Journal of Hebei Medical University ›› 2023, Vol. 44 ›› Issue (11): 1322-1327.doi: 10.3969/j.issn.1007-3205.2023.11.015

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Construction of a predictive model for the development of uterine fibroids based on ultrasonography and lipid-related indicators and validation of its value

  

  1. Department of Ultrasound, the First Hospital of Huai′an City Affiliated to Nanjing Medical University, Jiangsu Province, Huai′an 210000, China

  • Online:2023-11-25 Published:2023-12-05

Abstract: Objective To construct a predictive model for the development of uterine fibroids based on ultrasonography and lipid-related indicators, and to validate its predictive value. 
Methods A total of 6 333 female patients undergoing physical examination were selected to calculate the incidence of uterine fibroids, and they were divided into observation group and control group according to occurrence of uterine fibroids. The clinical data, ultrasound examination indicators [ultrasound characteristics, peak systolic velocity (PSV), resistance index (RI), pulsation index (PI)], and lipid-related indicators [triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), atherogenic index of plasma (AIP) and triglyceride glucose index (TyG)] were compared between two groups. A nomogram predictive model was constructed and validated. 
Results  After screening by selection criteria, a total of 4 812 female physical examinees were included as research subjects, among whom 1 065 patients with uterine fibroids were diagnosed by ultrasound, and the incidence of uterine fibroids was 22.13%, including 854 patients with intermyometrial fibroids (80.19%), 156 patietns with subplasmaline fibroids (14.65%), and 55 patients with submucosal fibroids (5.16%). The average number of fibroids was (4.18±1.02), and  the mean maximum fibroid diameter was (6.64±1.89) cm. The observation group had higher PSV and PI than the control group, but lower RI than the control group (P<0.05). The difference in HDL-C levels between two groups was not statistically significant (P>0.05), and the levels of TG, LDL-C, TC, AIP and TyG were higher than those in the control group (P<0.05). Logistic regression analysis showed that uterine artery PSV, RI, PI, TG, LDL-C, TC, AIP, and TyG were independent influencing factors for the development of uterine fibroids (P<0.05). The nomogram predictive model for the development of uterine fibroids was constructed based on the above ultrasound and lipid-related indicators, and the calibration curve showed that the consistency index of the predictive model was 0.827, which had good consistency. The Hosmer-Lemeshow goodness-of-fit test showed P=0.710>0.05, and the predictive model had a good fit. The area under receiver operating characteristic (ROC) curve (AUC) of this predictive model for predicting the onset of uterine fibroids was 0.912 (95%CI: 0.837-0.994), with a sensitivity of 92.02% and a specificity of 90.74%. 
Conclusion It is feasible to construct a predictive model for development of uterine fibroids based on ultrasonographic parameters, including uterine artery PSV, RI, PI, and lipid-related indicators TG, LDL-C, TC, AIP, and TyG, and the predictive value is more reliable. 

Key words: leiomyoma, uterus, ultrasonography, lipid-related indicators