Differences in 25-hydroxy vitamin D and vitamin D-binding protein concentrations according to the severity of endometriosis

Jong Chul Baek, Jae Yoon Jo, Seon Mi Lee, In Ae Cho, Jeong Kyu Shin, Soon Ae Lee, Jong Hak Lee, Min-Chul Cho, Won Jun Choi, Jong Chul Baek, Jae Yoon Jo, Seon Mi Lee, In Ae Cho, Jeong Kyu Shin, Soon Ae Lee, Jong Hak Lee, Min-Chul Cho, Won Jun Choi

Abstract

Objective: To investigate serum 25-hydroxyl vitamin D (25(OH)D) and vitamin D-binding protein (VDBP) concentrations in women with endometriosis according to the severity of disease.

Methods: Women with mild endometriosis (n = 9) and advanced endometriosis (n = 7), as well as healthy controls (n = 16), were enrolled in this observational study. Serum total 25(OH)D concentrations were analyzed using the Elecsys vitamin D total kit with the Cobas e602 module. Concentrations of bioavailable and free 25(OH)D were calculated. Concentrations of VDBP were measured using the Human Vitamin D BP Quantikine ELISA kit. Variables were tested for normality and homoscedasticity using the Shapiro-Wilk test and Leven F test, respectively. Correlation analysis was used to identify the variables related to total 25(OH)D and VDBP levels. To assess the effects of total 25(OH)D and VDBP levels in the three groups, multivariate generalized additive modeling (GAM) was performed.

Results: Gravidity and parity were significantly different across the three groups. Erythrocyte sedimentation rate (ESR) and CA-125 levels increased as a function of endometriosis severity, respectively (p= 0.051, p= 0.004). The correlation analysis showed that total 25(OH)D levels were positively correlated with gravidity (r = 0.59, p< 0.001) and parity (r = 0.51, p< 0.003). Multivariate GAM showed no significant relationship of total 25(OH)D levels with EMT severity after adjusting for gravidity and ESR. However, the coefficient of total 25(OH)D levels with gravidity was significant (1.87; 95% confidence interval, 0.12-3.63; p= 0.040).

Conclusion: These results indicate that vitamin D and VDBP levels were not associated with the severity of endometriosis.

Keywords: Endometriosis; Vitamin D; Vitamin D-binding protein.

Conflict of interest statement

Conflict of interest

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1.
Figure 1.
Pairwise comparison of serum (A) total, (B) bioavailable, (C) free 25-hydroxyl vitamin D (25(OH)D), and (D) vitamin D-binding protein (VDBP) according to disease severity. EMT, endometriosis (mild, American Society for Reproductive Medicine [ASRM] stage I and II; advanced, ASRM stage III and IV).

References

    1. Christodoulakos G, Augoulea A, Lambrinoudaki I, Sioulas V, Creatsas G. Pathogenesis of endometriosis: the role of defective ‘immunosurveillance’. Eur J Contracept Reprod Health Care. 2007;12:194–202.
    1. Akoum A, Kong J, Metz C, Beaumont MC. Spontaneous and stimulated secretion of monocyte chemotactic protein-1 and macrophage migration inhibitory factor by peritoneal macrophages in women with and without endometriosis. Fertil Steril. 2002;77:989–94.
    1. Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr. 2004;80(6 Suppl):1678S–1688S.
    1. van Hamburg JP, Asmawidjaja PS, Davelaar N, Mus AM, Cornelissen F, van Leeuwen JP, et al. TNF blockade requires 1,25(OH)2D3 to control human Th17-mediated synovial inflammation. Ann Rheum Dis. 2012;71:606–12.
    1. Karthaus N, van Spriel AB, Looman MW, Chen S, Spilgies LM, Lieben L, et al. Vitamin D controls murine and human plasmacytoid dendritic cell function. J Invest Dermatol. 2014;134:1255–64.
    1. Krishnan AV, Swami S, Peng L, Wang J, Moreno J, Feldman D. Tissue-selective regulation of aromatase expression by calcitriol: implications for breast cancer therapy. Endocrinology. 2010;151:32–42.
    1. Chun RF, Peercy BE, Orwoll ES, Nielson CM, Adams JS, Hewison M. Vitamin D and DBP: the free hormone hypothesis revisited. J Steroid Biochem Mol Biol. 2014;144 Pt A:132–7.
    1. Chun RF. New perspectives on the vitamin D binding protein. Cell Biochem Funct. 2012;30:445–56.
    1. Yousefzadeh P, Shapses SA, Wang X. Vitamin D binding protein impact on 25-hydroxyvitamin D levels under different physiologic and pathologic conditions. Int J Endocrinol. 2014;2014:981581.
    1. Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertil Steril. 1997;67:817–21.
    1. Bikle DD, Gee E, Halloran B, Kowalski MA, Ryzen E, Haddad JG. Assessment of the free fraction of 25-hydroxyvitamin D in serum and its regulation by albumin and the vitamin D-binding protein. J Clin Endocrinol Metab. 1986;63:954–9.
    1. Heijboer AC, Blankenstein MA, Kema IP, Buijs MM. Accuracy of 6 routine 25-hydroxyvitamin D assays: influence of vitamin D binding protein concentration. Clin Chem. 2012;58:543–8.
    1. Arnaud J, Constans J. Affinity differences for vitamin D metabolites associated with the genetic isoforms of the human serum carrier protein (DBP) Hum Genet. 1993;92:183–8.
    1. Song M, Konijeti GG, Yuan C, Ananthakrishnan AN, Ogino S, Fuchs CS, et al. Plasma 25-hydroxyvitamin D, vitamin D binding protein, and risk of colorectal cancer in the nurses’ health study. Cancer Prev Res (Phila) 2016;9:664–72.
    1. Muscogiuri G, Altieri B, Annweiler C, Balercia G, Pal HB, Boucher BJ, et al. Vitamin D and chronic diseases: the current state of the art. Arch Toxicol. 2017;91:97–107.
    1. Muscogiuri G, Altieri B, de Angelis C, Palomba S, Pivonello R, Colao A, et al. Shedding new light on female fertility: the role of vitamin D. Rev Endocr Metab Disord. 2017;18:273–83.
    1. Anastasi E, Fuggetta E, De Vito C, Migliara G, Viggiani V, Manganaro L, et al. Low levels of 25-OH vitamin D in women with endometriosis and associated pelvic pain. Clin Chem Lab Med. 2017;55:e282.
    1. Harris HR, Chavarro JE, Malspeis S, Willett WC, Missmer SA. Dairyfood, calcium, magnesium, and vitamin D intake and endometriosis: a prospective cohort study. Am J Epidemiol. 2013;177:420–30.
    1. Hartwell D, Rodbro P, Jensen SB, Thomsen K, Christiansen C. Vitamin D metabolites--relation to age, menopause and endometriosis. Scand J Clin Lab Invest. 1990;50:115–21.
    1. Somigliana E, Panina-Bordignon P, Murone S, Di Lucia P, Vercellini P, Vigano P. Vitamin D reserve is higher in women with endometriosis. Hum Reprod. 2007;22:2273–8.
    1. Miyashita M, Koga K, Izumi G, Sue F, Makabe T, Taguchi A, et al. Effects of 1,25-dihydroxy vitamin D3 on endometriosis. J Clin Endocrinol Metab. 2016;101:2371–9.
    1. de Ziegler D, Borghese B, Chapron C. Endometriosis and infertility: pathophysiology and management. Lancet. 2010;376:730–8.
    1. Shen A, Xu S, Ma Y, Guo H, Li C, Yang C, et al. Diagnostic value of serum CA125, CA19-9 and CA15-3 in endometriosis: a metaanalysis. J Int Med Res. 2015;43:599–609.
    1. Mgodi NM, Kelly C, Gati B, Greenspan S, Dai JY, Bragg V, et al. Factors associated with bone mineral density in healthy African women. Arch Osteoporos. 2015;10:206.

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