Introduction The age of onset of endometrioid adenocarcinoma is progressively younger, and changes in dietary habits have led to an increase in dyslipidemia problems in young people. This study intends to analyze the effect of blood lipids on the clinical efficacy of fertility-preserving treatment in patients with atypical endometrial hyperplasia and endometrial cancer.

Methods The clinical data of 109 patients with atypical endometrial hyperplasia and endometrial cancer who received fertility-preserving treatment in the Department of Obstetrics and Gynecology, Peking University People’s Hospital (Dec. 2005 to Sep. 2022) were collected, and a retrospective analysis was performed on the clinical characteristics, histopathology results, outcomes, and blood lipids.

Results Divide patients into three groups based on age: ≤ 29 years old(n=36), >29 years old or ≤ 35 years old(n=45), >35 years old(n=28). It was found that blood lipids gradually increase with age. Especially low density lipoprotein cholesterol (P=0.013) and total cholesterol (P=0.045). After 3 months of progesterone treatment, both low-density lipoprotein cholesterol and high-density lipoprotein cholesterol in the patient‘s blood significantly increased (P<0.05). According to the clinical efficacy of progesterone, patients were divided into an insensitive group and a sensitive group. Low density lipoprotein cholesterol (P=0.004) and free fatty acids (P=0.02) were found to be influencing factors for progesterone insensitivity (P=0.004).

Conclusion/Implications Pay attention to the whole process of blood lipid management in patients of atypical endometrial hyperplasia and endometrial cancer, especially in patients with dyslipidemia treated with progesterone.