Huang Jian
Clinical Laboratory Center, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Front Nutr. 2025 Feb 4;12:1513191. doi: 10.3389/fnut.2025.1513191. eCollection 2025.
The relationship between serum levels of carotenoids and endometriosis remains largely unknown. The aim of this study is to assess the association between serum levels of major carotenoids (-carotene, -carotene, β-cryptoxanthin, lutein/zeaxanthin, and trans-lycopene) and the risk of endometriosis in US women.
The data were obtained from the 2001-2006 National Health and Nutrition Examination Surveys (NHANES), which included a total of 3,636 women aged 20 to 54. Serum levels of -carotene, -carotene, β-cryptoxanthin, lutein/zeaxanthin, and trans-lycopene were measured using high performance liquid chromatography (HPLC) with photodiode array detection. Endometriosis was defined as self-report. Weighted multivariate logistic regression analyses were conducted to evaluate the associations of the serum levels of the major carotenoids with endometriosis risk. Additionally, restricted cubic spline (RCS) was employed to assess the possibility of nonlinear associations. Finally, subgroup analyses were utilized to estimate the influence of several covariates on the associations.
Weighted multivariate logistic regression analyses showed that, after adjusting for all covariates taken into account, there was a significant association between serum lutein/zeaxanthin levels and reduced risk of endometriosis (Quartile 3 vs. Quartile 1: odds ratio [OR] = 0.62, 95% confidence interval [CI]: 0.42-0.90; Quartile 4 vs. Quartile 1: OR = 0.54, 95% CI: 0.36-0.81, for trend = 0.001). However, no significant associations of serum levels of other carotenoids with endometriosis were found in multivariable-adjusted models that included all covariates. RCS analysis did not reveal any non-linear relationships. Subgroup analyses indicated that the inverse association between serum lutein/zeaxanthin levels and reduced endometriosis risk was significant only in individuals under 40 years of age, in both White and non-White populations, in smokers, and among those who had ever used oral contraceptives.
Serum lutein/zeaxanthin levels may offer protective effects against endometriosis in specific subpopulations. Further prospective research is necessary to validate these findings.
血清类胡萝卜素水平与子宫内膜异位症之间的关系在很大程度上仍不清楚。本研究的目的是评估美国女性血清中主要类胡萝卜素（α-胡萝卜素、γ-胡萝卜素、β-隐黄质、叶黄素/玉米黄质和反式番茄红素）水平与子宫内膜异位症风险之间的关联。
数据来自2001 - 2006年国家健康与营养检查调查（NHANES），共纳入3636名年龄在20至54岁的女性。使用带光电二极管阵列检测的高效液相色谱法（HPLC）测量α-胡萝卜素、γ-胡萝卜素、β-隐黄质、叶黄素/玉米黄质和反式番茄红素的血清水平。子宫内膜异位症通过自我报告定义。进行加权多变量逻辑回归分析，以评估主要类胡萝卜素血清水平与子宫内膜异位症风险的关联。此外，采用受限立方样条（RCS）来评估非线性关联的可能性。最后，利用亚组分析来估计几个协变量对这些关联的影响。
加权多变量逻辑回归分析表明，在对所有纳入的协变量进行调整后，血清叶黄素/玉米黄质水平与子宫内膜异位症风险降低之间存在显著关联（第3四分位数与第1四分位数相比：比值比[OR] = 0.62，95%置信区间[CI]：0.4至0.90；第4四分位数与第1四分位数相比：OR = 0.54，95% CI：0.36至0.81，趋势P = 0.001）。然而，在纳入所有协变量的多变量调整模型中，未发现其他类胡萝卜素血清水平与子宫内膜异位症之间存在显著关联。RCS分析未揭示任何非线性关系。亚组分析表明，血清叶黄素/玉米黄质水平与子宫内膜异位症风险降低之间存在的负相关仅在40岁以下个体、白人和非白人人群、吸烟者以及曾经使用过口服避孕药的人群中显著。
血清叶黄素/玉米黄质水平可能在特定亚组人群中对子宫内膜异位症起到保护作用。需要进一步的前瞻性研究来验证这些发现。
