Relationship between Metabolic Syndrome and Uterine Leiomyoma: A Case Control Study

BACKGROUND: Uterine leiomyoma is the most common benign gynaecological tumor of the female reproductive tract. Although, the cause of uterine leiomyoma is still unclear; however, studies have shown that individual or combination of components of metabolic syndrome such as hypertension, obesity, elevated triglycerides, and type 2 diabetes are also associated with the prevalence of uterine leiomyoma.

METHODS: This is a prospective case-control study conducted in the Department of Obstetrics and Gynaecological of the Lagos State University Teaching Hospital from 26th March 2020 to September 28th, 2020. This study aimed to evaluate the associations between metabolic syndrome and uterine leiomyoma. A total of 165 cases were recruited and analyzed for both the study population and control. All data was imputed onto a proforma. Statistical analysis was done using the Statistical Package for Social Science (SPSS) version 22. Conditional logistic regression was used to examine the associations between independent variables and uterine leiomyoma.

RESULTS: There was no statistically significant difference in the prevalence of metabolic syndrome between participants in the fibroid and non-fibroid group (3.7% vs1.8%, P=0.315). Prevalence of obesity and hyperglycemia were significantly higher in the leiomyoma group compared to the control group (77.4% vs 20.2%, P<0.001 and 6.7% vs 1.8%, P=0.028. Regression analysis showed a three-fold risk of uterine fibroids among cases when waist circumference was elevated, (OR=3.876;95% CI,1.759-7.981).

CONCLUSION:

There was no significant association between the prevalence of metabolic syndrome and uterine leiomyomas, however, the prevalence of obesity and hyperglycemia were significantly associated with uterine leiomyoma. Insulin resistance could be the common pathway in the evolution of uterine leiomyoma.