Yuanyue Li, Dimei Ouyang, Ling Liu, Dongyan Ren, Xiaomei Wu
Department of Gynecology, The First People's Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China.
Yunnan Provincial Key Laboratory of Clinical Virology, Kunming, Yunnan, China.
Front Microbiol. 2025 May 7;16:1552134. doi: 10.3389/fmicb.2025.1552134. eCollection 2025.
Endometriosis, a complex gynecological disorder, has been increasingly linked to gut microbiota dysbiosis, suggesting its potential role in disease pathogenesis.
This systematic review and meta-analysis explore the association between gut microbiota and endometriosis by evaluating alpha and beta diversity measures across 11 studies involving 1,727 women, including 433 diagnosed with endometriosis and 1,294 controls. Statistical analysis was performed utilizing either random effects models or fixed models by Revmen5.2 and STATA softwares.
Significant differences in alpha diversity between endometriosis and control groups were observed using the Shannon Index (SMD = 0.39; < 0.00001), Subgroup analysis showed significant differences for Chinese (SMD = 0.48; 95% CI = 0.14 to 0.82; = 0.006; = 30%), Swedish, (SMD = 0.55; 95% CI = 0.27 to 0.83; = 0.0001; = 30%) and Spanish (SMD = 0.34; 95% CI = -0.02 to 0.85; < 0.06; = 27%), compared to others which highlighting the correlation between gut microbiota diversity and endometriosis across different demographic groups. The Simpson Index also revealed a notable difference in richness (SMD = 0.91; = 0.03). However, no significant differences were detected using the Chao Index (SMD = 0.37; = 0.11). These findings underscore the importance of diversity measures in understanding gut microbiota's role in endometriosis. Seven studies employed PCoA, two used the Bray-Curtis dissimilarity index, and one performed PCA, revealing notable dissimilarities in gut microbiota composition between the groups. Using the Newcastle-Ottawa Scale, most studies scored ≥7 stars, indicating high quality. The funnel plot and Egger's linear regression analysis indicated no publication bias.
This study highlights significant alterations in gut microbiota diversity and composition in women with endometriosis, emphasizing the potential role of gut microbiota in its pathogenesis. Future research should focus on standardizing reporting methods to facilitate deeper quantitative analyses.
PROSPERO (registration number RD42024611701).
子宫内膜异位症是一种复杂的妇科疾病，越来越多地与肠道微生物群失调相关，提示其在疾病发病机制中的潜在作用。
本系统评价和荟萃分析通过评估11项研究中涉及1727名女性的α和β多样性指标，探讨肠道微生物群与子宫内膜异位症之间的关联，其中包括433名被诊断为子宫内膜异位症的患者和1294名对照。使用Revmen5.2和STATA软件，采用随机效应模型或固定模型进行统计分析。
使用香农指数观察到子宫内膜异位症组和对照组之间α多样性存在显著差异（标准化均数差[SMD]=0.39；P<0.00001）。亚组分析显示，中国人群（SMD=0.48；95%置信区间[CI]=0.14至0.82；P=0.006；样本量占比=30%）、瑞典人群（SMD=0.55；95%CI=0.27至0.83；P=0.0001；样本量占比=30%）和西班牙人群（SMD=0.34；95%CI=-0.02至0.85；P<0.06；样本量占比=27%）存在显著差异，与其他人群相比，这突出了不同人口统计学群体中肠道微生物群多样性与子宫内膜异位症之间的相关性。辛普森指数也显示出丰富度的显著差异（SMD=0.91；P=0.03）。然而，使用Chao指数未检测到显著差异（SMD=0.37；P=0.11）。这些发现强调了多样性指标在理解肠道微生物群在子宫内膜异位症中作用的重要性。七项研究采用主坐标分析（PCoA），两项使用Bray-Curtis差异指数，一项进行主成分分析（PCA），揭示了两组之间肠道微生物群组成的显著差异。使用纽卡斯尔-渥太华量表，大多数研究得分≥7星，表明质量较高。漏斗图和Egger线性回归分析表明不存在发表偏倚。
本研究突出了子宫内膜异位症女性肠道微生物群多样性和组成的显著改变，强调了肠道微生物群在其发病机制中的潜在作用。未来的研究应侧重于规范报告方法，以促进更深入的定量分析。
PROSPERO（注册号RD42024611701）
