Vitamin D deficiency and pain severity in endometriosis: a phenotype-based retrospective observational study
BMC Women's Health, cilt.26, sa.1, 2026 (SCI-Expanded, SSCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 26 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.1186/s12905-026-04542-8
- Dergi Adı: BMC Women's Health
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Anahtar Kelimeler: Biomarker, Deep infiltrating endometriosis, Endometriosis, Ovarian endometrioma, Vitamin D
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: To evaluate the association between serum 25-hydroxyvitamin D [25(OH)D] levels and pain severity in women with surgically and histopathologically confirmed endometriosis, and to assess whether this association differs between ovarian endometrioma (OE) and deep infiltrating endometriosis (DIE) phenotypes. Methods: This retrospective observational analytical study included 427 women with surgically confirmed endometriosis. Patients were classified according to dominant phenotype as OE (n=231) or DIE (n=196). Serum 25(OH)D levels were categorized as deficient (<20 ng/mL), insufficient (20–30 ng/mL), and sufficient (≥30 ng/mL). Pain severity—including dysmenorrhea, chronic pelvic pain, and dyspareunia—was assessed using the Visual Analog Scale (VAS). Multivariable linear regression analyses were performed to examine the association between vitamin D levels and pain scores, adjusting for age, body mass index, and seasonal variation. Results: Serum 25(OH)D levels were inversely associated with all pain parameters (p<0.001). Patients with vitamin D deficiency had higher median VAS scores compared to those with sufficient levels [7.0 (6.0–8.0) vs 4.0 (3.0–5.0), p<0.001]. In multivariable analyses, lower 25(OH)D levels remained significantly associated with higher pain severity (β = -0.28, p<0.001). A significant interaction between vitamin D levels and disease phenotype was observed (interaction p=0.004), suggesting that the association between lower vitamin D levels and higher pain scores was more pronounced in patients with the DIE phenotype compared to those with OE. A threshold value of 18.5 ng/mL demonstrated 74% sensitivity for identifying patients with severe pain (VAS ≥7). Conclusion: Lower serum vitamin D levels are significantly associated with greater pain severity in women with endometriosis, with a stronger association observed in the DIE phenotype. However, given the retrospective and cross-sectional nature of the analysis, causality cannot be inferred. Prospective studies are needed to further clarify these associations and their potential clinical implications.