Virginia Research Day 2025

Medical Student Research Clinical

36 Exploring the Association Between Body Mass Index, Race, and Endometriosis in Women of Reproductive Age: A Large-Scale Cohort Analysis

Erin Onken, OMS-II; Elizabeth Yi, OMS-II; Cara Satoskar, OMS-II; Kaitlyn McGinley, OMS-II; Maryam Zahid, OMS-II; Anita Register, DO; Ramzi Badra, OMS-II; Leona Jafari, OMS-II, Corresponding author: eonken@vcom.edu

Edward Via College of Osteopathic Medicine - Virginia Campus

matching (PSM) was employed to create a balanced cohort by 1:1 matching ENDO cases with controls. Variance across age and race was verified using an F-test. To test the significance of BMI differences between ENDO patients and controls, a two-sample t-test assuming equal variances was applied. Multiple analyses were conducted across different racial groups. Chi-square analysis was utilized to compare race between the two groups. Results: While the difference in BMI between the endometriosis (ENDO) group and controls was statistically significant (p = 2.93E-126), the clinical significance of this finding appears limited. This result was consistent across racial groups, with only minor differences observed in certain subgroups. This study reveals a statistically significant difference between observed rates of endometriosis diagnosis and expected rates of diagnosis in those patients who identified as Asian or Black or African American. In Asian patients, 21 patients were observed to have endometriosis compared to 46 expected patients (p<.01). In Black or African Americans, 80 patients were observed to have endometriosis compared to 125 expected patients (p<.01).

Introduction: Endometriosis (ENDO) is a chronic gynecological condition affecting approximately 10% of women of reproductive age globally. It is characterized by endometrial-like tissue growing outside the uterus, leading to significant pain, infertility, and a reduced quality of life. Despite its prevalence, endometriosis remains underdiagnosed, particularly among minority populations, due to systemic biases and social determinants of health. Body mass index (BMI) has been investigated as a potential influence on endometriosis risk and severity, though findings are inconclusive. Some research links lower BMI to a higher risk, while other studies suggest no association or a protective effect with higher BMI. This retrospective cohort study aims to assess the correlation between BMI and endometriosis risk and analyze racial disparities in diagnosed endometriosis using data from the All of Us Research Database. Methods: After excluding participants with incomplete data, we identified 3,060 white participants diagnosed with endometriosis (ENDO) from an initial sample of 194,624 participants who identified as female at birth. Propensity score

Conclusions: Although this study identified statistically significant differences in BMI between individuals with endometriosis (ENDO) and controls, the minimal variation in mean BMI suggests limited clinical relevance. These findings indicate that BMI may not be a strong or reliable measure for identifying or predicting endometriosis risk. The results of this study show a clear relationship between race and endometriosis, especially in terms of potential underdiagnosis in minority populations. Future research should investigate a larger sample size of patients as most of the patients in this study’s data identified as white. This study highlights a need to identify barriers and implement interventions to ensure that minority populations are provided access to adequate care and properly considered when diagnosing endometriosis. Future research should explore more specific and comprehensive biomarkers, clinical characteristics, and socioeconomic factors to better understand endometriosis risk.

VCOM IRB RECORD #: 2024-225

159 2025 Research Recognition Day