Introduction

Endometriosis is an inflammatory condition, affecting mainly women of reproductive age. Leptin is a regulator of food intake and energy expenditure, posing pleiotropic actions, and regulating immunity and fertility. The aim of this study was to systematically review the literature regarding leptin concentrations in biological fluids and tissues of women with endometriosis, and to investigate and propose a possible role of leptin in the pathophysiology of endometriosis.

Materials and methods

A systematic search of the literature was conducted in two electronic databases (MEDLINE, COCHRANE) and grey literature for original research articles on humans, published in any language.

Results

Twenty-nine studies with 1291 women with endometriosis and 1664 controls were included in the systematic review. Peritoneal fluid and follicular fluid leptin concentrations were higher in endometriosis compared with control group [mean difference (MD) 7.10, 95 % confidence interval (CI) 4.76 to 9.44 ng/mL, 18 studies), (MD 1.35, 95 % CI 0.54–2.17 ng/ml, 2 studies) respectively. No differences were evident in serum (MD 0.92, 95 % CI -0.84 to 2.68 ng/mL, 12 studies) or plasma (MD -0.95, 95 % CI -4.63 to 2.72 ng/mL, 3 studies) between the groups. No meta-analysis was conducted for ovarian tissue leptin (2 studies).

Conclusions

This meta-analysis provided evidence for increased leptin concentrations in both peritoneal fluid and follicular fluid of women with endometriosis compared with control; these differences were not present in the serum or plasma. The above results support a potential pathophysiologic role for leptin in the local microenvironment while declines its use as a blood diagnostic marker. Furthermore, we propose a possible role of leptin in the pathophysiology of endometriosis.

中文翻译：

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子宫内膜异位症中的瘦素浓度：系统评价和荟萃分析

介绍

子宫内膜异位症是一种炎症性疾病，主要影响育龄妇女。瘦素是食物摄入和能量消耗的调节剂，具有多效性，并调节免疫和生育能力。本研究的目的是系统回顾有关子宫内膜异位症女性生物体液和组织中瘦素浓度的文献，并研究并提出瘦素在子宫内膜异位症病理生理学中的可能作用。

材料和方法

在两个电子数据库（MEDLINE、COCHRANE）和灰色文献中对以任何语言发表的关于人类的原始研究文章进行了系统的文献检索。

结果

系统评价纳入了 29 项研究，涉及 1291 名患有子宫内膜异位症的女性和 1664 名对照。与对照组相比，子宫内膜异位症的腹膜液和卵泡液瘦素浓度更高 [平均差 (MD) 7.10, 95 % 置信区间 (CI) 4.76 至 9.44 ng/mL, 18 项研究), (MD 1.35, 95 % CI 0.54– 2.17 ng/ml，2 项研究）。血清（MD 0.92，95 % CI -0.84 至 2.68 ng/mL，12 项研究）或血浆（MD -0.95，95 % CI -4.63 至 2.72 ng/mL，3 项研究）在组间没有明显差异。没有对卵巢组织瘦素进行荟萃分析（2 项研究）。

结论

这项荟萃分析提供了与对照组相比，子宫内膜异位症女性腹膜液和卵泡液中瘦素浓度增加的证据；这些差异在血清或血浆中不存在。上述结果支持瘦素在局部微环境中的潜在病理生理作用，同时拒绝将其用作血液诊断标志物。此外，我们提出瘦素可能在子宫内膜异位症的病理生理学中发挥作用。