Metabolome analysis as a potential source of endometriosis biomarkers with the use of multiomics approach in its diagnosis

Endometriosis poses diagnostic challenges. This study aimed to analyze the metabolomic profiles of plasma and peritoneal fluid samples obtained from women with endometriosis compared to controls. Our multicenter study involved sample collection from women undergoing laparoscopic surgery. The metabolomic profiles of plasma samples obtained from 73 women with endometriosis and 35 controls, as well as peritoneal fluid samples from 53 women with endometriosis and 34 controls, were analysed using mass spectrometry techniques. Differences in lipid profiles were observed between the groups. Chemometric analyses identified a set of 20 metabolites present in peritoneal fluid and 26 compounds in plasma, which serve as potential diagnostic tools for endometriosis. Then, we used a simple approach to build a classification model based on the sets of metabolites in combination with autoantibodies selected using protein microarrays from our previous study. The classification performance obtained on the joined metabolomic and proteomic feature sets exceeds that achievable for separate assays (sensitivity/specificity for plasma and peritoneal fluid were respectively 0.98/0.86 and 0.92/0.82). Identified metabolites present promising candidates for biomarkers. Utilizing these metabolites in a diagnostic panel may enhance endometriosis detection. Moreover, we observed the potential benefits of a multi-omics approach based on integrated metabolomic and proteomic analysis to endometriosis research.