Is body mass index associated with the incidence of endometriosis and the severity of dysmenorrhoea: A case-control study in China?
Open accessAbstract
Objective Endometriosis is considered as a serious gynaecological disease in women at a reproductive age. Lower body mass index (BMI) is thought to be a risk factor. However, recent studies indicated that women with normal BMI were also more likely to develop endometriosis, suggesting the association with BMI is controversial. We therefore investigated the association of BMI and surgically diagnosed endometriosis in a cohort of Chinese women. Design Retrospective case–control study. Setting Tertiary hospital. Patients 709 women with endometriosis and 807 age matched controls between January 2018 and August 2019. Intervention Age at diagnosis, parity, gravida, BMI and self-reported dysmenorrhoea status were collected and the association of BMI and endometriosis was analysed. Measurement and main results Overall, the median BMI was not different between patients and controls (21.1 kg/m 2 vs 20.9 kg/m 2 , p=0.223). According to the BMI categories for Asians/Chinese by WHO (underweight: <18.5 kg/m 2 , normal weight: 18.5–22.99 kg/m 2 , overweight: 23–27.49 kg/m 2 , obese: ≥27.50 kg/m 2 ), overall, there was no difference in the association of BMI and endometriosis (p=0.112). 60% of patients were of normal weight. However, the OR of obese patients (BMI over 27.50 kg/m 2 ) having endometriosis was1.979 (95% CI 1.15 to 3.52, p=0.0185), compared with women with normal weight. 50.3% patients reported dysmenorrhoea, and the OR of developing severe dysmenorrhoea in obese patients (BMI over 27.50 kg/m 2 ) was 3.64 (95% CI 1.195 to 10.15, p=0.025), compared with patients with normal weight. Conclusion Our data demonstrate that overall there was no association between BMI and the incidence of endometriosis, but there was a significant increase in the incidence of endometriosis in obese women, compared with women with normal weight. Obesity was also a risk factor for severe dysmenorrhoea.
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There is generally no association between BMI and the incidence of endometriosis, but there has been a significant increase in the incidence of endometriosis in obese women compared to women with normal body weight.
“Interestingly, the latest data indicate that there is generally no association between BMI and the incidence of endometriosis, but there has been a significant increase in the incidence of endometriosis in obese women compared to women with normal body weight.”
From Endometriosis: Epidemiology, Classification, Pathogenesis, Treatment and Genetics (Review of Literature) (2021) · cites this paper as [50]
Obesity is a risk factor for severe dysmenorrhea.
“Obesity is also a risk factor for severe dysmenorrhea [50].”
From Endometriosis: Epidemiology, Classification, Pathogenesis, Treatment and Genetics (Review of Literature) (2021) · cites this paper as [50]
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- [24]Ju H, Jones M, Mishra GD A U-shaped relationship between body mass index and dysmenorrhea: a longitudinal study. PLoS One 2015; 10: e0134187. 10.1371/journal.pone.0134187 26218569 PMC4517870 · DOI
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Smolarz, B., Szyłło, K., & Romanowicz, H. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms221910554 · Cited by 560 · see citing works
- Authors
- Tang, Y., Zhao, M., Lin, L., Gao, Y., Chen, G. Q., Chen, S., & Chen, Q.
- Affiliations
- Fudan University (CN)
- Shanghai Medical College of Fudan University (CN)
- University of Auckland (NZ)
- University of Manchester (GB)
- Corresponding author
- Chen, Shouzhen
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2020-09
- Volume
- 10
- Issue
- 9
- Pages
- e037095
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC7478014
- OpenAlex
- W3083477101
- Cited by
- 53
- References
- 29
- Citations by year
- 2026: 12 · 2025: 12 · 2024: 3 · 2023: 7 · 2022: 13 · 2021: 6
- FWCI
- 5.73
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- HighWire Press Open Archive (submittedVersion)
- ResearchSpace (University of Auckland) (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Keywords
- body mass index, obesity, dysmenorrhea, endometriosis severity, Chinese women, overweight, parity, age at diagnosis, risk factors, underweight women, women of reproductive age
- MeSH terms
- China, Dysmenorrhea, Endometriosis, Female, Humans, Pregnancy, Retrospective Studies, Risk Factors, Body Mass Index, Incidence, Case-Control Studies, Overweight
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