{"paper_id":"76bd798b-71d3-4004-9f36-f79ec8689b6f","body_text":"Abstract\nEndometriosis diagnosis is usually delayed. The gold standard for diagnosing endometriosis is laparoscopy, which is invasive and accompanied by several risks. Currently, there are no effective non-invasive biomarkers for diagnosing endometriosis. Here, we investigated whether metabolites whose levels are altered in patients with endometriosis hold potential as diagnostic biomarkers for the disease. This case–control study involved 32 patients with endometriosis and 29 patients with other benign gynecological disease. The diagnosis of all patients was confirmed through postoperative histopathological examination, and the patients were divided into two groups: an endometriosis group (EM) and a control group. Fasting blood was collected and used for non-targeted metabolomic-based detection. The data were processed through principal component analysis, orthogonal partial least squares discriminant analysis, and significance analysis of microarrays. A univariate receiver operating characteristic curve was used to evaluate the diagnostic value of the metabolites. The metabolite profiles of patients with endometriosis were markedly different compared with those of the controls. In addition, several metabolic pathways, including biosynthesis of unsaturated fatty acids, arginine biosynthesis, and glutathione metabolism, were altered. Ornithine and medorinone showed better potential as biomarkers for endometriosis diagnosis than CA125. We analyzed the altered metabolic profiles in patients with endometriosis and found ornithine and medorinone as potential non-invasive biomarkers for endometriosis diagnosis, whereas the combined ornithine-medorinone diagnosis is more valuable. These findings may help advance research on non-invasive diagnostic biomarkers for endometriosis. 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Thrombosis Res. 1990;57(6):909–18.\nAcknowledgements\nWe acknowledge Aksomics (Shanghai, China) for the support in LC-MS/MS and data analysis, and thank Ran Chu for assistance with data collection.\nFunding\nThis study was funded by the National Key R&D Program of China (grant number 2022YFC2704000), the National Natural Science Foundation of China (grant number 82301855), the Major Basic Research of Natural Science Foundation of Shandong (grant number ZR2021ZD34), National Natural Science Foundation of China (grant number 82071621), and Natural Science Foundation of Shandong Province (grant number ZR2023QH186). The funders had not role in the design of the study; collection, analysis, and interpretation of data; writing of the report; and decision to submit the article for publication.\nAuthor information\nAuthors and Affiliations\nContributions\nQiuju Li: conception and design of the study; collection of samples; acquisition, analysis and interpretation of data; drafting the article. Le Xu: collection of samples; acquisition, analysis and interpretation of data; revising the article. Ying Lin: collection of samples, analysis and interpretation of data, revising the article. Ming Yuan: conception and design of the study, collection of samples, revising the article. Xue Jiao: collection of the samples, acquisition of data, revising the article. Qianhui Ren: collection of samples, acquisition of data, revising the article. Dong Li: conception and design of the study, analysis and interpretation of data, revising the article. Guoyun Wang: conception and design of the study, revising the article. All authors: final approval of the version to be published and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.\nCorresponding author\nEthics declarations\nConflicts of interest\nThe authors report no conflict of interest.\nResearch involving human participants ethics approval\nThis study was approved by the Ethics Committee of Medical Integration and Practice Center at the Cheeloo College of Medicine, Shandong University [SDULCLL2022-1–21]. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.\nInformed consent\nInformed consent was obtained from the patients before surgery.\nConsent to publish\nNot applicable.\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nSpringer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.\nAbout this article\nCite this article\nLi, Q., Xu, L., Lin, Y. et al. Serum Metabolites as Diagnostic Biomarkers in Patients with Endometriosis. Reprod. Sci. 31, 3719–3728 (2024). https://doi.org/10.1007/s43032-024-01536-5\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s43032-024-01536-5","source_license":"public-domain-us","license_restricted":false}