Serum and peritoneal fluid leptin levels in endometriosis: a systematic review and meta-analysis

Abstract

The role of leptin in the development of endometriosis has been investigated previously. However, researches on the change of leptin levels in endometriosis remains controversial. So, we aimed to clarify changes of leptin levels in patients with endometriosis and their association with the progression of endometriosis. We searched PubMed, Embase, Web of Science, and The Cochrane Library to identify relevant studies published before May 25, 2020. The detected levels of leptin in patients with endometriosis versus controls were evaluated in this meta-analysis. Eighteen studies met our inclusion criteria, five studies detected serum, nine detected peritoneal fluid and another four detected both serum and peritoneal fluid leptin levels. The overall results showed that peritoneal fluid leptin levels in patients with endometriosis was significantly higher than that in the control group, but the serum and corrected peritoneal fluid leptin levels were comparable in both groups. Subgroup analysis failed to eliminate the high degree of heterogeneity included in the studies and showed that peritoneal fluid leptin levels were significantly elevated in both early and advanced endometriosis. In conclusion, peritoneal fluid rather than serum leptin levels was elevated in patients with endometriosis, which did not seem to be related to the severity of endometriosis, but was related to body mass index.

子宫内膜异位症患者血清和腹腔液瘦素水平的系统回顾和meta分析 摘要

瘦素在子宫内膜异位症发生发展中的作用已有研究。然而, 关于子宫内膜异位症瘦素水平变化的研究仍存在争议。因此, 本研究旨在探讨子宫内膜异位症患者瘦素水平的变化及其与子宫内膜异位症进展的关系。我们检索了PubMed、Embase、Web of Science和Cochrane Library, 以确定2020年5月25日之前发表的相关研究。这项meta分析评估了子宫内膜异位症患者与对照组的瘦素水平。18项研究符合我们的纳入标准, 5项研究检测了血清, 9项研究检测了腹腔液, 另外4项研究同时检测了血清和腹腔液瘦素水平。总的结果表明, 子宫内膜异位症患者腹腔液瘦素水平明显高于对照组, 而血清和校正后的腹腔液瘦素水平在两组间具有可比性。亚组分析未能消除研究中包含的高度异质性, 并显示腹腔液瘦素水平在早期和进展期子宫内膜异位症中均有显著升高。总之, 子宫内膜异位症患者中腹腔液而不是血清瘦素水平升高, 这似乎与子宫内膜异位症的严重程度无关, 但与体重指数有关。

Keywords:

• Serum
• peritoneal fluid
• endometriosis
• leptin
• meta-analysis

Disclosure statement

The authors declare that they have no conflicts of interest.

Additional information

Funding

This work was supported by the Peking University Medicine Seed Fund for Interdisciplinary Research which was supported by ‘the Fundamental Research Funds for the Central Universities’ [No：BMU2020MX003].