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Vitamin D status in endometriosis: a systematic review and meta-analysis

Archives of Gynecology and Obstetrics volume 302, pages 141–152 (2020)Cite this article

Abstract

Purpose

No consensus exists on the relationship between vitamin D status and endometriosis. The chief aim of our study was to evaluate the association between serum vitamin D levels and endometriosis.

Methods

We searched for MEDLINE, EMBASE, and China National Knowledge Infrastructure (CNKI) databases for studies elucidated the circulating vitamin D levels in endometriosis. The standardized mean differences (SMDs) or odds ratios (ORs) with their 95% confidence interval (CIs) were calculated to evaluate the association between vitamin D levels and endometriosis.

Results

Nine studies were included in this meta-analysis. The pooled results indicated that women with endometriosis had lower vitamin D status than that in controls (SMD − 0.97 ng/mL, 95% CI − 1.80 to − 0.14; p = 0.02), and vitamin D status had a negative correlation with the severity of the disease (stage III–IV vs stage I–II: SMD − 1.33 ng/mL, 95% CI − 2.54 to − 0.12; p = 0.03). Although it was not statistically significantly different, hypovitaminosis D had a tendency to be associated with endometriosis (OR 2.77, 95% CI 0.85–6.08, p = 0.10). Heterogeneity was high among included studies. Subgroup analyses revealed that women with no hormone use had lower vitamin D status when compared with controls (SMD − 1.38 ng/mL, 95% CI − 2.59 to − 0.18; p = 0.02). For studies which sample size < 100, serum vitamin D levels were significantly lower in patients than that in controls (SMD − 0.65 ng/mL, 95% CI − 1.19 to − 0.11; p = 0.02).

Conclusions

Women with endometriosis had lower vitamin D status when compared with controls, and a negative relationship between vitamin D levels and severity of endometriosis was observed. In addition, hypovitaminosis D was a potential risk factor for endometriosis.

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Funding

Sichuan Science and Technology Program, Grant/Award Number: 2017FZ0068; Chengdu Science and Technology Huimin Technology Research and Development Project Grant/Award Number: 2015-HMO1-00414-SF.

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Authors and Affiliations

  1. Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China

    Yichao Qiu, Shuang Yuan & Hongjing Wang

  2. Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China

    Yichao Qiu, Shuang Yuan & Hongjing Wang

Authors
  1. Yichao Qiu
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  2. Shuang Yuan
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  3. Hongjing Wang
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Contributions

Yichao Qiu: project development, data collection and manuscript writing. Shuang Yuan: data collection and management. Hongjing Wang: manuscript writing, project supervision, and final approval.

Corresponding author

Correspondence to Hongjing Wang.

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Qiu, Y., Yuan, S. & Wang, H. Vitamin D status in endometriosis: a systematic review and meta-analysis. Arch Gynecol Obstet 302, 141–152 (2020). https://doi.org/10.1007/s00404-020-05576-5

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