The Association Between Body Mass Index, Waist to Hip Ratio and Mid-Upper Arm Circumference with Endometriosis
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Abstract
Endometriosis is characterized by the presence of endometrial tissue, in the form of glands and stroma outside of the uterus. This study aimed to determine the relationship between body mass index, waist to hip circumference ratio, and mid-upper arm circumference with the incidence of endometriosis. This study was analytical observational research with a case-control. The subjects were 63 patients diagnosed with endometriosis through laparoscopic action and 63 normal women who both met inclusion and exclusion criteria. The measurement result of body mass index (BMI) in kg/m² is categorized into ≤25 and >25, waist to hip ratio is categorized to <0.85 and ≥0.85, mid-upper arm circumference in centimeters to ≤23.0 and >23.0. The result showed the relationship of body mass index, waist to hip ratio, and mid-upper arm circumference with endometriosis incidence obtained BMI with endometriosis (b=0.824, CI 95%=0.99 to 5.25, p=0.053), waist to hip ratio (b=0.893, CI 95%=1.03 to 5.82, p=0.044), and mid-upper arm circumference (b=-0.246, CI 95%=0.10 to 6.09, p=0.814). There is a significant relationship between BMI and waist to hip ratio with the incidence of endometriosis. There is no significant relationship between mid-upper arm circumference with the incidence of endometriosis.
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How to Cite
Hanifah, A., Budihastuti, U., & Balgis, B. (2022). The Association Between Body Mass Index, Waist to Hip Ratio and Mid-Upper Arm Circumference with Endometriosis. Unnes Journal of Public Health, 11(2), 173-178. https://doi.org/10.15294/ujph.v11i2.46095
References
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Backonja, U., Buck Louis, G. M., & Lauver, D. R. (2016). Overall adiposity, adipose tissue distribution, and endometriosis: A systematic review. Nursing Research, 65(2), 151–166. https://doi.org/10.1097/NNR.0000000000000146
Backonja, U., Hediger, M. L., Chen, Z., Lauver, D. R., Sun, L., Peterson, C. M., & Buck Louis, G. M. (2017). Beyond Body Mass Index: Using Anthropometric Measures and Body Composition Indicators to Assess Odds of an Endometriosis Diagnosis. Journal of Women’s Health (2002), 26(9), 941–950. https://doi.org/10.1089/jwh.2016.6128
Butovskaya, M., Sorokowska, A., Karwowski, M., Sabiniewicz, A., Fedenok, J., Dronova, D., … Sorokowski, P. (2017). Waist-to-hip ratio, body-mass index, age and number of children in seven traditional societies. Scientific Reports, 7(1), 1–9. https://doi.org/10.1038/s41598-017-01916-9
Byun, J., Peterson, C. M., Backonja, U., Taylor, R. N., Stanford, J. B., Allen-Brady, K. L., … Schliep, K. C. (2020). Adiposity and Endometriosis Severity and Typology. Journal of Minimally Invasive Gynecology, 27(7), 1516–1523. https://doi.org/10.1016/j.jmig.2020.01.002
Colleluori, G., Chen, R., Napoli, N., Aguirre, L. E., Qualls, C., Villareal, D. T., & Armamento-Villareal, R. (2018). Fat mass follows a U-shaped distribution based on estradiol levels in postmenopausal women. Frontiers in Endocrinology, 9(JUL), 1–6. https://doi.org/10.3389/fendo.2018.00315
Dai, Y., Li, X., Shi, J., & Leng, J. (2018). A review of the risk factors, genetics and treatment of endometriosis in Chinese women: A comparative update. Reproductive Health, 15(1), 1–12. https://doi.org/10.1186/s12978-018-0506-7
Edmonds, D. K. (2007). Obstetrics & Gynaecology (Seventh Ed). Retrieved from http://library1.nida.ac.th/termpaper6/sd/2554/19755.pdf
Goetz, L. G., Mamillapalli, R., & Taylor, H. S. (2016). Low body mass index in endometriosis is promoted by hepatic metabolic gene dysregulation in mice. Biology of Reproduction, 95(6), 1–8. https://doi.org/10.1095/biolreprod.116.142877
Hediger, M. L., Hartnett, H. J., & Louis, G. M. B. (2005). Association of endometriosis with body size and figure. Fertility and Sterility, 84(5), 1366–1374. https://doi.org/10.1016/j.fertnstert.2005.05.029
Holdsworth-Carson, S. J., Dior, U. P., Colgrave, E. M., Healey, M., Montgomery, G. W., Rogers, P. A. W., & Girling, J. E. (2018). The association of body mass index with endometriosis and disease severity in women with pain. Journal of Endometriosis and Pelvic Pain Disorders, 10(2), 79–87. https://doi.org/10.1177/2284026518773939
Holdsworth-Carson, S. J., & Rogers, P. A. W. (2018). The complex relationship between body mass index and endometriosis. Journal of Endometriosis and Pelvic Pain Disorders, 10(4), 187–189. https://doi.org/10.1177/2284026518810586
Moini, A., Malekzadeh, F., Amirchaghmaghi, E., Kashfi, F., Akhoond, M. R., Saei, M., & Mirbolok, M. H. (2013). Risk factors associated with endometriosis among infertile Iranian women. Archives of Medical Science, 9(3), 506–514. https://doi.org/10.5114/aoms.2013.35420
Pandey, N., Kriplani, A., Yadav, R. K., Lyngdoh, B. T., & Mahapatra, S. C. (2010). Peritoneal fluid leptin levels are increased but adiponectin levels are not changed in infertile patients with pelvic endometriosis. Gynecological Endocrinology, 26(11), 843–849. https://doi.org/10.3109/09513590.2010.487585
Parasar, P., Ozcan, P., Terry, K. L., & Terry, K. L. (2017). Endometriosis : Epidemiology , Diagnosis and Clinical Management. Curr Obstet Gynecol Rep, 34–41. https://doi.org/10.1007/s13669-017-0187-1
Shah, D. K., Correia, K. F., Vitonis, A. F., & Missmer, S. A. (2013). Body size and endometriosis: results from 20 years of follow-up within the Nurses’ Health Study II prospective cohort. Human Reproduction (Oxford, England), 28(7), 1783–1792. https://doi.org/10.1093/humrep/det120
Shahbazi, S., & Shahrabi-Farahani, M. (2016). Evaluation of the correlation between body mass index and endometriosis among Iranian fertile women. Gynecological Endocrinology, 32(2), 157–160. https://doi.org/10.3109/09513590.2015.1101439
Silva, J. B. Da, Gurian, M. B. F., Nonino, C. B., Poli-Neto, O. B., Nogueira, A. A., Reis, F. J. C. Dos, & Silva, J. R. E. S. (2020). Analysis of Body Composition and Pain Intensity in Women with Chronic Pelvic Pain Secondary to Endometriosis. Revista Brasileira de Ginecologia e Obstetricia, 42(8), 486–492. https://doi.org/10.1055/s-0040-1713912
Tang, A. M., Chung, M., Dong, K., Wanke, C., Bahwere, P., Bose, K., … Maalouf-Manasseh, Z. (2017). Determining a Global Mid-Upper Arm Circumference Cutoff to Assess Underweight in Adults (Men and Nonpregnant Women) (FHI 360/FA). Retrieved from www.fantaproject.org
Triolo, O., Lagana, A. S., & Sturlese, E. (2013). Chronic Pelvic Pain in Endometriosis: An Overview. Journal of Clinical Medicine Research, 5(3), 153–163. https://doi.org/10.4021/jocmr1288w
Van Tonder, E., Mace, L., Steenkamp, L., Tydeman-Edwards, R., Gerber, K., & Friskin, D. (2019). Mid-upper arm circumference (MUAC) as a feasible tool in detecting adult malnutrition. South African Journal of Clinical Nutrition, 32(4), 93–98. https://doi.org/10.1080/16070658.2018.1484622
Vercellini, P., Buggio, L., Somigliana, E., Barbara, G., Viganò, P., & Fedele, L. (2013). Attractiveness of women with rectovaginal endometriosis: A case-control study. Fertility and Sterility, 99(1), 212–218. https://doi.org/10.1016/j.fertnstert.2012.08.039
World Health Organisation (WHO). (2008). Waist Circumference and Waist–Hip Ratio. Report of a WHO Expert Consultation. Geneva, 8-11 December 2008. Retrieved from http://www.who.int
Zolbin, M. M., Mamillapalli, R., Nematian, S. E., Goetz, L., & Taylor, H. S. (2019). Adipocyte alterations in endometriosis: Reduced numbers of stem cells and microRNA induced alterations in adipocyte metabolic gene expression. Reproductive Biology and Endocrinology, 17(1), 1–10. https://doi.org/10.1186/s12958-019-0480-0
Backonja, U., Buck Louis, G. M., & Lauver, D. R. (2016). Overall adiposity, adipose tissue distribution, and endometriosis: A systematic review. Nursing Research, 65(2), 151–166. https://doi.org/10.1097/NNR.0000000000000146
Backonja, U., Hediger, M. L., Chen, Z., Lauver, D. R., Sun, L., Peterson, C. M., & Buck Louis, G. M. (2017). Beyond Body Mass Index: Using Anthropometric Measures and Body Composition Indicators to Assess Odds of an Endometriosis Diagnosis. Journal of Women’s Health (2002), 26(9), 941–950. https://doi.org/10.1089/jwh.2016.6128
Butovskaya, M., Sorokowska, A., Karwowski, M., Sabiniewicz, A., Fedenok, J., Dronova, D., … Sorokowski, P. (2017). Waist-to-hip ratio, body-mass index, age and number of children in seven traditional societies. Scientific Reports, 7(1), 1–9. https://doi.org/10.1038/s41598-017-01916-9
Byun, J., Peterson, C. M., Backonja, U., Taylor, R. N., Stanford, J. B., Allen-Brady, K. L., … Schliep, K. C. (2020). Adiposity and Endometriosis Severity and Typology. Journal of Minimally Invasive Gynecology, 27(7), 1516–1523. https://doi.org/10.1016/j.jmig.2020.01.002
Colleluori, G., Chen, R., Napoli, N., Aguirre, L. E., Qualls, C., Villareal, D. T., & Armamento-Villareal, R. (2018). Fat mass follows a U-shaped distribution based on estradiol levels in postmenopausal women. Frontiers in Endocrinology, 9(JUL), 1–6. https://doi.org/10.3389/fendo.2018.00315
Dai, Y., Li, X., Shi, J., & Leng, J. (2018). A review of the risk factors, genetics and treatment of endometriosis in Chinese women: A comparative update. Reproductive Health, 15(1), 1–12. https://doi.org/10.1186/s12978-018-0506-7
Edmonds, D. K. (2007). Obstetrics & Gynaecology (Seventh Ed). Retrieved from http://library1.nida.ac.th/termpaper6/sd/2554/19755.pdf
Goetz, L. G., Mamillapalli, R., & Taylor, H. S. (2016). Low body mass index in endometriosis is promoted by hepatic metabolic gene dysregulation in mice. Biology of Reproduction, 95(6), 1–8. https://doi.org/10.1095/biolreprod.116.142877
Hediger, M. L., Hartnett, H. J., & Louis, G. M. B. (2005). Association of endometriosis with body size and figure. Fertility and Sterility, 84(5), 1366–1374. https://doi.org/10.1016/j.fertnstert.2005.05.029
Holdsworth-Carson, S. J., Dior, U. P., Colgrave, E. M., Healey, M., Montgomery, G. W., Rogers, P. A. W., & Girling, J. E. (2018). The association of body mass index with endometriosis and disease severity in women with pain. Journal of Endometriosis and Pelvic Pain Disorders, 10(2), 79–87. https://doi.org/10.1177/2284026518773939
Holdsworth-Carson, S. J., & Rogers, P. A. W. (2018). The complex relationship between body mass index and endometriosis. Journal of Endometriosis and Pelvic Pain Disorders, 10(4), 187–189. https://doi.org/10.1177/2284026518810586
Moini, A., Malekzadeh, F., Amirchaghmaghi, E., Kashfi, F., Akhoond, M. R., Saei, M., & Mirbolok, M. H. (2013). Risk factors associated with endometriosis among infertile Iranian women. Archives of Medical Science, 9(3), 506–514. https://doi.org/10.5114/aoms.2013.35420
Pandey, N., Kriplani, A., Yadav, R. K., Lyngdoh, B. T., & Mahapatra, S. C. (2010). Peritoneal fluid leptin levels are increased but adiponectin levels are not changed in infertile patients with pelvic endometriosis. Gynecological Endocrinology, 26(11), 843–849. https://doi.org/10.3109/09513590.2010.487585
Parasar, P., Ozcan, P., Terry, K. L., & Terry, K. L. (2017). Endometriosis : Epidemiology , Diagnosis and Clinical Management. Curr Obstet Gynecol Rep, 34–41. https://doi.org/10.1007/s13669-017-0187-1
Shah, D. K., Correia, K. F., Vitonis, A. F., & Missmer, S. A. (2013). Body size and endometriosis: results from 20 years of follow-up within the Nurses’ Health Study II prospective cohort. Human Reproduction (Oxford, England), 28(7), 1783–1792. https://doi.org/10.1093/humrep/det120
Shahbazi, S., & Shahrabi-Farahani, M. (2016). Evaluation of the correlation between body mass index and endometriosis among Iranian fertile women. Gynecological Endocrinology, 32(2), 157–160. https://doi.org/10.3109/09513590.2015.1101439
Silva, J. B. Da, Gurian, M. B. F., Nonino, C. B., Poli-Neto, O. B., Nogueira, A. A., Reis, F. J. C. Dos, & Silva, J. R. E. S. (2020). Analysis of Body Composition and Pain Intensity in Women with Chronic Pelvic Pain Secondary to Endometriosis. Revista Brasileira de Ginecologia e Obstetricia, 42(8), 486–492. https://doi.org/10.1055/s-0040-1713912
Tang, A. M., Chung, M., Dong, K., Wanke, C., Bahwere, P., Bose, K., … Maalouf-Manasseh, Z. (2017). Determining a Global Mid-Upper Arm Circumference Cutoff to Assess Underweight in Adults (Men and Nonpregnant Women) (FHI 360/FA). Retrieved from www.fantaproject.org
Triolo, O., Lagana, A. S., & Sturlese, E. (2013). Chronic Pelvic Pain in Endometriosis: An Overview. Journal of Clinical Medicine Research, 5(3), 153–163. https://doi.org/10.4021/jocmr1288w
Van Tonder, E., Mace, L., Steenkamp, L., Tydeman-Edwards, R., Gerber, K., & Friskin, D. (2019). Mid-upper arm circumference (MUAC) as a feasible tool in detecting adult malnutrition. South African Journal of Clinical Nutrition, 32(4), 93–98. https://doi.org/10.1080/16070658.2018.1484622
Vercellini, P., Buggio, L., Somigliana, E., Barbara, G., Viganò, P., & Fedele, L. (2013). Attractiveness of women with rectovaginal endometriosis: A case-control study. Fertility and Sterility, 99(1), 212–218. https://doi.org/10.1016/j.fertnstert.2012.08.039
World Health Organisation (WHO). (2008). Waist Circumference and Waist–Hip Ratio. Report of a WHO Expert Consultation. Geneva, 8-11 December 2008. Retrieved from http://www.who.int
Zolbin, M. M., Mamillapalli, R., Nematian, S. E., Goetz, L., & Taylor, H. S. (2019). Adipocyte alterations in endometriosis: Reduced numbers of stem cells and microRNA induced alterations in adipocyte metabolic gene expression. Reproductive Biology and Endocrinology, 17(1), 1–10. https://doi.org/10.1186/s12958-019-0480-0