الفهرس 
Fibroid classification, organogenesis and pathologyOnly 14 pages are availabe for public view
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Abstract
Uterine fibroids (UFs), also known as leiomyomas, are benign tumors originating from smooth muscle cells. Although commonly benign, UFs are associated with significant morbidity. Although some UF patients may be asymptomatic, 25–50% of them may present a wide range of severe and chronic symptoms, such as abnormal uterine bleeding (AUB), anemia, pelvic pain and pressure, gastrointestinal problems, subfertility, and various obstetric complication.
Recent evidence has suggested that vitamin D deficiency, a growing health concern with various consequences such as the increased risk of female reproductive tumors, has a potential role in the pathogenesis and growth of UL.
This study was aimed to explore the relationship between serum Vitamin D3 levels and UFs in Egyptian women seeking gynecological services.
This was a case-control study conducted at Ain Shams University Maternity Hospital, Gynecology Department during the period from April 2021 to October 2021on 80 women with symptomatic uterine fibroids attending the Gynecology outpatient clinic and age-matched controls free from uterine fibroids.
In the current study, age was significantly higher in the fibroid group compared to the control group (37.32 ± 5.68 years vs 33.75 ± 7.18 years, respectively, with p-value = 0.016*). Also, the BMI of women with ULs was significantly higher than the control group (P-value= 0.001*). There were no statistically significant differences between the groups in parity or BMI (p <0.05).
In the present study, complaints were significantly different among the study and control groups. The most common symptoms among the fibroid group were abnormal uterine bleeding followed by infertility and pressure symptoms. The hemoglobin level was significantly lower in women with ULs than in the control group, 10.41 ± 0.86 Vs 10.84 ± 0.57 respectively.
In the current work, vitamin D levels were statistically significantly lower in women with UFs compared to controls (P <0.001*). The proportion of women in the insufficiency range (21 – 29 ng/mL) was comparable in the two study groups, the deficiency condition (<20 ng/mL) was more common among cases, and the sufficient condition (30-100 ng/mL) was more common among controls.
We found in the fibroid group, there were 31 (77.5%) cases with vitamin D deficiency and 9 (22.5%) cases with vitamin D insufficiency. There was no significant relationship between vitamin D level (deficient and insufficient) and age, parity, hemoglobin, BMI, size and number of fibroids, complaints, previous intervention, family, and associated gynecological diseases (p >0.05).
CONCLUSION
Uterine leiomyomas are commonly associated with significant morbidity. Recent evidence has suggested that vitamin D deficiency has a potential role in the pathogenesis and growth of UL. This prospective case-control study was conducted to explore the relationship between serum Vitamin D3 levels and UFs in Egyptian women. We found although uterine leiomyomas are more prevalent among Egyptian women with D vitamin deficiency, no association between the vitamin D levels whether it was deficient or insufficient, and UL size and numbers were reported.
Data suggests routine vitamin D level measurement is recommended in Egyptian females with risk of developing ULs and in UL patients as well as vitamin D supplementation is recommended when uterine leiomyoma is diagnosed.
RECOMMENDATION
This study recommended the following:
• Routine vitamin D level measurement is recommended in Egyptian females with risk of developing ULs and in UL patients as well.
• Vitamin D supplementation is recommended when uterine leiomyoma is diagnosed