Reproductive
Endometriosis and hypertriglyceridemia, why we care about severity and typology? Karen Schliep* Karen Schliep Leslie Farland Anna Pollack Emmanuel Adediran Rachel Myrer Maggie Fuzak Kathryn Rexrode Michael Varner C. Matthew Peterson Madeline Paulson
While plausible mechanisms exist for an association between endometriosis and hypertriglyceridemia, prior studies have shown inconsistent findings, possibly due to the inability to assess endometriosis severity or subtypes. Among 473 premenopausal individuals undergoing gynecologic laparoscopy, regardless of clinical indication, the present study assessed the association between non-fasting serum triglycerides and incident endometriosis. Participants were recruited in Salt Lake City and San Francisco (2007–2009). Surgeons completed an operative report immediately after surgery to capture revised American Society for Reproductive Medicine staging (I−IV) and typology of endometriosis (superficial endometriosis [SE], ovarian endometrioma [OE], and deep infiltrating endometriosis [DE]). We collected biospecimens, anthropometrics, and self-reported sociodemographics at baseline. We evaluated the association between endometriosis diagnosis, stage, typology, and triglyceride concentrations using non-fasting female cutpoints (normal <175mg/dL vs hypertriglyceridemia ≥175mg/dL) via generalized linear models. Among the cohort, 108 women (23%) had high triglycerides. Endometriosis was associated with a slightly higher prevalence of high triglycerides (adjusted prevalence ratio (aPR): 1.41, 95% CI: 0.93, 2.12, Table 1). We found stronger associations by stage and type. Compared to no endometriosis, women with moderate to severe stage endometriosis had 2.03 (95% CI: 1.13, 3.63) higher adjusted aPR for hypertriglyceridemia. Women who were diagnosed with DE combined with OE had a 4.01 higher aPR (95% CI: 2.56, 6.29) for hypertriglyceridemia. In sum, we found that endometriosis staging and typology correlated more strongly with hypertriglyceridemia compared to diagnosis alone. A limitation of this study is not having fasting blood draws; however, prior research has shown that non-fasting triglyceride levels are a better predictor of cardiovascular risk than fasting triglycerides.
