Lipid metabolism and the «lipid peroxidation-antioxidant defense» system as a component of the pathogenesis of uterine fibroids

Abstract

Introduction. Despite the high prevalence of uterine fibroids (UF), its pathogenesis associated with metabolic disorders requires further study. Dyslipidemia and oxidative stress have been identified as triggers for UF development. Available evidence regarding lipid peroxidation and antioxidant defense in UF remains contradictory. Aim – to investigate the specific alterations in lipid metabolism and the lipid peroxidation-antioxidant defense system, and their associations with UF characteristics in women of reproductive age. Methods. This cross-sectional study included 1041 women aged 18-44 years. The study groups consisted of 147 cases (women with UF) and 894 controls. We measured the lipid profile (total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), triacylglycerides (TAG)), lipid peroxidation markers (diene conjugates (DC), ketodienes and conjugated trienes (KD-CT), thiobarbituric acid reactive substances (TBARS)), and antioxidant defense parameters (α-tocopherol, retinol, reduced and oxidized glutathione (GSH and GSSG), total antioxidant activity (TAA)). Data were analyzed in R using the t-test, Brunner-Munzel test, and Spearman correlation. Results. Patients with UF demonstrated altered lipid profile – elevated TC and LDL-C levels, activation of lipid peroxidation processes – increased KD-CT, along with elevated concentrations of α-tocopherol and retinol compared to the control group. Parameters of intramural fibroids had positive correlations with oxidative stress markers (DC, TBARS) and negative correlation with antioxidant defense indicators (TAA, GSH, HDL-C). Negative KD-CT correlations in subserosal fibroids suggest location-dependent pathogenesis. Conclusion. The obtained data demonstrate the diagnostic value of oxidative stress markers and lipid metabolism parameters for detecting metabolic disorders associated with UF.