Status of Vitamin D in Women with Uterine Fibroid and Impact of Vitamin D Supplementation

Abstract

Background: Uterine fibroids, also known as leiomyomas, are benign smooth muscle tumors of the uterus. The exact cause of uterine fibroids is indistinct. However, fibroids appear to be partly determined by hormone levels. There is a high prevalence of Vitamin D deficiency for uterine fibroids. Vitamin D from food or from skin synthesis by sunshine becomes biologically inactive. It is activated by two protein enzyme hydroxylation steps. The first in the liver and the second in the kidney. As Vitamin D can be synthesized, it is considered a prohormone. Vitamin D is taken to the liver where it is transformed into 25[OH] D. Objective: The objective of this study was to determine the impact of Vitamin D supplementation in women with fibroids uterus. Methods: This interventional study was conducted in the department of obstetrics & gynecology, BSMMU, Dhaka, Bangladesh. A purposive sampling method was done. A total of 95 patients diagnosed as uterine fibroids with Vitamin D deficiency were included in the study. BMI was measured and the size of the fibroid was determined by ultrasonography and serum Vitamin D level was estimated. Vitamin D was supplemented to the participants. Then repeat ultrasonography and serum Vitamin D level were done after 3 months, to the assessment of vitamin impact. Regression of the size of the fibroid was done. Results: The mean age was 37.31±7.10 years. The majority of the participants were housewives 67.4%. Mean Vitamin D was 21.71±7.32, BMI 27.96±4.72. At the initial stage, among total study population in 11.6% (n=11), 47.4% (n=45) and 41.0% (n=39) patients we found <2.5cm(Small), 2.5-4.9cm (Medium) and (≥5cm (Large) sized fibroids respectively. The mean size of fibroids in a total of 95 patients was 4.99 ± 2.59 and after Vitamin D supplementation it had been reduced to 4.77±3.04. Conclusion: Supplementation with Vitamin D in women with fibroid uterus regress the fibroid size and it is more effective in smaller fibroid sizes. In this study, the size of uterine fibroid was reduced after supplementation of Vitamin D among the patients. It was significant (p<0.05) of fibroid uterus size changed after the Vitamin D supplement.