Avaliação de doenças de pele, ansiedade, depressão e qualidade do sono em mulheres com endometriose: um estudo transversal
Carregando...
Data
2023-04-03
Autores
Sakiyama, Paula Hitomi
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
Fundamentos: Endometriose é uma doença crônica estrogênio-dependente, na qual, apesar da patogênese incerta, há envolvimento do sistema imunológico e resposta inflamatória. A pele, da mesma forma, apresenta doenças em que aspectos imunológicos, inflamatórios e hormonais estão envolvidos. Apesar dos possíveis fatores fisiopatológicos em comum, há poucos estudos que avaliam a coexistência de endometriose e dermatoses inflamatórias. As contingências crônicas ligadas à endometriose e às dermatoses associam-se com distúrbios afetivos e do sono, e, atualmente, discute-se também uma interação bidirecional entre esses elementos. Objetivo: Avaliar as prevalências de doenças de pele, ansiedade, depressão e prejuízo da qualidade do sono em portadores de endometriose, comparadas às de pessoas sem a doença. Métodos: Estudo transversal, no qual foram incluídas 835 pessoas com endometriose (diagnóstico confirmado por ginecologista), recrutadas a partir de grupos no Facebook e em um ambulatório de ginecologia, e 309 mulheres sem a doença (controles). Os participantes foram interrogados sobre a presença de doenças de pele (autorreferidas na amostra online e confirmadas por exame físico na amostra presencial de casos e de controles sem a doença) e responderam a questões sobre aspectos demográficos, clínicos, Escala Hospitalar de Ansiedade e Depressão (HADS) e Índice de Qualidade do Sono de Pittsburgh (PSQI). Variáveis quantitativas foram representadas pelas médias e desvios-padrão, e comparadas pelo teste t de Student, e as qualitativas pelo seu percentual e intervalo de confiança de 95% (IC95%), sendo comparadas pelo teste do qui-quadrado de Pearson, teste exato de Fisher, ou qui-quadrado de tendência. A dimensão do efeito das associações entre as variáveis foi estimada pela razão de prevalências (RP), e seu IC95%, estimado por um modelo linear generalizado (regressão de Poisson), ajustado pela idade, composição corporal, cor de pele e escolaridade. O valor de p<0,05 foi considerado estatisticamente significativo. Resultados: A maior parte da amostra de endometriose foi composta por pessoas entre 31 e 40 anos, brancas, que ingressaram no ensino superior e de composição corporal normal. A maioria apresentava diagnóstico da doença entre 1 e 10 anos (71,3%) e identificação inicialmente clínica (73,3%), mas 48,9% afirmou já ter realizado cirurgia (visualização direta das lesões). Identificou-se maior prevalência de urticária crônica (RP = 7,5; IC95% = 1,8–31,1), alopecia areata (RP = 4,6; IC95% = 1,4–15,2) e psoríase (RP = 4,8; IC95% = 1,2–19,5), assim como de escores altos de ansiedade (RP = 1,9; IC95% = 1,7–2,2), depressão (RP = 2,2; IC95% = 1,8–2,6), e má qualidade de sono (RP = 1,7; IC95% = 1,5–1,9), no grupo com endometriose, comparado com os controles. Conclusões: Urticária crônica, alopecia areata, psoríase, ansiedade, depressão e sono de má qualidade são mais prevalentes em portadores de endometriose, quando comparados aos controles sem a doença.
Background: Endometriosis is a chronic estrogen-dependent disease, in which, regardless of the uncertain pathogenesis, there is involvement of the immune system and inflammatory response. The skin, likewise, presents diseases in which immunological, inflammatory and hormonal aspects are involved. Despite the possible pathophysiological factors in common, there are few studies that evaluate the coexistence of endometriosis and inflammatory dermatoses. Chronic contingencies linked to endometriosis and dermatoses can result in affective and sleep disorders, and a bidirectional interaction between these elements is currently also being discussed. Objective: To evaluate the prevalence of skin diseases, anxiety, depression and impaired sleep quality in patients with endometriosis, compared to people without the disease. Methods: Cross-sectional study, which included 835 people with endometriosis (diagnosis confirmed by a gynecologist), recruited from Facebook groups and a gynecology outpatient clinic, and 309 women without the disease (controls). Participants were asked about the presence of skin diseases (self-reported in the online sample and confirmed by physical examination in the face-toface sample of cases and controls without the disease) and answered questions about demographic and clinical aspects, Hospital Anxiety and Depression Scale (HADS) and Pittsburgh Sleep Quality Index (PSQI). Quantitative variables were represented by means and standard deviations, and compared by Student's t test, and qualitative variables by their percentage and 95% confidence interval (95%CI), being compared by Pearson's chi-square test, exact test Fisher's, or trend chisquare. The dimension of the effect of the associations between the variables was estimated by the prevalence ratio (PR), and its 95%CI, estimated by a generalized linear model (Poisson regression), adjusted for age, body composition, skin color and education. The value of p<0,05 was considered statistically significant. Results: Most of the endometriosis sample consisted of people between 31 and 40 years old, white, who had entered higher education and had normal body composition. Most had been diagnosed with the disease between 1 and 10 years ago (71,3%) and initially clinically identified (73,3%), but 48,9% said they had already undergone surgery (direct visualization of the lesions). There was a higher prevalence of chronic urticaria (PR = 7,5; 95%CI = 1,8–31,1), alopecia areata (PR = 4,6; 95%CI = 1,4–15,2) and psoriasis ( PR = 4,8; 95%CI = 1,2–19,5), as well as high anxiety scores (PR = 1,9; 95%CI = 1,7–2,2), depression (PR = 2,2; 95%CI = 1,8–2,6), and poor sleep quality (PR = 1,7; 95%CI = 1,5–1,9), in the group with endometriosis, compared to controls. Conclusions: Chronic urticaria, alopecia areata, psoriasis, anxiety, depression and poor sleep are more prevalent in patients with endometriosis, compared to the group without the disease.
Background: Endometriosis is a chronic estrogen-dependent disease, in which, regardless of the uncertain pathogenesis, there is involvement of the immune system and inflammatory response. The skin, likewise, presents diseases in which immunological, inflammatory and hormonal aspects are involved. Despite the possible pathophysiological factors in common, there are few studies that evaluate the coexistence of endometriosis and inflammatory dermatoses. Chronic contingencies linked to endometriosis and dermatoses can result in affective and sleep disorders, and a bidirectional interaction between these elements is currently also being discussed. Objective: To evaluate the prevalence of skin diseases, anxiety, depression and impaired sleep quality in patients with endometriosis, compared to people without the disease. Methods: Cross-sectional study, which included 835 people with endometriosis (diagnosis confirmed by a gynecologist), recruited from Facebook groups and a gynecology outpatient clinic, and 309 women without the disease (controls). Participants were asked about the presence of skin diseases (self-reported in the online sample and confirmed by physical examination in the face-toface sample of cases and controls without the disease) and answered questions about demographic and clinical aspects, Hospital Anxiety and Depression Scale (HADS) and Pittsburgh Sleep Quality Index (PSQI). Quantitative variables were represented by means and standard deviations, and compared by Student's t test, and qualitative variables by their percentage and 95% confidence interval (95%CI), being compared by Pearson's chi-square test, exact test Fisher's, or trend chisquare. The dimension of the effect of the associations between the variables was estimated by the prevalence ratio (PR), and its 95%CI, estimated by a generalized linear model (Poisson regression), adjusted for age, body composition, skin color and education. The value of p<0,05 was considered statistically significant. Results: Most of the endometriosis sample consisted of people between 31 and 40 years old, white, who had entered higher education and had normal body composition. Most had been diagnosed with the disease between 1 and 10 years ago (71,3%) and initially clinically identified (73,3%), but 48,9% said they had already undergone surgery (direct visualization of the lesions). There was a higher prevalence of chronic urticaria (PR = 7,5; 95%CI = 1,8–31,1), alopecia areata (PR = 4,6; 95%CI = 1,4–15,2) and psoriasis ( PR = 4,8; 95%CI = 1,2–19,5), as well as high anxiety scores (PR = 1,9; 95%CI = 1,7–2,2), depression (PR = 2,2; 95%CI = 1,8–2,6), and poor sleep quality (PR = 1,7; 95%CI = 1,5–1,9), in the group with endometriosis, compared to controls. Conclusions: Chronic urticaria, alopecia areata, psoriasis, anxiety, depression and poor sleep are more prevalent in patients with endometriosis, compared to the group without the disease.
Descrição
Palavras-chave
Endometriose, Inflamação, Citocinas, Autoimunidade, Doenças autoimunes, Urticária, Psoríase, Ansiedade, Depressão, Sono, Doenças de pele, Alopecia areata, Endometriosis, Inflammation, Cytokines, Autoimmunity, Autoimmune diseases, Skin diseases, Anxiety, Depression, Sleep