Abstract
ObjectiveThe present study aimed to evaluate the association between serum ferritin and vitamin D levels in fibroid uterus cases presenting with anemia.MethodsSixty premenopausal women with uterine fibroids (30 associated with anemia and 30 without anemia) were enrolled as cases and control. All participants were evaluated on the basis of a questionnaire, which included queries related to obstetric, medical, and sociodemographic history. Peripheral blood smear, complete blood count (CBC), hemoglobin (Hb), and serum ferritin concentration were measured by a fully automated analyzer, and 25(OH) vitamin D level was measured by enzyme-linked immunosorbent assay (ELISA).ResultsThere was a significant difference in ferritin levels between cases and control (p<0.001). The exposure to sunlight was moderate (one-hour exposure) in all subjects, eliminating the confounding effect of sunlight exposure influencing vitamin D levels. The median vitamin D level in cases was 5.0 ng/ml [interquartile range (IQR): 4.8], and that in control was 18.4 ng/ml (IQR: 7.9; p<0.001). A strong positive correlation of (r)=0.616 (p<0.001) was found between serum ferritin and vitamin D levels.ConclusionFibroid uterus cases with anemia are more prone to vitamin D deficiency as compared to cases without anemia. Vitamin D estimation in fibroid uterus cases presenting with anemia would be useful for better patient management.
Highlights
Uterine fibroid is the most common benign tumor in the uterus, and there is a growing prevalence of fibroid uterus in India [1], which has been associated with major health and economic burden in women of reproductive age group
Peripheral blood smear, complete blood count (CBC), hemoglobin (Hb), and serum ferritin concentration were measured by a fully automated analyzer, and 25(OH) vitamin D level was measured by enzyme-linked immunosorbent assay (ELISA)
The present study was conducted to estimate serum ferritin, vitamin D, and hemoglobin (Hb) levels in fibroid uterus cases presenting with anemia and to compare these values with premenopausal fibroid uterus cases presenting without anemia
Summary
Uterine fibroid (leiomyoma) is the most common benign tumor in the uterus, and there is a growing prevalence of fibroid uterus in India [1], which has been associated with major health and economic burden in women of reproductive age group. The co-existence of anemia and hypovitaminosis D has emerged as a new causal association [6] in fibroid uterus cases, but many studies have reported vitamin D deficiency without anemia [7,8]. Some studies have reported that ferritin levels are positively associated with serum vitamin D [10,11,12]. Though the existing scientific data indicates the role of vitamin D in fibroid uterus cases, the co-existence of anemia with vitamin D deficiency and the association between ferritin and vitamin D levels in premenopausal women with fibroid uterus are still not fully understood. The present study was conducted to estimate serum ferritin, vitamin D, and hemoglobin (Hb) levels in fibroid uterus cases presenting with anemia and to compare these values with premenopausal fibroid uterus cases presenting without anemia. Further evaluation was done to determine the association between ferritin and serum vitamin D levels in anemic and non-anemic fibroid uterus women to ascertain the correlation
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