维生素D与子宫内膜异位症:是否存在机制联系?
Vitamin D and Endometriosis: Is There a Mechanistic Link?
作者信息
Jennings Bethany Scout, Hewison Martin
机构信息
Department of Metabolism and Systems Science, School of Medical Sciences, University of Birmingham, Birmingham, UK.
Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK.
出版信息
Cell Biochem Funct. 2025 Jan;43(1):e70037. doi: 10.1002/cbf.70037.
Endometriosis is a prevalent chronic gynaecological disorder, but its cause is still unclear, and both genetic and environmental factors may contribute disease aetiology. Prominent amongst the latter is vitamin D which can be obtained either by the action of sunlight on skin or from dietary sources. Serum levels of the main circulating form of vitamin D, 25-hydroxvitamin D (25(OH)D), have been reported to be inversely correlated with endometriosis, suggesting that vitamin D-deficiency may be a risk factor for the disease. Crucially, the active form of vitamin D, 1,25-dihydroxyvitamin D (1,25(OH)D) is known to exert many functions beyond its established role in the endocrinology of mineral homoeostasis and prevention of rickets. Several of these extra-skeletal effects of 1,25(OH)D may impact the risk and progression of endometriosis. The following review details the studies that have assessed associations between vitamin D status/supplementation and endometriosis severity and disease progression, but also describes the mechanistic targets for 1,25(OH)D in endometriosis with specific reference to immunomodulatory responses and effects on angiogenesis. Endometriosis is an under-reported health issue with poor non-invasive options for diagnosis. Given that vitamin D-deficiency may trigger or exacerbate key pathophysiological responses linked to endometriosis, analysis of vitamin D status in women may provide an alternative risk marker for endometriosis. Treatment options for endometriosis are also limited and the review will also consider whether vitamin D supplementation has a role in the management of endometriosis, either in prevention or treatment.
子宫内膜异位症是一种常见的慢性妇科疾病,但其病因仍不明确,遗传和环境因素都可能导致该疾病的发生。在环境因素中,维生素D尤为突出,它可以通过阳光照射皮肤或从饮食中获取。据报道,维生素D的主要循环形式25-羟维生素D(25(OH)D)的血清水平与子宫内膜异位症呈负相关,这表明维生素D缺乏可能是该疾病的一个危险因素。至关重要的是,已知维生素D的活性形式1,25-二羟维生素D(1,25(OH)D)除了在矿物质稳态内分泌学和预防佝偻病方面的既定作用外,还具有许多功能。1,25(OH)D的这些骨骼外效应中的一些可能会影响子宫内膜异位症的风险和进展。以下综述详细介绍了评估维生素D状态/补充与子宫内膜异位症严重程度和疾病进展之间关联的研究,同时还描述了1,25(OH)D在子宫内膜异位症中的作用机制靶点,特别提到了免疫调节反应和对血管生成的影响。子宫内膜异位症是一个报告不足的健康问题,诊断的非侵入性选择较差。鉴于维生素D缺乏可能引发或加剧与子宫内膜异位症相关的关键病理生理反应,对女性维生素D状态的分析可能为子宫内膜异位症提供一个替代风险标志物。子宫内膜异位症的治疗选择也很有限,该综述还将考虑维生素D补充在子宫内膜异位症的管理中是否具有预防或治疗作用。