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Hum. Reprod. Advance Access originally published online on June 4, 2007
Human Reproduction 2007 22(8):2273-2278; doi:10.1093/humrep/dem142
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Vitamin D reserve is higher in women with endometriosis

Edgardo Somigliana1,5, Paola Panina-Bordignon2, Simone Murone3, Pietro Di Lucia2, Paolo Vercellini1,4 and Paola Vigano3

1 Infertility Unit, Fondazione Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via M. Fanti 6, 20122 Milano, Italy 2 BioXell S.p.A., Milan, Italy 3 Istituto Auxologico Italiano, Milan, Italy 4 Università degli Studi di Milano, Milan, Italy

5 Correspondence address. Tel: +39-02-57992583; Fax: +39-02-50320260; E-mail: dadosomigliana{at}yahoo.it

BACKGROUND: An immune-mediated defect in recognition and elimination of endometrial fragments refluxed in the peritoneal cavity has been hypothesized to play a crucial role in endometriosis development. Since vitamin D is an effective modulator of the immune system, we have hypothesized that the vitamin D status may have a role in the pathogenesis of endometriosis.

METHODS: Women of reproductive age selected for surgery for gynecological indications were enrolled in this prospective cohort study. Serum levels of 25-hydroxyvitamin-D3, 1,25-dihydroxyvitamin-D3 and Ca2+ were assessed.

RESULTS: Eighty-seven women with endometriosis and 53 controls were recruited. Mean (± SD) levels of 25-hydroxyvitamin-D3 in women with and without endometriosis were 24.9 ± 14.8 ng/ml and 20.4 ± 11.8, respectively (P = 0.05). The Odds Ratio (95% Confidence Interval) for endometriosis in patients with levels exceeding the 75th percentile of the serum distribution of the molecule (28.2 ng/ml) was 4.8 (1.7–13.5). A positive gradient according to the severity of the disease was also documented. A trend towards higher levels of 1,25-dihydroxyvitamin-D3 and Ca2+ was observed in women with endometriosis, but differences did not reach statistical significance. As expected, serum concentrations of 25-hydroxyvitamin-D3 and 1,25-dihydroxyvitamin-D3, but not Ca2+, are influenced by the season (P < 0.001, P = 0.004, P = 0.57, respectively), while levels of the three molecules did not vary according to the phase of the menstrual cycle.

CONCLUSIONS: Endometriosis is associated with higher serum levels of vitamin D.

Key words: endometriosis/vitamin D/calcium

Submitted on January 30, 2007; resubmitted on April 23, 2007; accepted on May 1, 2007.


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