Serum Creatinine as a Valuable Adjunct in the Diagnosis of Endometriosis

Serum creatinine shows promise as a unique biomarker for endometriosis

Key Points

Highlights:

• Serum creatinine levels are significantly associated with endometriosis risk.
• Elevated creatinine may serve as a non-invasive biomarker and adjunct tool in diagnosis. 

Importance:

• Identifying simple, blood-based biomarkers such as creatinine could accelerate diagnosis and may reduce surgical burden.

What's done here:

• This is a cross-sectional study of 1,120 women; 490 with endometriosis, 630 controls.
• Serum creatinine levels measured and compared between groups, and possible relationships between serum creatinine and endometriosis was investigated.
• Mendelian randomization analysis used to test a causal link.
• A diagnostic model was developed integrating serum creatinine with clinical variables.

Key Results :

• Women with endometriosis had significantly higher serum creatinine than controls.
• Mendelian randomization supported a causal association between genetically determined creatinine and endometriosis risk.
• Diagnostic model incorporating creatinine achieved good predictive performance.
• Creatinine remained an independent risk factor after adjusting for age, BMI, and other variables.

Strengths and Limitations

• This is the first study combining epidemiological, genetic, and diagnostic modeling approaches to link creatinine with endometriosis. Large sample size and use of genetic validation strengthen causal inference is another strength.
• Limitation is the cross-sectional design that prevents evaluation of temporal trends.

From the Editor-in-Chief – EndoNews

"This work reframes a routine laboratory test into a potential breakthrough for women’s health. Serum creatinine—traditionally a marker of kidney function—emerges here as an independent risk factor for endometriosis, supported by epidemiologic data, genetic validation, and diagnostic modeling. The novelty is striking: a simple, inexpensive blood test, already available worldwide, may hold diagnostic value in a disease that too often requires invasive surgery to confirm.

The implications are twofold. First, the findings strengthen the view of endometriosis as a systemic, metabolism- and inflammation-linked disorder rather than a purely pelvic disease. Second, creatinine’s predictive role opens a realistic pathway toward earlier, less invasive diagnosis. If confirmed in larger and more diverse cohorts, this could shift the diagnostic paradigm, reducing delays that currently average 7–10 years.

The message for clinicians and researchers is clear: biomarkers hiding in plain sight should not be overlooked. Replication in multicenter studies and integration with other omics-based markers could finally bring precision diagnostics within reach for endometriosis."

Lay Summary

Although endometriois is quite prevalent condition, the diagnosis still often requires laparoscopy, underscoring the urgent need for reliable, non-invasive biomarkers.

Serum creatinine, a common blood test typically used to assess kidney function, may also reflect chronic inflammatory states. Researchers from Qingdao University and Jining Medical University in China explored its role as a biomarker for endometriosis in a study published in BMC Women’s Health.

The team analyzed data from more than 1,100 women, combining cross-sectional epidemiology, genetic analyses (Mendelian randomization), and diagnostic modeling. They found that women with endometriosis had higher serum creatinine levels than those without. Even after adjusting for confounders such as age and BMI, creatinine remained significantly associated with endometriosis. Mendelian randomization further suggested a causal relationship between genetically predicted creatinine and endometriosis risk.

A diagnostic model that included serum creatinine demonstrated strong predictive performance, indicating that this simple blood marker could serve as an independent risk factor and adjunct tool for diagnosis.

The authors emphasize that while creatinine shows promise as a unique biomarker, larger multicenter studies are needed to confirm its utility and clarify the biological mechanisms linking metabolism, inflammation, and endometriosis.

Research Source: https://pubmed.ncbi.nlm.nih.gov/40468362/zz