Laparoscopically confirmed endometriosis and midlife plasma markers of inflammation, cholesterol, and adipokines among participants in the Nurses' Health Study II

IF 3.9 2区医学 Q2 GERIATRICS & GERONTOLOGY

Maturitas Pub Date : 2025-07-14 DOI:10.1016/j.maturitas.2025.108663

Leslie V. Farland , William J. Degnan III , Holly R. Harris , Naoko Sasamoto , Kathryn M. Rexrode , Stacey A. Missmer

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引用次数: 0

Abstract

Objective

Endometriosis may increase the risk of cardiovascular disease, possibly through a detrimental impact on circulating biomarkers. However, there is a paucity of research on endometriosis and inflammation, lipids, and adipokines at midlife.

Methods

We used generalized linear models to determine the association between laparoscopically confirmed endometriosis and log-transformed levels of plasma C-reactive protein (n = 3936), interleukin-6 (n = 3495), tumor necrosis factor-alpha receptor 2 (n = 2967), high-density lipoprotein cholesterol (n = 1533), low-density lipoprotein cholesterol (n = 1324), total cholesterol (n = 4898), leptin (n = 2480), and adiponectin (n = 4262) among participants with existing biomarker measurements in the Nurses' Health Study II (average age 44 years). We investigated heterogeneity by body mass index (<25 kg/m² vs. ≥ 25 kg/m²).

Results

We did not observe associations between endometriosis and midlife inflammatory biomarkers (C-reactive protein % difference: -4.6, 95 % CI [−15.7,7.9]; interleukin-6: −0.4 % [−7.2,7.1]; tumor necrosis factor-alpha receptor 2: −1.3 % [−4.1,1.6]) or levels of high-density lipoprotein cholesterol (0.8 % [−3.7,5.6]), low-density lipoprotein cholesterol (−0.2 % [−5.2,5.1]), total cholesterol (1.0 % [−0.7,2.7]), or adiponectin (−4.0 [−8.8,1.0]). Women with endometriosis had higher leptin levels (9.0 % [0.5, 18.1]). Associations varied by body mass index for total cholesterol (p-value 0.05) and leptin (p-value 0.02). Among women with a body mass index ≥25 kg/m², those with endometriosis had a mean total cholesterol level that was 2.7 % higher (0.2,5.2) than among those without; among those with a body mass index <25 kg/m², those with endometriosis had a mean leptin level that was 15.7 % higher (4.6, 28.1) than among those without endometriosis.

Conclusions

Endometriosis was not associated with midlife systemic inflammation, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, or adiponectin. Endometriosis was associated with higher leptin among those with a body mass index <25 kg/m² and higher total cholesterol among those with a body mass index ≥25 kg/m². These findings suggest that endometriosis may influence cardiovascular disease risk via midlife cholesterol and leptin.

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在护士健康研究II的参与者中，腹腔镜确认子宫内膜异位症和中年血浆炎症标志物、胆固醇和脂肪因子

目的子宫内膜异位症可能增加心血管疾病的风险，可能是通过对循环生物标志物的有害影响。然而，对中年子宫内膜异位症、炎症、脂质和脂肪因子的研究却很少。MethodsWe用广义线性模型来确定腹腔镜确诊子宫内膜异位症和对数转换之间的关系水平的血浆c反应蛋白(n = 3936)、白细胞介素- 6 (n = 3495)、肿瘤坏死因子-α受体2 (n = 2967),高密度脂蛋白胆固醇(n = 1533)、低密度脂蛋白胆固醇(n = 1324)、总胆固醇(n = 4898),瘦素(n = 2480),和脂联素（n = 4262）在护士健康研究II（平均年龄44岁）中已有生物标志物测量的参与者中。我们通过体重指数（<25 kg/m2 vs.≥25 kg/m2）调查异质性。结果我们没有观察到子宫内膜异位症与中年炎症生物标志物之间的关联(c反应蛋白%差异：-4.6,95% CI [- 15.7,7.9]；白细胞介素-6:−0.4%[−7.2,7.1]；肿瘤坏死因子- α受体2:−1.3%[−4.1,1.6])或高密度脂蛋白胆固醇（0.8%[−3.7,5.6]）、低密度脂蛋白胆固醇（−0.2%[−5.2,5.1]）、总胆固醇（1.0%[−0.7,2.7]）或脂联素（−4.0[−8.8,1.0]）水平。子宫内膜异位症患者瘦素水平较高（9.0%[0.5,18.1]）。总胆固醇（p值0.05）和瘦素（p值0.02）的相关性因体重指数而异。在体重指数≥25kg /m2的女性中，子宫内膜异位症患者的平均总胆固醇水平比无子宫内膜异位症患者高2.7% (0.2,5.2)；在体重指数为25 kg/m2的人群中，子宫内膜异位症患者的平均瘦素水平比无子宫内膜异位症患者高15.7%（4.6,28.1）。结论子宫内膜异位症与中年全身性炎症、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇或脂联素无关。子宫内膜异位症与体重指数≥25 kg/m2的患者瘦素升高和体重指数≥25 kg/m2的患者总胆固醇升高有关。这些发现表明，子宫内膜异位症可能通过中年胆固醇和瘦素影响心血管疾病的风险。

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来源期刊

Maturitas 医学-妇产科学

CiteScore

9.10

自引率

2.00%

发文量

142

审稿时长

40 days

期刊介绍： Maturitas is an international multidisciplinary peer reviewed scientific journal of midlife health and beyond publishing original research, reviews, consensus statements and guidelines, and mini-reviews. The journal provides a forum for all aspects of postreproductive health in both genders ranging from basic science to health and social care. Topic areas include:• Aging• Alternative and Complementary medicines• Arthritis and Bone Health• Cancer• Cardiovascular Health• Cognitive and Physical Functioning• Epidemiology, health and social care• Gynecology/ Reproductive Endocrinology• Nutrition/ Obesity Diabetes/ Metabolic Syndrome• Menopause, Ovarian Aging• Mental Health• Pharmacology• Sexuality• Quality of Life