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Could body mass index be an indicator for endometrial biopsy in premenopausal women with heavy menstrual bleeding?

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the role of body mass index (BMI) in women with premenopausal heavy menstrual bleeding (HMB) to identify patients who should undergo endometrial biopsy.

Methods

This prospective cohort study included 1120 premenopausal women who presented to the Gynecology Clinic, Bakirkoy Dr. Sadi Konuk Training and Research Hospital in Istanbul, Turkey, due to HMB and who underwent endometrial sampling. The abnormal endometrial histopathological results were analyzed by separating patients into groups of all abnormal findings (hyperplasia without atypia + hyperplasia with atypia + carcinoma) and hyperplasia with atypia + carcinoma. Sensitivity and specificity of the abnormal histopathological results were calculated in both groups using BMI cut-off values as 25, 30 and 35 and age cut-offs as 40 and 45 years.

Results

The rate of hyperplasia with atypia and carcinoma was sevenfold higher in women with a BMI ≥30 compared to those with a BMI ≤30 (95 % CI 2.4–17.9). In the analyses, BMI was a stronger risk factor in women younger than 45 years of age. The risk of endometrial carcinoma and atypical hyperplasia was twofold higher in patients older than 45 years when compared with patients younger than 45 years (95 % CI 1.1–5.1).

Conclusions

All women with a BMI ≥30 and presenting premenopausal HMB should undergo endometrial biopsy regardless of age.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Bakirkoy Dr. Sadi Konuk Teaching and Research Hospital, Tevfik Saglam Street, No: 11, Zuhuratbaba, Bakirkoy, 34147, Istanbul, Turkey

    Hakan Guraslan, Keziban Dogan, Cihan Kaya, Birgul Guraslan, Caglar Helvacioglu & Levent Yasar

  2. Department of Obstetrics and Gynecology, Zeynep Kamil Teaching and Research Hospital, Istanbul, Turkey

    Mehmet Baki Senturk

  3. Department of Gynecologic Oncology, Kanuni Sultan Suleyman Teaching and Research Hospital, Istanbul, Turkey

    Ozgur Akbayir

Authors
  1. Hakan Guraslan
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  2. Keziban Dogan
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  3. Cihan Kaya
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  4. Mehmet Baki Senturk
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  5. Birgul Guraslan
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  6. Caglar Helvacioglu
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  7. Ozgur Akbayir
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  8. Levent Yasar
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Corresponding author

Correspondence to Cihan Kaya.

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Funding

The authors report no financial disclosure.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the ethical committee of Bakirkoy Dr Sadi Konuk Training and Research Hospital (approval number 2014/08/10) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Guraslan, H., Dogan, K., Kaya, C. et al. Could body mass index be an indicator for endometrial biopsy in premenopausal women with heavy menstrual bleeding?. Arch Gynecol Obstet 294, 395–402 (2016). https://doi.org/10.1007/s00404-016-4043-8

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  • DOI: https://doi.org/10.1007/s00404-016-4043-8

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