Review Article

The Formidable yet Unresolved Interplay between Endometriosis and Obesity

Table 2

Summary of the included studies on the correlation between endometriosis and obesity. The studies that found no or positive correlation are in bold.

Type of evidenceComponentSeminal studiesKey findings
First authorYear of publicationRef. no.Type of studyNo. of subjects

ClinicalBMIHemmings R.2004[16]Case-control2.777Inverse correlation between endometriosis and BMI
Ferrero S.2005[6]Case-control614Inverse correlation between endometriosis and BMI
Viganò P.2012[25]Systemic review187,340 (11 studies)Modest inverse correlation between endometriosis and BMI
Shah D. K.2013[8]Prospective cohort116.430Inverse correlation between endometriosis and BMI
Shaha R.201617Cross-sectional27.594No correlation between endometriosis and BMI
Liu Y.2017[18]Meta-analysis128,944 (11 studies)Inverse correlation between endometriosis and BMI
Holdswoth-Carson S. J.2018[20]Retrospective cohort509Inverse correlation between endometriosis and BMI
Jenabi E.2019[19]Meta-analysis96,249 (9 studies)Correlation between underweight and endometriosis but no (inverse) association between overweight and endometriosis
Yun K. Y.2020[21]Case-control416Inverse correlation between endometriosis and BMI
Vaghar M. I.2020[10]Questionnaire-based250Inverse correlation between endometriosis and BMI
PhenomicsViganò P.2012[25]Systemic review269,276 (5 studies)Strong inverse correlation between endometriosis and early life body size
Aarenstrup J.2020[26]Review of national registry171.447Lean and tall girls are more often diagnosed with endometriosis in adult life
Nonweight anthropometricsBackonjia U.2017[27]Cross-sectional473Inverse correlation between endometriosis and weight; subscapular skinfold thickness; waist and hip circumference; total upper arm and upper arm muscle areas; and BMI
Byun J.2020[28]Prospective cohort495Inverse correlation between severity/type of endometriosis and anthropometric/body composition indicators

GeneticGene expressionRahmioglu N.2015[30]Genome-wide association10.254Enrichment of common variants between endometriosis and fat distribution of genetic locus 7p15.2
Goetz L. G.2016[29]Experimental30In a murine model of endometriosis, 4 genes related to weight loss (Mrc1, Rock2, Cyp2r1, and Fabp4) were overexpressed and 2 genes linked to obesity (Igfbp1 and Mmd2) were underexpressed
Vilarinho Cardoso J.201731Case-control356The polymorphism CYP2C19∗2 is positively associated with both endometriosis and high BMI
MicroRNA assaysZolbin M. M.2019[33]Experimental20Endometriosis alters BMI through genetic alterations in adipocyte differentiation and metabolism, propagated by Let-7b and miR-342-3p miRNAs
Holdswoth-Carson S. J.202034Cross-sectional169No association between BMI and altered endometrial gene expression in women with or without endometriosis
MolecularGhrelinDziunycz P.2009[52]Case-control66Endometriosis associated with increased peritoneal ghrelin levels
Milewski L.2012[53]Cross-sectional20Colocalization of ghrelin and its receptor in human ovarian endometrioma tissue samples
Rathore N.2014[54]Cross-sectional50Median levels of ghrelin in patients with endometriosis were lower as compared to patients without endometriosis
LeptinMatarese G.2000[55]Case-control28Early-stage endometriosis is associated with higher leptin levels than advanced-stage disease
Styer A. K.2008[59]Experimental12In a murine model of endometriosis, leptin signaling was necessary for lesion proliferation, early vascular recruitment, and maintenance of neoangiogenesis
Gungor T.2009[58]Prospective cohort112Higher levels of leptin were observed in peritoneal environments of endometriosis subjects
Choi Y. S.2013[61]Case-control86The expressions of leptin and its receptor are induced in ovarian endometrioma tissue samples
Shah D. K.201360Case-control29.611No statistically significant association between endometriosis and leptin espression
Rathore N.2014[54]Cross-sectional50Median levels of leptin in patients with endometriosis were higher as compared to patients without endometriosis
Gonçalves H. F.2015[57]Case-control25Serum leptin levels were increased in patients versus controls, whereas there was no difference in peritoneal leptin levels
AdiponectinTakemura Y.2005[64]Case-control80Adiponectin concentrations in peritoneal fluid of women with endometriosis were significantly lower than those of women without it
Takemura Y.2005[65]Case-control78Adiponectin concenterations in serum of women with endometriosis were significantly lower than those of women without it
Choi Y. S.2013[61]Case-control86The expression of adiponectin and its receptor is similar between endometriosis and normal controls
Shah D. K.201360Case-control29.611No statistically significant association between endometriosis and adiponectin expression
ChemerinJin C. H.2015[68]Case-control79Chemerin concentrations in peritoneal fluid and serum are higher in women with endometriosis than controls