| Objective(s):The clinical characteristics of 65 patients with granulomatous lobular mastitis(GLM)were collected and analyzed.The correlation between prolactin(PRL)levels and body mass index(BMI)in GLM patients was investigated to provide new ideas for the treatment and prognosis of GLM.Methods:The clinical data of a total of 72 GLM inpatients attending the South Campus of Kunming First People’s Hospital from October 2020 to October 2022 were retrospectively analyzed,and the data analyzed included basic clinical information,pathology reports,clinical investigations,and ancillary examinations.Cases with GLM combined with benign and malignant breast tumors,positive pathogenic microbial tests,and incomplete clinical data were excluded,and 65 patients with GLM who met the study criteria were divided into non-hyperreorganization(BMI <24kg/m2)and hyperreorganization(BMI ≥24 kg/m2),and statistical analysis of clinical characteristics between the two groups was performed.65 patients with GLM were divided into the PRL normal group(PRL <29.9ng The 65 patients with GLM were divided into PRL normal group(PRL <29.9ng/ml)and HPRL group(PRL≥29.9ng/ml),and statistical analysis of clinical characteristics was also performed between the two groups.65 patients with GLM were divided into PRL low level group,PRL medium level group,and PRL high level group,and statistical analysis of prolactin level and BMI was performed between the three groups.The study was an unpaired case study type,and SPSS 26.0 was used for statistical analysis.The general characteristics of the numerical variable data were described using the mean ±standard deviation,and the t-test,ANOVA,or rank sum test was selected according to the results of normality and chi-square test,with statistical significance at p ≤ 0.05.Bonferroni method was used for multiple comparisons,and Bonferroni corrected p-value ≤ 0.05 was statistically significant.The general characteristics of the categorical variable data were described using composition ratios and statistically analyzed by chi-square test,and p≤0.05 was statistically significant.Results:The average age of onset of menstruation was 30.40±5.18 years and the average age of menarche was 13.42±1.35 years in 65 patients with GLM.65 patients with GLM were non-menopausal and 95.38%(62/65)had a history of pregnancy.65 patients had unilateral breast onset,63.08%(41/65)had lesions in the left breast in 41 cases,and the average diameter of lesions was 5.72±3.08 cm.The mean diameter of the lesions was 5.72±3.08 cm,47.69%(31/65)of the patients had nipple invagination on the affected side,52.31%(34/65)had no nipple invagination on the affected side,87.69%(57/65)of the lesions were of the abscess type and 12.31%(8/65)of the mass type.was 31.22 kg/m2 and the mean BMI was 23.44±3.50 kg/m2,of which 60%(39/65)patients were not overweight and 40%(26/65)were overweight.The lowest prolactin level value was 2.69 ng/ml,the highest prolactin level value was 113.50ng/ml,the mean prolactin level was 25.32 ± 24.69 ng/ml,76.92%(60/65)in the PRL normal group and 23.08%(15/65)in the HPRL group.the mean triglyceride level in65 GLM patients was 1.42 ± 0.70 mmol/L,mean total cholesterol level was 4.30±0.92mmol/L,mean LDL level was 2.61±0.73 mmol/L,and mean HDL level was1.23±0.27 mmol/L.Fatty liver was not diagnosed by liver ultrasound in 78.46%(51/65)of patients,and 21.54%(14/65)of liver ultrasound fatty liver.Statistical analysis of clinical characteristics of non-hyper-recombinant and hyper-recombinant: there was a statistical difference in the overall BMI distribution between the two groups(Z=6.79,P<0.001).There was a statistical difference in the distribution of overall PRL levels between the two groups(Z=3.06,P=0.002).There was a statistical difference in the overall TG distribution between the two groups(Z=2.578,P=0.01).There was a statistical difference in the overall mean of overall TC between the two groups(t=2.074,P=0.042).There was a statistical difference in the overall mean of overall HDL between the two groups(t=2.161,P=0.035).There was a statistical difference in the ratio of fatty liver suffering between the two groups by chi-square test(P=0.036<0.05).There was no statistical difference in age at onset,age at menarche,pregnancy rate,type of lesion,maximum diameter of lesion,and LDL level between super-reconstituted and non-super-reconstituted(P > 0.05).Statistical analysis of the clinical characteristics of the PRL normal group and the HPRL group: there was a statistical difference in the overall mean of BMI between the two groups(t=3.049,P=0.003).There was a statistical difference in the overall PRL level distribution between the two groups(Z=5.839,P<0.001).There was a statistical difference in the distribution of the maximum diameter of the overall lesions between the two groups(Z=2.208,P=0.027).There was a statistical difference in the ratio of fatty liver sufferers between the two groups by chi-square test(P=0.019<0.05).there was no statistical difference in age of onset,age at menarche,pregnancy rate,lesion type,and four lipid levels(TG,TC,LDL,HDL)between the PRL normal and HPRL groups(P>0.05).Statistical analysis of PRL levels and BMI between groups in the case of trichotomous grouping of PRL levels: independent sample rank sum test of PRL levels in the 3 groups,there were statistical differences in the overall distribution of PRL levels(H=56.895,P<0.001),and statistical post hoc comparisons,there were statistical differences in the levels of lactogen between the 3 groups with each other(P≤0.001).A one-way ANOVA was performed on the BMI of the data from the 3groups,and there was a statistical difference in the overall mean of BMI(F=10.145,P<0.001),and a statistical post hoc comparison,in which the BMI of the group with low PRL levels was statistically different from that of the group with high PRL levels(P<0.001).Conclusion(s):1.Abnormal TG,TC,HDL and the prevalence of fatty liver diagnosed by liver ultrasound in GLM patients were associated with overweight(BMI ≥ 24 kg/m2).The overall PRL levels were higher and statistically different in the overweight population than in the non-overweight population.2.Overweight,lesion size,and liver ultrasound diagnosis of fatty liver in GLM patients were correlated with HPRL(PRL ≥ 29.9 ng/ml).3.GLM patients with high PRL levels(22.83-113.50 ng/ml)had greater BMI and mean BMI > 24 kg/m2 compared to those with low PRL levels(2.69-1.68 ng/ml),suggesting that with elevated PRL,GLM patients are more likely to have overweight problems. |
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