Correlation of ferritin and glutathione peroxidase 4 (GPX4) level as a marker of ferroptosis process in endometrioma

Endometriosis is a chronic inflammatory disease characterized by the presence of endometrial-like tissues (glands and stroma) located outside the uterine cavity. The pathophysiology of this condition remains incompletely understood. Local bleeding and inflammation within endometriosis lesions, which occur in an environment rich in iron, reactive oxygen species (ROS), and free radicals, can disturb the balance of iron within the peritoneal cavity. This disruption can trigger oxidative injury and an inflammatory response, leading to ferroptosis, particularly in the endometrioma phenotype. This research utilized an observational analytical method with a cross-sectional design to examine the relationship between ferritin and GPx4 levels by assessing them simultaneously. The data collection occurred at Dr. Hasan Sadikin Hospital, Cibabat Hospital, Bandung Kiwari Hospital, and Limijati Women and Children Hospital Bandung. Observational analytic data were gathered between February and July 2023 from female patients diagnosed with endometrioma who underwent either laparoscopic or laparotomy surgery, either for therapeutic or diagnostic reasons. There were 58 patients who met the inclusion and exclusion criteria in this study. A significant correlation was observed between ferritin and glutathione peroxidase 4 (GPx4) levels with a correlation coefficient of -0.600 (p < 0.001). However, there was no significant correlation between both ferritin levels and the severity of endometriosis (based on Association of Gynecologic Laparoscopists staging). There was significant correlation between ferritin and glutathione peroxidase 4 (GPx4) levels.