title: Nuclear magnetic resonance metabolomic profiling of urine provides a noninvasive alternative to the identification of biomarkers associated with endometriosis.
abstract: OBJECTIVE
  To investigate whether urine metabolomic profile can be used to identify biomarkers associated to endometriosis.
  
  
  METHODS
  Prospective study. For each subject, a urine sample was collected after overnight fasting and before surgery.
  
  
  METHODS
  University medical center.
  
  
  METHODS
  The clinical cohort included 45 endometriosis patients, diagnosed at early (n = 6) and advanced (n = 39) stages of the disease, and 36 healthy women. All women underwent diagnostic laparoscopy to visually confirm the presence or absence of endometriotic lesions.
  
  
  METHODS
  Metabolomic profiling of urine samples based on (1)H-nuclear magnetic resonance (NMR) spectroscopy in combination with statistical approaches.
  
  
  METHODS
  Comparative identification of metabolites present in urine from endometriosis patients and healthy women.
  
  
  RESULTS
  The urine metabolomic profile of endometriosis patients exhibited higher concentrations of N(1)-methyl-4-pyridone-5-carboxamide, guanidinosuccinate, creatinine, taurine, valine, and 2-hydroxyisovalerate and decreased concentrations of lysine compared with healthy women. Most of these metabolites are involved in inflammation and oxidative stress processes. These pathophysiologic events had been previously described to be present in ectopic endometrial proliferation foci.
  
  
  CONCLUSIONS
  Overall, the results demonstrate the potential of (1)H-NMR-based metabolomics, a rapid and noninvasive approach, to identify metabolic changes associated to endometriosis in urine samples. This information could be useful to get a better understanding of the pathogenesis of endometriosis, thus providing support to the noninvasive diagnosis of this pathology.
authors: Structural Biochemistry Laboratory, Centro de Investigación Príncipe Felipe, Valencia, Spain; Department of Obstetrics and Gynecology, Hospital Universitario La Fe, Valencia, Spain.
authors: Sara
authors: S
authors: Vicente-Muñoz
authors: Department of Obstetrics and Gynecology, Hospital Universitario La Fe, Valencia, Spain.
authors: Inmaculada
authors: I
authors: Morcillo
authors: Structural Biochemistry Laboratory, Centro de Investigación Príncipe Felipe, Valencia, Spain.
authors: Leonor
authors: L
authors: Puchades-Carrasco
authors: Department of Obstetrics and Gynecology, Hospital Universitario La Fe, Valencia, Spain.
authors: Vicente
authors: V
authors: Payá
authors: Department of Obstetrics and Gynecology, Hospital Universitario La Fe, Valencia, Spain; Instituto Valenciano de Infertilidad, Valencia, Spain.
authors: Antonio
authors: A
authors: Pellicer
authors: Structural Biochemistry Laboratory, Centro de Investigación Príncipe Felipe, Valencia, Spain; Instituto de Investigación Sanitaria La Fe, Valencia, Spain. Electronic address: pineda_ant@gva.es.
authors: Antonio
authors: A
authors: Pineda-Lucena
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000652:urine; D016022:Case-Control Studies; D004715:Endometriosis / Q000175:diagnosis / Q000652:urine*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D010535:Laparoscopy; D055432:Metabolomics / Q000379:methods*; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D066244:Proton Magnetic Resonance Spectroscopy; D016482:Urinalysis
chemical_list: D015415:Biomarkers
keywords: (1)H-NMR spectroscopy; Endometriosis; biomarkers; metabolomics; urine