Investigation of Serum Vitamin D3 and Prolactin as Potential Biochemical Biomarkers for Uterine Fibroids in Premenopausal Women: A Case-Control Study from Andhra Pradesh

Abstract

Uterine fibroids (UFs) represent a significant clinical burden, affecting a vast majority of women during their reproductive years. Emerging evidence suggests that 1,25-dihydroxy vitamin D3 acts as a potent modulator of leiomyoma growth, while ectopic prolactin (PRL) secretion from fibroid tissue may contribute to systemic hormonal imbalances. This study evaluated the relationship between serum vitamin D3, PRL, and fibroid characteristics in a cohort from Andhra Pradesh. Following STROBE guidelines, this cross-sectional study analyzed 210 premenopausal women (105 cases with UFs ≥ 2 cm and 105 age- and BMI-matched controls). Serum was separated within 30 minutes of collection by centrifugation at 3000 rpm for 10 minutes and stored at -80°C until biochemical analysis. Vitamin D3 was quantified via ELISA, and PRL levels were determined through electrochemiluminescence immunoassay. Cases demonstrated significantly lower mean serum vitamin D3 levels compared to controls (10.85 ± 3.34 ng/mL vs. 19.64 ± 5.50 ng/mL; P < 0.001). Conversely, mean PRL levels were significantly higher in women with fibroids (27.79 ± 8.19 ng/mL vs. 13.96 ± 4.09 ng/mL; P < 0.001). We observed a strong negative correlation between vitamin D3 and fibroid number (r = -0.513; P < 0.0001) and a positive correlation with PRL levels (r = 0.453; P < 0.0001). Neither marker showed a statistically significant correlation with fibroid size. Our findings indicate that hypovitaminosis D and elevated serum prolactin are distinctive biochemical hallmarks in women with uterine fibroids. These parameters may serve as effective biomarkers for monitoring disease progression and informing therapeutic strategies.