Diagnostic and Predictive Performance of Differential Metabolites
A receiver operating characteristics (ROC) analysis of vaginal discharge
samples from the CTL and VVC groups was performed to explore the
potential effect of C. albicans infection on the vaginal metabolome. In
addition, the AUC values revealed the diagnostic potential of
metabolites as biomarkers specific to distinguishing healthy individuals
from patients with VVC. When comparing the samples from the CTL group
and the VVC group, 11 metabolites showed discriminative ability (AUC
values > 0.8). Among these, TBHQ,
3-Methoxy-4-hydroxyphenylglycol glucuronide, and deoxycholic acid had
AUC values > 0.85, and the AUC value of lecanoricacidde
> 0.9, which was considered an excellent discriminator
(Fig. 6A). This indicated significant consumption of these metabolites
in the VVC group. Subsequently, the features of VVC were investigated
using ROC analysis. The results showed that 25 differential metabolites
had AUC values of ≥ 0.8, and 14 metabolites had AUC values ≥ 0.9 (Fig.
6B). Among the metabolites that are discriminant factors of VVC,
L-(-)-arabitol, L-tyrosine, D-(+)-arabitol, psychosine had AUC values
> 0.97, and were identified as more accurate discriminating
factors and provided better predictive estimates than any other
metabolite detected. Overall, ROC analysis showed that VVC induced
significant changes in the metabolic profile of the vaginal
microenvironment, and these metabolites could distinguish between normal
individuals and VVC patients, which were potential markers for
predicting VVC.