Vitamin D deficiency as a risk factor for endometriosis in Iranian women

J Reprod Immunol. 2021 Feb:143:103266. doi: 10.1016/j.jri.2020.103266. Epub 2020 Dec 17.


Purpose: Vitamin D (Vit D), as an immunomodulator, has been hypothesized to play a critical role in the pathogenesis of endometriosis. Thus, in this study, we evaluated whether there is an association between 25-hydroxyvitamin D [25(OH)D] and susceptibility to endometriosis in Iranian women.

Methods: Women at reproductive age, including 56 healthy women and 54 patients with endometriosis, were enrolled in the study. Serum levels of 25(OH)D, calcium, parathyroid hormone (PTH), and peritoneal fluid (PF) levels of 25(OH)D were assessed.

Results: The serum and PF levels of 25(OH)D in the patients with endometriosis were significantly lower than the control group (P = 0.001 and P = 0.03, respectively). Subjects with serum levels of 25(OH)D lower than 20 ng/mL had a 2.7 times higher risk of endometriosis than people with 25(OH)D serum levels higher than 20 ng/mL (non-deficient) (OR = 2.7, 95 % confidence interval: 1.24-5.80, P = 0.01). The serum levels of calcium and PTH were significantly lower and higher in patients with endometriosis compared with controls, respectively (P < 0.001, P = 0.02, respectively). Also, the serum levels of 25(OH)D were lower in stages I-II endometriosis than stage III-IV; however, no significant difference was observed.

Conclusion: Our findings showed that people with Vit D deficiency are at higher risk of endometriosis.

Keywords: 25(OH)D; Calcium; Endometriosis; PTH; Vitamin D deficiency.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Calcium / blood
  • Case-Control Studies
  • Endometriosis / blood
  • Endometriosis / diagnosis
  • Endometriosis / epidemiology*
  • Endometriosis / immunology
  • Female
  • Healthy Volunteers
  • Humans
  • Iran / epidemiology
  • Middle Aged
  • Parathyroid Hormone / blood
  • Risk Factors
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood
  • Vitamin D / immunology
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / diagnosis
  • Vitamin D Deficiency / epidemiology*
  • Vitamin D Deficiency / immunology
  • Young Adult


  • Parathyroid Hormone
  • Vitamin D
  • 25-hydroxyvitamin D
  • Calcium