Alpha-Tocopherol Serum Levels Are Increased in Caucasian Women with Uterine Fibroids: A Pilot Study

Abstract

Uterine fibroids (UFs) are benign tumors of the reproductive tract, arising from smooth muscle cells of the uterus. Steroid hormones, estrogen, and progesterone are considered to be the most important links in the pathophysiology of UFs. Alpha-tocopherol (AT) is the most active form of vitamin E. What is important as far as UFs are concerned is that ATs contain structural determinants, which makes them possible ligands for estrogen receptors (ERs). We present a retrospective cohort study performed in a university teaching hospital. We included a total of 162 patients divided into 2 groups: with UFs and controls. The effects of age, body mass index (BMI), positive medical history, parity, and AT serum concentrations on the risk for the development of UFs were investigated. Mean AT serum concentrations were 11.66 ± 4.97 μg/ml and 7.83 ± 3.13 μg/ml (medians 10.56 μg/ml and 7.42 μg/ml) in patients with UFs confirmed on ultrasound and controls, respectively. The presented difference was statistically significant. Higher BMI, positive family history, and low parity were found to be major risk factors for UFs. In our study, we confirmed that elevated serum AT concentration might be an important risk factor for UFs in Caucasian women. Further research in this area is necessary.

Vitamins and Uterine Fibroids: Current Data on Pathophysiology and Possible Clinical Relevance

“…As for the correlation between vitamin E and UF development, Wise et al (2011) who followed 22,583 premenopausal women [ 34 ] and Martin et al’s (2011) study in 887 women [ 51 ] revealed no significant relationship between vitamin E and UFs. A study by Ciebiera et al (2018) demonstrated a correlation between elevated concentrations of one of the vitamin E vitamers (α-tocopherol) in the blood serum and UF occurrence in Caucasian women, but the study was conducted in a much smaller group than the previous studies [ 146 ]. Therefore, the positive influence of vitamin E could depend on particular gene polymorphisms.…”

“…In the pathophysiology of UFs, it is interesting that vitamin E contains structural determinants that make it a possible ligand for estrogen receptors (ERs) [102,156] and it can be described as a specific phytoestrogen [102,146]. A study conducted in postmenopausal women showed that vitamin E reduced the symptoms associated with the lack of estrogens, for ecample, hot flashes or sweating [157].…”

“…Such effects of tocopherols on endometrial growth could be attributed to only the antioxidant properties which stabilized the tissue [160]. However, the phytoestrogen activity could also be contributing [146].…”

“…Potential antifibrotic effect [92,93] Role in signal transduction in uterine fibroids [122,131] Cell proliferation control [130] Extracellular matrix formation control [186] Antifibrotic effect [121] Tumor growth control [120,123] Vitamin D Potential protective role [133] Antioxidant effect [145,147] Vitamin E Phytoestrogen, potential role in tumor development and growth [102,146] Potential anti-inflammatory effect [179,180]…”

“…Studies conducted on large groups have shown that this vitamin has no influence on UF risk [34,51]. However, some groups could be predisposed to an increased risk for the development of those tumors due to high concentrations of some vitamers [146]. Particular attention should be paid to the abovementioned estrogen component associated with vitamin E [102], because it could be the reason for UF growth in some patients, for example, with hypersensitivity.…”