Association of leptin and adiponectin levels with endometriosis: a systematic review and meta-analysis

Abstract

Background

We aimed to summarize the available data regarding the levels of leptin and adiponectin and the key modulators of endometriosis compared to the controls.

Methods

The electronic databases such as MEDLINE, Embase, Scopus, Cochrane Library, and Web of Science were searched up to October 2020. The circulating and peritoneal levels of leptin and circulating levels of adiponectin were included. We used the Cochrane’s Q test and the I² statistic in this study. These tests’ weighted mean difference (WMD) and 95% CIs were considered as the summary effect size. They were then pooled using a random-effects model with the DerSimonian-Laird method.

Results

Twenty eligible articles (or 25 studies) with 2645 participants (1362 women with endometriosis and 1283 controls) were included. Pooled results showed that women with endometriosis had significantly higher leptin levels (WMD = 4.45 mg/ml, 95%CI = 2.42–6.49, p < .01) and leptin/BMI ratio (WMD = 0.32 mg/ml, 95%CI = 0.23–0.42, p < .001) than the controls, whereas adiponectin levels (WMD = −0.24 mg/ml, 95%CI = −4.27 to −0.01, p = .038) were significantly lower. The pooled results also indicated significantly lower leptin levels in women with advanced-stage endometriosis (WMD = −8.07 mg/ml, 95%CI = −14.22 to −1.92, p = .01) than in the early stage. It was found, however, that there were no significant differences in adiponectin levels of women with advanced-stage endometriosis (WMD = −0.16 mg/ml, 95%CI = −0.64 to 0.32, p = .512) and the early-stage ones.

Conclusion

We showed that leptin levels and leptin/BMI ratio were significantly higher in women with endometriosis than the controls. Nonetheless, patients with endometriosis had significantly lower levels of adiponectin than the controls.

摘要

背景：我们旨在总结有关瘦素和脂联素水平以及子宫内膜异位症与对照组相比关键调节因子的可用数据。

方法：方法:检索截至2020年10月的MEDLINE、Embase、Scopus、Cochrane Library、Web of Science等电子数据库。包括循环和腹膜中瘦素水平和循环脂联素水平。本研究采用Cochrane’ Q检验和I²统计量检验。这些检验加权平均差异(WMD)和95%CI被认为是总效应量。然后应用随机效应模型和DerSimonian-Laird方法将他们集中起来。

结果：本研究纳入20篇符合条件的文章（25项研究）, 共有2645名受试者（1362名患有子宫内膜异位症的女性和1283名对照者）。汇总结果显示, 患有子宫内膜异位症女性的瘦素水平（WMD=4.45 mg/ml, 95%CI=2.42–6.49, p<.01）以及瘦素/BMI比值（WMD=0.32 mg/ml, 95%CI=0.23–0.42, p<.001)显著高于对照组, 而脂联素水平(WMD=-0.24 mg/ml, 95%CI=-4.27至-0.01, p=.038)显著低于对照组。汇总结果还表明, 患有晚期子宫内膜异位症（WMD=-8.07 mg/ml, 95%CI=-14.22 至 -1.92, p=.01）女性的瘦素水平显著低于早期患者。然而, 研究表明晚期子宫内膜异位症（WMD=-0.16 mg/ml, 95%CI=-0.64 to 0.32, p=.512）和早期子宫内膜异位症女性的脂联素水平没有显著差异。

结论：本研究发现患有子宫内膜异位症女性的瘦素水平和瘦素/BMI比值显著高于对照组。尽管如此, 子宫内膜异位症患者的脂联素水平显著低于对照组。

Keywords:

• Leptin
• adiponectin
• adipokine
• endometriosis
• meta-analysis

Disclosure statement

None of the authors have any conflict of interest to declare regarding the manuscript.

Additional information

Funding

1.  The Plan of Gusu Health Talents in Gusu District, Suzhou city, Jiangsu Province is stratified into key talents. No.2020076 2. Excellent talent Training program of General Practice of Chinese Medical Doctors Association. 3. Jiangsu Suzhou Science and Technology People's Livelihood Project. SYSD2019065,SYSD2019066