The impact of endometriosis on cardiovascular and cerebrovascular diseases: A Mendelian randomization study.

Abstract

Endometriosis has been linked to several systemic complications, including cardiovascular disease (CVD), atrial fibrillation (AF), heart failure (HF), hypertension, stroke, and ischemic stroke. The potential causal relationship between endometriosis and these diseases remains poorly understood. This Mendelian randomization (MR) study employed two-sample analyses to explore the associations between endometriosis and disease outcomes using data from large-scale genome-wide association studies (GWAS). The primary analysis method was the inverse variance weighted (IVW) method, which was supplemented by weighted median, weighted mode, and MR Egger methods. Our primary analysis revealed no significant causal association between endometriosis and cardiovascular or cerebrovascular diseases, including CVD, HF, stroke, ischemic stroke, and hypertension. Despite initial indications of a possible genetic link between endometriosis and AF (OR = 132.357; 95 percent CI: 1.126 -15,551.291; p = .045), this association was not robust. Sensitivity tests, including the "leave-one-out" analysis, showed the results to be unstable, and MR-weighted median analyses confirmed the lack of consistency in these findings. This MR study does not support a causal role of endometriosis in major cardiovascular or cerebrovascular diseases. The unstable association with AF may reflect residual pleiotropy or limited power, underscoring the need for validation in larger, diverse cohorts.