Abstract
Objective: to establish clinical and molecular features of endometrial hyperplasia in conditions of organic solvents exposure in patients with obesity. Materials and methods: postmenopausal women with endometrial hyperplasia (morphological criteria) were included to observational cross-sectional study. The main group included 140 subjects with occupational organic solvents exposure, aged 57,5 (46;64) years, of whom 70 had obesity and 70 had normal weight. Comparison group — 140 women without of occupational health risks, aged 56,5 (46;65) years, 68 with and 72 without obesity. Investigated workers were painters in machine building industry with length of service above 10 years, in post-contact period lasted for 1-5 years were 29 (20.7%) of participants. Organic solvents concentrations at the workplace’s areas were 1.5-5.5 times above occupational exposure limits. Linear and logistic regression were used to explore relationships. Level of significance p<0.05. Results: workers exposed to organic solvents had maximal percent of atypical endometrial hyperplasia: 34.3% in obesity subjects and 18.6% in those without obesity, in the comparison group 10.3% in subjects with and 6.9% in those without obesity, p=0.004. Subgroup with toxicant exposure with obesity characterized by maximal expression of Ki-67 (55,9±2,51, 51,4±4,95, 41,5±3,29 and 30,1±2,18 scores respectively), higher rate of uterine bleeding, M-echo thickness, blood interleukin 1β concentration. Atypical endometrial hyperplasia was associated with length of service (OR 1.80), maximal short-term exposure concentration of toluene (OR 2.51), waist circumference (OR 1.68), Ki-67 (OR 2,01), estrogen receptors on epithelium (OR 1.92). Conclusions: organic solvents exposure in postmenopausal women with endometrial hyperplasia contributes to development of atypical hyperplasia, systemic inflammation, Ki-67 expression, higher grades in subjects with obesity.
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