职业性体力活动及体质指数与子宫肌瘤关系

目的探讨职业性体力活动、体质指数（BMI）与中老年女性子宫肌瘤（UL）危险性之间的关系。方法采用以医院为基础的病例对照研究方法，抽取辽宁医学院附属第一医院、附属第三医院和锦州市妇婴医院，临床诊断为UL的353例患者为病例组，对照为同期入院并按年龄进行1∶1匹配未患UL的女性患者353例，采用自行设计的健康状况调查表和国际体力活动调查表进行问卷调查，同时测量其身高和体重；应用多因素logistic回归分析估计职业性体力活动、BMI与UL关联的比值比（OR）及其相应的95%可信区间（CI）。结果病例组与对照组年龄、婚姻状况、文化程度及家庭经济收入差异均无统计学意义（P >0.05）；而病例组产次 ≥2的比例（34.28%）低于对照组（44.19%）（P=0.026）。进行适度的职业性体力活动可使发生UL的危险性降低（OR=0.679，95%CI=0.480~0.925，P=0.007）。与BMI正常者比较，超重或肥胖者发生UL的危险性均升高（OR=1.571，95%CI=1.053~2.182，P=0.001；OR=1.875，95%CI=1.191~2.774，P=0.002）。BMI正常者（18.50~23.99 kg/m²）进行适度职业性体力活动可降低发生UL的危险性（OR=0.455，95%CI=0.215~0.960，P=0.039）。与代谢当量（MET）最低四分位数者比较，MET为第三个四分位数的超重者（BMI：24.00~27.99 kg/m²）发生UL的危险性下降（OR=0.389，95%CI=0.182~0.832，P=0.015）。结论进行适度的体力活动，维持正常的BMI，可能有助于预防UL的发生和发展。

Correlation of occupational physical activity and body mass index with uterine leiomyoma

Objective To investigate the association between occupational physical activity,body mass index(BMI)and uterine leiomyoma(UL)in middle aged and elderly women.Methods A hospital-based case control study was conducted.Totally 353 UL patients aged 35-62 years were selected as cases from the First Affiliated Hospital and the Third Affiliated Hospital of Liaoning Medical College and Jinzhou Women and Children's Hospitial.The controls(n=353)were patients suffering from diseases not related with UL.All subjects were interviewed using a structured interviewer-administrated questionnaire.The height and weight of the subjects were measured simultaneously.Then physical activities were investigated using International Physical Activity Questionnaire(IPAQ).The odds ratios(OR)and their 95% confidence intervals(95%CI)of UL for occupational physical activities and BMI were estimated with multiple logistic regression model.Results Socio-demographic characteristics(age,marital status,educational level,and familial income)were not significantly different between the two groups(P>0.05).However,the percentage of controls(34.28%)with number of live births ≥2 was significantly lower than the cases(44.19%)(P=0.026).Moderate occupational physical activity could decrease the risk of UL(OR=0.679,95%CI:0.480-0.925;P=0.007).Compared with the subjects with normal BMI,both overweight and obesity had higher odds of UL(OR=1.571,95%CI:1.053-2.182,;P=0.001;OR=1.875,95%CI:1.191-2.774;P=0.002,respectively).Moderate occupational physical activity could decrease the risk of UL in the subjects with normal BMI(OR=0.455,95%CI:0.215-0.960;P=0.039).After adjustment for multiple potential confounders,the results remained unchanged.For the subjects with higher BMI(24.00-27.99 kg/m²),the OR in third quartile of metabolic equivalents was 0.389(95%CI:0.182-0.832,P=0.015)compared to the lowest quartile.Conclusion Moderate physical activity and normal BMI can contribute to lower incidence of UL.