Association of body mass index (BMI) and adipokines with the prevalence of fibroids in young African-American women: a case-control study

Abstract

To determine a relationship between fibroid prevalence and markers of obesity in young African-American women (AAW). Case-Control. Study participants were selected from the Study of Environment, Lifestyle & Fibroids (SELF) (n=1695). Inclusion criteria for participating in SELF included AA race, age 23-34 years at recruitment, no known diagnosis of fibroids, no history of hysterectomy, and no history of cancer, Lupus, Grave’s Disease, Sjogren’s Disease, scleroderma, or multiple sclerosis that required medical or radiation treatment. All of the subjects underwent ultrasound and 364 women were found to have fibroids (cases). 364 age-matched controls were selected from the subjects without fibroids. Serum leptin and total adiponectin were determined with ELISA assays. Conditional logistic regression analysis was performed to obtain odds ratio estimates (OR) and 95% confidence intervals (95% CI). The prevalence of fibroids was significantly less common among women who reported ever-using hormonal contraception (OR=0.54, 95% CI=0.35-0.82 vs never), prior pregnancy (OR=0.52, 95% CI=0.36-0.74 vs. never pregnant) and parity (OR=0.48, 95% CI=0.35-0.62 vs. nulliparous) in univariate models. There was no association of fibroids with age at menarche, current hormonal birth control use, marital status, education level, smoking status, alcohol history, BMI, and serum levels of leptin and total adiponectin. In a multivariable model, both ever-using hormonal contraception and prior pregnancy remained significantly associated with a lower likelihood of having fibroids (OR=0.62 , 95% CI=0.400.96 vs. never; OR=0.54, 95% CI=0.38-0.78 vs never pregnant respectively). While previous reports in the literature have suggested a relationship between fibroid prevalence and obesity, in our study of African American women, we found no difference between several markers of adiposity i.e. BMI, leptin, and adiponectin, and the prevalence of fibroids. Further studies are needed to determine whether the incidence (versus the prevalence) of fibroids is impacted by serum and biometric markers of obesity.