Association between serum calcium levels and uterine leiomyoma: a retrospective case-control study exploring the potential mediating roles of inflammatory and lipid-related indicators.

BACKGROUND: The occurrence of uterine leiomyoma (UL) is closely related to metabolic abnormalities and inflammatory reactions, but the role of serum calcium in it and its relationship with inflammation and lipid metabolism are not yet clear. The aim of this study is to explore the association between serum calcium and UL risk, and evaluate the mediating role of inflammation and lipid indicators in it. METHOD: This study included 1,169 UL patients and 985 controls, and propensity score matching (PSM) was used to reduce confounding bias. Using logistic regression analysis to evaluate the association between serum calcium and UL, and combining generalized additive modeling (GAM) to explore nonlinear relationships and threshold effects. Meanwhile, the mediating role of inflammation and lipid indicators in this association was quantified through bootstrap mediation analysis. RESULT: Serum calcium was significantly negatively correlated with UL risk and remained stable after PSM correction. Nonlinear analysis shows a significant threshold effect between it and UL. In the mediation analysis, some inflammatory and lipid indicators play a significant mediating role between serum calcium and UL, suggesting that the metabolic inflammatory pathway is involved in the occurrence of UL. CONCLUSION: Serum calcium levels were associated with UL risk, and several inflammatory and lipid-related indicators showed significant statistical mediation effects in this association. The relevant indicators are derived from routine testing and have potential clinical application value, but further research is needed to verify their causal relationship.