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This cross-sectional study analyzed data from NHANES (1999\u20132006) and included 867 non-diabetic women aged 20\u201354 years. IR was assessed using the triglyceride-glucose (TyG) index, TyG-waist-to-height ratio (TyG-WHtR), TyG-body mass index (TyG-BMI), and the homeostasis model assessment of insulin resistance (HOMA-IR). Obesity was assessed by WHtR, weight-adjusted waist index (WWI), waist circumference (WC) and BMI. Logistic regression, restricted cubic spline curves (RCS), subgroup analyses, and interaction tests were performed to evaluate the associations. HOMA-IR index (OR\u2009=\u20091.17,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.004) and BMI (OR\u2009=\u20091.04,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.036) were significantly positively correlated with UFs. Subgroup analyses in those not using female hormones show that among women aged 20\u201338 years, the association between BMI and UFs was stronger (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.05), while in women aged 39\u201354 years, HOMA-IR was stronger (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.05). The RCS models indicated significant positive linear associations between HOMA-IR, as well as BMI, and UFs. Our study demonstrates that IR and BMI are independently and positively associated with the presence of UFs in non-diabetic women, indicating that they may be potentially modifiable factors associated with UFs development.\n                  <\/jats:p>","DOI":"10.1038\/s41598-025-30265-1","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T18:35:31Z","timestamp":1764095731000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The association of insulin resistance and obesity with uterine fibroids in non-diabetic populations: a cross-sectional study"],"prefix":"10.1038","volume":"15","author":[{"given":"Danting","family":"Sun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haixia","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaze","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yapei","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuance","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teng","family":"Lv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,25]]},"reference":[{"key":"30265_CR1","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1067\/mob.2003.99","volume":"188","author":"DD Baird","year":"2003","unstructured":"Baird, D. 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