25-hydroxyvitamin D and Endometriosis: A bidirectional Mendelian randomization study

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This Mendelian randomization study found no causal effect between 25-hydroxyvitamin D and endometriosis, but identified a positive correlation between ovarian endometriosis and higher 25-hydroxyvitamin D levels.

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This study used bidirectional two-sample Mendelian randomization to test potential causal relationships between serum 25-hydroxyvitamin D (25OHD) and endometriosis, using the latest publicly available GWAS summary statistics for 25OHD and overall endometriosis plus five subtypes. Primary analysis with inverse-variance weighting found no significant causal effect of 25OHD on endometriosis (OR 0.892, 95% CI 0.745–1.068, P=0.213) and no evidence that endometriosis causally affects 25OHD levels (IVW beta 0.005, 95% CI 0.993–1.018, P=0.406). In subtype analyses, the authors reported a positive correlation between ovarian endometriosis and higher 25OHD level (IVW beta 0.012, 95% CI 1.002–1.022, P=0.024). This paper is centrally about endometriosis — it directly applies bidirectional MR to assess causality between serum 25-hydroxyvitamin D and endometriosis (including the ovarian subtype).

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Abstract

Numerous studies have demonstrated a correlation between serum 25-hydroxyvitamin D (25OHD) and endometriosis. However, the precise nature of this association remains elusive. The causal connection between 25OHD and endometriosis remains uncertain, as it is yet to be determined whether one directly influences the other. The objective of our research was to investigate the cause-and-effect connection between 25OHD and endometriosis. The study employed Mendelian randomization (MR) in a bidirectional two-sample investigation to examine the causal relationship between 25OHD and endometriosis. The analysis utilized the most recent publicly accessible statistics from the genome-wide association study (GWAS) encompassing 25OHD, endometriosis, and its five subtypes. The primary analytical approach employed was Inverse-Variance Weighting (IVW), accompanied by supplementary analysis methods including weighted median, MR-Egger, simple mode, and weighted mode. Furthermore, sensitivity analyses were conducted to assess the potential influence of heterogeneity and pleiotropy on the MR outcomes. MR primary analysis showed no significant causal effect of 25OHD on endometriosis (OR = 0.892, 95%CI = 0.745 ~ 1.068, P = 0.213). Similarly, there was no evidence to support a causal relationship of endometriosis on 25OHD (IVW Beta = 0.005, 95%CI = 0.993 ~ 1.018, P = 0.406). However, when conducting MR analysis on different subtypes of endometriosis and 25OHD, we found a positive correlation between endometriosis of ovary and 25OHD level (IVW Beta = 0.012, 95%CI = 1.002 ~ 1.022, P = 0.024). This study indicates that there is no causal relationship between serum 25OHD and endometriosis. However, it is important to note that serum 25OHD levels will increase in patients with endometriosis of the ovary. Further observational studies and clinical trials are indispensable.
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Abstract

Numerous studies have demonstrated a correlation between serum 25-hydroxyvitamin D (25OHD) and endometriosis. However, the precise nature of this association remains elusive. The causal connection between 25OHD and endometriosis remains uncertain, as it is yet to be determined whether one directly influences the other. The objective of our research was to investigate the cause-and-effect connection between 25OHD and endometriosis. The study employed Mendelian randomization (MR) in a bidirectional two-sample investigation to examine the causal relationship between 25OHD and endometriosis. The analysis utilized the most recent publicly accessible statistics from the genome-wide association study (GWAS) encompassing 25OHD, endometriosis, and its five subtypes. The primary analytical approach employed was Inverse-Variance Weighting (IVW), accompanied by supplementary analysis methods including weighted median, MR-Egger, simple mode, and weighted mode. Furthermore, sensitivity analyses were conducted to assess the potential influence of heterogeneity and pleiotropy on the MR outcomes. MR primary analysis showed no significant causal effect of 25OHD on endometriosis (OR = 0.892, 95%CI = 0.745 ~ 1.068, P = 0.213). Similarly, there was no evidence to support a causal relationship of endometriosis on 25OHD (IVW Beta = 0.005, 95%CI = 0.993 ~ 1.018, P = 0.406). However, when conducting MR analysis on different subtypes of endometriosis and 25OHD, we found a positive correlation between endometriosis of ovary and 25OHD level (IVW Beta = 0.012, 95%CI = 1.002 ~ 1.022, P = 0.024). This study indicates that there is no causal relationship between serum 25OHD and endometriosis. However, it is important to note that serum 25OHD levels will increase in patients with endometriosis of the ovary. Further observational studies and clinical trials are indispensable. Similar content being viewed by others Data Availability The supporting figures and tables can be found in the article/Supplementary Material, and the original datasets can be obtained from the first author or corresponding author upon request. Code Availability Codes for data analysis are available upon request.

References

Vazgiourakis VM, Zervou MI, Papageorgiou L, et al. Association of endometriosis with cardiovascular disease: Genetic aspects (Review). Int J Mol Med. 2023;51(3):29. https://doi.org/10.3892/ijmm.2023.5232. Rowlands IJ, Abbott JA, Montgomery GW, et al. Prevalence and incidence of endometriosis in Australian women: a data linkage cohort study. BJOG. 2021;128(4):657–65. https://doi.org/10.1111/1471-0528.16447. McGrath IM, Montgomery GW, Mortlock S. Insights from Mendelian randomization and genetic correlation analyses into the relationship between endometriosis and its comorbidities. Hum Reprod Update. 2023;29(5):655–74. https://doi.org/10.1093/humupd/dmad009. Fawole AO, Bello FA, Ogunbode O, et al. Endometriosis and associated symptoms among Nigerian women. Int J Gynaecol Obstet. 2015;130(2):190–4. https://doi.org/10.1016/j.ijgo.2015.02.030. Lamceva J, Uljanovs R, Strumfa I. The main theories on the pathogenesis of endometriosis. Int J Mol Sci. 2023;24(5):4254. https://doi.org/10.3390/ijms24054254. Norman PE, Powell JT. Vitamin D and cardiovascular disease. Circ Res. 2014;114(2):379–93. https://doi.org/10.1161/CIRCRESAHA.113.301241. Jiang X, O'Reilly PF, Aschard H, et al. Genome-wide association study in 79,366 European-ancestry individuals informs the genetic architecture of 25-hydroxyvitamin D levels. Nat Commun. 2018;9(1):260 https://doi.org/10.1038/s41467-017-02662-2 Somigliana E, Panina-Bordignon P, Murone S, et al. Vitamin D reserve is higher in women with endometriosis. Hum Reprod. 2007;22(8):2273–8. https://doi.org/10.1093/humrep/dem142. Harris HR, Chavarro JE, Malspeis S, et al. Dairy-food, calcium, magnesium, and vitamin D intake and endometriosis: a prospective cohort study. Am J Epidemiol. 2013;177(5):420–30. https://doi.org/10.1093/aje/kws247. Kalaitzopoulos DR, Samartzis N, Daniilidis A, et al. Effects of vitamin D supplementation in endometriosis: a systematic review. Reprod Biol Endocrinol. 2022;20(1):176. https://doi.org/10.1186/s12958-022-01051-9. Kalaitzopoulos DR, Lempesis IG, Athanasaki F, et al. Association between vitamin D and endometriosis: a systematic review. Hormones (Athens). 2020;19(2):109–21. https://doi.org/10.1007/s42000-019-00166-w. Giampaolino PC, Foreste LD, et al. Is there a Relationship between Vitamin D and Endometriosis? An Overview of the Literature. Curr Pharma Des. 2019;25:22. https://doi.org/10.2174/1381612825666190722095401. Sayegh L, Gel-H F, Nassar AH. Vitamin D in endometriosis: a causative or confounding factor? Metabolism. 2014;63(1):32–41. https://doi.org/10.1016/j.metabolism.2013.09.012. Davies NM, Holmes MV, Davey SG. Reading Mendelian randomisation studies: a guide, glossary, and checklist for clinicians. BMJ. 2018;362:601. https://doi.org/10.1136/bmj.k601. Skrivankova VW, Richmond RC, Woolf BAR, et al. Strengthening the Reporting of Observational Studies in Epidemiology Using Mendelian Randomization: The STROBE-MR Statement. JAMA. 2021;326(16):1614–21. https://doi.org/10.1001/jama.2021.18236. Lawlor DA, Harbord RM, Sterne JA, et al. Mendelian randomization: using genes as instruments for making causal inferences in epidemiology. Stat Med. 2008;27(8):1133–63. https://doi.org/10.1002/sim.3034. Gupta V, Walia GK, Sachdeva MP. “Mendelian randomization”: an approach for exploring causal relations in epidemiology. Public Health. 2017;145:113–9. https://doi.org/10.1016/j.puhe.2016.12.033. Revez JA, Lin T, Qiao Z, et al. Genome-wide association study identifies 143 loci associated with 25 hydroxyvitamin D concentration. Nat Commun. 2020;11(1):1647. https://doi.org/10.1038/s41467-020-15421-7. Hemani G, Zheng J, Elsworth B, et al. The MR-Base platform supports systematic causal inference across the human phenome. Elife. 2018;7:e34408. https://doi.org/10.7554/eLife.34408. Kamat MA, Blackshaw JA, Young R, et al. PhenoScanner V2: an expanded tool for searching human genotype-phenotype associations. Bioinformatics. 2019;35(22):4851–3. https://doi.org/10.1093/bioinformatics/btz469. Chen L, Yang H, Li H, et al. Insights into modifiable risk factors of cholelithiasis: A Mendelian randomization study. Hepatology. 2022;75(4):785–96. https://doi.org/10.1002/hep.32183. Bowden J, Del Greco MF, Minelli C, et al. Assessing the suitability of summary data for two-sample Mendelian randomization analyses using MR-Egger regression: the role of the I2 statistic. Int J Epidemiol. 2016;45(6):1961–74. https://doi.org/10.1093/ije/dyw220. Verbanck M, Chen CY, Neale B, et al. Detection of widespread horizontal pleiotropy in causal relationships inferred from Mendelian randomization between complex traits and diseases. Nat Genet. 2018;50(5):693–8. https://doi.org/10.1038/s41588-018-0099-7. Gage SH, Jones HJ, Burgess S, et al. Assessing causality in associations between cannabis use and schizophrenia risk: a two-sample Mendelian randomization study. Psychol Med. 2017;47(5):971–80. https://doi.org/10.1017/S0033291716003172. Delbandi AA, Torab M, Abdollahi E, et al. Vitamin D deficiency as a risk factor for endometriosis in Iranian women. J Reprod Immunol. 2021;143:103266. https://doi.org/10.1016/j.jri.2020.103266. Qiu Y, Yuan S, Wang H. Vitamin D status in endometriosis: a systematic review and meta-analysis. Arch Gynecol Obstet. 2020;302(1):141–52. https://doi.org/10.1007/s00404-020-05576-5. Ciavattini A, Serri M, DelliCarpini G, et al. Ovarian endometriosis and vitamin D serum levels. Gynecol Endocrinol. 2017;33(2):164–7. https://doi.org/10.1080/09513590.2016.1239254. Buggio L, Somigliana E, Pizzi MN, et al. 25-Hydroxyvitamin D Serum Levels and Endometriosis: Results of a Case-Control Study. Reprod Sci. 2019;26(2):172–7. https://doi.org/10.1177/1933719118766259. Hartwell D, Rødbro P, Jensen SB, Thomsen K, Christiansen C. Vitamin D metabolites–relation to age, menopause and endometriosis. Scand J Clin Lab Invest. 1990;50(2):115–21. https://doi.org/10.3109/00365519009089142. Agic A, Xu H, Altgassen C, et al. Relative expression of 1,25-dihydroxyvitamin D3 receptor, vitamin D 1 alpha-hydroxylase, vitamin D 24-hydroxylase, and vitamin D 25-hydroxylase in endometriosis and gynecologic cancers. Reprod Sci. 2007;14(5):486–97. https://doi.org/10.1177/1933719107304565. Jeon SM, Shin EA. Exploring vitamin D metabolism and function in cancer. Exp Mol Med. 2018;50(4):1–14. https://doi.org/10.1038/s12276-018-0038-9. Li Wang, Xiaofeng Yang. Study on the relationship between vitamin d and endometriosis. Chin J Woman Child Health Res. 2019;08:908–12. Faserl K, Golderer G, Kremser L, et al. Polymorphism in vitamin D-binding protein as a genetic risk factor in the pathogenesis of endometriosis. J Clin Endocrinol Metab. 2011;96(1):E233–41. https://doi.org/10.1210/jc.2010-1532. Hapangama DK, Raju RS, Valentijn AJ, et al. Aberrant expression of metastasis-inducing proteins in ectopic and matched eutopic endometrium of women with endometriosis: implications for the pathogenesis of endometriosis. Hum Reprod. 2012;27(2):394–407. https://doi.org/10.1093/humrep/der412. Mariani M, Viganò P, Gentilini D, et al. The selective vitamin D receptor agonist, elocalcitol, reduces endometriosis development in a mouse model by inhibiting peritoneal inflammation. Hum Reprod. 2012;27(7):2010–9. https://doi.org/10.1093/humrep/des150. Londero AP, Calcagno A, Grassi T, et al. Survivin, MMP-2, MT1-MMP, and TIMP-2: their impact on survival, implantation, and proliferation of endometriotic tissues. Virchows Arch. 2012;461(5):589–99. https://doi.org/10.1007/s00428-012-1301-4. Yilmaz B, Sucak A, Kilic S, et al. Metformin regresses endometriotic implants in rats by improving implant levels of superoxide dismutase, vascular endothelial growth factor, tissue inhibitor of metalloproteinase-2, and matrix metalloproteinase-9. Am J Obstet Gynecol. 2010;202(4):368.e1-368.e3688. https://doi.org/10.1016/j.ajog.2009.10.873. Baeke F, Etten EV, Overbergh L, Mathieu C. Vitamin D3 and the immune system: maintaining the balance in health and disease. Nutr Res Rev. 2007;20(1):106–18. https://doi.org/10.1017/S0954422407742713. Mathieu C, Adorini L. The coming of age of 1,25-dihydroxyvitamin D(3) analogs as immunomodulatory agents. Trends Mol Med. 2002;8(4):174–9. https://doi.org/10.1016/s1471-4914(02)02294-3. Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911–30. https://doi.org/10.1210/jc.2011-0385.

Acknowledgements

Thanks to all the teachers and colleagues for their help, as well as the home of researchers. Author information Authors and Affiliations Contributions The study's conceptualization and design were the responsibility of DP and PL. DP and PL were responsible for data collection. DP, PL, XD and SX conducted data analysis and interpretation. DP completed the writing of the manuscript. DP, XD and SX reviewed and edited the manuscript. All authors contributed to the article and approved the submitted version. Corresponding author Ethics declarations Ethics Approval In this MR study, we used published studies or shared datasets that have been ethically approved. We did not need to obtain an additional ethics statement. Consent to Participate In this MR study, we used published studies or shared datasets that informed consent has been obtained. We did not need to obtain an additional consent. Consent for Publication All authors agree to the manuscript submitted and agree to be published in this journal. Conflicts of Interest/Competing Interests The author declares that there is no conflict of interest or competition in this article. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Supplementary Information Below is the link to the electronic supplementary material. 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 Pan, D., Li, P., Dai, X. et al. 25-hydroxyvitamin D and Endometriosis: A bidirectional Mendelian randomization study. Reprod. Sci. 32, 693–701 (2025). https://doi.org/10.1007/s43032-024-01517-8 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s43032-024-01517-8

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Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Vitamin D Vitamin D Vitamin D Vitamin D Vitamin D Vitamin D Vitamin D Vitamin D Vitamin D

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