ORIGINAL ARTICLE   

Minerva Obstetrics and Gynecology 2023 February;75(1):27-38

DOI: 10.23736/S2724-606X.22.04952-1

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Cardiometabolic profile of women with uterine leiomyoma: a cross-sectional study

Abdelrahman ALASHQAR ^{1, 2}, Hala EL OUWEINI ^{1, 3}, Megan GORNET ¹, Gayane YENOKYAN ⁴, Mostafa A. BORAHAY ¹ ✉

¹ Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD, USA; ² Department of Obstetrics and Gynecology, Kuwait University, Kuwait City, Kuwait; ³ American University of Beirut, Beirut, Lebanon; ⁴ Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Biostatistics Center, Baltimore, MD, USA

BACKGROUND: Emerging evidence suggests that cardiometabolic risk factors contribute to uterine leiomyoma development, but cardiometabolic profiles of women with the tumor remain poorly defined. This study aimed to determine the association of cardiometabolic comorbidities and cardiometabolic medication use with a leiomyoma diagnosis.
METHODS: In this cross-sectional study, aggregate-level data from 2013-2020 were collected using the SlicerDicer feature of Epic (Epic, Verona, WI, USA) electronic medical record system. Women ≥18 years with at least one visit or hospital encounter at the Johns Hopkins Health System (N.=679,981) were assigned as cases or controls according to leiomyoma status. Individual prevalence of each prespecified cardiometabolic comorbidity and relevant prescription medications was obtained. Prevalence Odds Ratios were used to assess the association of cardiometabolic comorbidities and medication use with uterine leiomyoma.
RESULTS: Women with uterine leiomyoma (N.=27,703) were more likely to be obese (2.56; 95% CI: 2.49-2.63), have metabolic syndrome (1.82; 95% CI: 1.51-2.19), essential hypertension (1.45; 95% CI: 1.42-1.49), diabetes mellitus (1.29; 95% CI: 1.24-1.33) and hyperlipidemia (1.23; 95% CI: 1.19-1.26). These associations were stronger among younger women and persisted after excluding those with a hysterectomy. Notably, statins were the only medications associated with a lower leiomyoma risk (0.81; 95% CI: 0.79-0.84).
CONCLUSIONS: Uterine leiomyoma is associated with a spectrum of cardiometabolic comorbidities and use of associated medications, constituting an unfavorable cardiometabolic profile in women with the tumor. If definitively correlated, prevention and early management of cardiometabolic risk factors may decrease uterine leiomyoma incidence, and screening women with uterine leiomyoma for cardiometabolic comorbidities may aid in cardiovascular disease prevention.

KEY WORDS: Comorbidity; Cardiovascular diseases; Metabolic syndrome; Leiomyoma