Link Between BMI and Uterine Tumors? A DLH-Supported Study Investigates

A research paper co-authored by a DLH epidemiologist has been selected as a Featured Article by a prestigious academic journal. The Journal of Clinical Endocrinology & Metabolism chose to highlight “Body Mass Index and Uterine Fibroid Development: A Prospective Study,” – co-authored by DLH researcher Sheri Denslow – on its website. The study investigates associations between body mass index (BMI) and the incidence and growth of fibroids, which are hormonally dependent uterine tumors.  

Why you should learn more: Uterine fibroids are common and occur in most women by menopause. Fibroids can cause severe symptoms, including heavy bleeding and pelvic pain, especially for those with large tumors. Fibroids are also the leading indication for hysterectomy in the United States, with annual health care costs in the billions.  

An increased BMI has numerous impacts on hormonal and metabolic processes, many of which could affect fibroid initiation or growth. These impacts include alterations in menstrual cycle frequency, disruption in ovulation, and changes in concentrations of reproductive and other hormones. 

Why this research is critical: The literature on BMI and fibroid prevalence is inconsistent. Previous work usually combined all those with a BMI of ≥30 kg/m2 into a single category and relied on clinically diagnosed fibroids, which misclassifies the many women with undiagnosed fibroids.  

Additionally, there are signs of significant racial health disparities. African American women are found to develop fibroids at earlier ages than White women, which results in more premenopausal years of tumor growth and partially accounts for their markedly higher fibroid removal procedures and hysterectomy rates for fibroids compared with White women.  

The DLH impact: The DLH-supported Study of Environment, Lifestyle & Fibroids (SELF) followed 1693 Black/African American women, ages 23 to 35 years from Detroit, Michigan, with ultrasound every 20 months for 5 years. This periodic ultrasound screening allowed our researchers to investigate associations between repeated measures of BMI and fibroid incidence and growth assessed at each follow-up ultrasound.  

The study’s results showed that compared with BMI <25 kg/m2, those with BMI 30 to <35 kg/m2 had increased fibroid incidence, those with BMI ≥40 kg/m2 had reduced incidence. Fibroid growth had mostly small magnitude associations with BMI. 

The researchers found that BMI has a nonlinear association with fibroid incidence, which could be driven by effects of BMI on inflammation and reproductive hormones. 

Interested in learning more about DLH-supported research? Check out how DLH innovation is driving public health progress in our latest Research Update.