Dysregulated Metabolomic Signatures of Young Patients With Endometriosis

Endometriosis surgery may have a positive effect on this dysregulation for some patients

Key Points

Highlights: 

• Adolescents and young adults with endometriosis exhibit significant dysregulation in plasma metabolites.
• Surgical treatment partially reverses these metabolic abnormalities in some patients.

Importance:

• This study underscores the need for long-term monitoring of adolescents with endometriosis, as persistent metabolic alterations may contribute to chronic disease risk later in life.

What’s done here:

• This is a a cross-sectional metabolomic analysis on 190 laparoscopically confirmed endometriosis cases and 120 controls.
• Among the cases, 81 had paired blood samples collected before and after surgery.

Key results:

• A total of 63 plasma metabolites were significantly associated with endometriosis. 
• Inflammatory (e.g., eicosatrienoic acid) and oxidative stress-related (e.g., xanthine) metabolites were elevated, while metabolites linked to apoptosis (e.g., glycocholic acid) were reduced in cases compared to controls.
• Metabolite set enrichment analysis revealed increased levels of fatty acyls and ceramides, and decreased levels of steroids and steroid derivatives in endometriosis cases.
• Postoperative samples from endometriosis patients showed reversal in some of these metabolic disturbances: steroids increased, fatty acyls decreased, ceramide levels remained elevated.
• A total of 55 endometriosis-associated metabolites changed significantly after surgery.

Limitations:

• The cohort was primarily composed of non-Hispanic White individuals with superficial peritoneal disease, which may limit generalizability.
• The sample size was insufficient for detailed subgroup analyses, particularly for outcomes related to pain or disease severity.

Lay Summary

A new study published in Human Reproduction reveals that adolescents and young adults with endometriosis exhibit significant dysregulation in their plasma metabolomic profiles.

In particular, fatty acyls and ceramides were found to be elevated in patients with endometriosis compared to those without the disease.

To investigate the metabolomic alterations associated withadolescents and young adult endometriosis, Dr.Lin and Dr.Sasamoto and colleagues from Brigham and Women’s Hospital, Harvard Medical School, and the Boston Center for Endometriosis conducted a cross-sectional study involving 190 adolescents and young adults with laparoscopically confirmed endometriosis (median age 17) and 120 control participants without the disease (median age 22). Blood samples were analyzed using advanced mass spectrometry, and 430 known plasma metabolites were evaluated.

The researchers identified 63 metabolites significantly associated with endometriosis. These included elevated markers of inflammation (e.g., eicosatrienoic acid), oxidative stress (e.g., xanthine), and reduced markers of apoptosis (e.g., glycocholic acid). Metabolite set enrichment analysis further revealed increases in fatty acyls and ceramides, and decreases in steroids and their derivatives.

Among 81 patients with paired blood samples collected before and after endometriosis surgery., 55 endometriosis-associated metabolites significantly changed postoperatively. Steroids and their derivatives increased, while fatty acyls decreased after surgery. However, ceramide levels remained elevated compared to controls, even after surgical treatment.

These findings suggest that while surgery may normalize certain metabolic imbalances, some systemic changes may persist, highlighting the need for long-term monitoring and further research into the implications of sustained metabolic dysregulation in young patients with endometriosis.

Research Source: https://pubmed.ncbi.nlm.nih.gov/40107296