Longitudinal trends in general, central, and visceral adiposity indices among women with endometriosis: a population-based study

Background Previous studies have suggested the close link between endometriosis and body size index. However, there are inconsistent associations between central, general, and visceral adiposity index and endometriosis. This study aimed to evaluate and compare trend of general, central, and visceral adiposity indices in women with and without endometriosis using longitudinal population-based data.

We analyzed data from 3159 premenopausal women aged 20–45 years with defined status of endometriosis who participated in the TLGS from phases 3 to 7. The interval between phases was 3 years. Adiposity indices including general (body mass index), abdominal (waist circumference, waist-to-hip ratio, waist-to-height ratio) and visceral (lipid accumulation product, a body shape index, body roundness index, and visceral adiposity index) were evaluated. Generalized Estimating Equations were used to examine longitudinal trends and associations of endometriosis status with adiposity indices, adjusting for age, parity, smoking, education, and physical activity.

Among the participants, 421 women (13.3%) had diagnosed endometriosis. All adiposity indices showed significant increasing trends over time in both groups. Endometriosis status was not significantly associated with general or central adiposity indices. However, among visceral adiposity measures, the visceral adiposity index was consistently higher in women with endometriosis (adjusted difference: 0.56; 95% CI: 0.10–1.03; p = 0.016), indicating greater visceral fat accumulation.

This study is the first to use longitudinal population-based data to simultaneously evaluate general, central, and visceral adiposity indices in women with endometriosis. Findings indicate that visceral adiposity, rather than general or central obesity, may represent a metabolically relevant phenotype. Similar content being viewed by others

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Author information Authors and Affiliations Contributions M.F.A. contributed substantially to the conception and design, interpretation of data, drafted the article and revised and approved the final version to be published. M.S.G.N. contributed substantially to interpretation of data, drafted the article and revised and approved the final version to be published. M.M. contributed substantially to analysis data, drafted the article, and revised and approved the final version to be published. P.P. contributed substantially to the draft of the article and revised and approved the final version to be published. F.A. contributed substantially to conception and design, revised and approved the final version to be published. F.R.T contributed substantially to conception and design, interpretation of data, drafting the article, and revising and approving the final version to be published. Corresponding author Ethics declarations Conflict of interest The authors declare that there are no conflicts of interest. Ethical approval The ethics review board of the Research Institute for Endocrine Sciences approved the study proposal (approval number: IR.SBMU.ENDOCRINE.REC.1404.058). Consent to participate Written informed consent was signed by all participants after a full explanation of the purpose of the study to them. Written consent was obtained from their parents if they were under 18 years old. Consent for publication All authors approved the final version of the article for publication. Additional information Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Farhadi-Azar, M., Saei Ghare Naz, M., Mousavi, M. et al. Longitudinal trends in general, central, and visceral adiposity indices among women with endometriosis: a population-based study. J Endocrinol Invest (2026). https://doi.org/10.1007/s40618-026-02993-2 Received: Accepted: Published: Version of record: DOI: https://doi.org/10.1007/s40618-026-02993-2