1 | Introduction
Uterine leiomyoma (UL) is one of the most common benign tumors of the
uterus; by menopause, the incidence of UL in the general female
population is 70%.1,2 UL is often asymptomatic and
rarely becomes malignant; however, it may cause pelvic pain,
dysmenorrhea, excessive uterine bleeding, and infertility in women of
reproductive age. Old age, younger age at menarche, and premenopausal
state are risk factors for developing UL, as it is linked to longer
duration of exposure to ovarian hormones.3,4
Insulin resistance was suggested as one of the possible
pathophysiological explanations for UL development.5,6Furthermore, hyperinsulinemia induced by insulin resistance can
upregulate serum insulin-like growth factor-1 and epidermal growth
factor levels.7-9 This can affect the development of
UL by enhancing either ovarian hormone secretion or myometrial smooth
muscle cell proliferation, or both. A report that supports this
rationale stated that metabolic syndrome was associated with
UL.10 Another study reported that the risk of
development of UL was decreased with the use of metformin in women with
type 2 diabetes mellitus.11 Based on these reports, we
can assume that there is a possible association between type 2 diabetes
and UL. However, there is no large scale, population-based study that
has investigated the association between presence of UL and development
of type 2 diabetes. The aim of this study was to evaluate the
association between UL and development of type 2 diabetes in a large
population of young women using a nationwide database.