Abstract：
Few studies have investigated the 1930s hypothesis that reproductive tract infections are risk factors for fibroid development. In our 2017 cross-sectional analysis from the Study of Environment, Lifestyle, and Fibroids (2010-2018), a large Detroit community-based cohort of 23-35 year-old African-American women with ultrasound fibroid screening, we found an inverse association between seropositivity for genital Chlamydia trachomatis (gCT) infection and fibroids. With prospective data from the cohort (standardized ultrasounds every 20 months over 5 years), we examined gCT\'s associations with fibroid incidence (among 1158 women fibroid-free at baseline) and growth. We computed adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for incidence by gCT serostatus using Cox proportional hazards models. GCT\'s influence on growth was assessed by estimating the difference between fibroid size change for seropositive vs. seronegative between successive ultrasounds (1254 growth measures) using a linear mixed model. Growth was scaled to change over 18 months. GCT seropositivity was not associated with fibroid incidence (aHR, 1.0 95% CI: 0.79, 1.29) or growth (4.4%, 95% CI: -5.02, 14.64). The current evidence based on both biomarker gCT data, which can capture the common undiagnosed infections, and prospective ultrasound data for fibroids suggests that Chlamydia is unlikely to increase fibroid risk.
摘要：
很少有研究调查1930年代的假设，即生殖道感染是肌瘤发展的危险因素。在我们2017年环境研究的横截面分析中，生活方式,和肌瘤（2010-2018），一个基于底特律社区的大型队列，由23-35岁的非洲裔美国妇女进行超声纤维瘤筛查，我们发现生殖器沙眼衣原体(gCT)感染的血清阳性与肌瘤呈负相关.根据队列的前瞻性数据（5年内每20个月进行一次标准化超声检查），我们检查了gCT与纤维瘤发生率(基线时1158例女性无纤维瘤)和生长的相关性.我们使用Cox比例风险模型计算了gCT血清状态发生率的校正风险比（aHRs）和95％置信区间（CIs）。GCT对生长的影响是通过估计血清阳性与纤维瘤大小变化之间的差异来评估的使用线性混合模型在连续超声（1254个生长测量）之间呈血清阴性。增长在18个月内按比例变化。GCT血清阳性与肌瘤发生率无关(aHR，1.095%CI：0.79，1.29）或增长（4.4%，95%CI：-5.02，14.64）。目前的证据基于两种生物标志物gCT数据，可以捕获常见的未诊断感染，纤维瘤的前瞻性超声数据表明,衣原体不太可能增加纤维瘤的风险.
