文章：

非酒精性脂肪肝病与20-39岁女性早发型子宫内膜癌风险增加：一项全国性队列研究

Increased Risk of Early-Onset Endometrial Cancer in Women Aged 20–39 Years with Non-Alcoholic Fatty Liver Disease: A Nationwide Cohort Study

原文发布日期：14 April 2025

DOI: 10.3390/cancers17081322

类型: Article

开放获取: 是

英文摘要：

Background/Objectives: Given the rising incidence of early-onset endometrial cancer diagnosed before the age of 50 years, this study examined whether non-alcoholic fatty liver disease (NAFLD) served as an independent risk factor for early-onset endometrial cancer, irrespective of obesity status.Methods: This nationwide cohort study included 2,311,949 Korean women aged 20–39 years who underwent health screenings from 2009 to 2012. NAFLD severity was classified based on the fatty liver index: none (<30), moderate (30–59), and severe (≥60). Multivariable-adjusted Cox proportional hazards models were applied to estimate adjusted hazard ratios (aHRs) for early-onset endometrial cancer.Results: During a median follow-up of 7.6 years, 1289 women developed early-onset endometrial cancer. The cumulative incidence of early-onset endometrial cancer was significantly higher in women with NAFLD than in those without (log-rankp< 0.001). A dose-dependent association was observed, with increased risk corresponding to greater NAFLD severity (aHR [95% confidence interval (CI)]: moderate NAFLD, 2.38 [1.99–2.85]; severe NAFLD, 5.39 [4.44–6.53];pfor trend < 0.01). Compared with non-obese women without NAFLD, the aHRs for early-onset endometrial cancer were 2.53 [2.11–3.05] in non-obese women with NAFLD, 1.66 [1.10–2.52] in obese women without NAFLD, and 4.30 [3.60–5.13] in obese women with NAFLD (synergy index = 1.50,p< 0.01).Conclusions: NAFLD was independently associated with increased risk of early-onset endometrial cancer in both non-obese and obese women. Furthermore, young women with both NAFLD and obesity exhibited a synergistically elevated risk. Early identification and management of NAFLD may help mitigate the rapidly growing burden of early-onset endometrial cancer.

摘要翻译： 

背景/目的：鉴于50岁前确诊的早发性子宫内膜癌发病率不断上升，本研究旨在探讨非酒精性脂肪性肝病（NAFLD）是否独立于肥胖状态，成为早发性子宫内膜癌的独立危险因素。 方法：这项全国性队列研究纳入了2009年至2012年间接受健康筛查的2,311,949名20-39岁韩国女性。根据脂肪肝指数将NAFLD严重程度分为：无（<30）、中度（30-59）和重度（≥60）。采用多变量调整Cox比例风险模型估算早发性子宫内膜癌的调整后风险比（aHR）。 结果：在中位随访7.6年期间，共有1289名女性罹患早发性子宫内膜癌。NAFLD女性的早发性子宫内膜癌累积发病率显著高于非NAFLD女性（时序检验p<0.001）。研究观察到剂量依赖关系，NAFLD严重程度越高风险越大（aHR[95%置信区间(CI)]：中度NAFLD为2.38[1.99-2.85]；重度NAFLD为5.39[4.44-6.53]；趋势性p<0.01）。与未患NAFLD的非肥胖女性相比，患NAFLD的非肥胖女性早发性子宫内膜癌aHR为2.53[2.11-3.05]，未患NAFLD的肥胖女性为1.66[1.10-2.52]，同时患有NAFLD和肥胖的女性为4.30[3.60-5.13]（协同指数=1.50，p<0.01）。 结论：NAFLD与非肥胖及肥胖女性早发性子宫内膜癌风险增加均独立相关。此外，同时患有NAFLD和肥胖的年轻女性表现出协同增强的风险。早期识别和管理NAFLD可能有助于缓解快速增长的早发性子宫内膜癌疾病负担。

原文链接：

Increased Risk of Early-Onset Endometrial Cancer in Women Aged 20–39 Years with Non-Alcoholic Fatty Liver Disease: A Nationwide Cohort Study