Metabolic syndrome as a predictor of endometrial polyps in postmenopausal women

Abstract

Objective:The aim of the study was to evaluate clinical predictive factors for endometrial polyps in postmenopausal women compared with postmenopausal women without polyps. Methods:In this cross-sectional study, 132 Brazilian women with a histopathological diagnosis of endometrial polyps were compared with 264 women without endometrial alterations (control). The study group included women aged at least 45 years with amenorrhea for at least 12 months, who underwent hysteroscopic polypectomy. The control group consisted of women aged at least 45 years with amenorrhea for at least 12 months, without postmenopausal bleeding and endometrial thickness less than 5mm by transvaginal ultrasonography. Clinical, anthropometric (body mass index and waist circumference), laboratory, and ultrasonographic data were collected to evaluate predictive factors for endometrial polyps. The Student's t test, χ2 test, and logistic regression (odds ratio [OR]) were used for statistical analysis. Results:A higher percentage of women with polyps were obese (72%) when compared with control (39%) (P<0.0001). Waist circumference was greater among women with polyps (P=0.0001). The incidence of diabetes, hypertension, and dyslipidemia was higher among women with endometrial polyps (P<0.0001). According to the diagnostic criteria of the US National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III), 48.5% of the women with polyps and 33.3% of the controls were classified as having metabolic syndrome (MetS) (P=0.004). The risk of endometrial polyps was higher in women with body mass index at least 25kg/m2 (OR=4.66; 95% CI 2.16-10.05); glucose at least 100mg/dL (OR=2.83; 95% CI 1.36-5.90); dyslipidemia (OR=7.02; 95% CI 3.70-13.32); diabetes (OR=2.58; 95% CI 1.05-6.32); and MetS (OR=2.76; 95% CI 1.18-6.46) when compared with control, adjusted for age, and time since menopause. Conclusions:In postmenopausal women, obesity, dyslipidemia, hyperglycemia, and the presence of MetS were predictive factors for endometrial polyps.