Vitamin D3 Level in Women with Uterine Fibroid: An Observational Study in Eastern Indian Population

  • Vinita SinghEmail author
  • Archana Barik
  • Nadia Imam
Original Article



Vitamin D deficiency has been proposed to be a risk factor in the pathogenesis of uterine fibroid in few recently published studies conducted in Europe and Africa. Nevertheless, no study has ever addressed similar query in Indian women where hypovitaminosis is very common.


A total of 144 women of age group 20–50 years belonging to Jamshedpur, Jharkhand, India, were included in the study. Out of which, 72 women had uterine fibroids and rest healthy women without fibroids served as controls. All women were subjected to ultrasound examination of uterus followed by measurement of serum FSH level (on 3rd day of menstruation) and serum vitamin D3.


The mean serum concentration of vitamin D3 was significantly lower in women with uterine fibroids compared to controls (10.81 ± 6.18 vs. 22.91 ± 16.18, p < 0.0001). On further analysis, 62.5% of cases were found to be severely deficient (vitamin D3 < 10 ng/mL) as compared to 26.39% of controls (p < 0.0001). Besides that, only 2.77% of cases had sufficient vitamin D level as compared to 23.61% of controls (p = 0.0002). The odds ratio (OR) of occurrence of fibroid with serum vitamin D3 level of < 10 ng/dl compared to that of level > 10 ng/dl was 4.64 (95% confidence interval [CI] 2.28–9.44) (p = 0.0001).


Serum vitamin D3 level inversely correlated with burden of uterine fibroid and possibly its deficiency is a risk factor for uterine fibroid occurrence in eastern part of India.


Vitamin D deficiency Risk factor Uterine fibroid 


Compliance with Ethical Standards

Conflict of interest

Dr Vinita Singh, Dr Archana Barik and Dr Nadia Imam declare that they have no conflict of interest.

Informed Consent in Studies with Human Subjects

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all patients for being included in the study.


  1. 1.
    Khyade RL. A study of menstrual disturbance in cases of fibroid uterus. Int J Reprod Contracept Obstet Gynecol. 2017;6:2494–7.CrossRefGoogle Scholar
  2. 2.
    Schwartz SM, Marshall LM, Baird DD. Epidemiologic contributions to understanding the etiology of uterine leiomyomata. Environ Health Perspect. 2000;108(suppl 5):821–7.CrossRefGoogle Scholar
  3. 3.
    Makariou S, Liberopoulos EN, Elisaf M, et al. Novel roles of vitamin D in disease: what is new in 2011? Eur J Intern Med. 2011;22:355–62.CrossRefPubMedGoogle Scholar
  4. 4.
    Sabry M, Halder SK, Allah AS, et al. Serum vitamin D3 level inversely correlates with uterine fibroid volume in different ethnic groups: a cross-sectional observational study. Int J Womens Health. 2013;5:93–100.PubMedPubMedCentralGoogle Scholar
  5. 5.
    Baird DD, Hill MC, Schectman JM, et al. Vitamin D and the risk of uterine fibroids. Epidemiology. 2013;24:447–53.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Paffoni A, Somigliana E, Vigano’ P, et al. Vitamin D status in women with uterine leiomyomas. J Clin Endocrinol Metab. 2013;98(8):E1374–8.CrossRefPubMedGoogle Scholar
  7. 7.
    Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357:266–81.CrossRefGoogle Scholar
  8. 8.
    Fleet JC, DeSmet M, Johnson R, et al. Vitamin D and cancer: a review of molecular mechanisms. Biochem J. 2012;441:61–76.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Vienonen A, Miettinen S, Blauer M, et al. Expression of nuclear receptors and cofactors in human endometrium and myometrium. J Soc Gynecol Investig. 2004;11(2):104–12.CrossRefPubMedGoogle Scholar
  10. 10.
    Feng L, Jayes FL, Jung SH, et al. Vitamin D receptor (VDR) is over-expressed in the center of uterine fibroids. Fertil Steril. 2010;94(4):S75.CrossRefGoogle Scholar
  11. 11.
    Leppert PC, Catherino WH, Segars JH. A new hypothesis about the origin of uterine fibroids based on gene expression profiling with microarrays. Am J Obstet Gynecol. 2006;195:415–20.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Halder SK, Sharan C, Al-Hendy A. 1,25-dihydroxyvitamin D3 treatment shrinks uterine leiomyoma tumors in the Eker rat model. Biol Reprod. 2012;86:116.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Gupta A. Vitamin D deficiency in India: prevalence, causalities and interventions. Nutrients. 2014;6(2):729–75.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Dutta D, Maisnam I, Shrivastava A, et al. Serum vitamin-D predicts insulin resistance in individuals with prediabetes. Indian J Med Res. 2013;138(6):853–60.PubMedPubMedCentralGoogle Scholar
  15. 15.
    Jones G. Pharmacokinetics of vitamin D toxicity. Am J Clin Nutr. 2008;88:582–6.CrossRefGoogle Scholar
  16. 16.
    Jorde R, Sneve M, Hutchinson M, et al. Tracking of serum 25-hydroxyvitamin D levels during 14 years in a population-based study and during 12 months in an intervention study. Am J Epidemiol. 2010;171:903–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Kluczynski MA, Wactawski-Wende J, Platek ME, et al. Changes in vitamin D supplement use and baseline plasma 25-hydroxyvitamin D concentration predict 5-year change in concentration in postmenopausal women. J Nutr. 2012;142:1705–12.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Sharan C, Halder SK, Thota C, et al. Vitamin D inhibits proliferation of human uterine leiomyoma cells via catechol-omethyl transferase. Fertil Steril. 2011;95:247–53.CrossRefPubMedGoogle Scholar
  19. 19.
    Bläuer M, Rovio PH, Ylikomi T, et al. Vitamin D inhibits myometrial and leiomyoma cell proliferation in vitro. Fertil Steril. 2009;91:1919–25.CrossRefPubMedGoogle Scholar
  20. 20.
    Ylikomi T, Laaksi I, Lou YR, et al. Antiproliferative action of vitamin D. Vitam Horm. 2002;64:357–406.CrossRefPubMedGoogle Scholar
  21. 21.
    Munusamy MM, Sheelaa WG, Lakshmi VP. Clinical presentation and prevalence of uterine fibroids: a 3-year study in 3-decade rural South Indian women. Int J Reprod Contracept Obstet Gynecol. 2017;6:5596–601.CrossRefGoogle Scholar

Copyright information

© Federation of Obstetric & Gynecological Societies of India 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and GynaecologyTata Main HospitalJamshedpurIndia

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