Association of Body Mass Index & Android Obesity with Uterine Leiomyoma Among Premenopausal Women: A Case–Control Study

Year 2022, Volume: 39 Issue: 4, 1235 - 1240, 29.10.2022

Zeynab Karamihamidabad Sara Azima Fatemeh Najib Marzieh Akbarzadeh

Abstract

Uterine leiomyomas (ULs) or uterine fibroids are the most common genital tumors in women of reproductive age. Obesity and increased visceral fat and the production of inflammatory mediators might be risk factors for ULs. This study aimed to investigate the relationship between ULs and body fat distribution among Iranian women. This case-control study was performed on 280 women of reproductive age with ULs and without myoma in 2020. They referred to three women's clinics in Shiraz (Shahid Faghihi, Zeinabieh, and Motahhari clinics). The sample size for each group consisted of at least 140 subjects selected via consumptive sampling methods. ULs were pre-diagnosed by a gynecologist based on the findings of a vaginal ultrasound. Demographic information, fertility history and history of ULs, body mass index (BMI) and android obesity were recorded and compared in both groups. Chi-square and t-test were used to analyze the data. Most patients with ULs (64 people, 45.7%) aged 41-50 years old. Most of them (126, 90%) were housewives, and the level of education of most patients (74 people, 52.9%) was under high school diploma. The mean of BMI in women with myoma was 26.05±5.32 and in women without myoma was 25.81 ±4.38. There was no significant difference in the mean scores of BMI between the two groups, but the Android fat obesity was higher in patients with ULs. Almost few studies have attempted to identify specific risk factors for this tumor. Preventing weight gain and obesity, and lifestyle modification can prevent Uterine leiomyoma.

Keywords

Gynecology, Premenopausal, Uterine Leiomyoma, Women, Body Mass Index, Android Obesity

References

• 1. Walker CL, Stewart EA. Uterine fibroids: the elephant in the room. Science. 2005;308(5728):1589-92.
• 2. Hoffman PJ, Milliken DB, Gregg LC, Davis RR, Gregg JP. Molecular characterization of uterine fibroids and its implication for underlying mechanisms of pathogenesis. Fertil Steril. 2004;82(3):639-49.
• 3. Catherino WH, Parrott E, Segars J. Proceedings from theNational Institute of Child Health and Human Development conference on the Uterine Fibroid Research Update Workshop. Fertil Steril. 2011;95(1):9-12.
• 4. Bulun SE. Uterine fibroids. N Engl J Med. 2013;369(14):1344-55.
• 5. Chen CR, Buck GM, Courey NG, Perez KM, Wactawski-Wende J. Risk factors for uterine fibroids among women undergoing tubal sterilization. Am J Epidemiol. 2001;153(1):20-6.
• 6. Ekin M, Cengiz H, Ozturk E, Kaya C, Yasar L, Savan K. Genitourinary symptoms and their effects on quality of life in women with uterine myomas. Int Urogynecol J. 2014;25(6):807-10.
• 7. Gambadauro P. Dealing with uterine fibroids in reproductive medicine. J Obstet Gynaecol. 2012;32(3):210-6.
• 8. Cook H, Ezzati M, Segars JH, McCarthy K. The impact of uterine leiomyomas on reproductive outcomes. Minerva Ginecol. 2010;62(3):225-36.
• 9. Farquhar CM, Steiner CA. Hysterectomy rates in the United States 1990-1997. Obstet Gynecol. 2002;99(2):229-34.
• 10. Hillard J. Benign disease of female reproductive tract symptoms and sign. In: Berek J, editor. Novaks gynecology 13th ed. Philadelphia: Lippincott William & willkins; 2002. p. 351-420.
• 11. Medikare V, Kandukuri LR, Ananthapur V, Deenadayal M, Nallari P. The genetic bases of uterine fibroids; a review. J Reprod Infertil. 2011;12(3):181-91.
• 12. Bharathi C, Anupama D, Pratibha N, Venkateshwari A. Impact of Genetic Variants in Estrogen Receptor-beta Gene in the Etiology of Uterine Leiomyomas. J Reprod Infertil. 2019;20(3):151-60.
• 13. Wise LA, Palmer JR, Harlow BL, Spiegelman D, Stewart EA, Adams-Campbell LL, et al. Reproductive factors, hormonal contraception, and risk of uterine leiomyomata in African-American women: a prospective study. Am J Epidemiol. 2004;159(2):113-23.
• 14. Wise LA, Palmer JR, Spiegelman D, Harlow BL, Stewart EA, Adams-Campbell LL, et al. Influence of body size and body fat distribution on risk of uterine leiomyomata in U.S. black women. Epidemiology. 2005;16(3):346-54.
• 15. Tak YJ, Lee SY, Park SK, Kim YJ, Lee JG, Jeong DW, et al. Association between uterine leiomyoma and metabolic syndrome in parous premenopausal women: A case-control study. Medicine (Baltimore). 2016;95(46):e5325.
• 16. Takeda T, Sakata M, Isobe A, Miyake A, Nishimoto F, Ota Y, et al. Relationship between metabolic syndrome and uterine leiomyomas: a case-control study. Gynecol Obstet Invest. 2008;66(1):14-7.
• 17. Giri A, Edwards TL, Hartmann KE, Torstenson ES, Wellons M, Schreiner PJ, et al. African genetic ancestry interacts with body mass index to modify risk for uterine fibroids. PLoS Genet. 2017;13(7):e1006871.
• 18. Fishman J, Boyar RM, Hellman L. Influence of body weight on estradiol metabolism in young women. J Clin Endocrinol Metab. 1975;41(5):989-91.
• 19. Terry KL, De Vivo I, Hankinson SE, Missmer SA. Reproductive characteristics and risk of uterine leiomyomata. Fertil Steril. 2010;94(7):2703-7.
• 20. Orsini G, Laricchia L, Fanelli M. [Low-dose combination oral contraceptives use in women with uterine leiomyomas]. Minerva Ginecol. 2002;54(3):253-61.
• 21. Harmon QE, Baird DD. Use of depot medroxyprogesterone acetate and prevalent leiomyoma in young African American women. Hum Reprod. 2015;30(6):1499-504.
• 22. Wise LA, Palmer JR, Harlow BL, Spiegelman D, Stewart EA, Adams-Campbell LL, et al. Risk of uterine leiomyomata in relation to tobacco, alcohol and caffeine consumption in the Black Women's Health Study. Hum Reprod. 2004;19(8):1746-54.
• 23. Faerstein E, Szklo M, Rosenshein N. Risk factors for uterine leiomyoma: a practice-based case-control study. I. African-American heritage, reproductive history, body size, and smoking. Am J Epidemiol. 2001;153(1):1-10.
• 24. Parazzini F, Negri E, La Vecchia C, Chatenoud L, Ricci E, Guarnerio P. Reproductive factors and risk of uterine fibroids. Epidemiology. 1996;7(4):440-2.
• 25. Romieu I, Walker A, Jick S. Determinants of uterine fibroids. 1991.
• 26. Samadi AR, Lee NC, Flanders WD, Boring JR, 3rd, Parris EB. Risk factors for self-reported uterine fibroids: a case-control study. Am J Public Health. 1996;86(6):858-62.
• 27. Marshall LM, Spiegelman D, Manson JE, Goldman MB, Barbieri RL, Stampfer MJ, et al. Risk of uterine leiomyomata among premenopausal women in relation to body size and cigarette smoking. Epidemiology. 1998;9(5):511-7.
• 28. Sharami S, Zahiri Z, Ghanaie M. Risk Factors of Uterine Leiomyoma in Women of Reproductive Ages. Journal of Babol University of Medical Sciences. 2009;11(4):54-61.
• 29. He Y, Zeng Q, Dong S, Qin L, Li G, Wang P. Associations between uterine fibroids and lifestyles including diet, physical activity and stress: a case-control study in China. Asia Pac J Clin Nutr. 2013;22(1):109-17.
• 30. Sun K, Xie Y, Zhao N, Li Z. A case-control study of the relationship between visceral fat and development of uterine fibroids. Exp Ther Med. 2019;18(1):404-10.
• 31. Boclin Kde L, Torres FP, Faerstein E. Body weight gain during adulthood and uterine myomas: Pro-Saude Study. Rev Saude Publica. 2015;49.
• 32. Wong JY, Gold EB, Johnson WO, Lee JS. Circulating Sex Hormones and Risk of Uterine Fibroids: Study of Women's Health Across the Nation (SWAN). J Clin Endocrinol Metab. 2016;101(1):123-30.
• 33. Zimmermann A, Bernuit D, Gerlinger C, Schaefers M, Geppert K. Prevalence, symptoms and management of uterine fibroids: an international internet-based survey of 21,746 women. BMC Womens Health. 2012;12:6.
• 34. Curti ML, Jacob P, Borges MC, Rogero MM, Ferreira SR. Studies of gene variants related to inflammation, oxidative stress, dyslipidemia, and obesity: implications for a nutrigenetic approach. J Obes. 2011;2011:497401.
• 35. Sparic R, Mirkovic L, Malvasi A, Tinelli A. Epidemiology of Uterine Myomas: A Review. Int J Fertil Steril. 2016;9(4):424-35.
• 36. Flood A, Strayer L, Schairer C, Schatzkin A. Diabetes and risk of incident colorectal cancer in a prospective cohort of women. Cancer Causes Control. 2010;21(8):1277-84.
• 37. Baker R, Dauner JG, Rodriguez AC, Williams MC, Kemp TJ, Hildesheim A, et al. Increased plasma levels of adipokines and inflammatory markers in older women with persistent HPV infection. Cytokine. 2011;53(3):282-5.