/25784364/full_citation L2 - https://doi.org/10.1007/s10654-015-0016-7 DB - PRIME DP - Unbound Medicine ER -