Can the MMP-9/NGAL ratio be a diagnostic biomarker for the diagnosis of endometrioma in infertile patients?

ObjectiveIn this study, we aimed to investigate whether serum NGAL, MMP-9 and the MMP-9/NGAL ratio, which are inflammatory markers used for the diagnosis and follow-up of some diseases, can be used as diagnostic and follow-up markers for the diagnosis of endometriomas in infertile patients.MethodsFo...

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Main Authors: Batuhan Turgay, Batuhan Özmen, Harun Kılıçkıran, Yavuz Emre Şükür, Murat Sönmezer, Bülent Berker, Cem Somer Atabekoğlu, Ruşen Aytaç
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Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1624717/full
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author Batuhan Turgay
Batuhan Özmen
Harun Kılıçkıran
Yavuz Emre Şükür
Murat Sönmezer
Bülent Berker
Cem Somer Atabekoğlu
Ruşen Aytaç
author_facet Batuhan Turgay
Batuhan Özmen
Harun Kılıçkıran
Yavuz Emre Şükür
Murat Sönmezer
Bülent Berker
Cem Somer Atabekoğlu
Ruşen Aytaç
author_sort Batuhan Turgay
collection DOAJ
description ObjectiveIn this study, we aimed to investigate whether serum NGAL, MMP-9 and the MMP-9/NGAL ratio, which are inflammatory markers used for the diagnosis and follow-up of some diseases, can be used as diagnostic and follow-up markers for the diagnosis of endometriomas in infertile patients.MethodsForty-five patients with unexplained infertility and 45 infertile patients with endometriomas were included in the study. Patients with endometriomas of at least 3 cm in size were included in the study. NGAL and MMP-9 levels in venous blood samples and the MMP-9/NGAL ratios of the unexplained infertility and endometrioma groups and the preoperative and postoperative results of the endometrioma group were compared.ResultsThe mean blood NGAL and MMP-9 levels in the endometrioma and unexplained groups were 22.0 ± 4.0 ng/ml and 25.4 ± 4.9 ng/ml and 43.7 ± 8.0 ng/ml and 39.3 ± 10.7 ng/ml, respectively, and all the results were statistically significant (p=0.001; p=0.012). The mean blood levels of NGAL and MMP-9 in endometriomas and the same patients at three months after surgery were 24.9 ± 4.9 ng/ml and 27.0 ± 4.9 ng/ml and 43.9 ± 7.3 ng/ml and 36.7 ± 8.7 ng/ml, respectively (p=0.179; p=0.006). The mean ratios of MMP-9/NGAL in the endometrioma, unexplained and postoperative groups were 2.0 ± 0.2, 1.5 ± 0.2 and 1.4 ± 0.2, respectively. All these results were significantly different between the endometrioma-unexplained group and the endometrioma-postoperative group (p=0.001; p=0.001). When we performed a ROC curve analysis for the presence of endometrioma, an MMP-9/NGAL ratio greater than 1.75 had 86.1% sensitivity and 84% specificity in indicating the presence of endometrioma (AUC=0.898). There was a positive correlation between the VAS score and the MMP-9/NGAL ratio.ConclusionsInterestingly, the NGAL blood NGAL level was lower in the endometrioma group than in the control group. The MMP-9/NGAL ratio can be useful in the diagnosis of endometrioma, and this ratio reflects the clinical findings of the disease.
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spelling doaj-art-1d28de3aaa6a4867a2df491bac32a8232025-08-20T03:34:33ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-07-011610.3389/fendo.2025.16247171624717Can the MMP-9/NGAL ratio be a diagnostic biomarker for the diagnosis of endometrioma in infertile patients?Batuhan Turgay0Batuhan Özmen1Harun Kılıçkıran2Yavuz Emre Şükür3Murat Sönmezer4Bülent Berker5Cem Somer Atabekoğlu6Ruşen Aytaç7Department of Obstetrics and Gynecology, Reproductive Endocrinology, School of Medicine, Ankara University, Ankara, TürkiyeDepartment of Obstetrics and Gynecology, Reproductive Endocrinology, School of Medicine, Ankara University, Ankara, TürkiyeHatay Dörtyol State Hospital Department of Obstetrics and Gynecology, Hatay, TürkiyeDepartment of Obstetrics and Gynecology, Reproductive Endocrinology, School of Medicine, Ankara University, Ankara, TürkiyeDepartment of Obstetrics and Gynecology, Reproductive Endocrinology, School of Medicine, Ankara University, Ankara, TürkiyeDepartment of Obstetrics and Gynecology, Reproductive Endocrinology, School of Medicine, Ankara University, Ankara, TürkiyeDepartment of Obstetrics and Gynecology, Reproductive Endocrinology, School of Medicine, Ankara University, Ankara, TürkiyeDepartment of Obstetrics and Gynecology, Reproductive Endocrinology, School of Medicine, Ankara University, Ankara, TürkiyeObjectiveIn this study, we aimed to investigate whether serum NGAL, MMP-9 and the MMP-9/NGAL ratio, which are inflammatory markers used for the diagnosis and follow-up of some diseases, can be used as diagnostic and follow-up markers for the diagnosis of endometriomas in infertile patients.MethodsForty-five patients with unexplained infertility and 45 infertile patients with endometriomas were included in the study. Patients with endometriomas of at least 3 cm in size were included in the study. NGAL and MMP-9 levels in venous blood samples and the MMP-9/NGAL ratios of the unexplained infertility and endometrioma groups and the preoperative and postoperative results of the endometrioma group were compared.ResultsThe mean blood NGAL and MMP-9 levels in the endometrioma and unexplained groups were 22.0 ± 4.0 ng/ml and 25.4 ± 4.9 ng/ml and 43.7 ± 8.0 ng/ml and 39.3 ± 10.7 ng/ml, respectively, and all the results were statistically significant (p=0.001; p=0.012). The mean blood levels of NGAL and MMP-9 in endometriomas and the same patients at three months after surgery were 24.9 ± 4.9 ng/ml and 27.0 ± 4.9 ng/ml and 43.9 ± 7.3 ng/ml and 36.7 ± 8.7 ng/ml, respectively (p=0.179; p=0.006). The mean ratios of MMP-9/NGAL in the endometrioma, unexplained and postoperative groups were 2.0 ± 0.2, 1.5 ± 0.2 and 1.4 ± 0.2, respectively. All these results were significantly different between the endometrioma-unexplained group and the endometrioma-postoperative group (p=0.001; p=0.001). When we performed a ROC curve analysis for the presence of endometrioma, an MMP-9/NGAL ratio greater than 1.75 had 86.1% sensitivity and 84% specificity in indicating the presence of endometrioma (AUC=0.898). There was a positive correlation between the VAS score and the MMP-9/NGAL ratio.ConclusionsInterestingly, the NGAL blood NGAL level was lower in the endometrioma group than in the control group. The MMP-9/NGAL ratio can be useful in the diagnosis of endometrioma, and this ratio reflects the clinical findings of the disease.https://www.frontiersin.org/articles/10.3389/fendo.2025.1624717/fullMMP-9NGALendometriomalaparoscopyinfertility
spellingShingle Batuhan Turgay
Batuhan Özmen
Harun Kılıçkıran
Yavuz Emre Şükür
Murat Sönmezer
Bülent Berker
Cem Somer Atabekoğlu
Ruşen Aytaç
Can the MMP-9/NGAL ratio be a diagnostic biomarker for the diagnosis of endometrioma in infertile patients?
Frontiers in Endocrinology
MMP-9
NGAL
endometrioma
laparoscopy
infertility
title Can the MMP-9/NGAL ratio be a diagnostic biomarker for the diagnosis of endometrioma in infertile patients?
title_full Can the MMP-9/NGAL ratio be a diagnostic biomarker for the diagnosis of endometrioma in infertile patients?
title_fullStr Can the MMP-9/NGAL ratio be a diagnostic biomarker for the diagnosis of endometrioma in infertile patients?
title_full_unstemmed Can the MMP-9/NGAL ratio be a diagnostic biomarker for the diagnosis of endometrioma in infertile patients?
title_short Can the MMP-9/NGAL ratio be a diagnostic biomarker for the diagnosis of endometrioma in infertile patients?
title_sort can the mmp 9 ngal ratio be a diagnostic biomarker for the diagnosis of endometrioma in infertile patients
topic MMP-9
NGAL
endometrioma
laparoscopy
infertility
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1624717/full
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