November 30th, 2023

A full text version of this article is available.
To access article obtain online access here or login
Evaluation of Endoplasmic Reticulum Stress in Endometriosis Patients by Determination of Serum X-box Binding Protein 1 Levels
Authors:  Pınar Yalçın Bahat, M.D., Nura Fitnat Topbas Selcuki, M.D., Necip Deniz, M.D., Cihan Kaya, M.D., Kübra Çakmak, M.D., and Engin Oral, M.D., Ph.D.
  OBJECTIVE: To evaluate endoplasmic reticulum stress levels in the presence of endometriosis by comparing the serum X-box binding protein 1 (XBP-1) levels between endometriosis patients and a healthy control group.

STUDY DESIGN: A total of 86 patients who were previously diagnosed with endometriosis with persistent endometriomas were included in the study group. Sixty healthy subjects were recruited to the control group. Serum XBP-1 levels were determined and pain symptoms were evaluated using visual analogue scale (VAS).

RESULTS: The area under curve for XBP-1 levels in the study group was 91% (95% CI 0.860–0.960, p<0.001) for the cutoff value of 1,279.52 with a sensitivity of 87.2%, specificity of 86.7%, PPV 90.4%, NPV 82.5%, +LR 6.5, and −LR 0.1. The area under curve for VAS scores ≥6 was 96.2% (95% CI 0.930–0.980, p<0.001) for the cutoff value 2,227.71, with a sensitivity of 90% and a specificity of 91.1%. In addition, a significant positive correlation between XBP-1 levels and endometrioma volume and VAS score was observed (r=0.51; r=0.79; r=0.65, respectively; p<0.001).

CONCLUSION: XBP-1 levels in the study group were significantly higher than those of the control group. In addition, significantly higher levels of XBP-1 in patients with VAS scores of ≥6 have been reported.
Keywords:  endometriosis; endoplasmic reticulum stress; pain; unfolded protein response; X-box binding protein 1 (XBP-1)
  Acrobat Reader 7.0 is recommended to properly view and print the article.
Reader can be downloaded from