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.