Dysmenorrhea pattern in adolescences informing adult endometriosis

作者全名："Dai, Yu; Luo, Huangjin; Zhu, Litong; Yang, Weichun; Xiang, Haishan; Shi, Qiuling; Jin, Ping"

作者地址："[Dai, Yu; Zhu, Litong; Yang, Weichun; Xiang, Haishan; Jin, Ping] Shenzhen Matern & Child Healthcare Hosp, Dept Gynecol, Shenzhen, Guangdong, Peoples R China; [Luo, Huangjin] Fujian Med Univ, Fujian Prov Hosp, Dept Gynecol, Shengli Clin Med Coll, Fuzhou, Fujian, Peoples R China; [Shi, Qiuling] Chongqing Med Univ, Coll Biomed Engn, State Key Lab Ultrasound Med & Engn, Chongqing, Peoples R China"

通信作者："Jin, P (通讯作者)，Shenzhen Matern & Child Healthcare Hosp, Dept Gynecol, Shenzhen, Guangdong, Peoples R China.; Shi, QL (通讯作者)，Chongqing Med Univ, Coll Biomed Engn, State Key Lab Ultrasound Med & Engn, Chongqing, Peoples R China."

来源：BMC PUBLIC HEALTH

ESI学科分类：SOCIAL SCIENCES, GENERAL

WOS号：WOS:001158152400002

JCR分区：Q1

影响因子：3.5

年份：2024

卷号：24

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Endometriosis; Adolescence; Dysmenorrhea pattern; Predictor

摘要："BackgroundEndometriosis (EMs) is a chronic and progressive disease that, if diagnosed late, can lead to infertility and deep infiltrating endometriosis (DIE). Dysmenorrhea is the most prominent symptom of EMs. However, limited research exists on the specific correlation between dysmenorrhea patterns and EMs. Early prevention of EMs is essential to effectively manage the progression of the disease, and is best detected during adolescence. Our objective was to associate the development of EMs with dysmenorrhea patterns during adolescence and quantify the risk of adult EMs for adolescent girls, with the aim of supporting primary intervention strategy planning.MethodsThis case-control study examined predictors for adult EMs based on dysmenorrhea patterns in adolescents. We collected 1,287 cases of 641 EMs and 646 healthy females regarding their basic demographic information, adolescent menstrual characteristics, adolescent dysmenorrheal patterns, and adolescent lifestyles. Age-matching (1-to-1) was employed to control for the confounding effect of age between the groups. Least Absolute Shrinkage and Selection Operator (LASSO) and logistic regression models were utilized to identify predictors for adult EMs. The predictive value of the model was evaluated using the area under the receiver operating characteristic curve (AUC) and the C-index, while Hosmer-Lemeshow Test assessed the goodness of fit of the model. Data from one additional cohort in Shenzhen hospitalized with EMs were used to external validation were analyzed.ResultsIndividuals who always experienced dysmenorrhea had a risk of adult endometriosis 18.874 (OR = 18.874; 95%CI = 10.309-34.555) times higher than those occasional dysmenorrhea, The risk of developing EMs was 5.257 times higher in those who experienced dysmenorrhea more than 12 months after menarche than in those who experienced dysmenorrhea less than 6 months after menarche (OR = 5.257, 95% CI = 3.343-8.266), AUC in the external validation cohort was 0.794(95%CI: 0.741-0.847). We further found that high-intensity physical activity and sun-sensitive skin of burning were influential factors in high-frequency dysmenorrhea. The AUC value for the internal evaluation of the model was 0.812 and the AUC value for the external validation was 0.794.ConclusionOur findings revealed that the frequency of dysmenorrhea during adolescence contributed to the development of adult endometriosis. The frequency and onset of dysmenorrhea in adolescence were promising predictors for adult EMs. Both internal and external validation proved the model's good predictive ability.Trial registrationhttp://www.chictr.org.cn/, TRN: ChicTR2200060429, date of registration: 2022/06/01, retrospectively registered."

基金机构：Chongqing science and Technology Bureau

基金资助正文："The researchers would like to thank Professor Zhibiao Wang for his advice and suggestions in conceptualizing and designing the study, and Dr. Xiaoying Lu for her contributions to data-entry. All participants who provided guidance and assistance during the study are gratefully acknowledged."