mvjrМедицинский вестник Юга РоссииMedical Herald of the South of Russia2219-80752618-7876The Rostov State Medical University10.21886/2219-8075-2022-13-4-28-38mvjr-1707Research Article3.2.4 МЕДИЦИНА ТРУДАOCCUPATIONAL MEDICINEОсобенности гиперплазии эндометрия в условиях воздействия органических растворителейEndometrial hyperplasia features in conditions of organic solvents exposurehttps://orcid.org/0000-0002-9409-4823МаринкинИ. О.MarinkinI. O.

Маринкин Игорь Олегович – доктор медицинских наук, профессор, Заслуженный врач РФ, ректор, заведующий кафедрой акушерства и гинекологии.

Новосибирск

Igor O. Marinkin - Dr. Sci. (Med.), Professor, Honored Doctor of the Russian Federation, rector, head of department of Obstetrics and Gynaecology, Novosibirsk State Medical University.

Novosibirsk

rector@ngmu.ruhttps://orcid.org/0000-0003-0871-7551ШпагинаЛ. А.ShpaginaL. A.

Шпагина Любовь Анатольевна - доктор медицинских наук, профессор, Заслуженный врач РФ, заведующий кафедрой госпитальной терапии и медицинской реабилитации.

Новосибирск

Lyubov A. Shpagina - Dr. Sci. (Med.), Professor, Honored Doctor of the Russian Federation, head of the internal medicine and rehabilitation department, Novosibirsk State Medical University.

Novosibirsk

lashpagina@gmail.comhttps://orcid.org/0000-0002-3469-8756ЛисоваЕ. С.LisovaE. S.

Лисова Евгения Сергеевна - аспирант кафедры госпитальной терапии и медицинской реабилитации.

Новосибирск

Evgeniya S. Lisova - graduate student of the internal medicine and rehabilitation department, Novosibirsk State Medical University.

Novosibirsk

mkb-2@yandex.ruhttps://orcid.org/0000-0002-3109-9811ШпагинИ. С.ShpaginI. S.

Шпагин Илья Семенович - доктор медицинских наук, доцент, доцент кафедры госпитальной терапии и медицинской реабилитации.

Новосибирск

Ilya S. Shpagin - Dr. Sci. (Med.), Assistant Professor of the internal medicine and rehabilitation department, Novosibirsk State Medical University.

Novosibirsk

https://orcid.org/0000-0003-0724-1539КотоваО. С.KotovaO. S.

Котова Ольга Сергеевна - доктор медицинских наук, доцент, доцент кафедры госпитальной терапии и медицинской реабилитации.

Новосибирск

Olga S. Kotova - Dr. Sci. (Med.), Assistant Professor of the internal medicine and rehabilitation department, Novosibirsk State Medical University.

Novosibirsk

ok526@yandex.ruhttps://orcid.org/0000-0001-7428-9159КузнецоваГ. В.KuznetsovaG. V.

Кузнецова Галина Владимировна – кандидат медицинских наук, доцент кафедры госпитальной терапии и медицинской реабилитации.

Новосибирск

Galina V. Kuznetsova - Cand. Sci. (Med.),Assistant Professor of the internal medicine and rehabilitation department, Novosibirsk State Medical University.

Novosibirsk

https://orcid.org/0000-0002-7370-6958ЛоктинЕ. М.LoktinE. M.

Локтин Евгений Михайлович - доктор медицинских наук, доцент, доцент кафедры анестезиологии и реаниматологии лечебного факультета.

Новосибирск

Evgenij M. Loktin - Dr. Sci. (Med.), Assistant Professor of the anesthesiology and resuscitation department, doctors’ faculty, Novosibirsk State Medical University.

Novosibirsk

https://orcid.org/0000-0003-3446-8018КармановскаяС. А.KarmanovskayaS. A.

Кармановская Светлана Александровна – доктор медицинских наук, доцент кафедры госпитальной терапии и медицинской реабилитации.

Новосибирск

Svetlana A. Karmanovskaya - Dr. Sci. (Med.), Assistant Professor of the internal medicine and rehabilitation department, Novosibirsk State Medical University.

Novosibirsk

Новосибирский государственный медицинский университетРоссияNovosibirsk State Medical UniversityRussian Federation2022010120231342838Copyright © Маринкин И.О., Шпагина Л.А., Лисова Е.С., Шпагин И.С., Котова О.С., Кузнецова Г.В., Локтин Е.М., Кармановская С.А., 20232023Маринкин И.О., Шпагина Л.А., Лисова Е.С., Шпагин И.С., Котова О.С., Кузнецова Г.В., Локтин Е.М., Кармановская С.А.Marinkin I.O., Shpagina L.A., Lisova E.S., Shpagin I.S., Kotova O.S., Kuznetsova G.V., Loktin E.M., Karmanovskaya S.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medicalherald.ru/jour/article/view/1707

Цель: установить клинические и молекулярные особенности гиперплазии эндометрия (ГЭ) в условиях воздействия органических растворителей и фактора ожирения. Материалы и методы: в наблюдательное одномоментное исследование включены женщины в постменопаузе с ГЭ (доказана гистологическим исследованием). Основная группа — 140 больных, имеющих профессиональный контакт с органическими растворителями, 70 — с ожирением, 70 — без ожирения, возраст — 57,5 (46;64) года. Группа сравнения — 140 женщин без контакта с токсикантами, 68 — с ожирением, 72 — без ожирения, возраст 56,5 — (46;65) лет. Исследуемые рабочие – маляры предприятия машиностроения, стаж более 10 лет. В основной группе 29 (20,7%) участниц были в постконтактном периоде продолжительностью 1–5 лет. Концентрации органических растворителей в воздухе рабочей зоны превышали ПДК в 1,5–5,0 раз. Взаимосвязи определяли линейной или логистической регрессией. Результаты: у работающих с органическими растворителями наблюдали большую долю атипической ГЭ (34,3% — у больных с ожирением, 18,6% — без ожирения, в подгруппах сравнения — 10,3% и 6,9%, р=0,004). Подгруппа контакта с токсикантами с ожирением характеризовалась максимальной экспрессией маркера пролиферации белка Ki-67 (55,9±2,51, 51,4±4,95, 41,5±3,29 и 30,1±2,18 баллов соответственно), большей частотой маточных кровотечений, толщиной М-эхо. Атипическая ГЭ была взаимосвязана со стажем работы (ОШ 1,80), максимальной разовой концентрацией толуола (ОШ 2,51), окружностью талии (ОШ 1,68), Ki-67 (ОШ 2,01), экспрессией эстрогеновых рецепторов эпителием (ОШ 1,92). Выводы: воздействие органических растворителей у женщин в постменопаузе с ГЭ способствует развитию атипических вариантов, экспрессии Ki-67, преимущественно при ожирении.

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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The authors declare that there are no conflicts of interest present.