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Causal Effect Between Natural Hair Color and Endometriosis in a European Population: A Two-Sample Mendelian Randomization

Published online by Cambridge University Press:  25 February 2025

Yuping Zhang
Affiliation:
West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan, China
Ying Feng*
Affiliation:
West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan, China
*
Corresponding author: Ying Feng; Email: [email protected]
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Abstract

Previous observational studies have suggested an association between natural hair color and the risk of endometriosis; however, the causal relationship remains unclear. Here, we conducted a two-sample Mendelian randomization (MR) study to evaluate the potential causal link between natural hair color and endometriosis using 428 single nucleotide polymorphisms (SNPs) as genetic instruments derived from a genomewide meta-analysis comprising over 4511 cases and 227,260 controls of European ancestry. Our findings indicate that dark brown hair is associated with a decreased risk of developing endometriosis (dark brown IVW OR: 0.844, 95% CI [0.725, 0.984], p < .05). Conversely, dark hair color and lighter hair colors (red, blonde, and light brown) did not demonstrate a significant association with endometriosis risk (dark IVW OR: 0.568, 95% CI [0.280, 1.15], p = .117; red IVW OR: 1.058, 95% CI [0.719, 1.558], p = .77; blonde IVW OR: 1.158, 95% CI [0.886, 1.514], p = .28; light brown IVW OR: 1.306, 95% CI [0.978, 1.743], p = .07). These results provide compelling MR evidence supporting a causal association between natural hair color and endometriosis risk. Our findings underscore the need for larger scale studies and randomized controlled trials to delineate the biological mechanisms driving the association between hair color and endometriosis.

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Article
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© The Author(s), 2025. Published by Cambridge University Press on behalf of International Society for Twin Studies

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References

Agarwal, S. K., Chapron, C., Giudice, L. C., Laufer, M. R., Leyland, N., Missmer, S. A., Singh, S. S., & Taylor, H. S. (2019). Clinical diagnosis of endometriosis: A call to action. American Journal of Obstetrics & Gynecology, 220, 354.e351354.e312. https://doi.org/10.1016/j.ajog.2018.12.039 CrossRefGoogle ScholarPubMed
Bohn, J. A., Bullard, K. A., Rodriguez, M. I., & Ecker, A. M. (2021). Stepwise approach to the management of endometriosis-related dysmenorrhea: A cost-effectiveness analysis. Obstetrics & Gynecology, 138, 557564. https://doi.org/10.1097/aog.0000000000004536 Google Scholar
Bowden, J., Davey Smith, G., Haycock, P. C., & Burgess, S. (2016). Consistent estimation in Mendelian randomization with some invalid instruments using a weighted median estimator. Genetic Epidemiology, 40, 304314. https://doi.org/10.1002/gepi.21965 CrossRefGoogle ScholarPubMed
Bowden, J., Del Greco, M. F., Minelli, C., Zhao, Q., Lawlor, D. A., Sheehan, N. A., Thompson, J., & Davey Smith, G. (2019). Improving the accuracy of two-sample summary-data Mendelian randomization: moving beyond the NOME assumption. International Journal of Epidemiology, 48, 728742. https://doi.org/10.1093/ije/dyy258 CrossRefGoogle ScholarPubMed
Bowden, J., Hemani, G., & Davey Smith, G. (2018). Invited commentary: Detecting individual and global horizontal pleiotropy in Mendelian randomization ¾- A job for the humble heterogeneity statistic? American Journal of Epidemiology, 187, 26812685. https://doi.org/10.1093/aje/kwy185 Google ScholarPubMed
Bowden, S. J., Kalliala, I., Veroniki, A. A., Arbyn, M., Mitra, A., Lathouras, K., Mirabello, L., Chadeau-Hyam, M., Paraskevaidis, E., Flanagan, J. M., & Kyrgiou, M. (2019). The use of human papillomavirus DNA methylation in cervical intraepithelial neoplasia: A systematic review and meta-analysis. EBioMedicine, 50, 246259. https://doi.org/10.1016/j.ebiom.2019.10.053 CrossRefGoogle ScholarPubMed
Burgess, S., & Thompson, S. G. (2017). Erratum to: Interpreting findings from Mendelian randomization using the MR-Egger method. European Journal of Epidemiology, 32, 391392. https://doi.org/10.1007/s10654-017-0276-5 CrossRefGoogle ScholarPubMed
Cardoso, J. V., Abrão, M. S., Vianna-Jorge, R., Ferrari, R., Berardo, P. T., Machado, D. E., & Perini, J. A. (2017). Combined effect of vascular endothelial growth factor and its receptor polymorphisms in endometriosis: A case-control study. European Journal of Obstetrics & Gynecology and Reproductive Biology, 209, 2533. https://doi.org/10.1016/j.ejogrb.2016.10.046 CrossRefGoogle ScholarPubMed
Dai, J., Li, T. Y., Cho, E., Qureshi, A. A., & Li, W. Q. (2022). Hair color and risk of keratinocyte carcinoma in US women and men. Journal of the American Academy of Dermatology, 86, 234237. https://doi.org/10.1016/j.jaad.2021.01.099 CrossRefGoogle ScholarPubMed
Dai, Y., Zhang, X., Xue, M., Zhou, Y., Sun, P., & Leng, J. (2019). Not having been breastfed may protect Chinese women from developing deep infiltrating endometriosis: Results from subgroup analyses of the FEELING Study. Reproductive Sciences, 26, 11581167. https://doi.org/10.1177/1933719118820469 CrossRefGoogle ScholarPubMed
Davenport, S., Smith, D., & Green, D. J. (2023). Barriers to a timely diagnosis of endometriosis: A qualitative systematic review. Obstetrics & Gynecology, 142, 571583. https://doi.org/10.1097/aog.0000000000005255 CrossRefGoogle ScholarPubMed
Davies, N. M., Holmes, M. V., & Davey Smith, G. (2018). Reading Mendelian randomisation studies: A guide, glossary, and checklist for clinicians. BMJ, 362, k601. https://doi.org/10.1136/bmj.k601 CrossRefGoogle ScholarPubMed
Eiberg, H., & Mohr, J. (1987). Major locus for red hair color linked to MNS blood groups on chromosome 4. Clinical Genetics, 32, 125128. https://doi.org/10.1111/j.1399-0004.1987.tb03339.x CrossRefGoogle ScholarPubMed
Eiberg, H., Mohr, J., Nielsen, L. S., & Simonsen, N. (1983). Genetics and linkage relationships of the C3 polymorphism: discovery of C3-Se linkage and assignment of LES-C3-DM-Se-PEPD-Lu synteny to chromosome 19. Clinical Genetics, 24, 159170. https://doi.org/10.1111/j.1399-0004.1983.tb02233.x CrossRefGoogle ScholarPubMed
Elsworth, B., Lyon, M., Alexander, T., Liu, Y., Matthews, P., Hallett, J., Bates, P., Palmer, T., Haberland, V., Smith, G. D., Zheng, J., Haycock, P., Gaunt, T. R., Hemani, G. (2020). The MRC IEU OpenGWAS data infrastructure. bioRxiv. Preprint. https://doi.org/10.1101/2020.08.10.244293 CrossRefGoogle Scholar
Farland, L. V., Degnan, W. J., Harris, H. R., Han, J., Cho, E., VoPham, T., Kvaskoff, M., & Missmer, S. A. (2021). Recreational and residential sun exposure and risk of endometriosis: A prospective cohort study. Human Reproduction, 36, 199210. https://doi.org/10.1093/humrep/deaa280 Google ScholarPubMed
Flegr, J., & Sýkorová, K. (2019). Skin fairness is a better predictor for impaired physical and mental health than hair redness. Scientific Reports, 9, 18138. https://doi.org/10.1038/s41598-019-54662-5 CrossRefGoogle ScholarPubMed
Flores-Torres, M. H., Bjornevik, K., Zhang, X., Gao, X., Hung, A. Y., Schwarzschild, M. A., Chen, X., & Ascherio, A. (2024). Hair color, family history of melanoma, and the risk of Parkinson’s disease: An analysis update. Parkinsonism & Related Disorders, 119, 105965. https://doi.org/10.1016/j.parkreldis.2023.105965 CrossRefGoogle ScholarPubMed
Frisch, R. E., Wyshak, G., Albert, L. S., & Sober, A. J. (1992). Dysplastic nevi, cutaneous melanoma, and gynecologic disorders. International Journal of Dermatology, 31, 331335. https://doi.org/10.1111/j.1365-4362.1992.tb03948.x CrossRefGoogle ScholarPubMed
Frost, P., Kleisner, K., & Flegr, J. (2017). Health status by gender, hair color, and eye color: Red-haired women are the most divergent. PLoS One, 12, e0190238. https://doi.org/10.1371/journal.pone.0190238 CrossRefGoogle ScholarPubMed
Griffiths, M. J., Horne, A. W., Gibson, D. A., Roberts, N., & Saunders, P. T. K. (2024). Endometriosis: Recent advances that could accelerate diagnosis and improve care. Trends in Molecular Medicine, 30, 875889. https://doi.org/10.1016/j.molmed.2024.06.008 CrossRefGoogle ScholarPubMed
Halme, J., Becker, S., & Haskill, S. (1987). Altered maturation and function of peritoneal macrophages: Possible role in pathogenesis of endometriosis. American Journal of Obstetrics & Gynecology, 156, 783789. https://doi.org/10.1016/0002-9378(87)90333-4 CrossRefGoogle ScholarPubMed
Hartwig, F. P., Davey Smith, G., & Bowden, J. (2017). Robust inference in summary data Mendelian randomization via the zero modal pleiotropy assumption. International Journal of Epidemiology, 46, 19851998. https://doi.org/10.1093/ije/dyx102 CrossRefGoogle ScholarPubMed
Healy, E., Jordan, S. A., Budd, P. S., Suffolk, R., Rees, J. L., & Jackson, I. J. (2001). Functional variation of MC1R alleles from red-haired individuals. Human Molecular Genetics, 10, 23972402. https://doi.org/10.1093/hmg/10.21.2397 CrossRefGoogle ScholarPubMed
Kvaskoff, M., Han, J., Qureshi, A. A., & Missmer, S. A. (2014). Pigmentary traits, family history of melanoma and the risk of endometriosis: A cohort study of US women. International Journal of Epidemiology, 43, 255263. https://doi.org/10.1093/ije/dyt235 CrossRefGoogle ScholarPubMed
Kvaskoff, M., Mesrine, S., Clavel-Chapelon, F., & Boutron-Ruault, M. C. (2009). Endometriosis risk in relation to naevi, freckles and skin sensitivity to sun exposure: The French E3N cohort. International Journal of Epidemiology, 38, 11431153. https://doi.org/10.1093/ije/dyp175 CrossRefGoogle ScholarPubMed
Li, Y., Liu, H., Ye, S., Zhang, B., Li, X., Yuan, J., Du, Y., Wang, J., & Yang, Y. (2023). The effects of coagulation factors on the risk of endometriosis: A Mendelian randomization study. BMC Medicine, 21, 195. https://doi.org/10.1186/s12916-023-02881-z CrossRefGoogle ScholarPubMed
Li, Y., Wu, J., & Cao, Z. (2023). Childhood sunburn and risk of melanoma and non-melanoma skin cancer: A Mendelian randomization study. Environmental Science and Pollution Research, 30, 122011122023. https://doi.org/10.1007/s11356-023-30535-3 CrossRefGoogle ScholarPubMed
Lona-Durazo, F., Mendes, M., Thakur, R., Funderburk, K., Zhang, T., Kovacs, M. A., Choi, J., Brown, K. M., & Parra, E. J. (2021). A large Canadian cohort provides insights into the genetic architecture of human hair colour. Communications Biology, 4, 1253. https://doi.org/10.1038/s42003-021-02764-0 CrossRefGoogle ScholarPubMed
Malvezzi, H., Marengo, E. B., Podgaec, S., & Piccinato, C. A. (2020). Endometriosis: current challenges in modeling a multifactorial disease of unknown etiology. Journal of Translational Medicine, 18, 311. https://doi.org/10.1186/s12967-020-02471-0 CrossRefGoogle ScholarPubMed
Millington, G. W. (2006). Proopiomelanocortin (POMC): the cutaneous roles of its melanocortin products and receptors. Clinical and Experimental Dermatology, 31, 407412. https://doi.org/10.1111/j.1365-2230.2006.02128.x CrossRefGoogle ScholarPubMed
Missmer, S. A., Spiegelman, D., Hankinson, S. E., Malspeis, S., Barbieri, R. L., & Hunter, D. J. (2006). Natural hair color and the incidence of endometriosis. Fertility and Sterility, 85, 866870. https://doi.org/10.1016/j.fertnstert.2005.12.008 CrossRefGoogle ScholarPubMed
Pośpiech, E., Teisseyre, P., Mielniczuk, J., & Branicki, W. (2022). Predicting physical appearance from DNA data ¾ Towards genomic solutions. Genes, 13, 121. https://doi.org/10.3390/genes13010121 CrossRefGoogle ScholarPubMed
Salmeri, N., Di Stefano, G., Viganò, P., Stratton, P., Somgliana, E., & Vercellini, P. (2024). Functional determinants of uterine contractility in endometriosis and adenomyosis: A systematic review and meta-analysis. Fertility and Sterility, 6, 10631078. https://doi.org/10.1016/j.fertnstert.2024.07.026 CrossRefGoogle Scholar
Salmeri, N., Ottolina, J., Bartiromo, L., Schimberni, M., Dolci, C., Ferrari, S., Villanacci, R., Arena, S., Berlanda, N., Buggio, L., Di Cello, A., Fuggetta, E., Maneschi, F., Massarotti, C., Mattei, A., Perelli, F., Pino, I., Porpora, M. G., Raimondo, D., ¼ Candiani, M. (2022). ‘Guess who’? An Italian multicentric study on pigmentation traits prevalence in endometriosis localizations. European Journal of Obstetrics & Gynecology and Reproductive Biology, 274, 512. https://doi.org/10.1016/j.ejogrb.2022.05.001 CrossRefGoogle Scholar
Saunders, P. T. K., & Horne, A. W. (2021). Endometriosis: Etiology, pathobiology, and therapeutic prospects. Cell, 184, 28072824. https://doi.org/10.1016/j.cell.2021.04.041 CrossRefGoogle ScholarPubMed
Stemberger, H., Leimer, R., & Wiedermann, G. (1984). Tolerability of long-term prophylaxis with fansidar: A randomized double-blind study in Nigeria. Acta Tropica, 41, 391399.Google ScholarPubMed
Sudlow, C., Gallacher, J., Allen, N., Beral, V., Burton, P., Danesh, J., Downey, P., Elliott, P., Green, J., Landray, M., Liu, B., Matthews, P., Ong, G., Pell, J., Silman, A., Young, A., Sprosen, T., Peakman, T., & Collins, R. (2015). UK biobank: An open access resource for identifying the causes of a wide range of complex diseases of middle and old age. PLoS Medicine, 12, e1001779. https://doi.org/10.1371/journal.pmed.1001779 CrossRefGoogle ScholarPubMed
Tschiderer, L., Bakker, M. K., Gill, D., Burgess, S., Willeit, P., Ruigrok, Y. M., & Peters, S. A. (2024). Sex differences in risk factor relationships with subarachnoid haemorrhage and intracranial aneurysms: A Mendelian randomization study. European Stroke Journal, 23969873241265224. https://doi.org/10.1177/23969873241265224 CrossRefGoogle Scholar
Verbanck, M., Chen, C. Y., Neale, B., & Do, R. (2018). Detection of widespread horizontal pleiotropy in causal relationships inferred from Mendelian randomization between complex traits and diseases. Nature Genetics, 50, 693698. https://doi.org/10.1038/s41588-018-0099-7 CrossRefGoogle ScholarPubMed
Wang, L., Lu, X., Wang, D., Qu, W., Li, W., Xu, X., Huang, Q., Han, X., & Lv, J. (2014). CYP19 gene variant confers susceptibility to endometriosis-associated infertility in Chinese women. Experimental & Molecular Medicine, 46, e103. https://doi.org/10.1038/emm.2014.31 CrossRefGoogle ScholarPubMed
Wang, S., Chen, J., Jin, Z., Xing, Y., & Wang, R. (2024). Natural hair color and skin cancers: A two-sample Mendelian randomization study. Gene, 893, 147940. https://doi.org/10.1016/j.gene.2023.147940 CrossRefGoogle ScholarPubMed
Warrington, N. M., Beaumont, R. N., Horikoshi, M., Day, F. R., Helgeland, Ø., Laurin, C., Bacelis, J., Peng, S., Hao, K., Feenstra, B., Wood, A. R., Mahajan, A., Tyrrell, J., Robertson, N. R., Rayner, N. W., Qiao, Z., Moen, G. H., Vaudel, M., Marsit, C. J., ¼ Freathy, R. M. (2019). Maternal and fetal genetic effects on birth weight and their relevance to cardio-metabolic risk factors. Nature Genetics, 51, 804814. https://doi.org/10.1038/s41588-019-0403-1 CrossRefGoogle ScholarPubMed
Woodworth, S. H., Singh, M., Yussman, M. A., Sanfilippo, J. S., Cook, C. L., & Lincoln, S. R. (1995). A prospective study on the association between red hair color and endometriosis in infertile patients. Fertility and Sterility, 64, 651652. https://doi.org/10.1016/s0015-0282(16)57809-1 CrossRefGoogle ScholarPubMed
Wyshak, G., & Frisch, R. E. (2000). Red hair color, melanoma, and endometriosis: Suggestive associations. International Journal of Dermatology, 39, 798. https://doi.org/10.1046/j.1365-4362.2000.00051-2.x CrossRefGoogle ScholarPubMed
Yang, F., Mortlock, S., MacGregor, S., Iles, M. M., Landi, M. T., Shi, J., Law, M. H., & Montgomery, G. W. (2021). Genetic relationship between endometriosis and melanoma. Frontiers in Reproductive Health, 3, 711123. https://doi.org/10.3389/frph.2021.711123 CrossRefGoogle ScholarPubMed
Yousaf, A., Lee, J., Fang, W., & Kolodney, M. S. (2021). Notice of Retraction. Yousaf A et al. Association Between Alopecia Areata and Natural Hair Color Among White Individuals. JAMA Dermatol. JAMA Dermatology, 157, 10071008. https://doi.org/10.1001/jamadermatol.2021.1832 CrossRefGoogle ScholarPubMed
Zhao, J., Ming, J., Hu, X., Chen, G., Liu, J., & Yang, C. (2020). Bayesian weighted Mendelian randomization for causal inference based on summary statistics. Bioinformatics, 36, 15011508. https://doi.org/10.1093/bioinformatics/btz749 CrossRefGoogle ScholarPubMed
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