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: 6.2). 05/2005; 16(3):346-54. DOI: 10.1097/01.ede.0000158742.11877.99
Source: PubMed


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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    • "Because BMI was shown to be associated with the risk of UL, albeit in a complex relationship [29] [22], we re-evaluated the genetic association in models with no adjustment for this covariate. Removing BMI from the models re-established the patterns of association observed in age-only adjusted models (Fig. S2), indicating that BMI significantly confounds the association of the tested SNPs with the risk for UL in EA but not in AA. "
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