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

Zhong X, Lu W, Zhang Q, Dong J, Xiao H, Tu R
2025 · W7084313183
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This retrospective study evaluated the association between changes in routine metabolic biomarkers and endometriosis severity in 94 patients diagnosed at Zhongshan Hospital (Fudan University), including 32 classified as ASRM stage IV. Using univariate logistic regression with adjusted multivariable modeling, the authors identified fasting blood glucose, total protein, direct and total bilirubin, and ALT as significant metabolic indicators, with CA125 and HE4 also showing significance as covariates, and applied restricted cubic spline models to assess nonlinear relationships. ROC analyses indicated that ALT had a discriminative performance with an AUC above 0.6, and the paper’s conclusion states that ALT was independently associated with lower endometriosis severity (negative correlation), while acknowledging only that the analyses were retrospective and based on the enrolled cohort. This paper is centrally about endometriosis — it analyzes how routine metabolic indices, particularly ALT, correlate with and discriminate among endometriosis severity.

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Abstract

Xiaolin Zhong,1,* Weihong Lu,1,* Qi Zhang,1 Jie Dong,1 Hongyang Xiao,2 Ruiqin Tu2 1Department of Gynecology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, 366100, People’s Republic of China; 2Department of Gynecology, Zhongshan Hospital, Fudan University, Shanghai, 200035, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hongyang Xiao; Ruiqin Tu, Department of Gynecology, Zhongshan Hospital, Fudan University, No. 180, Fenglin Road, Xuhui District, Shanghai, 200035, People’s Republic of China, Tel +86-592-3568682, Email [email protected]; [email protected]; [email protected]: 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.Keywords: endometriosis, metabolic, American Society for Reproductive Medicine staging
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International Journal of General Medicine (Sep 2025) Dynamics of Conventional Metabolic Indices in Relation to Endometriosis Severity: A Retrospective Analysis Abstract Xiaolin Zhong,1,* Weihong Lu,1,* Qi Zhang,1 Jie Dong,1 Hongyang Xiao,2 Ruiqin Tu2 1Department of Gynecology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, 366100, People’s Republic of China; 2Department of Gynecology, Zhongshan Hospital, Fudan University, Shanghai, 200035, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hongyang Xiao; Ruiqin Tu, Department of Gynecology, Zhongshan Hospital, Fudan University, No. 180, Fenglin Road, Xuhui District, Shanghai, 200035, People’s Republic of China, Tel +86-592-3568682, Email [email protected]; [email protected]; [email protected]: 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.Keywords: endometriosis, metabolic, American Society for Reproductive Medicine staging

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