Influence of Body Size and Body Fat Distribution on Risk of Uterine Leiomyomata in U.S. Black Women

Boston University, Boston, Massachusetts, United States
Epidemiology (Impact Factor: 6.18). 05/2005; 16(3):346-54. DOI: 10.1097/01.ede.0000158742.11877.99
Source: PubMed

ABSTRACT Uterine leiomyomata are a major source of morbidity in black women. We prospectively investigated the risk of self-reported uterine leiomyomata in relation to body mass index (BMI), weight change, height, waist and hip circumferences, and waist-to-hip ratio in a large cohort of U.S black women.
Data were derived from the Black Women's Health Study, a U.S. prospective cohort study of black women who complete biannual mailed health questionnaires. From 1997 through 2001, we followed 21,506 premenopausal women with intact uteri and no prior diagnosis of uterine leiomyomata. Cox regression models were used to estimate incidence rate ratios (IRRs) and 95% confidence intervals (CIs).
After 70,345 person-years of follow up, 2146 new cases of uterine leiomyomata confirmed by ultrasound (n = 1885) or hysterectomy (n = 261) were self-reported. Compared with the thinnest women (BMI <20.0 kg/m), the multivariate IRRs for women with BMIs of 20.0-22.4, 22.5-24.9, 25.0-27.4, 27.5-29.9, 30.0-32.4, and 32.5+ kg/m were 1.34 (95% CI = 1.02-1.75), 1.39 (1.07-1.81), 1.45 (1.12-1.89), 1.47 (1.11-1.93), 1.36 (1.02-1.80), and 1.21 (0.93-1.58), respectively. IRRs were larger among parous women. Weight gain since age 18 was positively associated with risk, but only among parous women. No other anthropometric measures were associated with risk.
BMI and weight gain exhibited a complex relation with risk of uterine leiomyomata in the Black Women's Health Study. The BMI association was inverse J-shaped and findings were stronger in parous women. Weight gain was positively associated with risk among parous women only.

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Available from: Elizabeth A Stewart, Feb 11, 2014
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    • "Black women are more likely to develop UL, develop tumors at a younger age, develop a greater number of tumors, have more severe symptoms , and are more likely to undergo hysterectomy as a treatment when compared to white women [4] [5] [6] [7] [8]. UL prevalence is also associated with age [9], body mass index (BMI) [10] [11], and parity [12] [13]. However, the known risk factors do not fully explain the elevated risk in black women [14]. "
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    ABSTRACT: Scientific understanding of the etiology of uterine leiomyomata (UL) remains incomplete, but recent investigations have suggested an association between low Vitamin D and UL risk. In this study, we conducted a cross-sectional analysis of Vitamin D exposure, measured using serum levels of 25(OH)D (a Vitamin D metabolite), and self-reported UL diagnosis among 3,590 women aged 20-54 in the National Health and Nutrition Examination Survey (NHANES 2001-2006). Multivariate logistic regression models comparing each quartile of 25(OH)D to the lowest quartile indicated no relationship between 25(OH)D and odds of UL in the whole population (Ptrend=0.37), or in sensitivity analyses. However, a probabilistic analysis correcting outcome misclassification indicated that insufficient 25(OH)D was associated with UL in white (Odds ratio (OR) median estimate: 2.17; 2.5, 97.5 percentiles: (1.26, 23.47)), but not black women (OR median estimate: 1.70; 2.5, 97.5 percentiles: (0.89, 3.51)), suggesting misclassification may have driven some of the null findings. Copyright © 2015. Published by Elsevier Inc.
    Reproductive Toxicology 06/2015; DOI:10.1016/j.reprotox.2015.05.013 · 2.77 Impact Factor
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    • "Risk factors for uterine fibroids in the Black Women's Health Study The Black Women's Health Study (BWHS) is a US prospective cohort study of almost 60 000 black women aged 21–69 years at baseline in 1995 (Wise et al., 2005a, b). An initial questionnaire was collected in 1995 and has been updated every 2 years since. "
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    • "Cases diagnosed by pelvic exam only (n ¼ 525) were analyzed as non-cases because of the uncertainty of this diagnostic method (Stewart, 2001). We conducted a validation study of self-reported UL confirmed by ultrasound or surgery in 248 randomly selected cases and verified the self-report in 96% of the 127 women for whom we obtained medical records (Wise et al., 2005a). "
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