The Diagnostic Value Of Multi-factor Analysis For Obesity With Ovarian Cyst

Objective: At present,clinical diagnosis of ovarian cyst mainly depends on gynecological color ultrasound examination,for obese patients,because of thick abdominal fat,the detection rate of ovarian cyst of general gynecological color ultrasound is not as good as transvaginal ultrasound,but the latter has many limitations,such as patients do not cooperate.Therefore,we intend to find more convenient and reliable indicators for screening obesity patients with ovarian cyst,and evaluate the screening value of these indicators in obesity patients with ovarian cyst.Methods: A total of 146 female patients with simple obesity and obesity complicated with ovarian cyst admitted to the Gastrointestinal surgery of xx hospital from January2020 to March 2021 were retrospectively analyzed.The general data measurements were improved,including BMI,waist circumference,hip circumference and age.Line and on that day in hospital of department of gynaecology to exceed（vaginal）and abdominal pelvic computed tomography（CT）,and all patients early in the morning the next day morning blood extraction,detection of serum TSH,C peptide and sex hormone six and glycosylated hemoglobin to statistical analysis of data,looking for obesity the clinical characteristics of patients with ovarian cyst and its influence factors,and explore the influence factors and correlation the diameter of the cyst.Results: A total of 146 obese patients were included in this study,including 70 patients with simple obesity and 76 patients with obesity complicated with ovarian cyst.Univariate analysis showed that there were no significant differences in thigh circumference（P=0.315）,waist circumference（P=0.239）and FSH（P=0.111）between the two groups.Age（P=0.014）,BMI（P=0.002）,TSH（P=0.003）,Hb A1c（P<0.001）,C peptide（P<0.001）and BMI/ thigh circumference（P<0.001）and BMI/ waist circumference（P<0.001）were statistically different.Multivariate Logistic regression analysis showed that the independent risk factors for ovarian cyst included C-peptide（P=0.001）,TSH（P=0.016）and waist-hip ratio（P=0.002）.Receiver operating characteristic curve（ROC）analysis showed that the area under the curve（AUC）of C-peptide,TSH and waist-to-hip ratio were: 0.851,0.832,0.726,and the area under the curve of p2-p2 combination was C-peptide +TSH（AUC was 0.910）,and the maximum approximation index was 0.753.The sensitivity and specificity were 85.3% and 90.0%,respectively.The sensitivity and specificity of TSH+ waist-hip ratio（AUC = 0.870）were 76.0% and 85.7%,respectively.The sensitivity and specificity were 81.3% and87.1%,respectively.C-peptide,TSH and waist-hip ratio could improve the AUC（0.916）.The sensitivity and specificity were 92.0% and 85.8% in the diagnosis of obese patients with ovarian cysts.Correlation analysis showed that there was a positive correlation between TSH and C-peptide and cyst diameter,the cyst diameter and TSH（r=0.180,P=0.006）,the cyst diameter and C-peptide（r=0.329,P<0.001）.Conclusion: 1.For obese female patients with ovarian cyst,c-peptide,TSH and waist-to-hip ratio combined detection has good sensitivity and specificity,especially good sensitivity（92.0%）,which can be used for screening obese patients with ovarian cyst;2.C-peptide and TSH may be closely related to the diameter of ovarian cysts,and the serum concentrations of C-peptide and TSH may play a predictive role in the diameter of ovarian cysts.