Baek Jong Chul, Jo Jae Yoon, Lee Seon Mi, Cho In Ae, Shin Jeong Kyu, Lee Soon Ae, Lee Jong Hak, Cho Min-Chul, Choi Won Jun
Department of Obstetrics and Gynecology, Gyeongsang National University Changwon Hospital, Changwon, Korea.
Department of Obstetrics and Gynecology, Gyeongsang National University Hospital, Jinju, Korea.
Clin Exp Reprod Med. 2019 Sep;46(3):125-131. doi: 10.5653/cerm.2018.00416. Epub 2019 Aug 1.
To investigate serum 25-hydroxyl vitamin D (25(OH)D) and vitamin D-binding protein (VDBP) concentrations in women with endometriosis according to the severity of disease.
Women with mild endometriosis (n = 9) and advanced endometriosis (n = 7), as well as healthy controls (n = 16), were enrolled in this observational study. Serum total 25(OH)D concentrations were analyzed using the Elecsys vitamin D total kit with the Cobas e602 module. Concentrations of bioavailable and free 25(OH)D were calculated. Concentrations of VDBP were measured using the Human Vitamin D BP Quantikine ELISA kit. Variables were tested for normality and homoscedasticity using the Shapiro-Wilk test and Leven F test, respectively. Correlation analysis was used to identify the variables related to total 25(OH)D and VDBP levels. To assess the effects of total 25(OH)D and VDBP levels in the three groups, multivariate generalized additive modeling (GAM) was performed.
Gravidity and parity were significantly different across the three groups. Erythrocyte sedimentation rate (ESR) and CA-125 levels increased as a function of endometriosis severity, respectively (p= 0.051, p= 0.004). The correlation analysis showed that total 25(OH)D levels were positively correlated with gravidity (r = 0.59, p< 0.001) and parity (r = 0.51, p< 0.003). Multivariate GAM showed no significant relationship of total 25(OH)D levels with EMT severity after adjusting for gravidity and ESR. However, the coefficient of total 25(OH)D levels with gravidity was significant (1.87; 95% confidence interval, 0.12-3.63; p= 0.040).
These results indicate that vitamin D and VDBP levels were not associated with the severity of endometriosis.
根据疾病严重程度调查子宫内膜异位症女性的血清25-羟基维生素D（25(OH)D）和维生素D结合蛋白（VDBP）浓度。
本观察性研究纳入了轻度子宫内膜异位症女性（n = 9）、重度子宫内膜异位症女性（n = 7）以及健康对照者（n = 16）。使用Elecsys维生素D总检测试剂盒和Cobas e602模块分析血清总25(OH)D浓度。计算生物可利用型和游离型25(OH)D的浓度。使用人维生素D结合蛋白定量ELISA试剂盒测量VDBP浓度。分别使用Shapiro-Wilk检验和Levene F检验对变量进行正态性和同质性检验。采用相关性分析确定与总25(OH)D和VDBP水平相关的变量。为评估三组中总25(OH)D和VDBP水平的影响，进行了多变量广义相加模型（GAM）分析。
三组之间的妊娠次数和产次存在显著差异。红细胞沉降率（ESR）和CA-125水平分别随着子宫内膜异位症严重程度的增加而升高（p = 0.051，p = 0.004）。相关性分析表明，总25(OH)D水平与妊娠次数（r = 0.59，p < 0.001）和产次（r = 0.51，p < 0.003）呈正相关。多变量GAM分析显示，在调整妊娠次数和ESR后，总25(OH)D水平与子宫内膜异位症严重程度无显著关系。然而，总25(OH)D水平与妊娠次数的系数具有显著性（1.87；95%置信区间，0.12 - 3.63；p = 0.040）。
这些结果表明维生素D和VDBP水平与子宫内膜异位症的严重程度无关。
