자궁근종과 성호르몬 대사물과의 연관성

Correlation between Steroid Hormone Metabolites and Leiomyomas of Uterus

  • 배상욱 (연세대학교 의과대학 산부인과학교실) ;
  • 정병화 (한국과학기술연구원 생체대사 연구센터) ;
  • 정봉철 (한국과학기술연구원 생체대사 연구센터) ;
  • 전진동 (연세대학교 의과대학 산부인과학교실) ;
  • 이현정 (연세대학교 의과대학 산부인과학교실) ;
  • 권한성 (연세대학교 의과대학 산부인과학교실) ;
  • 정경아 (연세대학교 의과대학 산부인과학교실) ;
  • 김세광 (연세대학교 의과대학 산부인과학교실) ;
  • 박기현 (연세대학교 의과대학 산부인과학교실)
  • Bai, Sang-Wook (Department of Obstetrics and Gynecology, Yonsei University College of Medicine) ;
  • Jung, Byung-Hwa (Bioanalysis and Biotransformation Research Center, Korea Institute of Science and Technology) ;
  • Chung, Bong-Chul (Bioanalysis and Biotransformation Research Center, Korea Institute of Science and Technology) ;
  • Jeon, Jin-Dong (Department of Obstetrics and Gynecology, Yonsei University College of Medicine) ;
  • Lee, Hyun-Jung (Department of Obstetrics and Gynecology, Yonsei University College of Medicine) ;
  • Kwon, Han-Sung (Department of Obstetrics and Gynecology, Yonsei University College of Medicine) ;
  • Chung, Kyung-Ah (Department of Obstetrics and Gynecology, Yonsei University College of Medicine) ;
  • Kim, Sei-Kwang (Department of Obstetrics and Gynecology, Yonsei University College of Medicine) ;
  • Park, Ki-Hyun (Department of Obstetrics and Gynecology, Yonsei University College of Medicine)
  • 발행 : 2001.12.30

초록

Objective: To elucidate 1) whether there are any differences in the urine concentrations of steroid hormone metabolites between patients with leiomyoma and normal controls 2) the correlation between urinary profiles of steroid hormones and leiomyomas of the uterus according to their type, location, volume, and weight. Materials of Methods : The study population consisted of 37 premenopausal patients with uterine leiomyoma and the control group consisted of 25 premenopausal normal volunteer women without uterine leiomyoma. Confirmation of the existence of uterine leiomyoma was done by ultrasonography and histopathological examination after surgery. The volume of the leiomyoma was estimated by trans-abdominal and/or trans-vaginal ultrasonography. The Leiomyomas were divided into 3 types (subserosal, intramural and submucosal). Seventeen patients had subserosal type of leiomyoma, 10 with the intramural type and 10 with the submucosal type. The locations of the leiomyoma were also divided into 3 groups (fundus, body and isthmus). Seventeen patients showed a fundus location, 10 in body, and 10 in isthmus. We compared urinary profiles of the endogenous steroids between patients with leiomyomas and normal controls, and also investigated the relationship between urinary profiles of the endogenous steroids and leiomyomas according to their type, location, volume and weight by using highly sensitive Gas Chromatography-Mass Spectrometry (GC-MS) system. Results: The mean ages of the patients with leiomyomas and the control group were $43.1{\pm}5.6$ and $40.6{\pm}7.2$ years, the weights were $63.4{\pm}7.3$ and $59.4{\pm}8.1\;kg$, and their heights were $155.4{\pm}4.8$ and $159.3{\pm}4.8\;cm$ respectively. Seventeen patients had subserosal, 10 had intramural, and 10 had submucosal leiomyomas. There were 17 patients with leiomyoma located in fundus, 10 in body and 10 in isthmus. $17{\beta}$-estradiol, 5-AT, 11-keto ET, $11{\beta}$-hydroxy An, $11{\beta}$-hydroxy Et, THS, THA, THE, a-cortolone, a-cortol, $\beta$-cortol, $11{\beta}$-OH Et/$11{\beta}$-OH An and E2/E1 were significantly increased in patients with leiomyoma than in the control group. $17{\beta}$-estradiol was significantly increased in the intramural and the submucosal types than in the subserosal type. There was no significant difference in the concentrations of urinary steroids according to the locations of leiomyomas. There was no significant relationship between the concentration of urinary steroids and the volume of the leiomyomas. $17{\beta}$-estradiol significantly decreased as the weight of uterus increased (r=-0.322, p=0.04). Conclusion: The concentrations of steroid hormone metabolites were generally increased in patients with leiomyoma but were not significantly related to the volume and weight of the leiomyomas. Our study suggests that steroid hormones may be involved in the initiation of leiomyomas but may not be involved in their progression. In addition, the concentrations of steroid hormone metabolites are not related to the leiomyoma type and location.

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