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Di Stasi V, Maseroli E, Rastrelli G, et al. SHBG as a Marker of NAFLD and Metabolic Impairments in Women Referred for Oligomenorrhea and/or Hirsutism and in Women With Sexual Dysfunction. Front Endocrinol (Lausanne). 2021;12:641446doi: 10.3389/fendo.2021.641446.
Di Stasi, V., Maseroli, E., Rastrelli, G., Scavello, I., Cipriani, S., Todisco, T., Marchiani, S., Sorbi, F., Fambrini, M., Petraglia, F., Maggi, M., & Vignozzi, L. (2021). SHBG as a Marker of NAFLD and Metabolic Impairments in Women Referred for Oligomenorrhea and/or Hirsutism and in Women With Sexual Dysfunction. Frontiers in endocrinology, 12641446. https://doi.org/10.3389/fendo.2021.641446
Di Stasi, Vincenza, et al. "SHBG as a Marker of NAFLD and Metabolic Impairments in Women Referred for Oligomenorrhea and/or Hirsutism and in Women With Sexual Dysfunction." Frontiers in endocrinology vol. 12 (2021): 641446. doi: https://doi.org/10.3389/fendo.2021.641446
Di Stasi V, Maseroli E, Rastrelli G, Scavello I, Cipriani S, Todisco T, Marchiani S, Sorbi F, Fambrini M, Petraglia F, Maggi M, Vignozzi L. SHBG as a Marker of NAFLD and Metabolic Impairments in Women Referred for Oligomenorrhea and/or Hirsutism and in Women With Sexual Dysfunction. Front Endocrinol (Lausanne). 2021 Mar 29;12:641446. doi: 10.3389/fendo.2021.641446. eCollection 2021. PMID: 33854482; PMCID: PMC8040974.
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Front Endocrinol (Lausanne). 2021 Mar 29;12:641446. doi: 10.3389/fendo.2021.641446. eCollection 2021.

SHBG as a Marker of NAFLD and Metabolic Impairments in Women Referred for Oligomenorrhea and/or Hirsutism and in Women With Sexual Dysfunction.

Frontiers in endocrinology

Vincenza Di Stasi, Elisa Maseroli, Giulia Rastrelli, Irene Scavello, Sarah Cipriani, Tommaso Todisco, Sara Marchiani, Flavia Sorbi, Massimiliano Fambrini, Felice Petraglia, Mario Maggi, Linda Vignozzi

Affiliations

  1. Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental Clinical and Biomedical Sciences "Mario Serio," University of Florence, Florence, Italy.
  2. Gynecology Unit, Department of Biomedical, Experimental and Clinical Sciences "Mario Serio," University of Florence, Florence, Italy.
  3. Endocrinology Unit, Department of Experimental Clinical and Biomedical Sciences "Mario Serio," University of Florence, Florence, Italy.
  4. I.N.B.B. (Istituto Nazionale Biostrutture e Biosistemi), Rome, Italy.

PMID: 33854482 PMCID: PMC8040974 DOI: 10.3389/fendo.2021.641446

Abstract

PCOS is one of the most common endocrine disorders and NAFLD is one of its most dangerous metabolic consequences. The diagnosis of NAFLD is not a practical task and the condition is at risk of being overlooked. The use of simpler but still reliable surrogate markers is necessary to identify women with a high likelihood of NAFLD. The aim of this study was to evaluate the clinical correlates of NAFLD Liver Fat Score (NAFLD-LFS) in women with oligomenorrhea and/or hirsutism. Furthermore, the study aimed to evaluate whether, among the hormonal parameters evaluated in such women, possible hallmarks of NAFLD may be identified. To this purpose, 66 women who attended our Outpatient Clinic for oligomenorrhea and/or hyperandrogenism were included in the study. In order to validate the results obtained in the first cohort, a second independent sample of 233 women evaluated for female sexual dysfunction (FSD) was analyzed. In cohort 1, NAFLD-LFS positively correlated with metabolic and inflammatory parameters. Among the hormone parameters, NAFLD-LFS showed no significant relationships with androgens but a significant negative correlation with SHBG (p<0.0001) that therefore appeared as a candidate hallmark for pathologic NAFLD-LFS. The ROC analysis showed a significant accuracy (81.1%, C.I.69.1-93.0, p <0.0001) for SHBG in identifying women with a pathological NAFLD-LFS. In particular, a SHBG 33.4 nmol/l was recognized as the best threshold, with a sensitivity of 73.3% and a specificity of 70.7%. In order to validate this SHBG as a marker of metabolic impairment possible related with the presence of NAFLD, we tested this threshold in cohort 2. FSD women with SHBG <33.4 nmol/l had worse metabolic parameters than women with SHBG ≥33.4 nmol/l and a significantly higher NAFLD-LFS even after adjusting for confounders (B=4.18 [2.05; 6.31], p=0.001). In conclusion, this study provides a new evidence in the diagnostic process of NAFLD, showing that the measurement of SHBG, which is routinely assessed in the workup of women referred for possible PCOS, could identify women at higher metabolic risk, thus detecting those who may deserve further targeted diagnostic assessment.

Copyright © 2021 Di Stasi, Maseroli, Rastrelli, Scavello, Cipriani, Todisco, Marchiani, Sorbi, Fambrini, Petraglia, Maggi and Vignozzi.

Keywords: female sexual dysfunction; metabolic syndrome; non-alcoholic fatty liver disease (NAFLD); polycystic ovary syndrome (PCOS); sex hormone binding globulin (SHBG)

Conflict of interest statement

The authors declare that this study received funding from Theramex Italy. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article or

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