1
|
Mitro SD, Wise LA, Waetjen LE, Lee C, Zaritsky E, Harlow SD, Solomon DH, Thurston RC, El Khoudary SR, Santoro N, Hedderson MM. Hypertension, Cardiovascular Risk Factors, and Uterine Fibroid Diagnosis in Midlife. JAMA Netw Open 2024; 7:e246832. [PMID: 38625699 PMCID: PMC11022113 DOI: 10.1001/jamanetworkopen.2024.6832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/18/2024] [Indexed: 04/17/2024] Open
Abstract
Importance Fibroids are benign neoplasms associated with severe gynecologic morbidity. There are no strategies to prevent fibroid development. Objective To examine associations of hypertension, antihypertensive treatment, anthropometry, and blood biomarkers with incidence of reported fibroid diagnosis in midlife. Design, Setting, and Participants The Study of Women's Health Across the Nation is a prospective, multisite cohort study in the US. Participants were followed-up from enrollment (1996-1997) through 13 semiannual visits (1998-2013). Participants had a menstrual period in the last 3 months, were not pregnant or lactating, were aged 42 to 52 years, were not using hormones, and had a uterus and at least 1 ovary. Participants with prior fibroid diagnoses were excluded. Data analysis was performed from November 2022 to February 2024. Exposures Blood pressure, anthropometry, biomarkers (cholesterol, triglycerides, and C-reactive protein), and self-reported antihypertensive treatment at baseline and follow-up visits were measured. Hypertension status (new-onset, preexisting, or never [reference]) and hypertension treatment (untreated, treated, or no hypertension [reference]) were categorized. Main Outcomes and Measures Participants reported fibroid diagnosis at each visit. Discrete-time survival models estimated hazard ratios (HRs) and 95% CIs for associations of time-varying hypertension status, antihypertensive treatment, anthropometry, and biomarkers with incident reported fibroid diagnoses. Results Among 2570 participants without a history of diagnosed fibroids (median [IQR] age at screening, 45 [43-48] years; 1079 [42.1%] college educated), 526 (20%) reported a new fibroid diagnosis during follow-up. Risk varied by category of hypertension treatment: compared with those with no hypertension, participants with untreated hypertension had a 19% greater risk of newly diagnosed fibroids (HR, 1.19; 95% CI, 0.91-1.57), whereas those with treated hypertension had a 20% lower risk (HR, 0.80; 95% CI, 0.56-1.15). Among eligible participants with hypertension, those taking antihypertensive treatment had a 37% lower risk of newly diagnosed fibroids (HR, 0.63; 95% CI, 0.38-1.05). Risk also varied by hypertension status: compared with never-hypertensive participants, participants with new-onset hypertension had 45% greater risk of newly diagnosed fibroids (HR, 1.45; 95% CI, 0.96-2.20). Anthropometric factors and blood biomarkers were not associated with fibroid risk. Conclusions and Relevance Participants with untreated and new-onset hypertension had increased risk of newly diagnosed fibroids, whereas those taking antihypertensive treatment had lower risk, suggesting that blood pressure control may provide new strategies for fibroid prevention.
Collapse
Affiliation(s)
- Susanna D. Mitro
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Lauren A. Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - L. Elaine Waetjen
- Department of Obstetrics and Gynecology, University of California Davis School of Medicine, Davis
| | - Catherine Lee
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Eve Zaritsky
- Department of Obstetrics and Gynecology, Kaiser Permanente Northern California, Oakland
| | - Siobán D. Harlow
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor
| | | | - Rebecca C. Thurston
- Department of Psychology and Psychiatry, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Samar R. El Khoudary
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Nanette Santoro
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora
| | | |
Collapse
|
2
|
AlAshqar A, Lulseged B, Mason-Otey A, Liang J, Begum UAM, Afrin S, Borahay MA. Oxidative Stress and Antioxidants in Uterine Fibroids: Pathophysiology and Clinical Implications. Antioxidants (Basel) 2023; 12:antiox12040807. [PMID: 37107181 PMCID: PMC10135366 DOI: 10.3390/antiox12040807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/21/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
In the last few decades, our understanding of the complex pathobiology of uterine fibroid development has grown. While previously believed to be a purely neoplastic entity, we now understand that uterine fibroids possess different and equally important aspects of their genesis. An increasing body of evidence suggests that oxidative stress, the imbalance between pro- and antioxidants, is an important factor in fibroid development. Oxidative stress is controlled by multiple, interconnecting cascades, including angiogenesis, hypoxia, and dietary factors. Oxidative stress in turn influences fibroid development through genetic, epigenetic, and profibrotic mechanisms. This unique aspect of fibroid pathobiology has introduced several clinical implications, both diagnostic and therapeutic, that can aid us in managing these debilitating tumors by using biomarkers as well as dietary and pharmaceutical antioxidants for diagnosis and treatment. This review strives to summarize and add to the current evidence revealing the relationship between oxidative stress and uterine fibroids by elucidating the proposed mechanisms and clinical implications.
Collapse
|
3
|
Gong L, Liu M, Shi H, Huang Y. Uterine fibroids are associated with increased risk of pre-eclampsia: A case-control study. Front Cardiovasc Med 2022; 9:1011311. [PMID: 36330006 PMCID: PMC9623039 DOI: 10.3389/fcvm.2022.1011311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/29/2022] [Indexed: 09/30/2023] Open
Abstract
PURPOSE Uterine fibroids are associated with hypertension in non-pregnant women. We aimed to evaluate the association between uterine fibroids and pre-eclampsia (PE). PATIENTS AND METHODS Participants were pregnant women who delivered in the Department of Obstetrics of the People's Hospital of Xinjiang Uygur Autonomous Region between January and December 2021. Patients with PE were identified as the case group, whereas those without PE were selected as the control group, using age-matching and a ratio of 1:5. Ultrasound examination during early pregnancy was used to detect uterine fibroids. Multivariable logistic regression was applied to evaluate the association between uterine fibroids and PE. RESULTS In total, 121 cases with PE and 578 controls without PE were included, with mean age of 32.9 years and gestational age of 37.7 weeks. Time of ultrasound examination was 12.0 ± 2.6 weeks. The case group had a significantly higher exposure rate of uterine fibroids than the control group (14.0 vs. 6.9%, P = 0.009). Multivariable Logistic regression models adjusted for potential confounding factors, including gestational age and blood pressure in early gestation, showed that pregnant women with uterine fibroids in early pregnancy exhibited three-fold higher odds for PE (OR, 3.02; 95% CI, 1.20-7.60; P = 0.019). Sensitivity analysis, which excluded those with gestational diabetes, further confirmed the robustness of the results. The association between uterine fibroids and PE was stronger in pregnant women aged ≥35 years and multiparas. CONCLUSION Uterine fibroids are significantly associated with an increased risk of PE in pregnant women. Uterine fibroids may serve as a new factor for identifying pregnant women at high risk of PE, and the effect of myomectomy before pregnancy on prevention of PE is worth further exploring.
Collapse
|
4
|
Delli Carpini G, Morini S, Tsiroglou D, Verdecchia V, Montanari M, Donati V, Giannella L, Burattini L, Giannubilo SR, Ciavattini A. Factors influencing intraoperative blood loss and hemoglobin drop during laparoscopic myomectomy: a tailored approach is possible? J OBSTET GYNAECOL 2021; 42:1404-1409. [PMID: 34918598 DOI: 10.1080/01443615.2021.1983782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
A retrospective study was conducted on patients subjected to laparoscopic myomectomy at our institution from January 2017 to December 2018 to identify predictive factors of blood loss. Two multiple regression models were run to predict intraoperative blood loss and haemoglobin drop. Predictors of an increased intraoperative blood loss and haemoglobin drop were the presence of three-four fibroids at ultrasound (+47 ml, p = .01; +0.58 g/dl, p = .05) and increased operative time (r = 0.57, p = .01; r = 0.01, p < .01), while predictors of a reduced intraoperative blood loss and haemoglobin drop were epinephrine injection (-50 ml, p < .01; -0.42 g/dl, p < .01), FIGO7 (-87 ml, p < .01; -0.85, p = .01), and FIGO6 (-35 ml, p < .01; -0.44, p = .02) fibroids at the ultrasound. Preoperative ultrasound evaluation is crucial in identifying patients at higher risk for blood loss, which could benefit from optimising haemoglobin values. The injection of diluted epinephrine could be proposed in selected high-risk patients. In the clinical practice, a tailored approach based on fibroids' ultrasonographic characteristics should be implemented to optimise preoperative Hb values and evaluate the use of diluted epinephrine in selected cases, reducing blood loss and the potential related complications.Impact statementWhat is already known on this subject? Laparoscopic myomectomy is the conservative surgical treatment of choice for symptomatic uterine fibroids. Still, it could represent a challenging procedure even for an experienced surgeon, with the risk of excessive blood loss, need of transfusions, prolonged operative time, and prolonged hospital stay. The knowledge of the predictive factors of blood loss is essential for patient preparation and surgical planning to reduce intraoperative and postoperative complications.What do the results of this study add? The results of the present study focus on the importance of presurgical evaluation to identify predictive factors of intraoperative blood loss and Hb drop such as the number of fibroids and the FIGO classification (at preoperative ultrasound), as well as intraoperative factors like operative time and the intramyometrial injection of diluted epinephrine.What are the implications of these findings for clinical practice and/or further research? A tailored approach based on the ultrasonographic characteristics of fibroids should be implemented to optimise preoperative haemoblobin levels.
Collapse
Affiliation(s)
- Giovanni Delli Carpini
- Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Stefano Morini
- Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Dimitrios Tsiroglou
- Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Valeria Verdecchia
- Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Michele Montanari
- Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Valentina Donati
- Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Luca Giannella
- Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Luca Burattini
- Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Stefano Raffaele Giannubilo
- Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Andrea Ciavattini
- Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
| |
Collapse
|
5
|
Jin H, Shan T, Li S, Fan X, Zhao Y, Li J, Tang X, Saffery R, Tong C, Wen L, Qi H, Kilby MD, Baker PN. Association of infant feeding patterns with body fat mass and obesity in the first 2 years of life: a longitudinal twin birth cohort study. Int J Food Sci Nutr 2021; 73:263-273. [PMID: 34412548 DOI: 10.1080/09637486.2021.1968357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Childhood obesity is a major public health problem with no effective intervention. We explored the influence of feeding patterns on infants' growth indices within the first 2 years in a twin birth cohort. Dietary intake at 12 months was recorded with a food frequency questionnaire, and dietary patterns were identified by principal component analysis. Milk feeding methods in first 6 months were categorised as breastfeeding or exclusive formula feeding. Correlations between feeding patterns and infants' growth indices were examined via generalised estimating equations. Two dietary patterns were identified and neither of which was related to growth indices. Breastfed infants had a higher body fat mass (BFM) percentage at 12 months, a higher body mass index (BMI) increment from birth to 6 months and a lower BMI increment from 6 to 12 months. Breastfed infants were likely positively correlated with BFM at 12 months; as complementary food was added, the effect of breastfeeding on growth gradually decreased.
Collapse
Affiliation(s)
- Huili Jin
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,International Collaborative Laboratory of Reproduction and Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Tengfei Shan
- Department of Obstetrics and Gynecology, The First People's Hospital of Yuhang District, Hangzhou, China
| | - Sisi Li
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,International Collaborative Laboratory of Reproduction and Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xin Fan
- Department of Child Healthcare, Chongqing Health Center for Women and Children, Chongqing, China
| | - Yan Zhao
- Department of Child Healthcare, Chongqing Health Center for Women and Children, Chongqing, China
| | - Jie Li
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,International Collaborative Laboratory of Reproduction and Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiqin Tang
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Richard Saffery
- Cancer, Disease and Developmental Epigenetics, Murdoch Children's Research Institute, Parkville, Australia
| | - Chao Tong
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,International Collaborative Laboratory of Reproduction and Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Wen
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,International Collaborative Laboratory of Reproduction and Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hongbo Qi
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,International Collaborative Laboratory of Reproduction and Development, Ministry of Education, Chongqing Medical University, Chongqing, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mark D Kilby
- Institute of Metabolism & Systems Research, University of Birmingham, Birmingham, UK
| | - Philip N Baker
- College of Life Sciences, University of Leicester, Leicester, UK
| |
Collapse
|
6
|
Li Q, Zhong J, Yi D, Deng G, Liu Z, Wang W. Assessing the risk of rapid fibroid growth in patients with asymptomatic solitary uterine myoma using a multivariate prediction model. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:370. [PMID: 33842591 PMCID: PMC8033343 DOI: 10.21037/atm-20-4559] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Long-term conservative approaches are effective management options for asymptomatic uterine fibroids, but not for uterine myomas with excessive growth. In this investigation, a regression model was constructed to evaluate the clinical characteristics related to uterine fibroids’ growth. Methods In this retrospective study, 19,840 patients with ultrasound-diagnosed uterine fibroids were identified from six centers between 2013 and 2019. In total, 739 patients were followed up for more than 1 year with B-ultrasound test results and clinical test results and had no acute events or surgical treatments. The endpoint was changed in the size of the uterine fibroids. Multivariate stepwise logistic regression analysis was used to identify predictors of uterine fibroid growth, and these were used to build a prediction model. The prediction model’s discrimination, calibration, and clinical efficacy were assessed using the area under the curve (AUC)/index of concordance (C-index), calibration plot, decision curve analysis, and clinical impact curve. Internal validation was performed using bootstrapping validation. A linear regression model was constructed to predict uterine fibroids’ growth rate without the occurrence of acute events. Results A total of 513 patients presented with significant growth of uterine fibroids, with an average follow-up time of 927 days, and 267 patients showed negative growth, with an average follow-up time of 960 days. Age, follicle-stimulating hormone (FSH), low-density lipoprotein (LDL), luteinizing hormone (LH), total cholesterol (TCHO), and neutrophil to lymphocyte ratio (NLR) were the main influential factors that predicted the uterine fibroid growth state, and these were used to develop a nomogram with predictive accuracy (AUC: 0.825). A linear regression prediction model was built based on the following factors: FSH, high-density lipoprotein (HDL), LH, triglyceride (TRIG), TCHO, and lymphocyte to monocyte ratio (LMR). The mean square error (MSE) was 0.32. Conclusions This study directly measured the growth rate of uterine fibroids. A prediction model assessing the growth rate of asymptomatic uterine fibroids was established. This model is useful for the early detection of potentially rapidly growing uterine fibroids in patients.
Collapse
Affiliation(s)
- Qingxiu Li
- Health Management Medical Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jiehui Zhong
- Department of Urology, Minimally Invasive Surgery Center, Guangdong Key Laboratory of Urology, Guangzhou Urology Research Institute, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Dongyi Yi
- Network and Information Technology Department, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Genqiang Deng
- Network and Information Technology Department, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Zezhen Liu
- Department of Urology, Minimally Invasive Surgery Center, Guangdong Key Laboratory of Urology, Guangzhou Urology Research Institute, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wei Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| |
Collapse
|
7
|
Qin H, Lin Z, Vásquez E, Luan X, Guo F, Xu L. Association between obesity and the risk of uterine fibroids: a systematic review and meta-analysis. J Epidemiol Community Health 2020; 75:197-204. [PMID: 33067250 DOI: 10.1136/jech-2019-213364] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 06/25/2020] [Accepted: 10/01/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Uterine fibroids (UFs) are the most common form of sex steroid hormone-dependent benign tumours that grow in the walls of the uterus. Several observational studies have examined the association between obesity and the risk of UFs, but findings are inconsistent. The objective of this systematic review and meta-analysis is to further examine the association of obesity with the risk/prevalence of UFs. METHODS A literature search was performed in three databases (PubMed, EMBASE and Web of Science) from 1 January 1992 to 30 May 2020. We used random-effect models to calculate the pooled ORs with corresponding 95% CIs. Additionally, we performed a dose-response meta-analysis to analyse the effect of body mass index (BMI), weight change since age 18, waist-to-hip ratio and waist circumference on the risk/prevalence of UFs. RESULTS A total of 22 articles, covering 24 studies including 325 899 participants and 19 593 cases, were selected based on our inclusion criteria. We found a positive association between obesity and the risk/prevalence of UFs (OR, 1.19; 95% CI, 1.09 to 1.29). Among participants with the highest BMI, the pooled OR was 1.19 (1.09 to 1.31) when compared to participants with normal BMI. For weight change since age 18, the pooled OR (95% CI) of UFs was 1.26 (1.12 to 1.42) among the highest change group when compared with no change. Additionally, our meta-analysis indicated the relationship of BMI with risk of UFs to be an inverse J-shaped pattern. CONCLUSIONS The results of this meta-analysis suggest that obesity may increase the risk/prevalence of UFs, and the association is non-linear.
Collapse
Affiliation(s)
- Hao Qin
- School of Public Health, Weifang Medical University, Weifang, China.,School of Basic Medicine, Qingdao University, Qingdao, China
| | - Zhijuan Lin
- Key Lab for Immunology in Universities of Shandong Province, School of Basic Medicine, Weifang Medical University, Weifang, China
| | - Elizabeth Vásquez
- School of Public Health, University at Albany, State University of New York, New York, USA
| | - Xiao Luan
- School of Basic Medicine, Qingdao University, Qingdao, China
| | - Feifei Guo
- School of Basic Medicine, Qingdao University, Qingdao, China
| | - Luo Xu
- School of Basic Medicine, Qingdao University, Qingdao, China
| |
Collapse
|
8
|
Srivastava P, Gupta HP, Singhi S, Khanduri S, Rathore B. Evaluation of 25-hydroxy vitamin D3 levels in patients with a fibroid uterus. J OBSTET GYNAECOL 2020; 40:710-714. [PMID: 31635506 DOI: 10.1080/01443615.2019.1654986] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A cross sectional study was done at Era's Lucknow Medical College & Hospital, Lucknowwith the objective to evaluate 25-hydroxyVitaminD3 level in women with and without uterine fibroid. Ninety subjects (45 cases and 45 controls) were enrolled. Cases were those having at least 1 uterine fibroid ≥10 mm detected on ultrasonography, while controls were those not having any uterine pathology. Estimation of Serum 25-hydroxyvitaminD3 Level was done. The mean ± SD concentration of 25-hydroxyvitaminD3 was Significantly lower in cases compared with controls (15.10 ± 6.09 vs 26.09 ± 7.90 respectively, p < 0.001).The number of women with 25-hydroxyvitaminD3 deficiency in cases and controls was 9(20%) and 3(6.67%) respectively (p < 0.001). Uterine fibroid size increased proportionately with decrease in 25-hydroxyvitaminD3 levels, (p = 0.014). We concluded that VitaminD3 deficiency is significantly associated with the occurrence of Uterine fibroids. Further studies need to be conducted in order to evaluate the therapeutic benefits VitaminD3 supplementation in the patients of Uterine fibroid.Impact Statementwhat is already known on this subject? Vitamin D is believed to regulate cell proliferation and differentiation, inhibit angiogenesis and stimulate apoptosis. Now a days hypovitaminosis D is believed to be a major risk factor in the development of uterine fibroids. There are several ideas about the use of vitamin D in uterine fibroid prevention or as a long term treatment but ongoing clinical trials in the area remain scarce.what do the results of this study add? Our study showed that 25-hydroxivitamin d3 deficiency is significantly associated with uterine fibroid.Lower levels of 25-hydroxivitamin d3were found to have aninverse relationship with increased size of fibroid uterus.what are the implications of these findings for clinical practice and / or further reasearch? Vitamin D seems to be a promising, safe and low-cost agent for the prevention and treatment of uterine fibroids. However, further studies with larger sample size are needed to confirm our findings.
Collapse
Affiliation(s)
- Pritika Srivastava
- Department of Obstetrics and Gynaecology, Era's Lucknow Medical College and Hospital, Lucknow, India
| | - Hem Prabha Gupta
- Department of Obstetrics and Gynaecology, Era's Lucknow Medical College and Hospital, Lucknow, India
| | - Shivani Singhi
- Department of Obstetrics and Gynaecology, Era's Lucknow Medical College and Hospital, Lucknow, India
| | - Sachin Khanduri
- HOD Department of Radiodiagnosis, Era's Lucknow Medical College and Hospital, Lucknow, India
| | - Brijesh Rathore
- Department of Biochemistry, Era's Lucknow Medical College and Hospital, Lucknow, India
| |
Collapse
|
9
|
Anorexia, Oral Health and Antioxidant Salivary System: A Clinical Study on Adult Female Subjects. Dent J (Basel) 2019; 7:dj7020060. [PMID: 31159381 PMCID: PMC6630380 DOI: 10.3390/dj7020060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 05/20/2019] [Accepted: 05/21/2019] [Indexed: 01/01/2023] Open
Abstract
The aim of this study was to compare the oral health status and salivary antioxidant system between patients diagnosed with anorexia nervosa (AN) and healthy controls. A total of 25 female AN patients and 25 matched healthy controls were enrolled. Clinical parameters and saliva samples were collected for each patient. Two questionnaires to investigate oral health and hygiene were administered. Superoxide Dismutase (SOD) activity and High Reactive Oxygen Species (hROS) were evaluated. Salivary concentration of SOD was significantly higher in subjects with AN compared with control group (1.010 ± 0.462 vs. 0.579 ± 0.296 U/mL; p = 0.0003). No significant differences between groups were identified for hROS (233.72 ± 88.27 vs. 199.49 ± 74.72; p = 0.15). Data from questionnaires indicated that, although most of the patients recognized the oral hygiene importance in maintaining a good oral health, more than half of them had poor oral hygiene. Altered biochemical composition of saliva in patients with AN could be interpreted as an effective defence mechanism against oxidative stress. Moreover, despite the discrepancy between clinical findings and perception of the oral health in AN population arose, the quality of life of these patients appears not to be significantly affected by their dental condition.
Collapse
|
10
|
Affiliation(s)
- Roberto Marci
- b Department of Morphology, Surgery and Experimental Medicine , University of Ferrara , Italy
- c Department of Obstetrics and Gynecology , University Hospital of Geneva , Switzerland
| |
Collapse
|