Abstract
Objective: T o evaluate the association between uterine
leiomyoma (UL) and development of type 2 diabetes mellitus in young
women using a nationwide database.
Design: Nationwide population-based cohort study
Setting: South Korea.
Population or Sample: Women aged between 20 and 40 years at
baseline who underwent at least one health checkup between 2009 and 2012
and followed until December 31, 2018
Methods : We excluded those who were previously diagnosed with
type 2 diabetes mellitus (n = 28,136), those diagnosed with type 2
diabetes mellitus within the first year of entry (n = 1,607), those who
had hysterectomy during the study period (n = 18,485), and those with
missing data (n = 166,012). Cox proportional hazards models were used to
analyze the risk of developing type 2 diabetes according to the presence
of UL.
Main outcome Measures: Incidence of the development of type 2
diabetes mellitus according to the presence of UL
Results: 2,755,790 women were selected and he mean age of the
enrolled population was 29.70 y, and mean body mass index was 21.31
kg/m2. Among 2,541,550 participants, 18,375 (0.72%)
women had UL. Over a median 7.45 years of follow-up, 23,829 women
(0.94%) were diagnosed with type 2 diabetes. The incidence of type 2
diabetes in women with UL (1.805/1,000 person-years) was higher than in
those without UL (1.289/1000 person-years). In the
multivariable-adjusted model, the hazard ratio for type 2 diabetes in
women with UL was 1.216 (95% confidence interval [CI] 1.071-1.382),
as compared to those without UL. Compared to women without UL, women
with UL who did not undergo myomectomy had a risk 1.328 times (95% CI
1.143-1.542) higher for developing type 2 diabetes. Interestingly, women
with UL who underwent myomectomy had no increased risk for developing
type 2 diabetes.
Conclusions: This study found that young women with UL are more
likely to develop type 2 diabetes than those without UL. In addition,
myomectomy seemed to attenuate the risk for developing type 2 diabetes
in young women with UL.
Keywords: Type 2 diabetes mellitus, uterine fibroids, surgery,
young women, incidence