The Association of Vitamin D with Uterine Fibroids in Premenopausal Patients: A Systematic Review and Meta-Analysis

IF 2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada Pub Date : 2024-08-10 DOI:10.1016/j.jogc.2024.102632

Marina Ivanova BHSc, BScN , Allison Soule BSc , Jessica Pudwell MSc, MPH , Olga Bougie MD, MPH

{"title":"The Association of Vitamin D with Uterine Fibroids in Premenopausal Patients: A Systematic Review and Meta-Analysis","authors":"Marina Ivanova BHSc, BScN , Allison Soule BSc , Jessica Pudwell MSc, MPH , Olga Bougie MD, MPH","doi":"10.1016/j.jogc.2024.102632","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to consolidate existing literature regarding the association between vitamin D and uterine fibroid presence and growth.</div></div><div><h3>Data sources</h3><div>A comprehensive search across databases including Medline, Embase, CINAHL, Web of Science, <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, and grey literature was conducted from inception to February 2023, using relevant keywords. Authors were contacted for unpublished data.</div></div><div><h3>Study selection</h3><div>From 9931 studies screened based on title and abstract, those evaluating serum vitamin D levels or vitamin D treatment effects, using ultrasonography for diagnosis, and involving at least 25 premenopausal participants were included. Case reports, case series, and reviews were excluded.</div></div><div><h3>Data extraction and synthesis</h3><div>Data were extracted using a predefined form. Methodological quality was assessed through the Newcastle-Ottawa Scale and the Risk of Bias-2 tools. Evidence quality was evaluated using Grading of Recommendations Assessment, Development, and Evaluation. Data from 3 randomised controlled trials (n = 328) and 23 observational studies (n = 5650) were meta-analyzed via random-effects modelling. Patients receiving oral vitamin D supplementation had a significantly different change in fibroid size (standardized mean difference −5.7%; CI −10.63 to −0.76, <em>P</em> = 0.02, I<sup>2</sup> = 99%), as measured by the percentage change in diameter or volume, compared to controls, over the span of 2–6 months. Those receiving supplementation had vitamin D insufficiency; regimens varied between 50 000 IU weekly for 12 weeks, 50 000 IU weekly for 8 weeks, and 50 000 IU biweekly for 10 weeks. Patients with fibroids exhibited lower serum vitamin D concentrations (mean difference −5.50 ng/mL; CI 6.99 to −4.01, <em>P</em> < 0.001, I<sup>2</sup> = 87%) and higher odds of vitamin D deficiency (OR 3.71; CI 1.90–7.24, <em>P</em> < 0.001, I<sup>2</sup> = 80%).</div></div><div><h3>Conclusion</h3><div>This review underscores the potential of vitamin D in mitigating fibroid development and growth. While promising, further research is warranted to optimise dosage and treatment duration, potentially offering a non-invasive solution for at-risk patients. Continued exploration of vitamin D's role in fibroid treatment is encouraged.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of obstetrics and gynaecology Canada","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1701216324004559","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

This study aims to consolidate existing literature regarding the association between vitamin D and uterine fibroid presence and growth.

Data sources

A comprehensive search across databases including Medline, Embase, CINAHL, Web of Science, ClinicalTrials.gov, and grey literature was conducted from inception to February 2023, using relevant keywords. Authors were contacted for unpublished data.

Study selection

From 9931 studies screened based on title and abstract, those evaluating serum vitamin D levels or vitamin D treatment effects, using ultrasonography for diagnosis, and involving at least 25 premenopausal participants were included. Case reports, case series, and reviews were excluded.

Data extraction and synthesis

Data were extracted using a predefined form. Methodological quality was assessed through the Newcastle-Ottawa Scale and the Risk of Bias-2 tools. Evidence quality was evaluated using Grading of Recommendations Assessment, Development, and Evaluation. Data from 3 randomised controlled trials (n = 328) and 23 observational studies (n = 5650) were meta-analyzed via random-effects modelling. Patients receiving oral vitamin D supplementation had a significantly different change in fibroid size (standardized mean difference −5.7%; CI −10.63 to −0.76, P = 0.02, I² = 99%), as measured by the percentage change in diameter or volume, compared to controls, over the span of 2–6 months. Those receiving supplementation had vitamin D insufficiency; regimens varied between 50 000 IU weekly for 12 weeks, 50 000 IU weekly for 8 weeks, and 50 000 IU biweekly for 10 weeks. Patients with fibroids exhibited lower serum vitamin D concentrations (mean difference −5.50 ng/mL; CI 6.99 to −4.01, P < 0.001, I² = 87%) and higher odds of vitamin D deficiency (OR 3.71; CI 1.90–7.24, P < 0.001, I² = 80%).

Conclusion

This review underscores the potential of vitamin D in mitigating fibroid development and growth. While promising, further research is warranted to optimise dosage and treatment duration, potentially offering a non-invasive solution for at-risk patients. Continued exploration of vitamin D's role in fibroid treatment is encouraged.

查看原文本刊更多论文

维生素 D 与绝经前患者子宫肌瘤的关系：系统回顾与元分析》（The Association of Vitamin D with Uterine Fibroids in Premenopausal Patients: a Systematic Review and Meta-Analysis）。

目的：本研究旨在整合有关维生素 D 与子宫肌瘤的存在和生长之间关系的现有文献。数据来源：使用相关关键词对 MEDLINE、Embase、CINAHL、Web of Science、ClinicalTrials.gov 和灰色文献等数据库进行了全面检索，检索期从开始到 2023 年 2 月。研究筛选：从根据标题和摘要筛选出的 9931 项研究中，纳入了那些评估血清维生素 D 水平或维生素 D 治疗效果、使用超声波诊断、至少有 25 名绝经前参与者参与的研究。数据提取与综合：采用预先定义的表格提取数据。方法学质量通过纽卡斯尔-渥太华量表和偏倚风险-2工具进行评估。证据质量采用建议评估、制定和评价分级法进行评估。通过随机效应模型对来自 3 项随机对照试验（n = 328）和 23 项观察性研究（n = 5650）的数据进行了元分析。与对照组相比，接受口服维生素 D 补充剂的患者在 2-6 个月的时间里，子宫肌瘤大小的变化（SMD -5.7%，CI -10.63~-0.76，P = 0.02，I2 = 99%）明显不同（以直径或体积的百分比变化来衡量）。接受补充剂治疗的患者都存在维生素 D 不足的问题；治疗方案各不相同，有的每周 50 000 IU，持续 12 周；有的每周 50 000 IU，持续 8 周；有的每两周 50 000 IU，持续 10 周。子宫肌瘤患者的血清维生素 D 浓度较低（MD -5.50 ng/mL，CI 6.99 至 -4.01，P < 0.001，I2 = 87%），维生素 D 缺乏的几率较高（OR 3.71，CI 1.90 至 7.24，P < 0.001，I2 = 80%）。尽管前景广阔，但仍需进一步研究以优化剂量和治疗时间，从而为高危患者提供一种非侵入性的解决方案。目的：本研究旨在整合有关维生素 D 与子宫肌瘤的存在和生长之间关系的现有文献。资料来源：使用相关关键词对 MEDLINE、Embase、CINAHL、Web of Science 和 ClinicalTrials.gov 数据库和文献进行了全面检索，检索时间从开始到 2023 年 2 月。还联系了作者以获取未发表的数据。研究筛选：在根据标题和摘要筛选出的 9931 项研究中，仅纳入了评估血清维生素 D 水平或维生素 D 治疗效果、使用超声波进行诊断并纳入至少 25 名非绝经期女性的研究。病例研究、病例系列研究和综述未被纳入。数据提取与分析：采用预定义表格提取数据。方法学质量采用纽卡斯尔-渥太华量表和 RoB-2 偏倚风险评估工具进行评估。数据质量采用 GRADE（建议、评估、开发和评价分级）方法进行评估。采用随机效应模型对 3 项随机临床试验（n = 328）和 23 项观察性研究（n = 5650）的数据进行了元分析。接受口服维生素 D 补充剂的患者子宫肌瘤大小的变化明显不同（标准化平均值的差异：-5.7%；CI：-10.63 至 -0.76；P = 0.02；I2 = 99%）。接受补充剂治疗的患者缺乏维生素D，治疗方案为每周50,000 IU，持续12周；每周50,000 IU，持续8周；或每隔一周50,000 IU，持续10周。子宫肌瘤患者的血清维生素 D 浓度较低（平均差异：-5.50 ng/mL；CI：6.99 至 -4.01；P < 0.001；I2 = 87%），维生素 D 缺乏的风险较高（OR：3.71；CI：1.90 至 7.24；P < 0.001；I2 = 80%）。虽然这些研究结果很有希望，但还需要进一步研究，以优化治疗剂量和持续时间，从而为有风险的患者提供一种非侵入性的解决方案。我们鼓励进一步研究维生素D在子宫肌瘤治疗中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of obstetrics and gynaecology Canada OBSTETRICS & GYNECOLOGY-

CiteScore

3.30

自引率

5.60%

发文量

302

审稿时长

32 days

期刊介绍： Journal of Obstetrics and Gynaecology Canada (JOGC) is Canada"s peer-reviewed journal of obstetrics, gynaecology, and women"s health. Each monthly issue contains original research articles, reviews, case reports, commentaries, and editorials on all aspects of reproductive health. JOGC is the original publication source of evidence-based clinical guidelines, committee opinions, and policy statements that derive from standing or ad hoc committees of the Society of Obstetricians and Gynaecologists of Canada. JOGC is included in the National Library of Medicine"s MEDLINE database, and abstracts from JOGC are accessible on PubMed.