BACKGROUND Although autoimmune abnormalities are common in patients with endometriosis, it is unknown whether patients with endometriosis have a higher risk of developing antiphospholipid syndrome (APS). METHODS We conducted a retrospective cohort study by using the multi-institutional research network TriNetX from 1 January 2012 to 31 December 2021. A total of 13 131 782 women aged 20-60 years from networks within the USA were included. The risks of APS were compared between an endometriosis cohort and a non-endometriosis cohort in subgroup analyses by age, obesity and systemic lupus erythematosus (SLE), and the sensitivity analysis was stratified by the presence or absence of a history of surgery of the uterus. RESULTS After 1:1 propensity score matching, the endometriosis and non-endometriosis cohorts each included 50 078 participants. Compared to individuals without endometriosis, patients with endometriosis had a higher risk of incident APS (log-rank test, P < 0.001). The hazard ratios (HRs) ranged from 1.82 [APS within 30 days to 1 year after the index date, 95% confidence intervals (CIs) 1.40-2.53] to 2.44 (APS within 30 days to any time after the index date, 95% CI 1.65-3.61). In the subgroup analyses, an increased risk of APS was observed in all ages, White race, and subgroups without smoking, obesity, asthma, inflammatory bowel disease and SLE (HR range 1.85-2.84). Sensitivity analyses revealed that the risk of APS increased in patients without surgery history of the uterus. CONCLUSIONS Patients with endometriosis had a higher risk (2.84-fold) of developing APS. Future large-scale prospective studies are warranted to confirm our results.

中文翻译：

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子宫内膜异位症患者随后发生抗磷脂综合征的风险增加。


背景 尽管自身免疫异常在子宫内膜异位症患者中很常见，但尚不清楚子宫内膜异位症患者发生抗磷脂综合征 （APS） 的风险是否更高。方法 我们于 2012 年 1 月 1 日至 2021 年 12 月 31 日使用多机构研究网络 TriNetX 进行了一项回顾性队列研究。共纳入了来自美国网络的 13 131 782 名年龄在 20-60 岁之间的女性。在亚组分析中，按年龄、肥胖和系统性红斑狼疮 （SLE） 比较子宫内膜异位症队列和非子宫内膜异位症队列之间的 APS 风险，并根据是否存在子宫手术史对敏感性分析进行分层。结果 1：1 倾向评分匹配后，子宫内膜异位症和非子宫内膜异位症队列各包括 50 078 名参与者。与无子宫内膜异位症的个体相比，子宫内膜异位症患者发生 APS 的风险更高 （log-rank 检验，P < 0.001）。风险比 （HRs） 范围为 1.82 [索引日期后 30 天内至 1 年的 APS，95% 置信区间 （CIs） 1.40-2.53] 至 2.44 （索引日期后 30 天内的 APS，95% CI 1.65-3.61）。在亚组分析中，在所有年龄、白种人和无吸烟、肥胖、哮喘、炎症性肠病和 SLE 的亚组中观察到 APS 风险增加 （HR 范围 1.85-2.84）。敏感性分析显示，无子宫手术史的患者发生 APS 的风险增加。结论 子宫内膜异位症患者发生 APS 的风险更高 （2.84 倍）。未来需要进行大规模的前瞻性研究来证实我们的结果。