Vol. 7, Issue 2, Part A (2025)

Background: Uterine fibroids (UFs) are the most prevalent benign gynecologic tumors among reproductive-aged women. Emerging evidence suggests a possible association between dyslipidemia and fibroid pathogenesis.

Aim: This study aimed to evaluate lipid profile alterations, atherogenic risk, and their associations with fibroid size, number, and clinical manifestations.

Methods: A case-control study was conducted at Tikrit Teaching Hospital between November 2024 and June 2025. Ninety women aged 18-45 years were enrolled and allocated into two groups: 45 patients with ultrasonographically confirmed uterine fibroids and 45 age-matched controls without fibroids. Detailed demographic, reproductive, and clinical data were recorded. Fasting lipid profiles were measured (TC, LDL-C, HDL-C, TG), and the Atherogenic Index of Plasma (AIP) was calculated. Statistical comparisons were made using t-tests and chi-square tests; significance was set at p<0.05.

Results: The fibroid group exhibited significantly higher levels of total cholesterol (198.56±34.94 vs. 165.52±20.08 mg/dL; p = 0.001), LDL-C (128.66±32.86 vs. 101.42±21.12 mg/dL; p = 0.001), triglycerides (173.80±112.13 vs. 109.22±51.73 mg/dL; p = 0.004), and AIP (4.30±1.41 vs. 2.86±0.97; p = 0.001), while HDL-C was significantly lower (39.46±10.51 vs. 44.92±11.57 mg/dL; p = 0.015). Menorrhagia (57.78% vs. 6.67%), pelvic pain (44.44% vs. 8.89%), and anemia (33.33% vs. 4.44%) were more prevalent among fibroid patients (all p<0.001). Among fibroid cases, elevated lipid levels were significantly associated with clinical symptoms and fibroid characteristics. For instance, raised total cholesterol was significantly associated with menorrhagia (66.67%), pelvic pain (75.00%), and fibroid size ≥5 cm (77.78%) (all p<0.05). Larger fibroid size (>5 cm) was significantly linked to high TG (88.89%), low HDL (83.33%), and high LDL (72.22%). Multiple fibroids were associated with higher prevalence of dyslipidemia than single fibroids (raised TC: 72.73% vs. 47.83%; p = 0.034).

Conclusion: This study confirms a significant association between uterine fibroids and dyslipidemia, particularly elevated atherogenic index and lipid fractions. Lipid abnormalities were closely linked to fibroid burden (size and multiplicity) and symptom severity. These findings underscore the importance of incorporating lipid screening into the clinical assessment of women with fibroids to identify cardiometabolic risks and strategies support individualized management.