Uterine leiomyomata in relation to insulin-like growth factor-I, insulin, and diabetes.

Published

Journal Article

Insulin-like growth factor-I (IGF-I) and insulin stimulate cell proliferation in uterine leiomyoma (fibroid) tissue. We hypothesized that circulating levels of these proteins would be associated with increased prevalence and size of uterine fibroids.Participants were 35-49-year-old, randomly selected members of an urban health plan who were enrolled in the study in 1996-1999. Premenopausal participants were screened for fibroids with ultrasound. Fasting blood samples were collected. Associations between fibroids and diabetes, plasma IGF-I, IGF binding protein 3 (BP3), and insulin were evaluated for blacks (n = 585) and whites (n = 403) by using multiple logistic regression.IGF-I showed no association with fibroids in blacks, but in whites the adjusted odds ratios (aORs) for both mid and upper tertiles compared with the lowest tertile were 0.6 (95% confidence intervals [CI] = 0.3-1.0 and 0.4-1.1, respectively). Insulin and diabetes both tended to be inversely associated with fibroids in blacks. The insulin association was with large fibroids; aOR for the upper insulin tertile relative to the lowest was 0.4 (0.2-0.9). The aOR for diabetes was 0.5 (0.2-1.0). Associations of insulin and diabetes with fibroids were weak for whites. Binding protein 3 showed no association with fibroids.Contrary to our hypothesis, high circulating IGF-I and insulin were not related to increased fibroid prevalence. Instead, there was suggestion of the opposite. The inverse association with diabetes, although based on small numbers, is consistent with previously reported findings. Future studies might investigate vascular dysfunction as a mediator between hyperinsulinemia or diabetes and possible reduced risk of fibroids.

Full Text

Duke Authors

Cited Authors

  • Baird, DD; Travlos, G; Wilson, R; Dunson, DB; Hill, MC; D'Aloisio, AA; London, SJ; Schectman, JM

Published Date

  • July 2009

Published In

Volume / Issue

  • 20 / 4

Start / End Page

  • 604 - 610

PubMed ID

  • 19305350

Pubmed Central ID

  • 19305350

Electronic International Standard Serial Number (EISSN)

  • 1531-5487

International Standard Serial Number (ISSN)

  • 1044-3983

Digital Object Identifier (DOI)

  • 10.1097/EDE.0b013e31819d8d3f

Language

  • eng