Abstract
The sensitivity and specificity of clinical diagnostic indicators and non-invasive diagnostic methods for endometriosis at early stage is not optimal. Previous studies demonstrated that abnormal lipid metabolism was involved in the pathological development of endometriosis. Our cross-sectional study included 21 patients with laparoscopically confirmed endometriosis at stage I–II and 20 infertile women who underwent diagnostic laparoscopy combined with hysteroscopy from January 2014 to January 2015. Eutopic endometrium was collected by pipelle endometrial biopsy. Lipid metabolites were quantified by ultra-high performance liquid chromatography coupled with electrospray ionization high-resolution mass spectrometry (UHPLC-ESI-HRMS). Lipid profiles of endometriosis patients at early stage (I–II) was characterized by a decreased concentration of phosphatidylcholine (18:1/22:6), (20:1/14:1), (20:3/20:4), and phosphatidylserine (20:3/23:1) and an increased concentration of phosphatidic acid (25:5/22:6) compared with control. The synthesized predicting strategy with 5 biomarkers has a specificity of 75.0% and a sensitivity of 90.5%. Lipid profile of eutopic endometrium in endometriosis was effectively characterized by UHPLC-ESI-HRMS-based metabolomics. Our study demonstrated the alteration of phosphatidic acid, phosphatidylcholine, phosphatidylserine metabolites in endometriosis and provided potential biomarkers for semi-invasive diagnose of endometriosis at early stage.
Highlights
The prevalence of endometriosis is estimated as 2–10% in the general female population and up to 40% in women with subfertility (Eskenazi and Warner, 1997; Ozkan et al, 2008; Dunselman et al, 2014), which significantly compromises quality of life in women and adolescents and causes a substantial societal economic burden (Gao et al, 2006; Nnoaham et al, 2011; Soliman et al, 2016)
We investigated alterations of lipid profile in eutopic endometrium of endometriosis patients at stage I–II by ultra-high performance liquid chromatography coupled with electrospray ionization high-resolution mass spectrometry (UHPLC-ESI-HRMS)-based metabolomics, which provided potential markers for early diagnosis of this disease
Orthogonal projection to latent structures discriminant analysis (OPLS-DA) models with acceptable R2Y and Q2 revealed a trend of separation between two groups (Figures 2A,B), indicating distinct lipid profiles of endometriosis patients
Summary
The prevalence of endometriosis is estimated as 2–10% in the general female population and up to 40% in women with subfertility (Eskenazi and Warner, 1997; Ozkan et al, 2008; Dunselman et al, 2014), which significantly compromises quality of life in women and adolescents and causes a substantial societal economic burden (Gao et al, 2006; Nnoaham et al, 2011; Soliman et al, 2016). Diagnosis of endometriosis is extremely challengeable due to similar symptoms to other gynecological and gastrointestinal diseases. Biomarkers for Endometriosis Diagnosis stage, is surgical laparoscopy. Diagnosis of endometriosis is typically delayed up to 8–10 years from the initial appearance of symptoms (Greene et al, 2009; Nnoaham et al, 2011; Hudelist et al, 2012). It is urgent to development novel diagnostic biomarkers and non-invasive methods for endometriosis diagnosis. We investigated alterations of lipid profile in eutopic endometrium of endometriosis patients at stage I–II by ultra-high performance liquid chromatography coupled with electrospray ionization high-resolution mass spectrometry (UHPLC-ESI-HRMS)-based metabolomics, which provided potential markers for early diagnosis of this disease
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