The Effect of Vitamin D Supplementation on Size of Uterine Leiomyoma in Women with Vitamin D Deficiency
DOI:
https://doi.org/10.3889/oamjms.2023.11694Keywords:
Deficiency, Leiomyoma, Vitamin DAbstract
BACKGROUND: Uterine leiomyomas (fibroids) are the most common benign genital tumors in women. There is a high prevalence of vitamin D deficiency and uterine leiomyomas.
AIM: To evaluate the effect of vitamin D supplementation on the size of uterine leiomyoma in women with vitamin D deficiency.
MATERIALS AND METHODS: It is case–control prospective study which was done in Gynecology Ward at Basrah Maternity and Child Hospital from January 2020 to August 2022. Patients at ages 20–45 years were initially included in the study if they were diagnosed with 1–3 uterine fibroids with a mean diameter ≥10 mm. Serum vitamin D levels were estimated for all women before intervention and in those with deficiency of vitamin D (level <30 ng/mL). Patients with vitamin D deficiency were divided into 2 groups. The 1st group was women who received vitamin D 50,000 cholecalciferol (oral solution) IU weekly for 10 weeks followed by 2000 IU daily for 6–9 month (as study group), while 2nd group received placebo (control group). After the duration of treatment, vitamin D level was estimated and sonography was done to assess the fibroid size at 9–12 months later. In relation to the achievement of normal 25-OH-D3 levels, after the supplementation, the studied population were divided into 2 subgroup of patients: “gave response” and “non-responders” according to their response to treatment.
RESULTS: Vitamin D level was 17.6 (±3.0) ng/mL and calcium status was 7 mg/dL among 43 females of the study group. Vitamin D level was 34.7 ± 5 ng/mL after 12 months vitamin treatment (p < 0.05). The early vitamin level among 23 control females was 22.4 ± 7.8 ng/mL in comparison to 24.6 ± 6.7 ng/mL after 12 months (p > 0.05). There was no change for calcium level before and after 12 months period (8.6 vs. 7.9 mg/dL respectively). No changes were noticed among both the study and the control groups as far as the type and position of leiomyoma between the 1st and the 2nd ultrasound after 12 months of therapy.
CONCLUSION: Lower serum vitamin D levels are significantly associated with the occurrence of uterine fibroids.
Downloads
Metrics
Plum Analytics Artifact Widget Block
References
Ciavattini A, Clemente N, Carpini GD, Di Giuseppe J, Giannubilo SR, Tranquilli AL. Number and size of uterine fibroids and obstetric outcomes. J Matern Fetal Neonatal Med. 2015;28(4):484-8. https://doi.org/10.3109/14767058.2014.921675 PMid:24803127 DOI: https://doi.org/10.3109/14767058.2014.921675
Wu JL, Segars JH. Is vitamin D the answer for prevention of uterine fibroids? Fertil Steril. 2015;104(3):559-60. https://doi.org/10.1016/j.fertnstert.2015.06.034 PMid:26187299 DOI: https://doi.org/10.1016/j.fertnstert.2015.06.034
Paffoni A, Somigliana E, Vigano’ P, Benaglia L, Cardellicchio L, Pagliardini L, et al. Vitamin D status in women with uterine leiomyomas. J Clin Endocrinol Metab. 2013;98(8):E1374-8. https://doi.org/10.1210/jc.2013-1777 PMid:23824422 DOI: https://doi.org/10.1210/jc.2013-1777
Brakta S, Diamond JS, Al-Hendy A, Diamond MP, Halder SK. Role of vitamin D in uterine fibroid biology. Fertil Steril. 2015;104(3):698-706. https://doi.org/10.1016/j.fertnstert.2015.05.031 PMid:26079694 DOI: https://doi.org/10.1016/j.fertnstert.2015.05.031
Halder SK, Goodwin JS, Al-Hendy A. 1,25-Dihydroxyvitamin D3 reduces TGF-beta3-induced fibrosis-related gene expression in human uterine leiomyoma cells. J Clin Endocrinol Metab. 2011;96(4):E754-62. https://doi.org/10.1210/jc.2010-2131 PMid:21289245 DOI: https://doi.org/10.1210/jc.2010-2131
Halder SK, Sharan C, Al-Hendy A. 1,25-dihydroxyvitamin D3 treatment shrinks uterine leiomyoma tumors in the Eker rat model. Biol Reprod. 2012;86(4):116. https://doi.org/10.1095/biolreprod.111.098145 PMid:22302692 DOI: https://doi.org/10.1095/biolreprod.111.098145
Cardozo ER, Clark AD, Banks NK, Henne MB, Stegmann BJ, Segars JH. The estimated annual cost of uterine leiomyomata in the United States. Am J Obstet Gynecol. 2012;206(3):211.e1-9. https://doi.org/10.1016/j.ajog.2011.12.002 PMid:22244472 DOI: https://doi.org/10.1016/j.ajog.2011.12.002
Al-Hendy A, Badr M. Can vitamin D reduce the risk of uterine fibroids? Women Health (Lond). 2014;10(4):353-8. https://doi.org/10.2217/whe.14.24 PMid:25259897 DOI: https://doi.org/10.2217/WHE.14.24
Ciebiera M, Wlodarczyk M, Slabuszewska-Jozwiak A, Nowicka G, Jakiel G. Influence of vitamin D and transforming growth factor β3 serum concentrations, obesity, and family history on the risk for uterine fibroids. Fertil Steril. 2016;106(7):1787-92. https://doi.org/10.1016/j.fertnstert.2016.09.007 PMid:27743697 DOI: https://doi.org/10.1016/j.fertnstert.2016.09.007
Corachán A, Trejo MG, Carbajo-García MC, Monleón J, Escrig J, Faus A, et al. Vitamin D as an effective treatment in human uterine leiomyomas independent of mediator complex subunit 12 mutation. Fertil Steril. 2021;115(2):512-21. https://doi.org/10.1016/j.fertnstert.2020.07.049 PMid:33036796 DOI: https://doi.org/10.1016/j.fertnstert.2020.07.049
Jukic AM, Steiner AZ, Baird DD. Association between serum 25-hydroxyvitamin D and ovarian reserve in premenopausal women. Menopause. 2015;22(3):312-6. https://doi.org/10.1097/GME.0000000000000312 PMid:25093721 DOI: https://doi.org/10.1097/GME.0000000000000312
Grant WB. A review of the evidence supporting the Vitamin D-cancer prevention hypothesis in 2017. Anticancer Res. 2018;38(2):1121-36. https://doi.org/10.21873/anticanres.12331 PMid:29374749 DOI: https://doi.org/10.21873/anticanres.12331
Matyjaszek-Matuszek B, Lenart-Lipinska M, Wozniakowska E. Clinical implications of vitamin D deficiency. Prz Menopauzalny. 2015;14(2):75-81. https://doi.org/10.5114/pm.2015.52149 PMid:26327893 DOI: https://doi.org/10.5114/pm.2015.52149
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: An endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911- 30. https://doi.org/10.1210/jc.2011-0385 PMid:21646368 DOI: https://doi.org/10.1210/jc.2011-0385
Sabry M, Halder SK, Allah AS, Roshdy E, Rajaratnam V, Al-Hendy A. Serum Vitamin D3 level inversely correlates with uterine fibroid volume in different ethnic groups: A cross-sectional observational study. Int J Womens Health. 2013;5:93- 100. https://doi.org/10.2147/IJWH.S38800 PMid:23467803 DOI: https://doi.org/10.2147/IJWH.S38800
Weir EC, Goad DL, Daifotis AG, Burtis WJ, Dreyer BE, Nowak RA. Relative overexpression of the parathyroid hormone-related protein gene in human leiomyomas. J Clin Endocrinol Metab. 1994;78(3):784-9. https://doi.org/10.1210/jcem.78.3.8126157 PMid:8126157 DOI: https://doi.org/10.1210/jcem.78.3.8126157
Abou-Samra AB, Jüppner H, Force T, Freeman MW, Kong XF, Schipani E, et al. Expression cloning of a common receptor for parathyroid hormone and parathyroid hormone-related peptide from rat osteoblast-like cells: A single receptor stimulates intracellular accumulation of both cAMP and inositol trisphosphates and increases intracellular free calcium. Proc Natl Acad Sci U S A. 1992;89(7):2732-6. https://doi.org/10.1073/pnas.89.7.2732 PMid:1313566 DOI: https://doi.org/10.1073/pnas.89.7.2732
Sharan C, Halder SK, Thota C, Jaleel S, Nair S, Al-Hendy A. Vitamin D inhibits proliferation of human uterine leiomyoma cells via catechol-O-methyl transferase. Fertil Steril. 2011;95(1):247- 53. https://doi.org/10.1016/j.fertnstert.2010.07.1041 PMid:20736132 DOI: https://doi.org/10.1016/j.fertnstert.2010.07.1041
Halder SK, Osteen KG, Al-Hendy A. Vitamin D3 inhibits expression and activities of matrix metalloproteinase-2 and -9 in human uterine fibroid cells. Hum Reprod. 2013;28(9):2407-16. https://doi.org/10.1093/humrep/det265 PMid:23814095 DOI: https://doi.org/10.1093/humrep/det265
Traub ML, Finnell JS, Bhandiwad A, Oberg E, Suhaila L, Bradley R. Impact of vitamin D3 dietary supplement matrix on clinical response. J Clin Endocrinol Metab. 2014;99(8):2720-8. https://doi.org/10.1210/jc.2013-3162 PMid:24684456 DOI: https://doi.org/10.1210/jc.2013-3162
Giannubilo SR, Ciavattini A, Petraglia F, Castellucci M, Ciarmela P. Management of fibroids in perimenopausal women. Curr Opin Obstet Gynecol. 2015;27(6):416-21. https://doi.org/10.1097/GCO.0000000000000219 PMid:26536206 DOI: https://doi.org/10.1097/GCO.0000000000000219
Ciarmela P, Ciavattini A, Giannubilo SR, Lamanna P, Fiorini R, Tranquilli AL, et al. Management of leiomyomas in perimenopausal women. Maturitas. 2014;78(3):168-73. https://doi.org/10.1016/j.maturitas.2014.04.011 PMid:2483500 DOI: https://doi.org/10.1016/j.maturitas.2014.04.011
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2023 Hibba Dawood, Maysoon Sharief (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
http://creativecommons.org/licenses/by-nc/4.0