Exploring the role of uterine fibroids in promotion of cardiovascular diseases by diabetes exposure: Findings from national health and nutrition examination survey 1999–2006

Abstract

ObjectiveThe relationship between uterine fibroids (UF) and cardiovascular diseases (CVDs) in the diabetes population seemed to remain undetermined in previous studies. This study aims to explore the association between UF and CVDs by using the database from the National Health and Nutrition Examination Survey (NHANES). To further evaluate the connection between UF and CVDs we also tested the potential differences due to diabetes exposure.Materials and methodsNational Health and Nutrition Examination Survey data (1999–2006) were collected and used in this study. A total of 5,509 individuals were included and analyzed. The student’s t-test and the chi-squared test were used to explore the demographic characteristic between UF and non-UF groups. Logistic regression analysis was performed to determine the odds ratios of UF and covariates.ResultsFemale participants were divided into UF (n = 694, 12.60%) and non-UF (n = 4,815, 87.40%) groups. The incidence of CVDs in UF patients (n = 245, 35.30%) were higher than non-UF individuals (n = 776, 16.12%) (p < 0.001). In addition, each subtype of CVDs were also different, which contains hypertension (33.29 vs. 15.31%, p < 0.001), heart failure (1.59 vs. 0.52%, p < 0.01), angina (2.59 vs. 0.62%, p < 0.001), heart attack (1.73 vs. 0.58%, p < 0.01) and coronary heart disease (1.44 vs. 0.54%, p < 0.01). The odds ratios of CVDs according to logistic regression were 2.840 (95% CI: 2.387–3.379) for UF patients (p < 0.001), while the odds ratios (ORs) were 1.438 (95% CI: 1.175–1.760) after taking account for the age, body mass index (BMI), diabetes, race, education, and annual family income (p < 0.001). In addition, secondary analysis indicated more adverse effects in by UF exposure on CVDs risk among non-diabetes individuals (OR = 1.389, 95% CI = 1.124–1.718, p < 0.01) than diabetes patients (p = 0.063).ConclusionOverall, UFs were positively associated with CVDs, and this effect seems blunted by diabetes exposure.

Blood pressure, cardiometabolic traits and cardiovascular events in women with uterine fibroids: a genetic correlation and Mendelian randomization study

“…Our results also show evidence for significant genetic correlation between UFs and T2D. Observational clinical data previously described higher risk of T2D among UF patients 14,31 . However, the absence of causal association established by MR suggests that the two diseases share genetically determined biological mechanisms but the currently established genetic determinants of T2D has little influence on the genetic risk for UFs.…”

“…We report only nominally significant genetic correlations with coronary artery disease and myocardial infraction, suggesting a potential common genetic background with atherosclerotic disease. Suspected biological mechanisms are notably hyperlipidemia and SMCs remodeling, two major mechanisms of atherosclerotic disease 31 . Nonetheless, we excluded any evidence of genetic correlations between UFs and fibromuscular dysplasia (FMD), a female arteriopathy, where SMCs proliferation is a suspected mechanism as reported in recent genetic investigation from our group (20).…”

Association between systemic immune-inflammation index and diabetes: a population-based study from the NHANES

“…To investigate the relationship between SII and the prevalence of diabetes, multivariate logistic regression was performed. Model 1 had no covariates, model 2 added covariates age, sex, and race, and model 3 adjusted variables: age, sex, race, urine albumin content (31), refrigerated serum content, blood urea nitrogen content (32), chloride content, dietary protein intake, carbohydrate intake, total sugar intake, total fat intake, cholesterol intake, education Degree (divided into no high school education, high school education, high school education or above), marital status (married with a partner, divorced and separated, widowed, never married), poverty-income ratio (0-1.5, 1.5-3.5, >3.5), BMI (0-25, 25-30, >30), whether you have high blood pressure (33), whether you smoke, whether you exercise regularly. SII and diabetes were assessed in the model using odds ratios (ORs) and 95% confidence intervals (CIs).…”