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.