Effect of education on endometriosis and mediating effects: a mendelian randomization study

Objectives

To assess the potential impact of years of education, which serves as a measure of socioeconomic inequality, on the occurrence of endometriosis, and to quantify the potential influence of modifiable factors as mediators.

Methods

The study used SNPs as genetic tools for genetic association. Analysis using 2-sample univariate and multivariate Mendelian randomization methods. Primary analyses were performed using an inverse variance weighted MR method. Data were obtained from publicly available genome-wide association studies (GWAS) from European populations. Data for ending endometriosis were obtained from the Neale lab.

Results

Each SD increase in years of education (4.2 years) has a protective effect on endometriosis (OR 0.9975; 95% CI 0.9958–0.9951). For individuals, the most significant contribution is the depression factor (mediation effect 53%, 95% CI: 3–102%). After combining, the mediator variable explains 64% (95% CI: 55%–290%) of the education—endometriosis association.

Summary

Higher education attainment potentially has a causal protective effect on endometriosis, while lower education levels may increase the risk of endometriosis through modifiable factors such as depression, insomnia, and anxiety.