Abstract
Objective: Endometriosis is a chronic gynecological condition linked to oxidative stress and inflammation. In order to investigate their potential as non-invasive biomarkers for the advancement of the disease, this study aimed to evaluate the levels of antioxidant enzymes and serum oxidative stress markers in endometriosis-affected women.
Methods: A prospective case control study was conducted at the Women and Children Teaching Hospital, Dera Ismail Khan, Pakistan. Twenty-seven healthy controls and thirty-one women with ovarian endometriomas that were histopathologically confirmed were included in the study. Serum concentrations of antioxidant enzymes like superoxide dismutase (SOD) and reduced glutathione (GSH) as well as oxidative stress indicators like malondialdehyde (MDA) were assessed. Clinical parameters such as disease stage, cyst size, and CA-125 levels were noted. To evaluate the connections between oxidative stress and disease traits, statistical comparisons and correlation analyses were conducted.
Results: Women diagnosed with endometriosis were found to have significantly increased serum malondialdehyde (MDA) levels (3.12 ± 0.85 μmol/L) compared to controls (1.78 ± 0.56 μmol/L, p < 0.001). This indicates a much higher oxidative stress burden in these subjects. Endometriosis patients demonstrated a significant reduction in total superoxide dismutase (SOD) activity (82.5 ± 14.2 U/mL vs 109.3 ± 12.7 U/mL, p < 0.001) and reduced glutathione (GSH) levels (4.21 ± 0.97 μmol/L vs 6.35 ± 1.12 μmol/L, p < 0.001), demonstrating impaired defense against oxidative stress. Additionally, MDA levels positively correlated with size of ovarian cysts (r = 0.421, p = 0.018) and the level of the tumor marker CA-125 (r = 0.385, p = 0.031), while SOD and GSH were negatively correlated with the stage of endometriosis (SOD: r = −0.448, p = 0.012; GSH: r = −0.401, p = 0.025) and the level of CA-125 (SOD: r = −0.372, p = 0.035; GSH: r = −0.389, p = 0.028).
Conclusion: In women diagnosed with endometriosis, oxidative stress levels were significantly higher than normal and have less capability to mitigate oxidative stress through the antioxidant response. Non-invasive biomarkers (MDA, SOD, and GSH) may serve as non-invasive biomarkers for monitoring disease activity and may also help in guiding antioxidant- based therapeutic strategies.