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维生素D缺乏与“小负荷”子宫肌瘤:补充维生素D的契机。

Hypovitaminosis D and "small burden" uterine fibroids: Opportunity for a vitamin D supplementation.

作者信息

Ciavattini Andrea, Delli Carpini Giovanni, Serri Matteo, Vignini Arianna, Sabbatinelli Jacopo, Tozzi Alessandra, Aggiusti Alice, Clemente Nicolò

机构信息

Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche Department of Clinical Sciences, Section of Biochemistry, Biology and Physics, Polytechnic University of Marche, Ancona, Italy.

出版信息

Medicine (Baltimore). 2016 Dec;95(52):e5698. doi: 10.1097/MD.0000000000005698.

Abstract

The aim of this study was to evaluate the effect of vitamin D supplementation in women with hypovitaminosis D and "small burden" uterine fibroids.This study focused on 208 women diagnosed with uterine fibroids and concomitant hypovitaminosis D, from January to December 2014. One hundred eight women of the initial study population were diagnosed with "small burden" uterine fibroids. Among them, those who underwent a proper vitamin D supplementation constituted the "study group" (n = 53), while women who spontaneously refused the therapy or did not perform it properly, constituted the "control group" (n = 55). The characteristics of uterine fibroids, the fibroid-related symptoms, and the vitamin D serum levels were evaluated 12 months after the initial diagnosis.In women with uterine fibroids, a negative correlation emerged between the baseline 25-hydroxy-cholecalciferol (25-OH-D3) concentration and both the volume of the largest fibroid (r = -0.18, P = 0.01) and the total volume of fibroids (r = -0.19, P = 0.01). No correlation was found between the baseline 25-OH-D3 levels and the number of fibroids per patient (r = -0.10, P = 0.16). In women of the "study group," a significant increase in the 25-OH-D3 serum level was observed after 12 months of supplementation, and a lower rate of surgical or medical treatment due to the "progression to extensive disease" was reported (13.2% vs 30.9%, P = 0.05).Supplementation therapy with 25-OH-D3 restores normal vitamin D serum levels in women with "small burden" fibroids. In these women, vitamin D supplementation seems to reduce the progression to an extensive disease, and thus the need of conventional surgical or medical therapy.

摘要

本研究的目的是评估补充维生素D对维生素D缺乏和患有“小负荷”子宫肌瘤的女性的影响。本研究聚焦于2014年1月至12月期间诊断为子宫肌瘤且伴有维生素D缺乏的208名女性。初始研究人群中有108名女性被诊断为“小负荷”子宫肌瘤。其中,接受适当维生素D补充的女性构成“研究组”(n = 53),而自发拒绝治疗或未正确进行治疗的女性构成“对照组”(n = 55)。在初次诊断12个月后评估子宫肌瘤的特征、与肌瘤相关的症状以及维生素D血清水平。

在患有子宫肌瘤的女性中,基线25-羟基胆钙化醇(25-OH-D3)浓度与最大肌瘤体积(r = -0.18,P = 0.01)和肌瘤总体积(r = -0.19,P = 0.01)之间均呈负相关。未发现基线25-OH-D3水平与每位患者的肌瘤数量之间存在相关性(r = -0.10,P = 0.16)。在“研究组”女性中,补充12个月后观察到25-OH-D3血清水平显著升高,并且报告因“进展为广泛疾病”而进行手术或药物治疗的比例较低(13.2%对30.9%,P = 0.05)。

用25-OH-D3进行补充治疗可使患有“小负荷”肌瘤的女性恢复正常的维生素D血清水平。在这些女性中,补充维生素D似乎可减少进展为广泛疾病的情况,从而减少常规手术或药物治疗的需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9cfc/5207559/cfb49fb53c70/medi-95-e5698-g001.jpg

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