Uterine fibroid and its association with metabolic syndrome in women of reproductive age (literature review)

   Uterine fibroid is one of the most common gynecological diseases in women of reproductive age and many aspects of this disease remain the subject of investigation. In particular, the role of the metabolic syndrome is of interest as a potential predictor of uterine fibroid or a comorbid condition that has pathogenetic significance.
   The aim of this literature review is to systematize current data on the prevalence and associations of the metabolic syndrome and uterine fibroid in women of reproductive age.
   Literature search was carried out using the scientific literature databases eLIBRARY, PubMed, NCBI, CyberLeninka, and the official IDF website for the period from 2010 to 2022. In PubMed search, we used the following terms: uterine fibroid, metabolic syndrome, uterine fibroid and metabolic syndrome, uterine myoma and metabolic syndrome, uterine myoma and metabolic disorders, uterine myoma and MetS. A total of 439 sources were analized, 32 sources met the search criteria.
   Results. An analysis of the largest epidemiological studies conducted in recent years, both in non-selective populations and in hospital samples, demonstrates a significant prevalence of both uterine fibroid and metabolic syndrome among women. The results presented in the publications which were included in the review indicate that there is a relationship between the presence of uterine fibroid and the manifestations of the metabolic syndrome.
   Conclusions. Uterine fibroid and metabolic syndrome are mutually aggravating conditions. Women with uterine fibroid have a worse risk profile for cardiovascular disease, and the presence of metabolic syndrome increases the risk of uterine fibroid. One of the ways to reduce the risk of occurrence and growth of uterine fibroid is the timely correction of the metabolic syndrome and its components. On the other hand, the presence of uterine fibroid should be considered as a basis for active detection of metabolic disorders and cardiovascular risks.

1. Ryan G. L., Syrop C. H., van Voorhis B. J. Role, epidemiology, and natural history of benign uterine mass lesions. Clin Obstet Gynecol. 2005; 48 (2): 312-324. doi: 10.1097/01.grf.0000159538.27221.8c

2. Wallach E. E., Vlahos N. F. Uterine myomas: An overview of development, clinical features, and management. Obstet Gynecol. 2004; 104 (2): 393-406. doi: 10.1097/01.AOG.0000136079.62513.39

3. Minsart A. F., Ntoutoume Sima F., Vandenhoute K., Jani J., Van Pachterbeke C. Does three-dimensional power Doppler ultrasound predict histopathological findings of uterine fibroids? A preliminary study. Ultrasound Obstet Gynecol. 2012; 40 (6): 714-720. doi: 10.1002/uog.11155

4. Pérez-López F. R., Ornat L., Ceausu I., Depypere H., Erel C. T., Lambrinoudaki I., et al. EMAS position statement: Management of uterine fibroids. Maturitas. 2014; 79 (1): 106-116. doi: 10.1016/j.maturitas.2014.06.002

5. Kubik-Huch R. A., Weston M., Nougaret S., Leonhardt H., Thomassin-Naggara I., Horta M., et al. European Society of Urogenital Radiology (ESUR) guidelines: MR imaging of leiomyomas. Eur Radiol. 2018; 28 (8): 3125-3137. doi: 10.1007/s00330-017-5157-5

6. Zimmermann A., Bernuit D., Gerlinger C., Schaefers M., Geppert K. Prevalence, symptoms and management of uterine fibroids: an international internet-based survey of 21,746 women. BMC Womens Health. 2012; 12: 6. doi: 10.1186/1472-6874-12-6

7. Samigullina A. E., Agaydarov R. D. Uterine fibrous: Frequency and forecast of operational activity (for example NCMCW). International Journal of Applied and fundamental research. 2020; 9: 30-38. (In Russ.). doi: 10.17513/mjpfi.13123

8. Fuldeore M. J., Soliman A. M. Patient-reported prevalence and symptomatic burden of uterine fibroids among women in the United States: Findings from a cross-sectional survey analysis. Int J Womens Health. 2017; 9: 403-411. doi: 10.2147/IJWH.S133212

9. Marsh E. E., Al-Hendy A., Kappus D., Galitsky A., Stewart E. A., Kerolous M. Burden, prevalence, and treatment of uterine fibroids: A survey of U. S. women. J Womens Health (Larchmt). 2018; 27 (11): 1359-1367. doi: 10.1089/jwh.2018.7076

10. Atalyan A. V., Suturina L. V., Nadeliaeva I. G., Lazareva L. M., Sharifulin E. M., Danusevich I. N. Prevalence of uterine fibroids in women in Eastern Siberia: A cross-sectional study. International Journal of Biomedicine. 2021; 11 (4): 515-518. doi: 10.21103/Article11(4)_OA18

11. Millien C., Manzi A., Katz A. M., Gilbert H., Smith Fawzi M. C., Farmer P. E., et al. Assessing burden, risk factors, and perceived impact of uterine fibroids on women’s lives in rural Haiti: Implications for advancing a health equity agenda, a mixed methods study. Int J Equity Health. 2021; 20 (1): 1. doi: 10.1186/s12939-020-01327-9

12. Tsyrenov T. B., Darzhayev Z. Yu., Suturina L. V., Labygina A. V., Pavlova V. P., Rinchindorzhiyeva M. P., et al. Hormone-dependent gynecological diseases in infertile women from main ethnic groups of Buryat Republic. Acta biomedica scientifica. 2013; (4): 74-76. (In Russ.).

13. Stewart E. A., Cookson C. L., Gandolfo R. A., Schulze-Rath R. Epidemiology of uterine fibroids: A systematic review. BJOG. 2017; 124 (10): 1501-1512. doi: 10.1111/1471-0528.14640

14. National Cholesterol Education Program. Second report of the expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel II).” Circulation. 1994; 89 (3): 1333-1445.

15. Alberti K. G., Zimmet P., Shaw J. Metabolic syndrome – A new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med. 2006; 23 (5): 469-480. doi: 10.1111/j.1464-5491.2006.01858.x

16. Einhorn D., Reaven G. M., Cobin R. H., Ford E., Ganda O. P., Handelsman Y., et al. American College of Endocrinology position statement on the insulin resistance syndrome. Endocr Pract. 2003; 9 (3): 237-252.

17. Alberti K. G., Eckel R. H., Grundy S. M., Zimmet P. Z., Cleeman J. I., Donato K. A., et al. Harmonizing the metabolic syndrome: A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009; 120 (16): 1640-1645. doi: 10.1161/CIRCULATIONAHA.109.192644

18. Grundy S. M., Cleeman J. I., Daniels S. R., Donato K. A., Eckel R. H., Franklin B. A., et al. Diagnosis and management of the metabolic syndrome: An American Heart Association / National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005; 112 (17): 2735-2752. doi: 10.1161/CIRCULATIONAHA.105.169404

19. Recommendations of experts of Russian Scientific Society of Cardiologists on diagnosis and treatment of metabolic syndrome. Second revision. Practical Medicine. 2010; 44: 81-101. (In Russ.).

20. Shlyakhto E. V., Konrady А. О. Epidemiology of metabolic syndrome in different regions. Impact of used definitions and prognostic value. Arterial Hypertension. 2007; 13 (2): 95-112. doi: 10.18705/1607-419X-2007-13-2-95-112

21. Li Y., Zhao L., Yu D., Wang Z., Ding G. Metabolic syndrome prevalence and its risk factors among adults in China: Anationally representative cross-sectional study. PLoS One. 2018; 13 (6): e0199293. doi: 10.1371/journal.pone.0199293

22. Chowdhury M. Z. I., Anik A. M., Farhana Z., Bristi P. D., Abu A. l. Mamun B. M., et al. Prevalence of metabolic syndrome in Bangladesh: A systematic review and meta-analysis of the studies. BMC Public Health. 2018; 18 (1): 308. doi: 10.1186/s12889-018-5209-z

23. Vilson N. I., Belenkaya L, V., Sholokhov L. F., Igumnov I. A., Nadelyaeva Y. G., Suturina L. V. Metabolic syndrome: Epidemiology, diagnostic criteria, racial characteristics. Acta biomedica scientifica. 2021; 6 (4): 180-191. (In Russ.). doi: 10.29413/ABS.2021-6.4.16

24. Smirnova T. A. Metabolic syndrome and uterine fibroids. Reproductive Health. Eastern Europe. 2013; 4 (28): 114-126. (In Russ.).

25. Sivri N., Yalta T., Sayın C., Yalta K., Ozpuyan F., Taştekin E., et al. Evaluation of cardiovascular risk factors in women with uterine leimyoma: Is there a link with atherosclerosis? Balkan Med J. 2012; 29 (3): 320-323. doi: 10.5152/balkanmedj.2012.002

26. Tak Y. J., Lee S. Y., Park S. K., Kim Y. J., Lee J. G., Jeong D. W., et al. Association between uterine leiomyoma and metabolic syndrome in parous premenopausal women: A case-control study. Medicine (Baltimore). 2016; 95 (46): e5325. doi: 10.1097/MD.0000000000005325

27. Stupko E. E., Shenin V. A., Kolesnikova L. I., Labygina A. V., Suturina L. V. The role of polymorphisms genes of detoxification of xenobiotics in the development of endometriosis and hysteromyoma in women. Siberian Medical Journal (Irkutsk). 2011; 104 (5): 5-8. (In Russ.).

28. Diemer F. S., Aartman J. Q., Karamat F. A., Baldew S. M., Jarbandhan A. V., van Montfrans G. A., et al. Exploring cardiovascular health: The Healthy Life in Suriname (HELISUR) study. A protocol of a cross‐sectional study. BMJ Open. 2014; 4: e006380. doi: 10.1136/bmjopen-2014-006380

29. Haan Y. C., Diemer F. S., van Der Woude L., van Montfrans G. A., Oehlers G. P., Brewster L. M. The risk of hypertension and cardiovascular disease in women with uterine fibroids. J Clin Hypertens (Greenwich). 2018; 20 (4): 718-726. doi: 10.1111/jch.13253

30. Sun K., Xie Y., Zhao N., Li Z. A case-control study of the relationship between visceral fat and development of uterine fibroids. Exp Ther Med. 2019; 18 (1): 404-410. doi: 10.3892/etm.2019.7575

31. Laughlin-Tommaso S. K., Fuchs E. L., Wellons M. F., Lewis C. E., Calderon-Margalit R., Stewart E. A., et al. Uterine fibroids and the risk of cardiovascular disease in the coronary artery risk development in young adult women’s study. J Womens Health (Larchmt). 2019; 28 (1): 46-52. doi: 10.1089/jwh.2018.7122

32. Alashqar A., E. l. Ouweini H., Gornet M., Yenokyan G., Borahay M. A. Cardiometabolic profile of women with uterine leiomyoma: A cross-sectional study. Minerva Obstet Gynecol. 2022. URL: https://pubmed.ncbi.nlm.nih.gov/35333033/