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Published online: 2024-07-24

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Levels of a novel metabolic marker, spexin in patients with hirsutism: metabolic syndrome risk in idiopathic and polycystic ovarian syndrome (PCOS) hirsutismirsutism

Nil Atakul1, Berna Sermin Kılıc1, Sahabettin Selek2, Yildiz Atamer3

Abstract

Objectives: Polycystic ovarian syndrome (PCOS) disease the most common endocrinopathy among reproductive age women , and its association with metabolic syndrome is investigated in many reports. The most common cause of hirsutism worldwide is considered to be idiopathic hirsutism (IH) defined as clinical hirsutism without underlying hormonal imbalance. Spexin is a novel peptide and is mainly involved in energy homeostasis and, has not yet made its way into clinical practice. We aim to investigate spexin in an understudied population of hirsute patients.

Material and methods: This prospective case-control study analysis involved 48 patients with hirsutism.and, was further divided into two groups: 26 had PCOS syndrome and 22 had IH. 40 healthy, age and BMI-matched non-hirsute women enrolled as the control group. The spexin level was determined using a human spexin ELISA kit.

Results: There was no statistically significant difference in spexin levels found between hirsutism and control patients 1514 vs 1425 ng/L, (p  =  0.849). Spexin levels were found to be significantly higher in the PCOS hirsutism group than in the IH group (1668.5 ng/L vs 1021 ng/L), (p  =  0.022). Correlations of spexin levels with total testosterone, low-density lipoprotein, and total cholesterol were found in hirsutism patients.

Conclusions: Our findings conclude that both IH and PCOS hirsutism patients have an increased risk of metabolic syndrome; hyperandrogenemia and dyslipidemia contribute to the progression of upcoming research on metabolic syndrome. Low spexin levels in IH in hirsute patients

Could potentially elucidate the pathogenesis of the condition, consequently assisting in diminishing the risk of associated complications.

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References

  1. Aswini R, Jayapalan S. Modified Ferriman-Gallwey Score in Hirsutism and its Association with Metabolic Syndrome. Int J Trichology. 2017; 9(1): 7–13.
  2. Glintborg D, Andersen M. An update on the pathogenesis, inflammation, and metabolism in hirsutism and polycystic ovary syndrome. Gynecol Endocrinol. 2010; 26(4): 281–296.
  3. Wiltgen D, Furtado L, Kohek MBF, et al. CAPN10 UCSNP-43, UCSNP-19 and UCSNP-63 polymorphisms and metabolic syndrome in polycystic ovary syndrome. Gynecol Endocrinol. 2007; 23(3): 173–178.
  4. Hahn S, Tan S, Sack S, et al. Prevalence of the metabolic syndrome in German women with polycystic ovary syndrome. Exp Clin Endocrinol Diabetes. 2007; 115(2): 130–135.
  5. Glintborg D, Andersen M, Hagen C, et al. Evaluation of metabolic risk markers in polycystic ovary syndrome (PCOS). Adiponectin, ghrelin, leptin and body composition in hirsute PCOS patients and controls. Eur J Endocrinol. 2006; 155(2): 337–345.
  6. Abruzzese GA, Gamez J, Belli SH, et al. Increased chemerin serum levels in hyperandrogenic and normoandrogenic women from Argentina with polycystic ovary syndrome. Gynecol Endocrinol. 2020; 36(12): 1057–1061.
  7. Sobti S, Dewan R, Ranga S. Metabolic syndrome and insulin resistance in PCOS phenotypes. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2017; 6(11): 5067.
  8. Zaeemzadeh N, Sadatmahalleh SJ, Ziaei S, et al. Prevalence of metabolic syndrome in four phenotypes of PCOS and its relationship with androgenic components among Iranian women: A cross-sectional study. Int J Reprod Biomed. 2020; 18(4): 253–264.
  9. Mehrabian F, Khani B, Kelishadi R, et al. The prevalence of metabolic syndrome and insulin resistance according to the phenotypic subgroups of polycystic ovary syndrome in a representative sample of Iranian females. J Res Med Sci. 2011; 16(6): 763–769.
  10. Seadan A, Bakry O, Gayed EAl. Assessment of obesity, dyslipidemia, and insulin resistance in idiopathic hirsutism: a case–control study. Journal of the Egyptian Women's Dermatologic Society. 2020; 17(2): 113.
  11. Ramezani Tehrani F, Behboudi-Gandevani S, Simbar M, et al. A population-based study of the relationship between idiopathic hirsutism and metabolic disturbances. J Endocrinol Invest. 2015; 38(2): 155–162.
  12. Unlühizarci K, Karababa Y, Bayram F, et al. The investigation of insulin resistance in patients with idiopathic hirsutism. J Clin Endocrinol Metab. 2004; 89(6): 2741–2744.
  13. Sadat Hosseini M, Ramezani Tehrani F, Azizi F. The lack of association between idiopathic hirsutism and metabolic disturbances: Iranian PCOS Prevalence Study. Gynecol Endocrinol. 2013; 29(9): 821–825.
  14. Walewski JL, Ge F, Gagner M, et al. Adipocyte accumulation of long-chain fatty acids in obesity is multifactorial, resulting from increased fatty acid uptake and decreased activity of genes involved in fat utilization. Obes Surg. 2010; 20(1): 93–107.
  15. Said MA, Nafeh NY, Abdallah HA. Spexin alleviates hypertension, hyperuricaemia, dyslipidemia and insulin resistance in high fructose diet induced metabolic syndrome in rats via enhancing PPAR-ɣ and AMPK and inhibiting IL-6 and TNF-α. Arch Physiol Biochem. 2023; 129(5): 1111–1116.
  16. Ge JF, Walewski JL, Anglade D, et al. Regulation of Hepatocellular Fatty Acid Uptake in Mouse Models of Fatty Liver Disease with and without Functional Leptin Signaling: Roles of NfKB and SREBP-1C and the Effects of Spexin. Semin Liver Dis. 2016; 36(4): 360–372.
  17. Kumar S, Hossain J, Nader N, et al. Decreased Circulating Levels of Spexin in Obese Children. J Clin Endocrinol Metab. 2016; 101(7): 2931–2936.
  18. Behrooz M, Vaghef-Mehrabany E, Moludi J, et al. Are spexin levels associated with metabolic syndrome, dietary intakes and body composition in children? Diabetes Res Clin Pract. 2021; 172: 108634.
  19. Behrooz M, Vaghef-Mehrabany E, Moludi J, et al. Are spexin levels associated with metabolic syndrome, dietary intakes and body composition in children? Diabetes Res Clin Pract. 2021; 172: 108634.
  20. Karaca A, Bakar-Ates F, Ersoz-Gulcelik N. Decreased Spexin Levels in Patients with Type 1 and Type 2 Diabetes. Med Princ Pract. 2018; 27(6): 549–554.
  21. Bitarafan V, Esteghamati A, Azam K, et al. Comparing serum concentration of spexin among patients with metabolic syndrome, healthy overweight/obese, and normal-weight individuals. Med J Islam Repub Iran. 2019; 33: 93.
  22. Kołodziejski PA, Pruszyńska-Oszmałek E, Korek E, et al. Serum levels of spexin and kisspeptin negatively correlate with obesity and insulin resistance in women. Physiol Res. 2018; 67(1): 45–56.
  23. Amirpour M, Tarighat-Esfanjani A, Payahoo L, et al. Relationship between serum spexin levels and metabolic syndrome components in obese and normal weight people with or without diabetes. Obesity Medicine. 2021; 24: 100337.
  24. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004; 19(1): 41–47.
  25. FERRIMAN D, GALLWEY JD. Clinical assessment of body hair growth in women. J Clin Endocrinol Metab. 1961; 21: 1440–1447.
  26. Azziz R, Carmina E, Sawaya ME. Idiopathic hirsutism. Endocr Rev. 2000; 21(4): 347–362.
  27. Beyazit F, Hiz MM, Turkon H, et al. Serum spexin, adiponectin and leptin levels in polycystic ovarian syndrome in association with FTO gene polymorphism. Ginekol Pol. 2021; 92(10): 682–688.
  28. Guler A, Demir İ. Decreased levels of spexin are associated with hormonal and metabolic disturbance in subjects with polycystic ovary syndrome. J Obstet Gynaecol. 2021; 41(3): 408–413.
  29. Zhang L, Li G, She Y, et al. Low levels of spexin and adiponectin may predict insulin resistance in patients with non-alcoholic fatty liver. Pract Lab Med. 2021; 24: e00207.
  30. Gu L, Ma Y, Gu M, et al. Spexin peptide is expressed in human endocrine and epithelial tissues and reduced after glucose load in type 2 diabetes. Peptides. 2015; 71: 232–239.
  31. Lin CY, Huang T, Zhao L, et al. Circulating Spexin Levels Negatively Correlate With Age, BMI, Fasting Glucose, and Triglycerides in Healthy Adult Women. J Endocr Soc. 2018; 2(5): 409–419.