{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:06:35Z","timestamp":1784696795231,"version":"3.55.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1871649","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:45:53Z","timestamp":1784695553000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between serum calcium levels and uterine leiomyoma: a retrospective case\u2013control study exploring the potential mediating roles of inflammatory and lipid-related indicators"],"prefix":"10.3389","volume":"13","author":[{"given":"Yanan","family":"Duan","sequence":"first","affiliation":[{"name":"Department of Gynecology, The Affiliated Hospital of Qingdao University","place":["Qingdao, Shandong, China"]},{"name":"Qingdao Medical College, Qingdao University","place":["Qingdao, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaotong","family":"Cui","sequence":"additional","affiliation":[{"name":"Qingdao Medical College, Qingdao University","place":["Qingdao, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanmao","family":"Kong","sequence":"additional","affiliation":[{"name":"Zhongshan Road Community Health Service Center of Shinan District","place":["Qingdao, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaqin","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Gynecology, The Affiliated Hospital of Qingdao University","place":["Qingdao, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aiping","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gynecology, The Affiliated Hospital of Qingdao University","place":["Qingdao, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yushuang","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Gynecology, The Affiliated Hospital of Qingdao University","place":["Qingdao, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1947","DOI":"10.1152\/physrev.00010.2024","article-title":"Uterine fibroids","volume":"105","author":"Bulun","year":"2025","journal-title":"Physiol Rev"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"S124","DOI":"10.1016\/j.ajog.2024.08.037","article-title":"Uterine fibroids at single-cell resolution: unveiling cellular heterogeneity to improve understanding of pathogenesis and guide future therapies","volume":"232","author":"Goad","year":"2025","journal-title":"Am J Obstet Gynecol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1649","DOI":"10.1007\/s40265-023-01958-6","article-title":"Current and emerging treatment options for uterine fibroids","volume":"83","author":"Ali","year":"2023","journal-title":"Drugs"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1038\/s43856-025-01051-x","article-title":"A systems-based approach to uterine fibroids identifies differential splicing associated with abnormal uterine bleeding","volume":"5","author":"Wang","year":"2025","journal-title":"Commun Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.fertnstert.2024.02.049","article-title":"Uterine fibroid-related infertility: mechanisms and management","volume":"122","author":"Donnez","year":"2024","journal-title":"Fertil Steril"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"103411","DOI":"10.1016\/j.redox.2024.103411","article-title":"Regulatory roles of NAMPT and NAD+ metabolism in uterine leiomyoma progression: implications for ECM accumulation, stemness, and microenvironment","volume":"78","author":"Chiang","year":"2024","journal-title":"Redox Biol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"807","DOI":"10.3390\/antiox12040807","article-title":"Oxidative stress and antioxidants in uterine fibroids: pathophysiology and clinical implications","volume":"12","author":"AlAshqar","year":"2023","journal-title":"Antioxidants"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"115393","DOI":"10.1016\/j.biopha.2023.115393","article-title":"Role of the NLRP3 inflammasome in gynecological disease","volume":"166","author":"Zheng","year":"2023","journal-title":"Biomed Pharmacother"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1007\/s00281-025-01043-y","article-title":"Dyslipidemia and female reproductive failures: perspectives on lipid metabolism and endometrial immune dysregulation","volume":"47","author":"Zhang","year":"2025","journal-title":"Semin Immunopathol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e13385","DOI":"10.1111\/cpr.13385","article-title":"Functional cooperation between IKCa and TRPC1 channels regulates serum-induced vascular smooth muscle cell proliferation via mediating Ca2+ influx and ERK1\/2 activation","volume":"56","author":"Jia","year":"2023","journal-title":"Cell Prolif"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e102","DOI":"10.1161\/CIRCRESAHA.122.321041","article-title":"Orai1 inhibitors as potential treatments for pulmonary arterial hypertension","volume":"131","author":"Masson","year":"2022","journal-title":"Circ Res"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"158182","DOI":"10.1016\/j.phymed.2026.158182","article-title":"Sesamin ameliorates high-fat diet-induced inflammation and metabolic dysfunction in pregnant uterine smooth muscle via cGAS-STING inhibition","volume":"156","author":"Xu","year":"2026","journal-title":"Phytomedicine"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1097\/RLU.0000000000004395","article-title":"Monitoring the progression of a calcifying uterine leiomyoma: detection using 18 F-NaF-PET\/CT","volume":"48","author":"Resto","year":"2023","journal-title":"Clin Nucl Med"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1016\/j.aninu.2024.04.023","article-title":"Compound Bacillus improves eggshell quality and egg metabolites of hens by promoting the metabolism balance of calcium and phosphorus and uterine cell proliferation","volume":"19","author":"Jin","year":"2024","journal-title":"Anim Nutr"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"a041764","DOI":"10.1101\/cshperspect.a041764","article-title":"Calcium signaling and metabolic reprogramming in Cancer: mechanisms and therapeutic implications","volume":"18","author":"Courmont","year":"2026","journal-title":"Cold Spring Harb Perspect Biol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"557935","DOI":"10.2147\/IJN.S557935","article-title":"Next generation calcium nanomaterials: disrupting tumor Ca2+ homeostasis for enhanced Cancer therapy","volume":"21","author":"Gangadhar","year":"2026","journal-title":"Int J Nanomedicine"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"9768","DOI":"10.1021\/acsami.3c17087","article-title":"Chestnut-inspired hollow hydroxyapatite 3D printing scaffolds accelerate bone regeneration by recruiting calcium ions and regulating inflammation","volume":"16","author":"Wei","year":"2024","journal-title":"ACS Appl Mater Interfaces"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"116532","DOI":"10.1016\/j.bcp.2024.116532","article-title":"Transcriptome sequencing analysis reveals the molecular regulatory mechanism of myocardial hypertrophy induced by angiotensin II","volume":"229","author":"Zhang","year":"2024","journal-title":"Biochem Pharmacol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"2537","DOI":"10.1093\/humrep\/deae214","article-title":"Functional, patient-derived 3D tri-culture models of the uterine wall in a microfluidic array","volume":"39","author":"Busch","year":"2024","journal-title":"Hum Reprod"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"945","DOI":"10.1038\/s41467-024-45143-z","article-title":"Effect of aging on the human myometrium at single-cell resolution","volume":"15","author":"Punzon-Jimenez","year":"2024","journal-title":"Nat Commun"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"103014","DOI":"10.1016\/j.ceca.2025.103014","article-title":"Crosstalk between calcium and reactive oxygen species signaling in cancer revisited","volume":"127","author":"Pathak","year":"2025","journal-title":"Cell Calcium"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"217908","DOI":"10.1016\/j.canlet.2025.217908","article-title":"The calcium homeostasis in tumor and the mechanism involving progression and metastasis","volume":"630","author":"Qin","year":"2025","journal-title":"Cancer Lett"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"116583","DOI":"10.1016\/j.intimp.2026.116583","article-title":"H3K4 methylation of CALB2 facilitates immune evasion and chemoradiotherapy resistance in cholangiocarcinoma through KRT7-mediated PD-L1 upregulation","volume":"179","author":"Wang","year":"2026","journal-title":"Int Immunopharmacol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"155718","DOI":"10.1016\/j.metabol.2023.155718","article-title":"Interplay of lipid metabolism and inflammation in podocyte injury","volume":"150","author":"Luo","year":"2024","journal-title":"Metabolism"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1064872","DOI":"10.3389\/fphar.2022.1064872","article-title":"Usnea improves high-fat diet- and vitamin D3-induced atherosclerosis in rats by remodeling intestinal flora homeostasis","volume":"13","author":"Liu","year":"2022","journal-title":"Front Pharmacol"}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1871649\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:46:03Z","timestamp":1784695563000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1871649\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,22]]},"references-count":25,"alternative-id":["10.3389\/fnut.2026.1871649"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2026.1871649","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,22]]},"article-number":"1871649"}}