Université de Paris, Faculty of Medicine, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital universitaire Paris Centre, Paris, France; Department of Gynecology Obstetrics II and Reproductive Medicine, Cochin University Hospital Center, Paris, France; Department 3I "Infection, Immunité et inflammation," Cochin Institute, Institut national de la santé et de la recherche médicale U1016, Paris, France.
Université de Paris, Faculty of Sciences, Campus Saint-Germain-des-Prés, Paris, France; Laboratory of Pharmacological and Toxicological Chemistry and Biochemistry, Unité mixte de recherche 8601-Centre national de la recherche scientifique, Paris, France.
Fertil Steril. 2021 Jul;116(1):243-254. doi: 10.1016/j.fertnstert.2021.02.031. Epub 2021 Apr 11.
To determine whether the adenomyosis phenotype affects the proton nuclear magnetic resonance (H-NMR)-based serum metabolic profile of patients.
Cohort study.
University hospital-based research center.
Seventy-seven patients who underwent laparoscopy for a benign gynecologic condition.
Pelvic magnetic resonance imaging and collection of a venous peripheral blood sample were performed during the preoperative workup. The women were allocated to the adenomyosis group (n = 32), or the control group (n = 45). The adenomyosis group was further subdivided into two groups: diffuse adenomyosis of the inner myometrium (n = 14) and focal adenomyosis of the outer myometrium (n = 18). Other adenomyosis phenotypes were excluded.
Metabolomic profiling based on H-NMR spectroscopy in combination with statistical approaches.
The serum metabolic profiles of the patients with adenomyosis indicated lower concentrations of 3-hydroxybutyrate, glutamate, and serine compared with controls. Conversely, the concentrations of proline, choline, citrate, 2-hydroxybutyrate, and creatinine were higher in the adenomyosis group. The focal adenomyosis of the outer myometrium and the diffuse adenomyosis phenotypes also each exhibited a specific metabolic profile.
Serum metabolic changes were detected in women with features of adenomyosis compared with their disease-free counterparts, and a number of specific metabolic pathways appear to be engaged according to the adenomyosis phenotype. The metabolites with altered levels are particularly involved in immune activation as well as cell proliferation and cell migration. Nevertheless, this study did find evidence of a correlation between metabolite levels and symptoms thought to be related to adenomyosis. Further studies are required to determine the clinical significance of these differences in metabolic profiles.
确定子宫腺肌病表型是否影响基于质子磁共振（H-NMR）的患者血清代谢谱。
队列研究。
大学医院为基础的研究中心。
77 名因良性妇科疾病接受腹腔镜检查的患者。
在术前检查期间进行盆腔磁共振成像和采集静脉外周血样。将女性分配到子宫腺肌病组（n=32）或对照组（n=45）。子宫腺肌病组进一步分为两组：内肌层弥漫性子宫腺肌病（n=14）和外肌层局灶性子宫腺肌病（n=18）。排除其他子宫腺肌病表型。
基于 H-NMR 光谱的代谢组学分析结合统计方法。
与对照组相比，患有子宫腺肌病的患者的血清代谢谱显示 3-羟基丁酸、谷氨酸和丝氨酸的浓度较低。相反，腺肌病组的脯氨酸、胆碱、柠檬酸、2-羟基丁酸和肌酐浓度较高。外肌层局灶性子宫腺肌病和弥漫性子宫腺肌病表型也各自表现出特定的代谢谱。
与无疾病对照组相比，患有子宫腺肌病特征的女性血清代谢发生变化，根据子宫腺肌病表型似乎涉及一些特定的代谢途径。改变水平的代谢物特别参与免疫激活以及细胞增殖和细胞迁移。然而，本研究确实发现代谢物水平与被认为与子宫腺肌病相关的症状之间存在相关性的证据。需要进一步的研究来确定这些代谢谱差异的临床意义。
