Abstract
<title>Abstract</title> <p> <bold>Objective</bold> To investigate dietary patterns and their relationship with uterine fibroids (UFs) among women in Yunnan Province, and to provide a scientific basis for regional health improvement. <bold>Methods</bold> Data on dietary intake, lifestyle, demographics, and laboratory measurements were collected from 14,115 women aged 30–79 years. Principal component analysis was used to derive dietary patterns. Logistic regression, stratified analysis, and mediation analysis were employed to examine the associations between dietary patterns and UFs. <bold>Results</bold> A total of 14,115 women aged 30-79 years were included, with a UF prevalence of 5.6%. Four dietary patterns were identified: Poultry-Red Meat Pattern, Eggs-Soy Products Pattern, Rice-Tubers Pattern, and Coarse Grains-Fruits Pattern. For the Poultry-Red Meat Pattern, women in the highest quartile (Q4) of adherence had a significantly higher risk of UFs compared to those in the lowest quartile (Q1) ( <italic>OR</italic> = 1.258, 95% <italic>CI</italic> : 1.003, 1.579, <italic>P</italic> < 0.05). Stratified analysis showed that the positive association between the Poultry-Red Meat Pattern and UF risk was significant among subgroups with total annual income >20,000 RMB, age >50 years, BMI ≤24, and Han ethnicity. The Rice-Tubers Pattern was positively associated with UF risk among premenopausal women. The Coarse Grains-Fruits Pattern was inversely associated with UF risk among the Han population. Mediation analysis revealed that age at menarche significantly mediated the association between the Poultry-Red Meat Pattern and UFs, with an indirect effect <italic>β</italic> = 0.016 (Bootstrap <italic>CI</italic> : 0.007–0.026). <bold>Conclusion</bold> The Poultry-Red Meat dietary pattern is positively associated with the risk of uterine fibroids. Age at menarche partially mediates this association,Ethnicity was identified as a key modifier of the diet-UF association. The positive association between the Poultry-Red Meat Pattern and UFs was significant only among Han Chinese women ( <italic>OR</italic> = 1.477, 95% <italic>CI</italic> : 1.012, 2.158), with no significant association observed among Bai and Yi women. Similarly, the protective effect of the Coarse Grains-Fruits Pattern was also concentrated in the Han population ( <italic>OR</italic> = 0.681, 95% <italic>CI</italic> : 0.480, 0.967), and not evident in other ethnic groups. These findings provide evidence for developing targeted prevention and control strategies for uterine fibroids among Han women in Yunnan Province. </p>