{"paper_id":"93222d92-ec20-4795-89fd-aa80e3b495b8","body_text":"Abstract\nPurpose\nNo 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.\nMethods\nWe 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.\nResults\nNine 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).\nConclusions\nWomen 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.\nSimilar content being viewed by others\nReferences\nGiudice LC, Kao LC (2004) Endometriosis. Lancet 364(9447):1789–1799\nBurney RO, Giudice LC (2012) Pathogenesis and pathophysiology of endometriosis. Fertil Steril 98(3):511–519\nLips P (2006) Vitamin D physiology. Prog Biophys Mol Biol 92(1):4–8\nSzczepanska M et al (2015) Polymorphic variants in vitamin D signaling pathway genes and the risk of endometriosis-associated infertility. 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Shuang Yuan: data collection and management. Hongjing Wang: manuscript writing, project supervision, and final approval.\nCorresponding author\nEthics declarations\nConflict of interest\nThe authors declare that they have no competing interests.\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nElectronic supplementary material\nBelow is the link to the electronic supplementary material.\nRights and permissions\nAbout this article\nCite this article\nQiu, 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\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s00404-020-05576-5","source_license":"CC0","license_restricted":false}