Endometriosis-Angiopoietin-like Protein-4

Evaluation of Angiopoietin-like Protein 4 Levels in Patients With Endometriosis

Endometriosis is a chronic inflammatory disease associated with pelvic pain, dyspareunia, and impaired ovarian reserve. Cancer antigen-125 (CA-125) is widely studied but limited by low specificity, while angiopoietin-like protein-4 (ANGPTL4) has emerged as a potential biomarker due to its role in angiogenesis and inflammation. In the current study it was aimed to investigate serum and peritoneal fluid ANGPTL4 levels in women with endometriosis compared to healthy controls, and to evaluate their associations with clinical symptoms, serum CA-125, and anti-Müllerian hormone levels.

Inclusion Criteria:

• Diagnosis of endometriosis for study group who underwent laparoscopic endometriosis surgery
• Healthy women for control group

Exclusion Criteria:

• Cardiovascular diseases including hypertension
• Type 1 or type 2 diabetes mellitus
• Morbid obesity
• Primary adrenal insufficiency
• Uterine fibroids
• Thyroid dysfunctions including Hashimoto thyroiditis and Grave's disease
• Hepatic dysfunctions
• Renal insufficiency
• Genetic disorders in chromosome constitution or karyotype analysis including monosomy X, trisomy X and gene mutations as BMP15, FMR I, POFIB, and GDF9
• Neurologic diseases
• Psychiatric disorders
• Autoimmune diseases or syndromes including Addison's disease, autoimmune syndromes, scleroderma, Sjogren's syndrome, myasthenia gravis, inflammatory bowel diseases, multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosus and familial Mediterranean fever
• History of any malignancy
• History of exposure to chemotherapeutic agents or radiotherapy