Serum vitamin D₃ level inversely correlates with uterine fibroid volume in different ethnic groups: a cross-sectional observational study

Mohamed Sabry,^1,2 Sunil K Halder,² Abdou S Ait Allah,¹ Eman Roshdy,^2,3 Veera Rajaratnam,² Ayman Al-Hendy<sup>2

1</sup>Department of Obstetrics and Gynecology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt; ²Department of Obstetrics and Gynecology, Center for Women's Health Research, Meharry Medical College, Nashville, TN, USA; ³Department of Public Health and Community Medicine, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt

Purpose: Currently there is no effective medicinal treatment for uterine fibroids (UFs), a common health disorder that affects women of reproductive age. Identification of modifiable risk factors such as vitamin D (Vit D) deficiency could help develop novel strategies for the prevention and/or treatment of UFs. The purpose of this study was to identify whether low serum Vit D₃ levels correlate with increased risk of UFs.
Methods: A total of 154 premenopausal women were recruited for this cross-sectional study. The control group comprised 50 subjects with a normal, fibroid-free uterine structure, confirmed by transvaginal ultrasonography. The 104 case subjects had at least one fibroid lesion that was 2 cm3 in volume or larger, confirmed by transvaginal ultrasonography. For each case subject, total uterine volume and total volume of all existing fibroids were measured in three perpendicular planes, with volume determined according to the prolate ellipse formula (a × b × c × 0.523), where a is height, b is width, and c is depth. Serum Vit D [25(OH) D₃] levels were measured by radioimmunoassay. The independent t-test was used to compare serum Vit D levels across groups. Correlations were assessed by Spearman's rank correlation test.
Results: Lower serum 25-(OH) Vit D levels were significantly associated with the occurrence of UFs (P = 0.01). A statistically significant inverse correlation was also observed between serum 25-(OH) Vit D levels and total UF volume (r = −0.31; P = 0.002) within the case cohort. Subjects with larger fibroid volumes had lower serum Vit D levels and vice versa. Data stratified for ethnicity showed a statistically significant inverse correlation between serum 25-(OH) Vit D levels and total fibroid volume in black subjects (r = −0.42; P = 0.001). An inverse correlation was also evident in white subjects (r = −0.86; P = 0.58) but this did not reach statistical significance.
Conclusion: Lower serum Vit D levels are inversely correlated with UF burden in different ethnic groups. Vit D deficiency is a possible risk factor for the occurrence of UFs.

Keywords: vitamin D deficiency, race/ethnicity, risk factor, premenopausal women