Hypovitaminosis D and “small burden” uterine fibroids

Abstract

The aim of this study was to evaluate the effect of vitamin D supplementation in women with hypovitaminosis D and “small burden” uterine fibroids.This study focused on 208 women diagnosed with uterine fibroids and concomitant hypovitaminosis D, from January to December 2014. One hundred eight women of the initial study population were diagnosed with “small burden” uterine fibroids. Among them, those who underwent a proper vitamin D supplementation constituted the “study group” (n = 53), while women who spontaneously refused the therapy or did not perform it properly, constituted the “control group” (n = 55). The characteristics of uterine fibroids, the fibroid-related symptoms, and the vitamin D serum levels were evaluated 12 months after the initial diagnosis.In women with uterine fibroids, a negative correlation emerged between the baseline 25-hydroxy-cholecalciferol (25-OH-D3) concentration and both the volume of the largest fibroid (r = −0.18, P = 0.01) and the total volume of fibroids (r = −0.19, P = 0.01). No correlation was found between the baseline 25-OH-D3 levels and the number of fibroids per patient (r = −0.10, P = 0.16). In women of the “study group,” a significant increase in the 25-OH-D3 serum level was observed after 12 months of supplementation, and a lower rate of surgical or medical treatment due to the “progression to extensive disease” was reported (13.2% vs 30.9%, P = 0.05).Supplementation therapy with 25-OH-D3 restores normal vitamin D serum levels in women with “small burden” fibroids. In these women, vitamin D supplementation seems to reduce the progression to an extensive disease, and thus the need of conventional surgical or medical therapy.

Inhibition of tumor cell proliferation in human uterine leiomyomas by vitamin D via Wnt/β-catenin pathway

“…Based on our findings, we suggest that the highest therapeutic benefit of VitD treatment would be from preventing leiomyoma growth and stabilizing its size, thus preventing leiomyomas from reaching a size at which adverse effects would be expected. This approach would be supported by the results of a recent study that showed that patients who were supplemented with VitD showed a lower rate of surgical or medical treatment because of the effect of VitD on leiomyoma progression (47). In addition, VitD treatment could be administered in combination with other treatments when they are temporarily suspended because of their side effects to prevent regrowth of the leiomyoma, thereby offering a great advantage for leiomyoma treatment in current clinical…”

Uterine Fibroids: Burden and Unmet Medical Need

“… 9 10 11 12 13 14 15 16 17 18 Modifiable lifestyle factors that may significantly impact UF incidence include vitamin D deficiency, 7 19 20 21 22 exercise and diet, 23 smoking, 24 obesity, 7 23 25 contraceptive use, 23 and dyslipidemia. 25 26 27 There is some evidence that vitamin D supplementation 28 and statin use 29 have some protective effects. Together, these data suggest that several lifestyle factors may collectively contribute to the development of UF; further studies—including clinical trials of weight loss, exercise, and/or dietary modification for the prevention or treatment of symptomatic UF—are warranted.…”

Associations between serum vitamin D and the risk of female reproductive tumors

“…[ 38 ] A study included in our meta-analysis reported that insufficient vitamin D was associated with uterine leiomyoma in white but not black women, which may suggest different latitude and race could influence the risk of female reproductive tumors. [ 6 ] Another influence deserving discussion is the sensitivity and specificity which are expected to be different with diverse detection methods. In the last 4 decades, the detection methods of vitamin D has undergone continuous change from the early competitive binding assays to immunoassay and liquid chromatography and currently mass spectrometry.…”

“…Taking uterine fibroids as an example, it potentially influences women's health because it results in abnormal uterine bleeding, urinary dysfunction, constipation, pain, infertility, miscarriage, and some pregnancy complications. [ 6 ] Therapies for the female reproductive tumors include surgery, chemotherapy, radiation therapy, and expectant treatments at present. [ 7 ] Patients undergoing these treatments modalities bear higher expenses than expected.…”