Association of Vitamin D Level and Its Receptor With Endometriosis
Endometriosis, a condition where endometrial-like tissue grows outside the uterus, often occurs due to retrograde menstruation, where menstrual blood flows backward through the fallopian tubes into the pelvic cavity. This tissue can then implant and grow within the pelvic peritoneum. The survival of these ectopic implants leads to chronic inflammation, adhesion formation, and scarring of surrounding tissues, including the ovaries and fallopian tubes. Symptoms include cyclic pelvic pain, dysmenorrhea, dyspareunia, and infertility.

Ectopic endometrial tissue survival is not attributed to mutations but rather epigenetic changes. Studies have linked this phenomenon to genes such as KRAS (Kirsten Rat Sarcoma Virus Oncogene), involved in cell proliferation and survival. Dysregulated KRAS activity can lead to increased production of MMP-2 and MMP-9 proteins, implicated in angiogenesis and tissue invasion, facilitating the spread of endometrial tissue.

Vitamin D has been shown to modulate immune function and reduce inflammation. Studies suggest that vitamin D deficiency may exacerbate endometriosis symptoms and severity. However, evidence regarding the efficacy of vitamin D supplementation in managing endometriosis symptoms is mixed.

One study found that long-term intake of vitamin D-rich foods was associated with an 18% lower risk of developing endometriosis. Additionally, vitamin D deficiency has been correlated with increased expression of mutated KRAS in colorectal cancer patients, suggesting a potential link between vitamin D status and genetic abnormalities in disease progression.

Further research is needed to fully understand the relationship between vitamin D deficiency and endometriosis severity, particularly in specific populations like the Thai population.
- EligibilityCriteria: Inclusion Criteria Endometriosis Group:  Women diagnosed with ectopic endometriotic tissue: Have a scheduled surgery appointment at Sri Nakarin Hospital. Are aged 18 years or older.  Inclusion Criteria Control Group:  Women undergoing examination at the outpatient department of Sri Nakarin Hospital. No history of gynecological diseases or previous treatment for gynecological conditions associated with lower abdominal pain, infections, or abdominal masses at present. Have undergone a gynecological examination within the past year, or if examined during the current visit, the results were normal. Have undergone an ultrasound examination within the past year, or if examined during the current visit, the ultrasound results were normal.  Exclusion Criteria:  Received vitamin D supplements within the past 3 months prior to volunteering. History of chronic infectious diseases. Previously treated for autoimmune diseases. History of polycystic ovarian. History of bone disorders or receiving medications affecting bones. Irregular menstrual cycles or absence of menstruation for more than 3 months up to 1 year. - HealthyVolunteers: Accepts Healthy Volunteers - Gender: Female - GenderBased: Yes - GenderDescription: Reproductive age - MinimumAge: 18 Years - StdAgeList: Adult, Older Adult - StudyPopulation: Thai women, reproductive age - SamplingMethod: Non-Probability Sample