The Relation Between Serum Lipid Profile And Homocysteine And Endometriosis-related Infertility

OBJECTIVE:To investigate the serum lipid profile and homocysteine levels in Chinese women with endometriosis-related infertility and its association with the disease.METHODS:A case-control study was conducted.A total of 202 patients with infertility were included in the study.The recruited patients were divided into two groups:endometriosis(EM)group(n=110)and control group(n=92).The two groups were matched with age and body mass index.Ovulation-related infertility,male infertility and metabolic diseases were excluded.The patients were divided into two subgroups according the rASRM classification:subgroup 1(EM ?/?)(n=61)and subgroup2(EM?/?)(n=49).The parameters,triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL),low-density lipoprotein cholesterol(LDL),TG/HDL,TC/HDL,LDL/HDL and homocysteine(HCY)were recorded and analyzed between the groups.All the parameters were obtained through blood chemistry panel assays.The data were analyzed using SPSS 23(Statistical Package for Social Science-version 23)software program.Univariate analysis and stepwise regression model were used to calculate the odd ratios(ORs).The receiver-operating characteristic(ROC)curve analysis was carried out to measure the diagnostic performance of the parameters by calculating the area under the curve(AUC).RESULTS:Serum TG,LDL,TG/HDL,LDL/HDL and HCY levels were significantly lower in EMs group compared to the control group(P=0.02;P=0.01;P=0.04;P=0.03;P<0.01 respectively).Serum TC,HDL and TC/HDL did not show any significant difference(P>0.05).In the subgroup analysis,patients with EM ?/? and EM ?/? had significantly lower serum TG and LDL levels than the matched controls(P=0.04;P=0.03 respectively).The parameters did not show any significant differences between EM ?/?and EM ?/?.In addition,patients with EM ?/? and EM ?/? had lower serum homocysteine level compared to the controls,respectively(P=0.01).After using the stepwise logistic regression analysis and correcting for potential confounders,there was an inverse relationship between both TG and HCY and endometriosis-related infertility,respectively[Adjusted Odds Ratio(AOR)0.71;95%confidence interval(CI):0.55-0.92,AOR 0.7;95%CI:0.54-0.91].In the subgroup analysis,there was an inverse relationship between LDL and EM ?/?[AOR 0.68;95%CI:0.5-0.92].Also,an inverse relationship was observed between both TG and HCY and EM ?/?[AOR 0.68;95%CI:0.48-0.94,AOR 0.64;95%CI:0.46-0.89].The area under curve(AUC)for TG and HCY was 0.6469 in endometriosis.The AUC of TG and HCY was 0.6155 and 0.6899 in EM ?/? and EM ?/?,respectively.CONCLUSIONS:The current study shows that serum lipid profile and homocysteine have association with endometriosis-related infertility,irrespective of the stages.Serum TG and HCY are protective factors of endometriosis-related infertility and serum LDL is a protective factor of minimal/mild endometriosis.The values obtained for TG and HCY from area under curve are insufficient to be used as a diagnostic marker for endometriosis-related infertility.