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Peer-reviewedCC BY 4.0Frontiers in Endocrinology

Trace element imbalance and oxidative-inflammatory dysregulation in women with endometriosis

  • Ashish Ashish1
  • Sangeeta Rai2
  • Shivani Mishra3
  • Anil Kumar Maurya3
  • Shani Vishwakarma3
  • Nitish Kumar Singh1
  • Abhay Kumar Yadav1
  • Royana Singh3
  1. 1Multidisciplinary Research Unit, ICMR-DHR, Institute of Medical Sciences, Banaras Hindu University
  2. 2Department of Obstetrics & Gynaecology, Institute of Medical Sciences, Banaras Hindu University
  3. 3Department of Anatomy, Institute of Medical Sciences, Banaras Hindu University
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Abstract

Background: Endometriosis is a chronic inflammatory and estrogen-dependent disorder associated with oxidative stress, immune dysregulation, and altered trace-element homeostasis. This study investigated the association between serum trace elements, oxidative-stress biomarkers, and inflammatory cytokines in women with endometriosis, with particular emphasis on their interplay in disease pathophysiology and their potential utility for integrated biomarker profiling.

Materials and Methods: A total of 120 women, comprising 60 women with endometriosis and 60 healthy controls, were enrolled. Serum concentrations of trace elements (As, Pb, Cd, Hg, Cu, Fe, Zn, and Se) were measured using graphite furnace atomic absorption spectrophotometry. Oxidative-stress biomarkers (MDA, SOD, glutathione, and 8-OHdG) and inflammatory cytokines (TNF-α, TGF-β, IFN-γ, IL-6, IL-1β, and IL-10) were assessed using ELISA-based methods. Data distribution was assessed using the Shapiro–Wilk test before group comparisons. Trace-element and oxidative-stress biomarkers showed non-normal distributions and were analyzed using the Mann–Whitney U test, whereas inflammatory cytokine variables met normality assumptions and were analyzed using the unpaired Student’s t-test. Associations among biomarkers were evaluated using Spearman’s rank correlation analysis.

Results: Women with endometriosis exhibited significantly higher serum levels of As, Pb, Hg, Cu, and Fe and significantly lower Zn and Se levels compared with healthy controls. Oxidative-stress profiling demonstrated significantly increased MDA, SOD, and 8-OHdG levels and significantly reduced glutathione levels in the endometriosis group ( p < 0.001). Inflammatory profiling revealed significantly elevated TNF-α, IL-6, IL-1β, and IL-10 levels, whereas IFN-γ was significantly reduced; TGF-β showed a non-significant increasing trend. Spearman’s correlation analysis identified selective associations among trace elements, oxidative-stress biomarkers, and inflammatory cytokines, including positive correlations of Cu with IL-1β and As with TGF-β, and a negative correlation of Fe with glutathione.

Conclusion: Women with endometriosis demonstrated coordinated alterations in trace-element status, redox homeostasis, and inflammatory signaling. The observed associations suggest an interconnected redox-inflammatory phenotype that may contribute to the biological stress environment associated with endometriosis. These findings support further investigation of trace-element and oxidative-stress profiles as potential biomarkers of disease-related biological alterations, while larger multicenter and longitudinal studies are needed to establish their clinical relevance and causal relationships.

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Cite

BibTeXRIS
BibTeX
@article{ashish2026trace,
  title = {{Trace element imbalance and oxidative-inflammatory dysregulation in women with endometriosis}},
  author = {Ashish Ashish and Sangeeta Rai and Shivani Mishra and Anil Kumar Maurya and Shani Vishwakarma and Nitish Kumar Singh and Abhay Kumar Yadav and Royana Singh},
  journal = {Frontiers in Endocrinology},
  year = {2026},
  month = oct,
  doi = {10.3389/fendo.2026.1973603},
  url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.1973603/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Trace element imbalance and oxidative-inflammatory dysregulation in women with endometriosis
AU  - Ashish Ashish
AU  - Sangeeta Rai
AU  - Shivani Mishra
AU  - Anil Kumar Maurya
AU  - Shani Vishwakarma
AU  - Nitish Kumar Singh
AU  - Abhay Kumar Yadav
AU  - Royana Singh
PY  - 2026
DA  - 2026/10/29
JO  - Frontiers in Endocrinology
DO  - 10.3389/fendo.2026.1973603
UR  - https://www.frontiersin.org/articles/10.3389/fendo.2026.1973603/full
AB  - Background: Endometriosis is a chronic inflammatory and estrogen-dependent disorder associated with oxidative stress, immune dysregulation, and altered trace-element homeostasis. This study investigated the association between serum trace elements, oxidative-stress biomarkers, and inflammatory cytokines in women with endometriosis, with particular emphasis on their interplay in disease pathophysiology and their potential utility for integrated biomarker profiling.  Materials and Methods: A total of 120 women, comprising 60 women with endometriosis and 60 healthy controls, were enrolled. Serum concentrations of trace elements (As, Pb, Cd, Hg, Cu, Fe, Zn, and Se) were measured using graphite furnace atomic absorption spectrophotometry. Oxidative-stress biomarkers (MDA, SOD, glutathione, and 8-OHdG) and inflammatory cytokines (TNF-α, TGF-β, IFN-γ, IL-6, IL-1β, and IL-10) were assessed using ELISA-based methods. Data distribution was assessed using the Shapiro–Wilk test before group comparisons. Trace-element and oxidative-stress biomarkers showed non-normal distributions and were analyzed using the Mann–Whitney U test, whereas inflammatory cytokine variables met normality assumptions and were analyzed using the unpaired Student’s t-test. Associations among biomarkers were evaluated using Spearman’s rank correlation analysis.  Results: Women with endometriosis exhibited significantly higher serum levels of As, Pb, Hg, Cu, and Fe and significantly lower Zn and Se levels compared with healthy controls. Oxidative-stress profiling demonstrated significantly increased MDA, SOD, and 8-OHdG levels and significantly reduced glutathione levels in the endometriosis group ( p < 0.001). Inflammatory profiling revealed significantly elevated TNF-α, IL-6, IL-1β, and IL-10 levels, whereas IFN-γ was significantly reduced; TGF-β showed a non-significant increasing trend. Spearman’s correlation analysis identified selective associations among trace elements, oxidative-stress biomarkers, and inflammatory cytokines, including positive correlations of Cu with IL-1β and As with TGF-β, and a negative correlation of Fe with glutathione.  Conclusion: Women with endometriosis demonstrated coordinated alterations in trace-element status, redox homeostasis, and inflammatory signaling. The observed associations suggest an interconnected redox-inflammatory phenotype that may contribute to the biological stress environment associated with endometriosis. These findings support further investigation of trace-element and oxidative-stress profiles as potential biomarkers of disease-related biological alterations, while larger multicenter and longitudinal studies are needed to establish their clinical relevance and causal relationships.
SN  - 1664-2392
ER  -