LIPID PROFILE IS CORRELATED WITH ENDOMETRIOSIS’ PHENOTYPES

Vol 1, 2020 - 131288
Iniciação Científica
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Abstract

Introduction and objectives: Endometriosis is a gynecological estrogen and angiogenesis dependentdisorder characterized by endometrial tissue outside the uterine cavity. It has a prevalence of 10-15% in women of reproductive age worldwide and it is associated with different symptoms, such as dysmenorrhea, chronic pelvic pain, dyspareunia, infertility, and cyclical intestinal and urinary complaints.Endometriosis is benign disease, however, certain aspects are similar to those found in cancer, such asincreasedproliferation, cell invasion and neoangiogenesis. Moreover, women with endometriosis, mainly with advanced stage, may have an increased risk of developing some types of gynecological cancers. An increase in serum levels of low density lipoprotein (LDL) and LDL oxidation in women with endometriosis can promoting establishment, adhesion and development of endometriotic foci. However, this relationship is not well understood.Therefore, the present study aimed to review the correlation between endometriosis and lipidic profile. Materials and Methods: Prospero registration number CRD42020146646. Eligible studies were identified using four international databases (PubMed, Medline, Lilacs and SciELO), published in the last 15 years, and without languagerestrictions. All articles that measured serum lipid profile, by any method, from women with endometrios is compared with healthy women were included in this review. Results and conclusions: Eighty-nine publications were identified in the databases, but only 6 articles were eligible. All studies were case-control designs, with a total of 590 women.The studies included Brazilian, Italian, Turkish and Iranian populations. There was no significant difference in mean age between women with and without endometriosis. Four studies showed no significant difference regarding body mass index (BMI) between cases and controls, while two showed lower BMI in endometriosis women (P<0.05). Significant correlations were found between the lipidic profile and endometriosis. Four studies showed that total cholesterol and LDL were significantly increased in endometriosis patients (P<0.05) compared with control. However, three of them found a positive association between triglyceride levels and endometriosis. Interestingly, high-density lipoproteins (HDL) were increased in 3 studies and decreased in two other studies in women with endometriosis when compared to controls. Finally, only one study found a controversial significant association between endometriosis and lower levels of LDL (P=0.001).It is possible to observe that most of these studies had a small sample size, varying from 39 to 204 women.The relationship between cholesterol and endometriosis is unclear, however, drugs that reduce cholesterol levels can be a potential therapeutic target for endometriosis.

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Author

Marllow Claudino

Olá Murilo, tudo bem? 1- O principal critério para descarte para partir de um total de 89 trabalhos e chegar em somente 6 foi a não utilização do plasma para forma de quantificação de possível hipercolesterolemia. 2- Acredito que não ocasionaria em diferença nos parâmetros avaliados, visto que seriam feitas somente análises bioquímicas. 3- Há um estudo que utiliza a sinvastatina na endometriose, entretanto não acharam dados conclusivos. Desta forma, destaca-se a necessidade de mais estudo com ênfase nessa área. Com relação a hipótese, temos sim. A relação entre uma lipidemia elevada e endometriose está ligada diretamente por se tratar de uma doença inflamatória crônica e com alto estresse oxidativo. No momento em que os macrófagos estão agindo no combate dos focos endometrióticos eles liberaram citocinas responsáveis pelo recrutamento de células sanguíneas leucocitárias, essas que passam dos vasos para o tecido por diapedese. Nesse momento, há o extravasam concomitante do infiltrado leucocitário composto por lipoproteínas. Essas lipoproteínas sofrem ação do estresse oxidativo do microambiente endometriótico, dando origem a lipoproteínas oxidadas, que passa a serem alvos dos macrófagos. No momento em que os macrofagos as fagocitam perdem sua atividade por se tornarem células esponjosas. A partir daí se cria um microambiente propício para o estabelecimento, adesão e desenvolvimento dos focos endometrióticos.  Obrigado!!  

Murilo Rocha

Entendi Marllow! Todo o processo de seleção dos trabalhos e analise de dados foi feita por você?
Author

Marllow Claudino

Boa tarde Igor Petrone,  1) Os criterios de exclusão foram: A quantificação do perfil lipídico ser feita pelo soro/plasma; Ser um estudo de caso controle; Estudos de 10/2004 a 10/2019; Ausência da correlação entre endometriose e lipoproteínas. 2) A importância da inclusão desses trabalhos da relação entre o perfil lipidico e endometriose são de extrema importância, visto que esse correlação ainda não é bem detalhada e somente é baseada em hipóteses. 
Author

Marllow Claudino

Muito obrigado!!

Igor Petrone

Obrigado pelos esclarecimentos e, mais uma vez, parabéns pelo trabalho!
Institutions
  • 1 Centro Universitário Estadual da Zona Oeste
  • 2 Programa de Ciências Morfológicas / Instituto de Ciências Biomédicas (ICB/UFRJ / Universidade Federal do Rio de Janeiro
  • 3 National Institute of Traumatology and Orthopaedics
Keywords
Endometriosis
lipid profile
cholesterol