Dynamics of Conventional Metabolic Indices in Relation to Endometriosis Severity: A Retrospective Analysis

Xiaolin Zhong, Weihong Lu, Wenwei Lu, Qi Zhang, Jie Dong, Hongyang Xiao, Ruiqin Tu
International journal of general medicine · 2025 · vol. Volume 18 , pp. 5183–5193 · doi:10.2147/ijgm.s537848 · PMID:40927773 · PMC12416391 · W4413989681
article OA: gold CC0 ⤵ 1 in-corpus citation
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This retrospective analysis found that alanine transaminase (ALT) is negatively correlated with endometriosis severity and can serve as an independent, statistically significant influencing factor.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This retrospective study analyzed 94 laparoscopically or laparoscopically confirmed endometriosis patients from Zhongshan Hospital (2018–2022) to evaluate how the dynamics of conventional metabolic markers relate to endometriosis severity as staged by ASRM, using univariate/multivariate logistic regression with covariate adjustment, restricted cubic spline modeling for nonlinear effects, and ROC curves for discriminative ability. Univariable analyses identified fasting blood glucose, total protein, direct bilirubin, total bilirubin, and ALT as significant metabolic indicators, but after adjustment (including CA125 and HE4 in the final model), ALT remained significantly associated with severity. Restricted cubic spline results showed mostly no significant nonlinear associations, with fasting blood glucose showing a significant nonlinear relationship. The paper concludes that ALT has a negative correlation with endometriosis severity and is an independent influencing factor, and it does not explicitly state a major limitation in the provided text. This paper is centrally about endometriosis — it specifically examines associations between routine metabolic indices (especially ALT) and ASRM-severity of endometriosis.

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Abstract

Objective: This study aims to investigate the association between the dynamics of routine metabolic markers and endometriosis severity. Methods: A retrospective analysis was conducted on patients diagnosed with endometriosis at Zhongshan Hospital, Xiamen, affiliated with Fudan University. The collected data encompassed demographic details and biochemical indicators related to lipid, hepatobiliary, renal metabolism, and electrolyte balance. Independent influencing factors were screened by univariate logistic regression and statistically significant variables were included in the model for adjustment. Restricted cubic spline (RCS) models were also plotted to analyze the nonlinear relationship between factors and endometriosis severity. The receiver operating characteristic (ROC) curve was used to validate the discriminative ability of independent influencing factors. Results: Ninety-four patients were enrolled in the study, including 32 at stage IV as classified by the American Society for Reproductive Medicine (ASRM) staging. Univariate analysis identified fasting blood glucose (FBG), total protein, direct bilirubin, total bilirubin (TBil) and glutamic-pyruvic transaminase (ALT) as significant metabolic indicators. Additionally, carbohydrate antigen 125 (CA125) and human epididymal protein 4 (HE4) emerged as significant covariates. The RCS analysis revealed a nonlinear association between most metabolic indicators and outcome measures. ROC curve analysis showed that the area under the curve (AUC) of the alanine transaminase (ALT) was above 0.6. Conclusion: ALT had a negative correlation with the severity of endometriosis and was an independent influencing factor with statistical significance. This finding could offer clinicians non-invasive biomarkers for early detection and precise monitoring of disease progression.

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endometriosis

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