Anthropometric Measures and the Risk of Developing leiomyoma in Ghana

Background: The etiology of uterine leiomyoma (or fibroids) is poorly understood. Sex steroid hormones, genetic, and growth factors have been hypothesized to play a role in their development, and anthropometric characteristics may influence uterine leiomyoma risk through these sex steroid hormones. Methods: We analyzed retrospectively-collected data from two hundred (200) patients diagnosed as having fibroids and two hundred (200) control subjects with similar age distribution as the patients. Anthropometric features of all participants were taken. Data on anthropometric were analyzed by unpaired t-test analysis and Logistic regression. Results: There were significant differences between the patients and controls groups in terms of weight, waist circumference, hip circumference, BMI, and waist-to-hip ratio. When subjects’ BMI were classified as underweight (<18.5), normal (18.5 – 24.9), overweight (25.0 – 29.9) and obese (?30), analysis using Logistic regression revealed a strong association between the development of fibroid with an increase in the patients BMI; with the over weight patients having an almost two fold increased risk (OR= 1.91; exact 95% CI= 1.14 3.20) and the obese having far more than a two fold risk increased (OR= 2.25; exact CI= 1.21 4.17) of developing fibroid when compared to the patients with normal BMI. The under weight patients however had a decreased risk (OR= 0.70; exact 95% CI= 0.34 1.42) of developing fibroid when compared to the normal BMI patients. When subjects were categorized as normal or obese based on their waist-to-ratio and analyzed using Logistic regression, there was a strong association between obesity and the development of fibroid (OR= 3.60; exact 95% CI= 1.74 7.47) with the obese having close to a fourfold increased risk of developing fibroids. Conclusion: High BMI and waist-to-hip ratio are may increase the risk of uterine leiomyoma possibly reflecting associated hormonal changes as well as alterations in metabolic controls that affect myometrial cell signaling through mediators such as insulin receptors, insulin-like growth factors, peroxisome proliferating activating receptors, and also influence uterine leiomyomata through changes in steroid hormone metabolism and bioavailability.