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已发表论文
1999 至 2006 年美国国家健康与营养调查（NHANES）中残余胆固醇与子宫内膜异位症之间的关联研究
Authors Su L, Wang X, Zhang J, Xu R, Ren Y, Wang S
Received 9 October 2025
Accepted for publication 19 December 2025
Published 30 December 2025 Volume 2025:17 Pages 5709—5718
DOI https://doi.org/10.2147/IJWH.S568397
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Everett Magann
Luyang Su,1,* Xiaona Wang,2,* Junqin Zhang,2,* Ren Xu,3,* Yanan Ren,2,* Shaoqing Wang4,*
1Physical Examination Center, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China; 2Department of Obstetrics and Gynecology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China; 3Quality Management Department, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China; 4Department of Reproductive Medicine, the Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Shaoqing Wang, Email wsq06021010407@hebmu.edu.cn
Background: Endometriosis is a chronic gynecological disorder causing significant morbidity and health burden. Recent evidence suggests that lipid metabolism, particularly remnant cholesterol (RC), may be involved in its development. RC—the cholesterol content of triglyceride-rich lipoproteins (TGRLs), including chylomicrons, very low-density lipoproteins (VLDL), and intermediate-density lipoproteins (IDL). Elevated RC is closely associated with arteriosclerosis and increased cardiovascular disease incidence, making it a valuable biomarker for assessing cardiovascular health. This study explores the association between RC levels and endometriosis prevalence in a representative sample of women.
Methods: Using cross-sectional data from NHANES (1999– 2006), we analyzed 1,979 women aged 20– 54 years. Weighted logistic regression models were applied to assess the relationship between RC and endometriosis. Three models were used: unadjusted (Model 1), adjusted for age, ethnicity, education, and marital status (Model 2), and fully adjusted for additional variables (Model 3). Subgroup analyses and smoothing curve fitting were also performed.
Results: Elevated RC levels were significantly associated with higher endometriosis prevalence across all models. Each 1 mg/dL above the mean level of RC was linked to a 2.3% higher incidence of endometriosis (Model 1: OR 1.023, 95% CI 1.009– 1.036, p = 0.001; Model 2: OR 1.022, p = 0.004; Model 3: OR 1.023, p = 0.022). Individuals in the highest RC tertile had a higher incidence of endometriosis compared to the lowest tertile (OR 1.833, p for trend = 0.077). A linear dose-response relationship was identified, with no threshold or saturation effects.
Conclusion: The study indicates a strong correlation between elevated RC levels and increased endometriosis incidence, highlighting the potential role of lipid metabolism in endometriosis development.
Keywords: remnant cholesterol, endometriosis, lipid metabolism, inflammation, NHANES
1Physical Examination Center, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China; 2Department of Obstetrics and Gynecology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China; 3Quality Management Department, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China; 4Department of Reproductive Medicine, the Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Shaoqing Wang, Email wsq06021010407@hebmu.edu.cn
Background: Endometriosis is a chronic gynecological disorder causing significant morbidity and health burden. Recent evidence suggests that lipid metabolism, particularly remnant cholesterol (RC), may be involved in its development. RC—the cholesterol content of triglyceride-rich lipoproteins (TGRLs), including chylomicrons, very low-density lipoproteins (VLDL), and intermediate-density lipoproteins (IDL). Elevated RC is closely associated with arteriosclerosis and increased cardiovascular disease incidence, making it a valuable biomarker for assessing cardiovascular health. This study explores the association between RC levels and endometriosis prevalence in a representative sample of women.
Methods: Using cross-sectional data from NHANES (1999– 2006), we analyzed 1,979 women aged 20– 54 years. Weighted logistic regression models were applied to assess the relationship between RC and endometriosis. Three models were used: unadjusted (Model 1), adjusted for age, ethnicity, education, and marital status (Model 2), and fully adjusted for additional variables (Model 3). Subgroup analyses and smoothing curve fitting were also performed.
Results: Elevated RC levels were significantly associated with higher endometriosis prevalence across all models. Each 1 mg/dL above the mean level of RC was linked to a 2.3% higher incidence of endometriosis (Model 1: OR 1.023, 95% CI 1.009– 1.036, p = 0.001; Model 2: OR 1.022, p = 0.004; Model 3: OR 1.023, p = 0.022). Individuals in the highest RC tertile had a higher incidence of endometriosis compared to the lowest tertile (OR 1.833, p for trend = 0.077). A linear dose-response relationship was identified, with no threshold or saturation effects.
Conclusion: The study indicates a strong correlation between elevated RC levels and increased endometriosis incidence, highlighting the potential role of lipid metabolism in endometriosis development.
Keywords: remnant cholesterol, endometriosis, lipid metabolism, inflammation, NHANES