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



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.


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.


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).


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

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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).

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