Biochemical and Metabolic Disruptions in Endometriosis

Deepthi Sudharma, Natrajan Muninathan, Arumugam Suresh, M D Parthasarathy, Sheeja Mullukalayil Joseph, Bobby Joseph, Sindhu Koyilerian, J. Chalil, Jayasudha Edatholath, Priya Raveendran, Dinesh Roy Divakaran
In: Thai Journal of Obstetrics and Gynaecology · 2026 · pp. 178–189 · doi:10.66650/tjog.v34i3.273981 · W7160246449
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

This study found that women with endometriosis exhibited altered metabolic and hormonal profiles, including higher BMI, triglycerides, IL-6, and prolactin, identifying prolactin and IL-6 as potential diagnostic biomarkers.

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This case-control study enrolled 150 women diagnosed with endometriosis and 150 healthy controls (ages 20–45) from hospitals in Thiruvananthapuram to assess biochemical, hormonal, and inflammatory differences, measuring serum IL-6, prolactin, LH, FSH, thyroid hormones (T3, T4, TSH), and metabolic parameters. Women with endometriosis showed higher BMI and abdominal circumference plus higher fasting blood sugar, triglycerides, LDL, IL-6, TSH, prolactin, and FSH, alongside lower HDL, T3, T4, and LH; diabetes mellitus, dyslipidemia, thyroid disorders, PCOS, and psychological stress were also more prevalent. Diagnostic analyses identified prolactin and IL-6 as strongest predictors, and multivariable models associated BMI, abdominal circumference, prolactin, and IL-6 with endometriosis, with the key limitation being the cross-sectional, case-control design that cannot establish temporality. This paper is centrally about endometriosis — it characterizes biochemical, hormonal, and inflammatory disruptions and evaluates candidate biomarkers (notably IL-6 and prolactin) in relation to disease status.

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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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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. Article Details This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

References

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