| خلاصه مقاله | Study question:
Are there associations between serum levels of vitamin D binding protein (DBP) and free 25(OH)-vitamin D with leiomyoma and the lesions characteristics?
Summary answer:
Free 25(OH)-vitamin D and DBP had respectively positive and negative correlations with the leiomyomas size and could be potential biomarkers for leiomyoma.
What is known already:
Role of vitamin D particularly its free form and also DBP as the modulator has been demonstrated in tumor progression. Moreover, the association of the blood levels of total vitamin D with the prevalence of uterine leiomyoma has been reported. Furthermore, the inhibitory effect of vitamin D on leiomyoma formation and progression has been documented. Previous studies also showed significantly lower and higher levels of respectively vitamin D and DBP in the blood of women with leiomyoma compared to healthy subjects.
Study design, size, duration:
Leiomyoma was diagnosed using transabdominal ultrasound screening and confirmed by histological analysis. In the patients, the number, size and location (Intramural, Subserosal, Transmural, Submucosal, Intramural- Subserosal, and Intramural- Submucosal) of the leiomyomas were determined.
Participants/materials, setting, methods:
Forty-four leiomyoma patients aged 35.32±6.15 and forty-one healthy women with age of 32.69±6.44 were enrolled in this study. In all the participants, serum levels of total 25(OH)-vitamin D and DBP were measured using commercial ELISA kits. Furthermore, serum levels of 25(OH)-vitamin D/DPB ratio and free 25(OH)-vitamin D were calculated.
Main results and the role of chance:
Levels of 25(OH)-vitamin D/DPB ratio and free 25(OH)-vitamin D were significantly lower in patients group compared to the controls (p<0.001). We also found statistically higher levels of DBP in the patient with leiomyoma in comparison with the healthy women (p<0.001). There was no significant association between the evaluated serum factors with the location and number of the leiomyomas (p>0.05). However, the size of the largest leiomyomas had negative correlations with 25(OH)-vitamin D/DPB ratio and free 25(OH)-vitamin D levels and a positive correlation with DBP. Based on receiver operating characteristic (ROC) analyses, cutoff values for free 25(OH)-vitamin D and DBP as markers for leiomyoma diagnosis were 4.36 (pg/ml) and 251.7 (µg/ml) with sensitivity 78% and 88% and specificity of 76.7% and 71%, respectively.
Limitations, reasons for caution:
Our study had a relatively small sample size.
Wider implications of the findings:
Free 25(OH)-vitamin D and DBP had a role in leiomyoma pathogenesis and were associated with the size of leiomyomas. Serum levels of these factors can be used as biomarkers for the leiomyoma diagnosis.
Trial registration number:
not applicable |