Multifactorial Etiology of Uterine Fibroids: A Comparative Study on Endocrine Imbalance, Oxidative Stress Markers, and Vitamin D3 Status

Abstract

Uterine fibroids are the most common tumor among women of reproductive age, with genetic, inflammatory, hormonal, and other related factors playing a significant role in their development. A comparative study included 55 patients with uterine fibroids and 30 healthy women as a control group. These samples were collected in collaboration with obstetrics and gynecology consultants at hospitals in Diyala and Duhok, northern Iraq, as well as from outpatient clinics in both cities. The results showed significantly higher levels of testosterone and estradiol in patients with uterine fibroids (1.23 ± 0.03 and 13.23 ± 0.32) compared to the control group (0.37 ± 0.13 and 8.12 ± 0.49), while progesterone levels were lower in patients with fibroids (0.11±0.027) compared to healthy women (0.55±0.013). The results showed elevated follicle-stimulating hormone (FSH) and decreased luteinizing hormone (LH) and anti-Müllerian hormone (AMH) levels in patients (12.43, 4.92, and 1.47) compared to healthy controls (8.54, 7.43, and 4.39) respectively. The results also showed a significant increase in the oxidative stress index (MDA) and leptin levels in patients (16.23 ng/mL, and 18.48 nmol/L) compared to healthy controls (10.49ng/mL and 15.23 nmol/L) respectively. Regarding thyroid hormones, the results indicated elevated T3 levels (3.21 vs. 1.4 nmol/L) and decreased T4 (57.83 vs. 154) and thyroid-stimulating hormone (TSH) levels (1.65 vs. 3.2). Vitamin D levels were also significantly lower in the fibroid group 15 ng/mL compared to 55 ng/mL healthy controls. These findings suggest that uterine fibroids are a systemic metabolic-endocrine disorder. Therefore, their management should be approached within the context of a broader interaction between malnutrition, systemic oxidative stress, and hormonal imbalances as contributing factors to the disease.