Altered Lipid Metabolism in the Vaginal Wall of Women With Pelvic Organ Prolapse: A Targeted Lipidomics Study

Pelvic organ prolapse (POP) severely impacts quality of life, but its association with lipid metabolism remains unclear. This study explored lipidomic alterations in vaginal anterior wall tissues of POP patients. We performed UHPLC-MS/MS-based targeted lipidomics on vaginal anterior wall tissues from 8 POP patients and 8 matched controls. Multivariate analyses (PCA, PLS-DA, OPLS-DA) identified significantly altered lipids, and KEGG pathway analysis determined related metabolic pathways. Among 1010 identified lipids, POP tissues exhibited significant lipid remodeling: phosphatidic acid (PA) increased from 0.048% to 0.226%, triglycerides (TG) decreased from 94.901% to 83.927%. Forty- four lipids were significantly altered (VIP > 1, p < 0.05), with KEGG analysis highlighting enrichment in glycerophospholipid metabolism. Reprogramming of lipid chain length and saturation further confirmed metabolic dysregulation. POP may be associated with disrupted lipid metabolism, characterized by elevated PA/PE/PC and reduced TG, potentially impairing membrane stability, mitochondrial function, and energy homeostasis. These findings reveal novel molecular mechanisms in POP and suggest lipid metabolism as a therapeutic target.