Dietary carotenoids and risk of uterine leiomyomata: A prospective ultrasound study.
Wise LA, Wesselink AK, Bethea TN, Brasky TM, Wegienka G, Harmon Q, and Baird DD. Dietary carotenoids and risk of uterine leiomyomata: A prospective ultrasound study. Reprod Sci 2019; 26:135A.
Introduction: Uterine leiomyomata (UL) are the leading indication for hysterectomy in the U.S., accounting for over $2.2 billion in annual health care costs. Compared with other racial/ethnic groups, Non-Hispanic Black women have higher incidence rates of UL. They also have lower intakes of carotenoids. In animal studies, dietary supplementation with lycopene or tomato powder reduced the incidence and size of leiomyoma of the oviduct in the Japanese quail. However, two large U.S. prospective cohort studies of Black and White women reported weak associations between intakes of lycopene or other carotenoids and UL risk. Both studies relied on self-reported physician-diagnosed UL, which is prone to differential misclassification. Methods: We assessed the association of carotenoid intake and UL incidence in the Study of the Environment, Lifestyle, and Fibroids (SELF), a Detroit-based prospective cohort of 1,693 Black women aged 23-34 years at enrollment (2010-2012). We used transvaginal ultrasound to assess UL at baseline and 20, 40, and 60 months of follow-up. At baseline, women completed a self-administered questionnaire on demographics, reproductive history, and lifestyle, including a 110-item validated food frequency questionnaire, from which we estimated dietary intakes of carotenoids, including alpha-carotene, beta-carotene, cryptoxanthin, lutein-zeaxanthin, lycopene, retinol, and vitamin A. We used Cox proportional hazards regression models to estimate incidence rate ratios (IRR) and 95% confidence intervals (CI), adjusted for energy intake, age at menarche, parity, age at first and last birth, oral contraceptive use, body mass index, smoking, alcohol use, multivitamin use, education, income, and marital status. Results: Among 1,244 women without prevalent UL, we identified 296 incident UL cases during follow-up. Intakes of carotenoids, including lycopene, were not appreciably associated with UL risk. Adjusted IRRs comparing quartiles 2 (2601-3721 μg/day), 3 (3722-5270 μg/day), and 4 (≥5271 μg/day) with quartile 1 (<2601 μg/day) of lycopene intake were 1.04 (95% CI: 0.74-1.45), 1.06 (95% CI: 0.76-1.48), and 1.00 (95% CI: 0.71-1.40), respectively. Conclusion: Results from this prospective ultrasound study do not support an inverse association between intake of lycopene, or any other carotenoid, and UL risk.