Correlation of low serum vitamin-D with uterine leiomyoma: a systematic review and meta-analysis

Abstract

Background: There is a growing body of evidence on low serum vitamin-D levels and the risk of uterine leiomyomas (UL). Therefore, this systematic review and meta-analysis was conducted to investigate the association between serum vitamin D levels and UL occurrence. Methods: Searches were systematically conducted of the electronic databases PubMed, Scopus, EMBASE, Web of Science (ISI), Cochrane library, Ovid, and Google Scholar to identify relevant studies from inception until February 6, 2020. Heterogeneity across the included studies was examined using Cochran's Q and I-square (I 2). Data was pooled using random effects modeling and expressed as standardized mean differences (SMDs). Results: Nine eligible studies with a total of 1730 participants (835 patients with UL and 895 controls) were included in the current meta-analysis. Pooled results with random effects modeling indicated that serum vitamin D levels were significantly lower in patients with UL than in the control group (n = 9, SMD = − 0.67; 95% CI, − 0.98, − 0.35, p < 0.001; I 2 = 89.3%, p < 0.001). Based on the findings of subgroup analyses, it was found that the SMD values across the included studies from Asia (n = 4, SMD = − 1.20; 95% CI, − 1.45, − 0.96, p < 0.001; I 2 = 30.6%, p = 0.229) were lower than those from Europe (n = 3, SMD = − 0.34; 95% CI, − 0.49, − 0.18, p < 0.001; I 2 = 0.0%, p = 0.602) and Africa (n = 2, SMD = − 0.13; 95% CI, − 0.29, 0.04, p = 0.128; I 2 = 0.0%, p = 0.417), although the difference was not significant in Africa. Publication year was also found to be a potential contributor's variable in the pooled SMD using the meta-regression method (t = − 3.00, p = 0.02). Conclusions: To the best of our knowledge, the current meta-analysis showed for the first time that serum vitamin D levels were significantly lower in women with UL in selected populations.

Evaluation of vitamin D receptor expression in uterine leiomyoma and nonneoplastic myometrial tissue: a cross‐sectional controlled study

“…In this study, we evaluated the expression of the biomarker VDR in human uterine leiomyoma tissue and compared it that in nonneoplastic myometrial tissue. Studies demonstrating the identification of VDR expression in most cells and the ability of some cells to produce active forms of vitamin D have suggesting an influence of this vitamin on the pathogenesis of uterine fibroids [ 8 , 9 , 17 , 18 ].…”

Evaluation of 25-hydroxy vitamin d3 levels in patients with small uterine myomas

“…Mohammadi et al, [12], in a new systemic review, evaluated pooled data from trials with a total of 1730 subjects (835 patients with UFs and 895 controls). After analyzing the data, the researchers came to the conclusion that low vitamin D levels are linked to a greater risk of UFs diagnosis.…”

Vitamin D and uterine fibroid growth, incidence, and loss: a prospective ultrasound study

“…In vitro and animal studies support a protective effect of vitamin D. In these models, vitamin D reduces fibroid tissue proliferation, changes the expression of estrogen and progesterone receptors, alters gene expression in proliferation and apoptosis pathways, and reduces expression of extracellular matrix proteins (8,(10)(11)(12)(13)(14)(15)(16)(17)(18). Human observational studies report lower fibroid prevalence among women with higher serum levels of vitamin D (6,11). Most (19)(20)(21)(22), but not all (23), human interventional studies document reduced fibroid growth when participants are treated with vitamin D, but studies were small (30-205 participants).…”

“…Vitamin D concentration, which is lower on average among self-identified Black women, has been proposed as a possible modifiable risk factor for the development of fibroids (6-9). In vitro and animal studies support a protective effect of vitamin D. In these models, vitamin D reduces fibroid tissue proliferation, changes the expression of estrogen and progesterone receptors, alters gene expression in proliferation and apoptosis pathways, and reduces expression of extracellular matrix proteins (8,(10)(11)(12)(13)(14)(15)(16)(17)(18). Human observational studies report lower fibroid prevalence among women with higher serum levels of vitamin D (6,11).…”