Association between Uterine Fibroid and Metabolic Syndrome in Premenopausal Women

Abstract

Background: Uterine fibroids (UFs) are the most common benign tumors of the female reproductive tract and are often associated with significant gynecological morbidity. Metabolic syndrome (MetS), characterized by central obesity, dyslipidemia, hypertension, and hyperglycemia, has emerged as a potential risk factor for fibroid development through shared mechanisms such as insulin resistance, altered lipid metabolism, and chronic inflammation. However, evidence on the association between UFs and MetS in premenopausal women remains limited, particularly in South Asian populations. Objective: To investigate the association between uterine fibroids and metabolic syndrome in premenopausal women. Method: This case-control study was conducted at Chittagong Medical College Hospital, Bangladesh, from July 2023 to June 2024. A total of 152 premenopausal women were included: 76 with UFs confirmed by transvaginal ultrasonography and 76 age-matched controls without UFs. Data on demographic, clinical, and biochemical parameters were collected. MetS was defined according to NCEP: ATP III criteria. Statistical analysis included chi-square test, t-test, and multivariate logistic regression to assess independent risk factors. Results: The mean age of UF patients was 44.4±2.5 years, with menorrhagia being the most common symptom (92.1%). Women with UFs had significantly higher waist circumference (84.4±6.9 vs. 75.7±7.6, p<0.001) and lower HDL-C (32.8±6.5 vs. 47.3±7.7, p<0.001) compared to controls. The UF group had higher prevalence of abdominal obesity (73.7% vs. 22.4%, p<0.001), hyperglycemia (15.8% vs. 1.3%, p<0.001), hypertriglyceridemia (53.9% vs. 23.7%, p<0.001), and low HDL-C (97.4% vs. 51.3%, p<0.001). Overall, 68.4% of women with UFs had MetS compared to 19.7% in controls (p<0.001). Logistic regression analysis showed MetS was an independent risk factor for UFs, with women having MetS being nine times more likely to develop UFs (OR 9.08; 95% CI: 4.16–19.84; p<0.001). Conclusion: This study demonstrates a strong association between uterine fibroids and metabolic syndrome in premenopausal women, with MetS conferring a significantly increased risk of fibroid development. These findings highlight the importance of integrated clinical management that addresses both gynecological and metabolic health to improve outcomes in affected women.