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ORIGINAL RESEARCH article

Front. Nutr.
Sec. Nutritional Epidemiology
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1513191

Association between serum carotenoids levels and endometriosis risk: evidence from the National Health and Nutrition Examination Survey

Provisionally accepted
Jian Huang Jian Huang *
  • First Affiliated Hospital, Guangxi Medical University, Nanning, China

The final, formatted version of the article will be published soon.

    Background: The relationship between serum levels of carotenoids and endometriosis remains largely unknown. The aim of this study is to assess the association between serum levels of major carotenoids (ɑ-carotene, β-carotene, β-cryptoxanthin, lutein/zeaxanthin, and trans-lycopene) and the risk of endometriosis in US women. Methods: The data were obtained from the 2001-2006 National Health and Nutrition Examination Surveys (NHANES), which included a total of 3,636 women aged 20 to 54. Serum levels of ɑ-carotene, β-carotene, β-cryptoxanthin, lutein/zeaxanthin, and trans-lycopene were measured using high performance liquid chromatography (HPLC) with photodiode array detection. Endometriosis was defined as self-report. Weighted multivariate logistic regression analyses were conducted to evaluate the associations of the serum levels of the major carotenoids with endometriosis risk. Additionally, restricted cubic spline (RCS) was employed to assess the possibility of nonlinear associations. Finally, subgroup analyses were utilized to estimate the influence of several covariates on the associations. Results: Weighted multivariate logistic regression analyses showed that, after adjusting for all covariates taken into account, there was a significant association between serum lutein/zeaxanthin levels and reduced risk of endometriosis (Quartile 3 vs Quartile 1: odds ratio [OR]=0.62, 95% confidence interval [CI]: 0.42-0.90; Quartile 4 vs Quartile 1: OR=0.54, 95% CI: 0.36-0.81, P for trend=0.001). However, no significant associations of serum levels of other carotenoids with endometriosis were found in multivariable-adjusted models that included all covariates. RCS analysis did not reveal any non-linear relationships. Subgroup analyses indicated that the inverse association between serum lutein/zeaxanthin levels and reduced endometriosis risk was significant only in individuals under 40 years of age, in both White and non-White populations, in smokers, and among those who had ever used oral contraceptives. Conclusion: Serum lutein/zeaxanthin levels may offer protective effects against endometriosis in specific subpopulations. Further prospective research is necessary to validate these findings.

    Keywords: Endometriosis, risk, Carotenoids, Serum lutein/zeaxanthin levels, NHANES

    Received: 21 Oct 2024; Accepted: 03 Jan 2025.

    Copyright: © 2025 Huang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Jian Huang, First Affiliated Hospital, Guangxi Medical University, Nanning, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.