Association between serum carotenoids and risk of endometriosis evidence from NHANES data

Endometriosis is a prevalent gynecological disorder, with its pathogenesis potentially linked to oxidative stress. Carotenoids, as natural antioxidants, may play a role in its prevention. This study aimed to investigate the association between serum carotenoid levels and the prevalence of endometriosis. This cross-sectional analysis utilized data from the National Health and Nutrition Examination Survey 2001 to 2006, including 1825 female participants. Survey-weighted logistic regression models were used to assess the associations between serum levels of α-carotene, β-carotene, lycopene, β-cryptoxanthin, lutein/zeaxanthin, and total carotenoids with endometriosis prevalence, adjusting for age, body mass index, poverty income ratio, education level, race/ethnicity, smoking status, age at menarche, and number of pregnancies. Higher serum levels of α-carotene (odds ratio [OR] = 0.94, 95% confidence interval [CI]: 0.89-0.99, P = .048), β-carotene (OR = 0.98, 95% CI: 0.96-1.00, P = .038), lycopene (OR = 0.95, 95% CI: 0.91-0.99, P = .021), and total carotenoids (OR = 0.99, 95% CI: 0.98-1.00, P = .044) were significantly associated with a lower prevalence of endometriosis. However, β-cryptoxanthin (OR = 0.94, 95% CI: 0.88-1.01, P = .12) and lutein/zeaxanthin (OR = 1.00, 95% CI: 0.97-1.03, P = .92) were not significantly associated with endometriosis. Subgroup analysis revealed a significant interaction between β-carotene levels and age at menarche (P for interaction < .05). These findings suggest that higher serum levels of α-carotene, β-carotene, lycopene, and total carotenoids may be associated with a lower prevalence of endometriosis. This study highlights the potential role of carotenoid-rich diets in mitigating endometriosis risk; however, further prospective studies are warranted to confirm these associations and explore underlying biological mechanisms.