Clinical features of endometriosis in patients with type 1 diabetes mellitus
Notice bibliographique
Résumé
BACKGROUND: Endometriosis affects 5–10% of women of reproductive age worldwide. Despite the high prevalence of the disease, its diagnosis is usually delayed for several years and misdiagnosis is common, leading to delay in effective pathogen-based treatment. Early diagnosis and timely treatment of endometriosis are particularly important in patients with type 1 diabetes mellitus, as the longer the disease lasts, the greater the risk of vascular complications and the lower ovarian reserve, thus decreasing the reproductive capacity. AIM: The aim of this study was to analyze the clinical features of endometriosis in patients with type 1 diabetes mellitus allowing for a timely and accurate diagnosis. METHODS: This clinical study included women with endometriosis, type 1 diabetes mellitus, and a combination of the two. The control group consisted of healthy women of reproductive age. The diagnosis of endometriosis was confirmed by laparoscopic surgery and verified by histological examination. Serum anti-Müllerian hormone levels were determined using the immunochemiluminescence method from days 2 to 5 of the menstrual cycle. Glycated hemoglobin levels were measured in patients with type 1 diabetes mellitus. RESULTS: The study included 51 patients with endometriosis, 209 patients with type 1 diabetes mellitus, 79 patients with a combination of these diseases, and 31 conditionally healthy women. In patients with endometriosis combined with type 1 diabetes mellitus, the frequency of abnormal uterine bleeding was 31%, which is higher than in patients with only type 1 diabetes mellitus (11%), but lower than in those with only endometriosis (71%). Dysmenorrhea according to the McGill visual analogue pain scale in patients with endometriosis combined with type 1 diabetes mellitus was 3.9 ± 1.48 points, with endometriosis 7.06 ± 1.27 points, and with type 1 diabetes mellitus 1.2 ± 0.7 points. In patients with endometriosis combined with type 1 diabetes mellitus, there was a decrease in the number of antral follicles (8 ± 3) and anti-Müllerian hormone level (3.12 ± 1.78 ng/ml) compared to patients with type 1 diabetes mellitus (12 ± 4, 3.52 ± 2.0 ng/ml, respectively). The most pronounced decrease in the number of antral follicles (4 ± 2) and anti-Müllerian hormone level (0.94 ± 0.4 ng/ml) was found in patients with endometriosis. The incidence of deep infiltrative endometriosis was higher in patients without diabetes mellitus, occurring in 71% of cases. In patients with endometriosis combined with type 1 diabetes mellitus, it only occurred in 42% of cases. Endometrioid cysts were found in 42% of patients without type 1 diabetes mellitus and in 22% of those with the disease. Repeat surgical interventions were performed in 25% of patients with endometriosis without type 1 diabetes mellitus, compared to only 10% of women with endometriosis combined with type 1 diabetes mellitus. CONCLUSION: Late diagnosis and delayed treatment of endometriosis, which is often asymptomatic when combined with type 1 diabetes mellitus, can lead to a decrease in ovarian reserve and infertility. In patients with type 1 diabetes mellitus, endometriosis should be suspected in the presence of mild pain, abnormal uterine bleeding, decreased anti-Müllerian hormone levels and antral follicle count, and infertility to ensure timely diagnosis and selection of treatment strategies. Diabetic patients require a long period of pre-pregnancy planning in order to compensate for their disease.
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Comment cette classification a été obtenuedéplier
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Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
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Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».