PDF(Pubmed)
Abstract：
To examine the association between keloids, hypertrophic scars, and uterine fibroid incidence as well as growth. Both keloids and fibroids are fibroproliferative conditions that have been reported to be more prevalent among Blacks than Whites, and they share similar fibrotic tissue structures, including extracellular matrix composition, gene expression, and protein profiles. We hypothesized that women with a history of keloids would have greater uterine fibroid development.
A prospective community cohort study (enrollment 2010-2012) with 4 study visits over 5 years to conduct standardized ultrasounds to detect and measure fibroids ≥0.5 cm in diameter, assess the history of keloid and hypertrophic scars, and update covariates.
Detroit, Michigan area.
A total of 1,610 self-identified Black and/or African American women aged 23-35 years at enrollment without a previous clinical diagnosis of fibroids.
Keloids (raised scars that grow beyond the margins of the original injury) and hypertrophic scars (raised scars that stay within the bounds of the original injury). Because of the difficulties in distinguishing keloids and hypertrophic scars, we separately examined the history of keloids and the history of either keloids or hypertrophic scars (any abnormal scarring) and their associations with fibroid incidence and growth.
Fibroid incidence (new fibroid after a fibroid-free ultrasound at enrollment) was assessed using Cox proportional-hazards regression. Fibroid growth was assessed using linear mixed models. The estimates for the change in log volume per 18 months were converted to the estimated percentage difference in volume for scarring vs. no-scarring. Both incidence and growth models were adjusted for time-varying demographic, reproductive, and anthropometric factors.
Of the 1,230 fibroid-free participants, 199 (16%) reported ever having keloids, 578 (47%) reported keloids or hypertrophic scars, and 293 (24%) developed incident fibroids. Neither keloids (adjusted hazard ratio = 1.04; 95% confidence interval: 0.77, 1.40) nor any abnormal scarring (adjusted hazard ratio = 1.10; 95% confidence interval: 0.88, 1.38) were associated with fibroid incidence. Fibroid growth differed little by scarring status.
Despite molecular similarities, self-reported keloid and hypertrophic scars did not show an association with fibroid development. Future research may benefit from the examination of dermatologist-confirmed keloids or hypertrophic scars; however, our data suggest little shared susceptibility for these 2 types of fibrotic conditions.
A prospective community cohort study (enrollment 2010-2012) with 4 study visits over 5 years to conduct standardized ultrasounds to detect and measure fibroids ≥0.5 cm in diameter, assess the history of keloid and hypertrophic scars, and update covariates.
Detroit, Michigan area.
A total of 1,610 self-identified Black and/or African American women aged 23-35 years at enrollment without a previous clinical diagnosis of fibroids.
Keloids (raised scars that grow beyond the margins of the original injury) and hypertrophic scars (raised scars that stay within the bounds of the original injury). Because of the difficulties in distinguishing keloids and hypertrophic scars, we separately examined the history of keloids and the history of either keloids or hypertrophic scars (any abnormal scarring) and their associations with fibroid incidence and growth.
Fibroid incidence (new fibroid after a fibroid-free ultrasound at enrollment) was assessed using Cox proportional-hazards regression. Fibroid growth was assessed using linear mixed models. The estimates for the change in log volume per 18 months were converted to the estimated percentage difference in volume for scarring vs. no-scarring. Both incidence and growth models were adjusted for time-varying demographic, reproductive, and anthropometric factors.
Of the 1,230 fibroid-free participants, 199 (16%) reported ever having keloids, 578 (47%) reported keloids or hypertrophic scars, and 293 (24%) developed incident fibroids. Neither keloids (adjusted hazard ratio = 1.04; 95% confidence interval: 0.77, 1.40) nor any abnormal scarring (adjusted hazard ratio = 1.10; 95% confidence interval: 0.88, 1.38) were associated with fibroid incidence. Fibroid growth differed little by scarring status.
Despite molecular similarities, self-reported keloid and hypertrophic scars did not show an association with fibroid development. Future research may benefit from the examination of dermatologist-confirmed keloids or hypertrophic scars; however, our data suggest little shared susceptibility for these 2 types of fibrotic conditions.
摘要：
目的：为了检查瘢痕疙瘩，增生性疤痕,和子宫肌瘤的发病率以及生长。瘢痕疙瘩和肌瘤都是纤维增生性疾病，据报道，黑人比白人更普遍。它们具有相似的纤维化组织结构，包括细胞外基质成分，基因表达，和蛋白质谱。我们假设有瘢痕疙瘩病史的女性会有更大的子宫肌瘤发展。
方法：一项前瞻性社区队列研究（2010-2012年注册），在5年内进行4次研究访问，以进行标准化超声检查，以检测和测量直径≥0.5cm的肌瘤，评估瘢痕疙瘩和肥厚性瘢痕的病史，并更新协变量。
方法：底特律，密歇根地区。
方法：共有1,610名自我鉴定的黑人和/或非裔美国妇女，年龄在23-35岁之间，先前没有肌瘤的临床诊断。
方法：瘢痕疙瘩（长出超出原始损伤边缘的凸起疤痕）和肥厚性疤痕（停留在原始损伤范围内的凸起疤痕）。由于很难区分瘢痕疙瘩和肥厚性疤痕，我们分别检查了瘢痕疙瘩的病史和瘢痕疙瘩或肥厚性瘢痕(任何异常瘢痕形成)的病史,以及它们与肌瘤的发生和生长的关系.
方法：使用Cox比例风险回归评估纤维瘤发生率（在登记时进行无纤维瘤超声检查后出现新的纤维瘤）。使用线性混合模型评估纤维生长。每18个月对数体积变化的估计值转换为疤痕与体积的估计百分比差异没有疤痕.发病率和增长模型都根据随时间变化的人口统计学进行了调整，生殖,和人体测量因素。
结果：在1,230名无纤维瘤的参与者中，199（16%）报告有瘢痕疙瘩，578（47％）报告了瘢痕疙瘩或肥厚性疤痕，和293（24％）发生了肌瘤。瘢痕疙瘩（调整后的风险比=1.04；95%置信区间：0.77，1.40）或任何异常瘢痕形成（调整后的风险比=1.10；95%置信区间：0.88，1.38）均与肌瘤发生率无关。纤维生长因疤痕状态而几乎没有差异。
结论：尽管分子相似，自我报告的瘢痕疙瘩和肥厚性瘢痕未显示与肌瘤发展相关。未来的研究可能受益于皮肤科医生证实的瘢痕疙瘩或肥厚性瘢痕的检查;然而，我们的数据提示这两种纤维化疾病的共同易感性较小.
方法：一项前瞻性社区队列研究（2010-2012年注册），在5年内进行4次研究访问，以进行标准化超声检查，以检测和测量直径≥0.5cm的肌瘤，评估瘢痕疙瘩和肥厚性瘢痕的病史，并更新协变量。
方法：底特律，密歇根地区。
方法：共有1,610名自我鉴定的黑人和/或非裔美国妇女，年龄在23-35岁之间，先前没有肌瘤的临床诊断。
方法：瘢痕疙瘩（长出超出原始损伤边缘的凸起疤痕）和肥厚性疤痕（停留在原始损伤范围内的凸起疤痕）。由于很难区分瘢痕疙瘩和肥厚性疤痕，我们分别检查了瘢痕疙瘩的病史和瘢痕疙瘩或肥厚性瘢痕(任何异常瘢痕形成)的病史,以及它们与肌瘤的发生和生长的关系.
方法：使用Cox比例风险回归评估纤维瘤发生率（在登记时进行无纤维瘤超声检查后出现新的纤维瘤）。使用线性混合模型评估纤维生长。每18个月对数体积变化的估计值转换为疤痕与体积的估计百分比差异没有疤痕.发病率和增长模型都根据随时间变化的人口统计学进行了调整，生殖,和人体测量因素。
结果：在1,230名无纤维瘤的参与者中，199（16%）报告有瘢痕疙瘩，578（47％）报告了瘢痕疙瘩或肥厚性疤痕，和293（24％）发生了肌瘤。瘢痕疙瘩（调整后的风险比=1.04；95%置信区间：0.77，1.40）或任何异常瘢痕形成（调整后的风险比=1.10；95%置信区间：0.88，1.38）均与肌瘤发生率无关。纤维生长因疤痕状态而几乎没有差异。
结论：尽管分子相似，自我报告的瘢痕疙瘩和肥厚性瘢痕未显示与肌瘤发展相关。未来的研究可能受益于皮肤科医生证实的瘢痕疙瘩或肥厚性瘢痕的检查;然而，我们的数据提示这两种纤维化疾病的共同易感性较小.
