Table 2.
Summary of the included studies on the correlation between endometriosis and obesity. The studies that found no or positive correlation are in bold.
| Type of evidence | Component | Seminal studies | Key findings | ||||
|---|---|---|---|---|---|---|---|
| First author | Year of publication | Ref. no. | Type of study | No. of subjects | |||
| Clinical | BMI | Hemmings R. | 2004 | [16] | Case-control | 2.777 | Inverse correlation between endometriosis and BMI |
| Ferrero S. | 2005 | [6] | Case-control | 614 | Inverse correlation between endometriosis and BMI | ||
| Viganò P. | 2012 | [25] | Systemic review | 187,340 (11 studies) | Modest inverse correlation between endometriosis and BMI | ||
| Shah D. K. | 2013 | [8] | Prospective cohort | 116.430 | Inverse correlation between endometriosis and BMI | ||
| Shaha R. | 2016 | 17 | Cross-sectional | 27.594 | No correlation between endometriosis and BMI | ||
| Liu Y. | 2017 | [18] | Meta-analysis | 128,944 (11 studies) | Inverse correlation between endometriosis and BMI | ||
| Holdswoth-Carson S. J. | 2018 | [20] | Retrospective cohort | 509 | Inverse correlation between endometriosis and BMI | ||
| Jenabi E. | 2019 | [19] | Meta-analysis | 96,249 (9 studies) | Correlation between underweight and endometriosis but no (inverse) association between overweight and endometriosis | ||
| Yun K. Y. | 2020 | [21] | Case-control | 416 | Inverse correlation between endometriosis and BMI | ||
| Vaghar M. I. | 2020 | [10] | Questionnaire-based | 250 | Inverse correlation between endometriosis and BMI | ||
| Phenomics | Viganò P. | 2012 | [25] | Systemic review | 269,276 (5 studies) | Strong inverse correlation between endometriosis and early life body size | |
| Aarenstrup J. | 2020 | [26] | Review of national registry | 171.447 | Lean and tall girls are more often diagnosed with endometriosis in adult life | ||
| Nonweight anthropometrics | Backonjia U. | 2017 | [27] | Cross-sectional | 473 | Inverse correlation between endometriosis and weight; subscapular skinfold thickness; waist and hip circumference; total upper arm and upper arm muscle areas; and BMI | |
| Byun J. | 2020 | [28] | Prospective cohort | 495 | Inverse correlation between severity/type of endometriosis and anthropometric/body composition indicators | ||
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| Genetic | Gene expression | Rahmioglu N. | 2015 | [30] | Genome-wide association | 10.254 | Enrichment of common variants between endometriosis and fat distribution of genetic locus 7p15.2 |
| Goetz L. G. | 2016 | [29] | Experimental | 30 | In a murine model of endometriosis, 4 genes related to weight loss (Mrc1, Rock2, Cyp2r1, and Fabp4) were overexpressed and 2 genes linked to obesity (Igfbp1 and Mmd2) were underexpressed | ||
| Vilarinho Cardoso J. | 2017 | 31 | Case-control | 356 | The polymorphism CYP2C19∗2 is positively associated with both endometriosis and high BMI | ||
| MicroRNA assays | Zolbin M. M. | 2019 | [33] | Experimental | 20 | Endometriosis alters BMI through genetic alterations in adipocyte differentiation and metabolism, propagated by Let-7b and miR-342-3p miRNAs | |
| Holdswoth-Carson S. J. | 2020 | 34 | Cross-sectional | 169 | No association between BMI and altered endometrial gene expression in women with or without endometriosis | ||
| Molecular | Ghrelin | Dziunycz P. | 2009 | [52] | Case-control | 66 | Endometriosis associated with increased peritoneal ghrelin levels |
| Milewski L. | 2012 | [53] | Cross-sectional | 20 | Colocalization of ghrelin and its receptor in human ovarian endometrioma tissue samples | ||
| Rathore N. | 2014 | [54] | Cross-sectional | 50 | Median levels of ghrelin in patients with endometriosis were lower as compared to patients without endometriosis | ||
| Leptin | Matarese G. | 2000 | [55] | Case-control | 28 | Early-stage endometriosis is associated with higher leptin levels than advanced-stage disease | |
| Styer A. K. | 2008 | [59] | Experimental | 12 | In a murine model of endometriosis, leptin signaling was necessary for lesion proliferation, early vascular recruitment, and maintenance of neoangiogenesis | ||
| Gungor T. | 2009 | [58] | Prospective cohort | 112 | Higher levels of leptin were observed in peritoneal environments of endometriosis subjects | ||
| Choi Y. S. | 2013 | [61] | Case-control | 86 | The expressions of leptin and its receptor are induced in ovarian endometrioma tissue samples | ||
| Shah D. K. | 2013 | 60 | Case-control | 29.611 | No statistically significant association between endometriosis and leptin espression | ||
| Rathore N. | 2014 | [54] | Cross-sectional | 50 | Median levels of leptin in patients with endometriosis were higher as compared to patients without endometriosis | ||
| Gonçalves H. F. | 2015 | [57] | Case-control | 25 | Serum leptin levels were increased in patients versus controls, whereas there was no difference in peritoneal leptin levels | ||
| Adiponectin | Takemura Y. | 2005 | [64] | Case-control | 80 | Adiponectin concentrations in peritoneal fluid of women with endometriosis were significantly lower than those of women without it | |
| Takemura Y. | 2005 | [65] | Case-control | 78 | Adiponectin concenterations in serum of women with endometriosis were significantly lower than those of women without it | ||
| Choi Y. S. | 2013 | [61] | Case-control | 86 | The expression of adiponectin and its receptor is similar between endometriosis and normal controls | ||
| Shah D. K. | 2013 | 60 | Case-control | 29.611 | No statistically significant association between endometriosis and adiponectin expression | ||
| Chemerin | Jin C. H. | 2015 | [68] | Case-control | 79 | Chemerin concentrations in peritoneal fluid and serum are higher in women with endometriosis than controls | |