Epidemiological characteristics of suspected adenomyosis in the Chinese physical examination population: a nested case-control study

Objectives We aimed to explore the epidemiological characteristics of suspected adenomyosis within a physical examination population in China.Design A retrospective, nested case-control study; we matched healthy people and those with potential adenomyosis on a 1:2 ratio by age.Setting A tertiary hos...

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Main Authors: Wei Xu, Lijun Zhang, Qiuling Shi, Fan Xu, Ke Chen, Yanyan Huang, Ruoyan Gong, Yang Pu, Yuxian Nie, Xueyao Su, Jiayuan Zhang
Format: Article
Language:English
Published: BMJ Publishing Group 2024-01-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/1/e074488.full
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author Wei Xu
Lijun Zhang
Qiuling Shi
Fan Xu
Ke Chen
Yanyan Huang
Ruoyan Gong
Yang Pu
Yuxian Nie
Xueyao Su
Jiayuan Zhang
author_facet Wei Xu
Lijun Zhang
Qiuling Shi
Fan Xu
Ke Chen
Yanyan Huang
Ruoyan Gong
Yang Pu
Yuxian Nie
Xueyao Su
Jiayuan Zhang
author_sort Wei Xu
collection DOAJ
description Objectives We aimed to explore the epidemiological characteristics of suspected adenomyosis within a physical examination population in China.Design A retrospective, nested case-control study; we matched healthy people and those with potential adenomyosis on a 1:2 ratio by age.Setting A tertiary hospital health management centre.Participants We included 15–60 years old women who underwent at least one uterine examination from October 2017 to December 2020, excluding those who had undergone hysterectomy and menopause.Primary and secondary outcome measures We estimated the incidence and prevalence rate of suspected adenomyosis. Conditional logistic regression was used to estimate associations between serum biomarkers and potential adenomyosis. Areas under the receiver-operating characteristic curves (AUC) were used to determine the cut-off point of the cancer antigen 125 (CA125) level for suspected adenomyosis.Results A total of 30 629 women had uterus-related imaging examinations; 877 had suspected adenomyosis. The standardised incidence and prevalence of suspected adenomyosis was 1.32% and 2.35%, respectively, for all age groups. The conditional logistic regression analysis results showed that total bilirubin≥18.81 µmol/L (HR: 2.129; 95% CI 1.067 to 4.249; p<0.0321) and CA125 levels (HR: 1.014; 95% CI 1.002 to 4.731; p<0.0273) were positively correlated with onset of suspected adenomyosis; body mass index>24 kg/m2 (HR: 1.262; 95% CI 1.055 to 1.511; p<0.0109), CA125 levels (HR: 1.007; 95% CI 1.006 to 1.009; p<0.0001), and blood platelet levels (HR: 1.002; 95% CI 1 to 1.003; p<0.0141) were positively correlated with potential adenomyosis. The optimal cut-off of CA125 for new suspected adenomyosis was 10.714 U/mL, with a sensitivity of 77.42%, specificity of 53.76%, and AUC of 0.7841 (95% CI 0.7276 to 0.8407).Conclusions The disease burden of suspected adenomyosis remains huge and can be informed by biomarkers. The disease-specific threshold of CA125 will support further preventive strategy development in population.Trial registration number ChiCTR2100049520, 2021/8/2.
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spelling doaj-art-38c67a7c29674f00a686f55abed573df2025-08-20T02:13:32ZengBMJ Publishing GroupBMJ Open2044-60552024-01-0114110.1136/bmjopen-2023-074488Epidemiological characteristics of suspected adenomyosis in the Chinese physical examination population: a nested case-control studyWei Xu0Lijun Zhang1Qiuling Shi2Fan Xu3Ke Chen4Yanyan Huang5Ruoyan Gong6Yang Pu7Yuxian Nie8Xueyao Su9Jiayuan Zhang102METiS Pharmaceuticals, Hangzhou, ChinaBiocytogen Pharmaceuticals, Beijing, ChinaSchool of Public Health and Management, Chongqing Medical University, Chongqing, China2 Department of Obstetrics and Gynecology, Nanchong Central Hospital Affiliated to North Sichuan Medical College, Nanchong, Sichuan, China3 Department of Health Management Center, Nanchong Central Hospital Affiliated to North Sichuan Medical College, Nanchong, Sichuan, China1 School of Public Health, Chongqing Medical University, Chongqing, China1 School of Public Health, Chongqing Medical University, Chongqing, China1 School of Public Health, Chongqing Medical University, Chongqing, ChinaState Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Medical University, Chongqing, China1 School of Public Health, Chongqing Medical University, Chongqing, China6 College of Biomedical Engineering, Chongqing Medical University, Chongqing, ChinaObjectives We aimed to explore the epidemiological characteristics of suspected adenomyosis within a physical examination population in China.Design A retrospective, nested case-control study; we matched healthy people and those with potential adenomyosis on a 1:2 ratio by age.Setting A tertiary hospital health management centre.Participants We included 15–60 years old women who underwent at least one uterine examination from October 2017 to December 2020, excluding those who had undergone hysterectomy and menopause.Primary and secondary outcome measures We estimated the incidence and prevalence rate of suspected adenomyosis. Conditional logistic regression was used to estimate associations between serum biomarkers and potential adenomyosis. Areas under the receiver-operating characteristic curves (AUC) were used to determine the cut-off point of the cancer antigen 125 (CA125) level for suspected adenomyosis.Results A total of 30 629 women had uterus-related imaging examinations; 877 had suspected adenomyosis. The standardised incidence and prevalence of suspected adenomyosis was 1.32% and 2.35%, respectively, for all age groups. The conditional logistic regression analysis results showed that total bilirubin≥18.81 µmol/L (HR: 2.129; 95% CI 1.067 to 4.249; p<0.0321) and CA125 levels (HR: 1.014; 95% CI 1.002 to 4.731; p<0.0273) were positively correlated with onset of suspected adenomyosis; body mass index>24 kg/m2 (HR: 1.262; 95% CI 1.055 to 1.511; p<0.0109), CA125 levels (HR: 1.007; 95% CI 1.006 to 1.009; p<0.0001), and blood platelet levels (HR: 1.002; 95% CI 1 to 1.003; p<0.0141) were positively correlated with potential adenomyosis. The optimal cut-off of CA125 for new suspected adenomyosis was 10.714 U/mL, with a sensitivity of 77.42%, specificity of 53.76%, and AUC of 0.7841 (95% CI 0.7276 to 0.8407).Conclusions The disease burden of suspected adenomyosis remains huge and can be informed by biomarkers. The disease-specific threshold of CA125 will support further preventive strategy development in population.Trial registration number ChiCTR2100049520, 2021/8/2.https://bmjopen.bmj.com/content/14/1/e074488.full
spellingShingle Wei Xu
Lijun Zhang
Qiuling Shi
Fan Xu
Ke Chen
Yanyan Huang
Ruoyan Gong
Yang Pu
Yuxian Nie
Xueyao Su
Jiayuan Zhang
Epidemiological characteristics of suspected adenomyosis in the Chinese physical examination population: a nested case-control study
BMJ Open
title Epidemiological characteristics of suspected adenomyosis in the Chinese physical examination population: a nested case-control study
title_full Epidemiological characteristics of suspected adenomyosis in the Chinese physical examination population: a nested case-control study
title_fullStr Epidemiological characteristics of suspected adenomyosis in the Chinese physical examination population: a nested case-control study
title_full_unstemmed Epidemiological characteristics of suspected adenomyosis in the Chinese physical examination population: a nested case-control study
title_short Epidemiological characteristics of suspected adenomyosis in the Chinese physical examination population: a nested case-control study
title_sort epidemiological characteristics of suspected adenomyosis in the chinese physical examination population a nested case control study
url https://bmjopen.bmj.com/content/14/1/e074488.full
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