Endometrial hyperplasia in women with comorbid obesity working in contact with organic solvents
- Authors: Marinkin I.O.1, Shpagina L.A.1, Lisova E.S.1, Kotova O.S.1, Kuznetsova G.V.1, Loktin E.M.1, Karmanovskaya S.A.1
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Affiliations:
- Novosibirsk State Medical University, Ministry of Health of the Russian Federation
- Issue: No 3 (2023)
- Pages: 57-64
- Section: Original Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/323118
- DOI: https://doi.org/10.18565/aig.2022.289
- ID: 323118
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Abstract
Objective: To determine the effect of organic solvents on the clinical, morphological, and molecular characteristics of endometrial hyperplasia in relation to obesity.
Materials and methods: This single-center cross-sectional study included 140 women with histologically confirmed endometrial hyperplasia and occupational exposure to organic solvents; of these, 70 women were obese. The comparison group comprised140 women with endometrial hyperplasia without occupational health risks; of these, 68 were obese. The participants were 57 (45; 64) and 56 (46; 63) years of age and had been menopausal for more than 2 years. The concentrations of organic solvents exceeded the maximum permissible exposure limit by a factor of 1.1 to 5, and the duration of exposure was 22 (18; 28) years. All patients underwent pelvic ultrasound, hysteroscopy with biopsy, and histological and immunohistochemical (Ki-67, estrogen, and progesterone receptor) examinations. Protein concentrations in the blood were determined using a solid-phase enzyme immunoassay.
Results: Organic solvent exposure was associated with a higher incidence of atypical endometrial hyperplasia, mainly in the obese subgroup – 24/70 (34.3%). In the non-obese subgroup, it was 13/70 (18.6%) in the comparison group (7/68 (10.3%) vs. 5/72 (6.9%), p=0.003). There was simultaneous increase in Ki-67 expression (for atypical endometrial hyperplasia 55.7% (53.5; 60,1)% и 42,0 (40,4; 45.6)% in obese and non-obese subgroups), increased frequency of abnormal uterine bleeding – 20/70 (28.5%) and 11/70(15.7%), M-echo thickness – 12 (11; 13) and 9.0 (9; 9.5) mm), blood concentrations of interleukins 1β and 6 (higher in obesity), transforming growth factor β1, platelet-derived growth factor-AB, fibroblast growth factor-2 (independent of obesity), p<0.01. The organic solvent exposure group showed correlations between atypical endometrial hyperplasia and age, maximum single concentrations of toluene, waist circumference, Ki-67, and platelet-derived growth factor-AB.
Conclusion: This study identified the clinical and pathogenetic features of endometrial hyperplasia in women exposed to organic solvents associated with comorbid obesity.
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About the authors
Igor O. Marinkin
Novosibirsk State Medical University, Ministry of Health of the Russian Federation
Author for correspondence.
Email: rector@ngmu.ru
ORCID iD: 0000-0002-9409-4823
Dr. Med. Sci., Professor, Merited Doctor of the Russian Federation, Rector, Head of the Department of Obstetrics and Gynecology
Russian Federation, NovosibirskLyubov A. Shpagina
Novosibirsk State Medical University, Ministry of Health of the Russian Federation
Email: lashpagina@gmail.com
ORCID iD: 0000-0003-0871-7551
Dr. Med. Sci., Professor, Merited Doctor of the Russian Federation, Head of the Internal Medicine and Rehabilitation Department
Russian Federation, NovosibirskEvgeniya S. Lisova
Novosibirsk State Medical University, Ministry of Health of the Russian Federation
Email: mkb-2@yandex.ru
ORCID iD: 0000-0002-3469-8756
PhD Student at the Internal Medicine and Rehabilitation Department
Russian Federation, NovosibirskOlga S. Kotova
Novosibirsk State Medical University, Ministry of Health of the Russian Federation
Email: ok526@yandex.ru
ORCID iD: 0000-0003-0724-1539
Dr. Med. Sci., Associate Professor at the Internal Medicine and Rehabilitation Department
Russian Federation, NovosibirskGalina V. Kuznetsova
Novosibirsk State Medical University, Ministry of Health of the Russian Federation
Email: mkb-2@yandex.ru
ORCID iD: 0000-0001-7428-9159
PhD, Associate Professor at the Internal Medicine and Rehabilitation Department
Russian Federation, NovosibirskEvgenij M. Loktin
Novosibirsk State Medical University, Ministry of Health of the Russian Federation
Email: mkb-2@yandex.ru
ORCID iD: 0000-0002-7370-6958
Dr. Med. Sci., Associate Professor at the Internal Medicine and Rehabilitation Department
Russian Federation, NovosibirskSvetlana A. Karmanovskaya
Novosibirsk State Medical University, Ministry of Health of the Russian Federation
Email: mkb-2@yandex.ru
ORCID iD: 0000-0003-3446-8018
Dr. Med. Sci., Associate Professor at the Internal Medicine and Rehabilitation Department
Russian Federation, NovosibirskReferences
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