Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
Leiomyomas are the most common gynaecological neoplasms. Despite the major public health impact of leiomyomas, little is known about their cause. As fibroids are hormone-dependent tumours and their development can be promoted by estrogens, an inverse association between hypercholesterolemia and fibroids should be observed as well as direct association between high-density lipoprotein cholesterol (HDL-C) levels and the presence of fibroids.
OBJECTIVE:
To investigate the lipid profile in patients with uterine fibroids and to compare it with the lipid profile of women without fibroids.
METHODS:
A case-control study was conducted in the Department of Obstetrics and Gynaecology at Al-Yarmouk Teaching Hospital during the period from May 2008 to May 2009. Participants were one-hundred twenty pre-menopausal women aged between 18 and 45 years who were recruited during their visit to the gynaecological outpatient clinic and were not taking hormonal therapy. Cases consisted of 60 women with uterine fibroids, and controls were 60 women visiting the same gynaecological outpatient clinic for routine reasons. Thorough history and examination was done for each participant. Body Mass Index (BMI) was measured in kg/m2. All patients underwent a baseline ultrasound examination and classified into two groups according to the presence or absence of uterine fibroids. All women where scheduled to undergo blood test at the beginning (2nd -5th day) of their next menstrual cycle. Fasting venous blood glucose and lipid profile were determined in blood samples taken for each patient. Atherogenic index was also calculated.
RESULTS:
Women with uterine fibroids were found to have significantly higher levels of serum HDL-C compared to the controls (P=0.0001). A significantly lower levels of total serum cholesterol, low-density lipoprotein cholesterol (LDL-C) were also found in women with uterine fibroids compared to the controls (P=0.0001). Atherogenic index was significantly lower in fibroid group compared with controls (P=0.0001). There was a significant positive correlation between largest fibroid volume and HDL-C level (P<0.0001).
CONCLUSION:
Women with uterine fibroid have lower atherogenic index compared to women without uterine fibroid. Larger volume of fibroid is associated with higher level of HDL-C.