Hypovitaminosis D and "small burden" uterine fibroids: Opportunity for a vitamin D supplementation

Andrea Ciavattini; Giovanni Delli Carpini; Matteo Serri; Arianna Vignini; Jacopo Sabbatinelli; Alessandra Tozzi; Alice Aggiusti; Nicolò Clemente

doi:10.1097/MD.0000000000005698

Uterine and Pelvic Conditions Fibroids

Hypovitaminosis D and "small burden" uterine fibroids: Opportunity for a vitamin D supplementation

Ciavattini A, Delli Carpini G, Serri M, Vignini A, Sabbatinelli J, Tozzi A, Aggiusti A, Clemente N

Published December 2016 Medicine, 95(52), e5698

DOI 10.1097/MD.0000000000005698 PMID 28033263 PMC PMC5207559

RRM Academy Synopsis

Vitamin D users with small fibroids progressed less often

In a one-year study of 108 women with small fibroids and low vitamin D, vitamin D users progressed to extensive fibroid disease less often than non-users. About 13 of 100 users needed medical or surgical treatment, versus about 31 of 100 non-users (P = 0.05). Groups were defined by whether women took the vitamin D supplement as directed.

Needed medical or surgical care: Vitamin D users, 13.2 in 100; Non-users, 30.9 in 100. Source: Ciavattini A et al., 2016, PMID 28033263.

Study at a glance, cohort study of 108 women with small fibroids: Vitamin D users with small fibroids progressed less often. Source: Ciavattini A et al., 2016, PMID 28033263.

Key Findings

Among 208 women with fibroids, baseline vitamin D level correlated negatively with largest fibroid volume (r = −0.18, P = 0.01) and total fibroid volume (r = −0.19, P = 0.01).
Progression to extensive disease led to medical or surgical therapy in 7 of 53 women in the study group (13.2%) and 17 of 55 controls (30.9%), P = 0.05.
Fibroid diameter and volume rose significantly in the control group (P < 0.001). No significant difference in diameter or volume emerged in the study group.
Of 43 study-group women seen at follow-up, 18 (41.9%) reached normal vitamin D levels and 25 (58.1%) did not.
Pregnancy in the 12 months after diagnosis was similar: 5.7% in the study group and 7.3% in controls (P = 0.96).

Interpretation

This cohort study followed 108 women with small fibroids and low vitamin D at one ultrasound clinic. Women were split into a vitamin D group and a control group. Vitamin D users progressed to extensive fibroid disease less often than non-users. Their fibroid size held steady over the year, while the control group's fibroids grew significantly. The authors call the findings preliminary and ask for randomized trials. The findings support larger studies of vitamin D and fibroid growth.

RRM Context

Restorative reproductive medicine looks for contributing factors in the body. Vitamin D status is one factor the authors measured in women with fibroids. The study notes that GnRH drugs work only short term, since they cause menopause-like side effects.

Our editorial summary of this paper, not the article's abstract.

Abstract

The aim of this study was to evaluate the effect of vitamin D supplementation in women with hypovitaminosis D and "small burden" uterine fibroids.This study focused on 208 women diagnosed with uterine fibroids and concomitant hypovitaminosis D, from January to December 2014. One hundred eight women of the initial study population were diagnosed with "small burden" uterine fibroids. Among them, those who underwent a proper vitamin D supplementation constituted the "study group" (n = 53), while women who spontaneously refused the therapy or did not perform it properly, constituted the "control group" (n = 55). The characteristics of uterine fibroids, the fibroid-related symptoms, and the vitamin D serum levels were evaluated 12 months after the initial diagnosis.In women with uterine fibroids, a negative correlation emerged between the baseline 25-hydroxy-cholecalciferol (25-OH-D3) concentration and both the volume of the largest fibroid (r = -0.18, P = 0.01) and the total volume of fibroids (r = -0.19, P = 0.01). No correlation was found between the baseline 25-OH-D3 levels and the number of fibroids per patient (r = -0.10, P = 0.16). In women of the "study group," a significant increase in the 25-OH-D3 serum level was observed after 12 months of supplementation, and a lower rate of surgical or medical treatment due to the "progression to extensive disease" was reported (13.2% vs 30.9%, P = 0.05).Supplementation therapy with 25-OH-D3 restores normal vitamin D serum levels in women with "small burden" fibroids. In these women, vitamin D supplementation seems to reduce the progression to an extensive disease, and thus the need of conventional surgical or medical therapy.

Topics

Uterine and Pelvic Conditions › Fibroids › Fibroid Management · Therapeutics › Supplements and Botanicals › Vitamins and Minerals · Lifestyle and Environment › Nutrition and Metabolic Health › Dietary Patterns

Andrea Ciavattini, Giovanni Delli Carpini, Matteo Serri, Arianna Vignini, Jacopo Sabbatinelli, Alessandra Tozzi, Alice Aggiusti, Nicolò Clemente

A Ciavattini, G Carpini, M Serri, A Vignini, J Sabbatinelli, A Tozzi, A Aggiusti, N Clemente

PMID 28033263 28033263 DOI 10.1097/MD.0000000000005698 10.1097/MD.0000000000005698 Ciavattini et al. 2016, Ciavattini 2016

Hypovitaminosis D and "small burden" uterine fibroids: Opportunity for a vitamin D supplementation

Vitamin D users with small fibroids progressed less often

Key Findings

Interpretation

RRM Context

Abstract

Topics

Related research

Effect of Oral Consumption of Vitamin D on Uterine Fibroids: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

The effect of vitamin D supplementation on the size of uterine leiomyoma in women with vitamin D deficiency

1,25-dihydroxyvitamin D3 treatment shrinks uterine leiomyoma tumors in the Eker rat model

Vitamin D and Ovarian Reserve and Fecundability among Women with Proven Fecundity