FCO-289 An exploration of body mass index, lifetime body shape, physical activity and figure descriptors and a diagnosis of endometriosis

Name: The British Society for Gynaecological Endoscopy's Annual Scientific Meeting 2024
Start: 2024-05-02T08:00:00Z
End: 2024-05-03T16:30:00Z
Location: ICC Belfast

Background: The exact etiology and pathophysiology of endometriosis are not well understood. Numerous environmental and lifestyle risk factors have been identified including a lower body mass index (BMI). We have further examined this relationship including lifetime body shape, figure descriptors and physical activity.

Methods: 402 consecutive patients age 18-49 attending their first laparoscopy for symptoms suspicious of endometriosis were prospectively recruited. BMI was calculated and participants completed the ‘Personal information and lifestyle’ section of the WERF EPQ-S.

Results: BMI was significantly different between cases and controls (24.7kg/m2 vs. 27.2kg/m2, p=<0.00001), ranges 25-30kg/m2 and >30kg/m2 gave odds ratios of 0.61 (95% CI 0.37-0.98, p=0.044) and 0.34 (0.19-57, p=<0.0001) compared to normal BMI respectively. The odds of endometriosis increased by 4.6% for every unit increase >25kg/m2. Slimmer body shape in teens and 20s gave odds ratios of 0.77 (0.64-0.93, p=0.008) and 0.75 (0.62-0.92, p=0.006) respectively, including in those with BMI>25kg/m2 at the time of surgery. The figure descriptor “Pear” correlated most strongly with endometriosis (OR 3.5 (1.15-10.6, p=0.027). Change in body shape or figure over preceding decade did not correlate with endometriosis at any age. Level of physical activity was independent of BMI (p=0.328) and did not correlate with a diagnosis of endometriosis (p=0.434). BMI did not correlate with site or severity of endometriosis (ovarian endometrioma p=0.102, invasive endometriosis p=0.369)

Conclusion: A lower BMI was strongly associated with a diagnosis but not severity of endometriosis. Slimmer body shape at adolescence and early 20s was associated with endometriosis even in those who were overweight at the time of surgery. This suggests an early adolescent association between adiposity and endometriosis etiology that warrants further exploration.