Biochemical and Metabolic Disruptions in Endometriosis
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Abstract
Objectives: Endometriosis is a chronic gynecological disorder characterized by endometrial glands and stroma outside the uterine cavity. This study aimed to characterize biochemical, hormonal, and inflammatory alterations in endometriosis, with the goal of gaining insights into disease mechanisms and exploring candidate biomarkers that could inform future studies on early diagnosis or targeted interventions.
Materials and Methods: A case-control study enrolled 300 participants aged 20 to 45 years, including 150 individuals diagnosed with endometriosis and 150 healthy controls recruited from hospitals across Thiruvananthapuram. Serum interleukin-6 (IL-6), prolactin, luteinizing hormone (LH), and follicle stimulating hormone (FSH) were measured using enzyme linked immunosorbent assay (ELISA), while triiodothyronine (T3), thyroxine (T4), and thyroid stimulating hormone (TSH) were analyzed via chemiluminescent immunoassay (CLIA). Metabolic parameters were assessed using a semi-automated analyzer.
Results: Findings suggested that women with endometriosis had significantly higher body mass index (BMI), abdominal circumference, fasting blood sugar (FBS), triglycerides, low-density lipoprotein (LDL), IL-6, TSH, prolactin, and FSH, while high-density lipoprotein (HDL), T3, T4, and LH levels were lower (p < 0.05). Clinical conditions such as diabetes mellitus, dyslipidemia, thyroid disorders, polycystic ovarian syndrome (PCOS), and psychological stress were more prevalent in cases. Receiver operating characteristic analysis identified prolactin and IL-6 as the strongest diagnostic predictors, while multivariable analysis confirmed body mass index, abdominal circumference, prolactin, and IL-6 as key factors associated with endometriosis.
Conclusion: This study revealed key biochemical and metabolic disruptions in endometriosis, linking obesity, PCOS, and stress to disease progression, and highlighted potential biomarkers for early diagnosis and targeted treatment.
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References
Taylor HS, Kotlyar AM, Flores VA. Endometriosis is a chronic systemic disease: clinical challenges and novel innovations. Lancet 2021;397:839-52.
Wang PH, Yang ST, Chang WH, Liu CH, Lee FK, Lee WL. Endometriosis: part I. Basic concept. Taiwanese J Obstet Gynecol 2022;61:927-34.
Kapoor R, Stratopoulou CA, Dolmans MM. Pathogenesis of endometriosis: new insights into prospective therapies. Int J Mol Sci 2021;22:11700.
Machairiotis N, Vasilakaki S, Thomakos N. Inflammatory mediators and pain in endometriosis: a systematic review. Biomedicines 2021;9:54.
Yotova I, Harzif AK. Recent advances in endometriosis: from Bench to clinical application. Front Endocrinol 2025;16:1570284.
Şerifoğlu H, Arinkan SA, Pasin O, Vural F. Is there an association between endometriosis and thyroid autoimmunity?. Rev Assoc Med Bras 2023;69: e20221679.
Seyfettinoglu S, Pekoz B, Uysal G, Kablan G. Comparison of thyroid volumes in patients with and without endometrioma: Thyroid volume and endometriosis. J Surg Med 2023;7:473-6.
Bianco B, Loureiro FA, Trevisan CM, Peluso C, Christofolini DM, Montagna E, et al. Effects of FSHR and FSHB variants on hormonal profile and reproductive outcomes of infertile women with endometriosis. Front Endocrinol 2021;12:760616.
Meczekalski B, Nowicka A, Bochynska S, Szczesnowicz A, Bala G, Szeliga A. Kisspeptin and endometriosis—Is there a link?. J Clin Med 2024;13:7683.
Kutlesic R, Kutlesic M, Milosevic-Stevanovic J, Vukomanovic P, Stefanovic M, Mostic-Stanisic D. Prolactin and hyperprolactinaemia in endometriosis-related infertility: Are there clinically significant connections?. J Clin Med 2024;13:5868.
Chen JP, Zhang YY, Jin JN, Ying Y, Song ZM, Xu QQ, et al. Effects of dysregulated glucose metabolism on the occurrence and ART outcome of endometriosis. Eur J Med Res 2023;28:305.
Ortiz CN, Torres-Reverón A, Appleyard CB. Metabolomics in endometriosis: challenges and perspectives for future studies. Reproduction and Fertility 2021;2:R35-50.
Zheng R, Du X, Lei Y. Correlations between endometriosis, lipid profile, and estrogen levels. Medicine (Baltimore) 2023;102:e34348.
Wang J, Wang B, Liu T, Shang J, Gu X, Zhang T, Cong H. Association between cardiometabolic index (CMI) and endometriosis: a cross-sectional study on NHANES. Lipids Health Dis 2024;23:328.
Xin Q, Li HJ, Chen HK, Zhu XF, Yu L. Causal effects of glycemic traits and endometriosis: a bidirectional and multivariate mendelian randomization study. Diabetol Metab Synd 2024;16:77.
Malvezzi H, Marengo EB, Podgaec S, Piccinato CD. Endometriosis: current challenges in modeling a multifactorial disease of unknown etiology. J Transl Med 2020;18:311.
Melo AS, Rosa-e-Silva JC, de Sá Rosa AC, Poli-Neto OB, Ferriani RA, Vieira CS. Unfavorable lipid profile in women with endometriosis. Fertil Steril 2010;93: 2433-6.
Zhang H, Fan Y, Li H, Feng X, Yue D. Genetic association of serum lipids and lipid-modifying targets with endometriosis: trans-ethnic mendelian-randomization and mediation analysis. Plos One 2024;19:e0301752.
Nahar K, Khanam NN, Chowdhury AA, Khan NJ, Mohamed Z. Association of dyslipidemia with endometriosis: A case control study. Mymensingh Med J 2023;32:118-24.
Cao Y, Yang Q, Mai Q, Wuliu J, Deng K. Relationship between triglyceride-glucose index and endometriosis: a cross-sectional analysis. BMC Women’s Health 2024;24:447.
Incognito GG, Di Guardo F, Gulino FA, Genovese F, Benvenuto D, Lello C, et al. Interleukin-6 as a useful predictor of endometriosis-associated infertility: a systematic review. Int J Fertil Steril 2023;17:226.
Othman EE, Hornung D, Salem HT, Khalifa EA, El-Metwally TH, Al-Hendy A. Serum cytokines as biomarkers for nonsurgical prediction of endometriosis. Eur J Obstet Gynecol Reprod Biol 2008;137:240-6.
Kokot I, Piwowar A, Jędryka M, Sołkiewicz K, Kratz EM. Diagnostic significance of selected serum inflammatory markers in women with advanced endometriosis. Int J Mol Sci 2021;22:2295.
Bilibio JP, Souza CA, Rodini GP, Andreoli CG, Genro VK, De Conto E, et al. Serum prolactin and CA-125 levels as biomarkers of peritoneal endometriosis. Gynecol Obstet Investig 2014;78:45-52.
de Carvalho BR, de Sá Rosa AC, Rosa-e-Silva JC, dos Reis RM, Ferriani RA, Silva-de-Sá MF. Increased basal FSH levels as predictors of low-quality follicles in infertile women with endometriosis. Int J Gynecol Obstet 2010;110:208-12.
Qi Q, Li Y, Chen Z, Luo Z, Zhou T, Zhou J, et al. Update on the pathogenesis of endometriosis-related infertility based on contemporary evidence. Front Endocrinol 2025;16:1558271.
Sinaii N, Cleary SD, Ballweg ML, Nieman LK, Stratton P. High rates of autoimmune and endocrine disorders, fibromyalgia, chronic fatigue syndrome and atopic diseases among women with endometriosis: a survey analysis. Hum Reprod 2002;17:2715-24.
Al Beaiji M, Khan L, Felimban HM, Qureshi S, Al-Kadri H. Effect of high BMI on endometriosis-a chart review study. J Pub Health Comm Med 2019;4:1-5.
Tang Y, Zhao M, Lin L, Gao Y, Chen GQ, Chen S, et al. Is body mass index associated with the incidence of endometriosis and the severity of dysmenorrhoea: a case–control study in China?. BMJ open 2020;10:e037095.
Holoch KJ, Savaris RF, Forstein DA, Miller PB, Higdon III HL, Likes CE, et al. Coexistence of polycystic ovary syndrome and endometriosis in women with infertility. J Endometriosis Pelvic Pain Dis 2014;6:79-83.
Tan H, Long P, Xiao H. Dissecting the shared genetic architecture between endometriosis and polycystic ovary syndrome. Front Endocrinol 2024; 15:1359236.
Reis FM, Coutinho LM, Vannuccini S, Luisi S, Petraglia F. Is stress a cause or a consequence of endometriosis?. Reprod Sci 2020;27:39-45.
Matasariu RD, Mihaila A, Iacob M, Dumitrascu I, Onofriescu M, Tanasa IC, et al. Psycho-social aspects of quality of life in women with endometriosis. Acta Endocrinol (Buchar) 2017;13:334.
