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Vitamin d and the risk of uterine fibroids.

Abstract

BACKGROUND

Uterine leiomyomata (also known as fibroids) are benign tumors of uterine smooth muscle that are characterized by overproduction of extracellular matrix. Fibroids are the leading indication for hysterectomy in the United States. The active metabolite of vitamin D has been shown to inhibit cell proliferation and extracellular matrix production in fibroid tissue culture and to reduce fibroid volume in the Eker rat. No previous study has examined whether vitamin D is related to fibroid status in women.

METHODS

The National Institute of Environmental Health Sciences Uterine Fibroid Study enrolled randomly selected 35- to 49-year-old women who were members of an urban health plan during 1996-1999. Fibroid status was determined by ultrasound screening of premenopausal women (620 blacks, 416 whites). Vitamin D status was assessed in stored plasma by radioimmunoassay of 25-hydroxyvitamin D (25(OH)D) and questionnaire data on sun exposure. Associations were evaluated with logistic regression, controlling for potential confounders.

RESULTS

Only 10% of blacks and 50% of whites had levels of 25(OH)D regarded as sufficient (>20 ng/ml). Women with sufficient vitamin D had an estimated 32% lower odds of fibroids compared with those with vitamin D insufficiency (adjusted odds ratio [aOR] = 0.68, 95% confidence interval [CI] = 0.48-0.96). The association was similar for blacks and whites. Self-reported sun exposure ≥ 1 hour per day (weather permitting) was also associated with reduced odds of fibroids (aOR = 06. [0.4-0.9]), with no evidence of heterogeneity by ethnicity.

CONCLUSIONS

The consistency of findings for questionnaire and biomarker data, the similar patterns seen in blacks and whites, and the biological plausibility provide evidence that sufficient vitamin D is associated with a reduced risk of uterine fibroids.

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  • Authors+Show Affiliations

    ,

    Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709, USA. baird@niehs.nih.gov

    , ,

    Source

    Epidemiology (Cambridge, Mass.) 24:3 2013 May pg 447-53

    MeSH

    Adult
    African Americans
    Biomarkers
    Cross-Sectional Studies
    District of Columbia
    European Continental Ancestry Group
    Female
    Humans
    Leiomyoma
    Linear Models
    Logistic Models
    Middle Aged
    Risk Factors
    Sunlight
    Surveys and Questionnaires
    Ultrasonography
    Uterine Neoplasms
    Vitamin D
    Vitamin D Deficiency

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Intramural

    Language

    eng

    PubMed ID

    23493030

    Citation

    Baird, Donna Day, et al. "Vitamin D and the Risk of Uterine Fibroids." Epidemiology (Cambridge, Mass.), vol. 24, no. 3, 2013, pp. 447-53.
    Baird DD, Hill MC, Schectman JM, et al. Vitamin d and the risk of uterine fibroids. Epidemiology. 2013;24(3):447-53.
    Baird, D. D., Hill, M. C., Schectman, J. M., & Hollis, B. W. (2013). Vitamin d and the risk of uterine fibroids. Epidemiology (Cambridge, Mass.), 24(3), pp. 447-53. doi:10.1097/EDE.0b013e31828acca0.
    Baird DD, et al. Vitamin D and the Risk of Uterine Fibroids. Epidemiology. 2013;24(3):447-53. PubMed PMID: 23493030.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Vitamin d and the risk of uterine fibroids. AU - Baird,Donna Day, AU - Hill,Michael C, AU - Schectman,Joel M, AU - Hollis,Bruce W, PY - 2013/3/16/entrez PY - 2013/3/16/pubmed PY - 2013/10/1/medline SP - 447 EP - 53 JF - Epidemiology (Cambridge, Mass.) JO - Epidemiology VL - 24 IS - 3 N2 - BACKGROUND: Uterine leiomyomata (also known as fibroids) are benign tumors of uterine smooth muscle that are characterized by overproduction of extracellular matrix. Fibroids are the leading indication for hysterectomy in the United States. The active metabolite of vitamin D has been shown to inhibit cell proliferation and extracellular matrix production in fibroid tissue culture and to reduce fibroid volume in the Eker rat. No previous study has examined whether vitamin D is related to fibroid status in women. METHODS: The National Institute of Environmental Health Sciences Uterine Fibroid Study enrolled randomly selected 35- to 49-year-old women who were members of an urban health plan during 1996-1999. Fibroid status was determined by ultrasound screening of premenopausal women (620 blacks, 416 whites). Vitamin D status was assessed in stored plasma by radioimmunoassay of 25-hydroxyvitamin D (25(OH)D) and questionnaire data on sun exposure. Associations were evaluated with logistic regression, controlling for potential confounders. RESULTS: Only 10% of blacks and 50% of whites had levels of 25(OH)D regarded as sufficient (>20 ng/ml). Women with sufficient vitamin D had an estimated 32% lower odds of fibroids compared with those with vitamin D insufficiency (adjusted odds ratio [aOR] = 0.68, 95% confidence interval [CI] = 0.48-0.96). The association was similar for blacks and whites. Self-reported sun exposure ≥ 1 hour per day (weather permitting) was also associated with reduced odds of fibroids (aOR = 06. [0.4-0.9]), with no evidence of heterogeneity by ethnicity. CONCLUSIONS: The consistency of findings for questionnaire and biomarker data, the similar patterns seen in blacks and whites, and the biological plausibility provide evidence that sufficient vitamin D is associated with a reduced risk of uterine fibroids. SN - 1531-5487 UR - https://www.unboundmedicine.com/medline/citation/23493030/Vitamin_d_and_the_risk_of_uterine_fibroids_ L2 - http://Insights.ovid.com/pubmed?pmid=23493030 DB - PRIME DP - Unbound Medicine ER -