Association between hypovitaminosis D and uterine leiomyomas among women of reproductive age attending selected hospitals in Uganda: A multicenter cross-sectional study

Résumé

BACKGROUND: Uterine leiomyoma, is a common benign neoplasm among women of reproductive age with a potential of causing significant health complications and financial burdens in severe cases. Recent research suggests a possible link between vitamin D deficiency and uterine leiomyoma development; however, this relationship has not been established in the Ugandan population. For this reason, there is no individualized or public health interventions targeting this modifiable risk factor. The study aimed to determine the relationship between hypovitaminosis D and uterine leiomyoma among women of reproductive age attending Jinja, Lira and Fort Portal Regional Referral Hospitals in Uganda. METHODS: A cross-sectional multicentre study was conducted at Jinja, Lira and Fort Portal Regional Referral Hospitals between 1st October 2022-31st January 2023. 246 non-pregnant women of reproductive age were included in the study. Questionnaires were administered to the participants, their serum vitamin D analysed and a transabdominal pelvic scan done. A p value of ≤0.05 was the threshold for statistical significance. RESULTS: The prevalence of hypovitaminosis D among participants was high at 54.1%. There was no significant difference in the proportions of leiomyoma among those with and without hypovitaminosis D (χ2 = 0.503, p = 0.478 > 0.05). The mean serum vitamin D level was lower in individuals with uterine leiomyomas compared to those without (19.954 ± 9.77 versus 21.552 ± 9.54 [95% CI: -0.04 to 4.24, p = 0.235]). There was no statistically significant association between hypovitaminosis D and uterine leiomyoma (OR 1.22, 95% CI 0.70-2.12; p = 0.478). There was a weak negative correlation observed between serum vitamin D levels and leiomyoma site number (r = -0.2482, p = 0.0342 < 0.05). CONCLUSION AND RECOMMENDATIONS: The prevalence of hypovitaminosis D was high among women of reproductive age. There was no statistically significant relationship between hypovitaminosis D and uterine leiomyomas despite a weak negative correlation between vitamin D levels and leiomyoma site number which was statistically significant. High prevalence of hypovitaminosis D underscores the need for health education and public health measures by healthcare providers to manage and prevent vitamin D deficiency-related morbidity among women of reproductive age. Further research by the scientists is needed to investigate the potential association between hypovitaminosis D and uterine leiomyoma, in regards to increased site number, among the African population.

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