Supplementary Material for: Endometriosis, Raynaud’s Syndrome and Migraine: A Retrospective Study of 12 Million Women

Objective: Our study focused on evaluating a possible relationship between endometriosis, Raynaud’s syndrome or migraine among women.
Design: This was a cross-sectional population-based study.
Participants/Materials, Setting, Methods: We used 12,684,067 hospitalized patient records in the Healthcare Cost and Utilization Project (HCUP) database between 2007 and 2014. We calculated the prevalence of endometriosis, Raynaud’s syndrome and migraine. We also evaluated the possible role of depression, anxiety and autoimmune diseases to eliminate confounding factors. Unadjusted and adjusted multivariate logistic regression were applied to evaluate the relationship between variables.
Results: Unadjusted analysis revealed a strong association between endometriosis and Raynaud’s syndrome and migraine. (OR=2.491 95%CI 1.677-3.699). After adjusting for sociodemographic characteristics as well as depression and anxiety, the association remained significant (OR=1.779; 95%CI 1.166-2.716). Among younger patients aged 18–35 with endometriosis, the associations were stronger with Raynaud's Syndrome (adjusted OR = 1.61, 95% CI = 1.20–2.16) and migraine (adjusted OR = 2.59, 95% CI = 2.47–2.72).
Limitations: The HCUP database is cross-sectional in nature, and hence, we could not establish the temporal relationship between endometriosis, Raynaud’s syndrome and migraine. Also, the severity of endometriosis and the treatment received by the patients were not included in the dataset, and it prevented us from investigating the role of potential confounding factors.
Conclusion: Our study suggests an association between endometriosis, Raynaud’s syndrome and migraine. It is possible that these conditions share a similar mechanism possibly vascular reaction and endothelial dysfunction related to chronic inflammation.

研究目的：本研究旨在探讨女性群体中子宫内膜异位症（endometriosis）、雷诺综合征（Raynaud’s syndrome）与偏头痛（migraine）之间可能存在的关联。
研究设计：本研究为基于人群的横断面研究。
研究对象/材料、研究场景与方法：本研究使用2007年至2014年间医疗成本和利用项目（Healthcare Cost and Utilization Project, HCUP）数据库中的12,684,067份住院患者病历。研究人员计算了子宫内膜异位症、雷诺综合征与偏头痛的患病率，并纳入抑郁症、焦虑症及自身免疫性疾病以控制混杂因素。采用未校正与校正后的多因素logistic回归分析变量间的关联。
研究结果：未校正分析显示，子宫内膜异位症与雷诺综合征、偏头痛之间存在显著关联（比值比（Odds Ratio, OR）=2.491，95%置信区间（Confidence Interval, CI）为1.677~3.699）。在校正社会人口学特征、抑郁症及焦虑症因素后，该关联仍具有统计学意义（OR=1.779，95%CI=1.166~2.716）。在18~35岁的子宫内膜异位症年轻患者中，其与雷诺综合征（校正后OR=1.61，95%CI=1.20~2.16）及偏头痛（校正后OR=2.59，95%CI=2.47~2.72）的关联更强。
研究局限性：HCUP数据库本质为横断面数据库，因此本研究无法明确子宫内膜异位症、雷诺综合征与偏头痛之间的时间先后关联。此外，数据集未纳入子宫内膜异位症的严重程度及患者接受的治疗方案，导致我们无法探究潜在混杂因素的影响。
研究结论：本研究证实子宫内膜异位症、雷诺综合征与偏头痛之间存在关联。这三类疾病可能共享相似的发病机制，即与慢性炎症相关的血管反应及内皮功能异常。