The Association of Vitamin D with Uterine Fibroids in Premenopausal Patients: A Systematic Review and Meta-Analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials and observational studies
PubMed 39128544 · doi:10.1016/j.jogc.2024.102632
What was done
Authors conducted a systematic review and random-effects meta-analysis of studies published up to February 2023 examining the link between vitamin D and uterine fibroids diagnosed via ultrasonography in premenopausal women. Databases searched included Medline, Embase, CINAHL, Web of Science, ClinicalTrials.gov, and grey literature. Methodological quality was assessed using the Newcastle-Ottawa Scale and Risk of Bias-2 tools, and evidence quality was evaluated using GRADE. The analysis pooled 3 randomized controlled trials (n = 328) and 23 observational studies (n = 5650).
What was found
Oral vitamin D supplementation in patients with insufficiency was associated with a significant difference in fibroid size change over 2 to 6 months compared to controls (standardized mean difference -5.7%, 95% CI -10.63 to -0.76, P = 0.02, I2 = 99%). Supplementation regimens ranged from 50,000 IU biweekly for 10 weeks to 50,000 IU weekly for 8 to 12 weeks. Patients with fibroids had lower serum vitamin D concentrations (mean difference -5.50 ng/mL, 95% CI -6.99 to -4.01, P < 0.001, I2 = 87%) and higher odds of vitamin D deficiency (OR 3.71, 95% CI 1.90 to 7.24, P < 0.001, I2 = 80%).
Why it matters
This review synthesizes clinical and observational evidence showing that vitamin D deficiency is associated with uterine fibroids and indicates that oral supplementation may help inhibit fibroid growth in premenopausal patients.
Limits
The interventional findings rely on only 3 small RCTs totaling 328 participants with variable dosing regimens and durations. There was extreme statistical heterogeneity across all meta-analyses (I2 from 80% to 99%), and most included data were observational.
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- context Using high doses of vitamin D3 can significantly help shrink uterine fibroids.