Vitamin D in endometriosis: a causative or confounding factor?

Sayegh L, Lamia Sayegh, Ghada El-Hajj Fuleihan, Ghada El‐Hajj Fuleihan, Fuleihan Gel-H, Nassar AH, Anwar H. Nassar
Metabolism: clinical and experimental · 2013 · vol. 63(1) , pp. 32–41 · doi:10.1016/j.metabol.2013.09.012 · PMID:24135500 · W2054966650
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This review investigates whether vitamin D plays a causal role in endometriosis development or if its observed association is merely correlational.

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Abstract

OBJECTIVE: The aim of this paper is to review the evidence from studies that evaluated the relationship between vitamin D and endometriosis. DESIGN: Comprehensive review. MATERIALS AND METHODS: Systematic literature search in Medline for relevant publications from 1946 until June 2013. RESULTS: Endometriosis risk may be influenced by dietary vitamin D intake and plasma hydroxyvitamin D concentration. Vitamin D receptor and vitamin D metabolizing enzymes, 24-hydroxylase and 1-α hydroxylase, are found in the normal cycling endometrium and also in the eutopic and ectopic endometrium of women with endometriosis. The endometrium is a target of 1, 25 dihydroxyvitamin D actions through regulation of specific genes and via immunomodulation. The endometrium in endometriosis expresses dysregulation of some vitamin D enzymes and receptors. If vitamin D and its metabolites are implicated in endometriosis-associated infertility, it is likely through interference with HOXA10 gene expression. The Gc2 phenotype of vitamin D binding protein is prevalent in women with endometriosis and may be implicated in its pathogenesis. In a mouse model, Elocalcitol, a VDR-agonist was shown to reduce the development of endometriotic lesions and recurrence. CONCLUSION: A biological plausibility for a role of vitamin D, as an immunomodulator and anti-inflammatory agent, in the pathogenesis and treatment of endometriosis is suggested in this article, but is difficult to illustrate due to sparse evidence from human studies limited primarily to case-control studies. A significant knowledge gap precludes the establishment of a clear cause-effect relationship. The intriguing leads presented herein need to be investigated further with placebo-controlled supplementation trials.

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Condition tags

dysmenorrheaendometriosis

MeSH descriptors

Calcitriol Endometriosis Endometrium Infertility, Female Receptors, Calcitriol Vitamin D Animals Animals Antineoplastic Agents Antineoplastic Agents Antineoplastic Agents Autoimmunity Autoimmunity Calcitriol Calcitriol Calcitriol Calcitriol Chronic Pain Chronic Pain Chronic Pain

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (100)

Cited by (29)

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License: CC0 · commercial use OK