The peritoneal fluid concentration of leptin is increased in women with peritoneal but not ovarian endometriosis

Abstract

This study was designed to measure leptin concentrations in the peritoneal fluid (PF) of women with different aspects of pelvic endometriosis. Among 36 consecutive women undergoing laparoscopy, nine were diagnosed as having minimal-mild endometriosis (stage I-II). Among nine other subjects with advanced stage (III-IV) disease, six showed one or more ovarian endometriotic cysts as the only operative finding. The remaining 18 unaffected women constituted the control group. Patients with endometriosis had significantly higher PF leptin concentrations (32.6 +/- 16.2 versus 17.1 +/- 6.6 ng/ml, P = 0.002); this difference remained significant when corrected for body mass index (BMI) (PF leptin/BMI ratio 1.41 +/- 0.67 versus 0.76 +/- 0.28, P = 0.001). Furthermore, the PF leptin/BMI ratio was significantly higher in women with peritoneal implants than in those in whom no implant was found at laparoscopy (1.6 +/- 0.7 versus 0.83 +/- 0.33, P = 0.007). Conversely, patients with one or more ovarian endometriomata as the only finding, had a PF leptin/BMI ratio comparable with that in women where no cyst was found (1.05 +/- 0.4 versus 1.1 +/- 0.65). In women with stage I-II endometriosis, a higher mean PF leptin/BMI ratio was found compared with those affected by stage III-IV (1.78 +/- 0.68 versus 1.05 +/- 0.43, P = 0.01). These results show that during endometriosis the presence of peritoneal disease, and not of ovarian endometriotic cysts, influences leptin concentrations in PF. The data suggest that leptin may play a role in the development of peritoneal endometriosis, and that different biochemical phenomena might be involved in the pathogenesis of the ovarian form of the disease.

Steroids and protein markers in the follicular fluid as indicators of oocyte quality in patients with and without endometriosis

“…An earlier report suggested low serum levels to be related to infertility (3), a finding which has not been confirmed. One study reported an increased leptin concentration in peritoneal fluid in women with peritoneal endometriosis (21). Information on leptin levels in the follicular fluid of endometriosis patients is scarce, but we are confirming the parallelism between serum and follicular fluid via correlation of the latter with the BMI.…”

Elevated ghrelin levels in the peritoneal fluid of patients with endometriosis: associations with vascular endothelial growth factor (VEGF) and inflammatory cytokines

“…Superficial pelvic endometriosis is hormonally influenced mainly by the peritoneal fluid microenvironment, whereas deep endometriosis is mainly influenced by plasma hormone concentrations (4). Leptin, which is an adipocyte-derived protein belonging to the class of helical cytokines and ghrelin antagonizers, was found to be increased in peritoneal but not in ovarian endometriosis (5). In this study, peritoneal ghrelin levels were higher in moderate/severe endometriosis compared with in minimal/mild disease, but this was not statistically significant.…”

Adipokines in reproductive function: a link between obesity and polycystic ovary syndrome

“…Administration of leptin to ob/ob mice induces pubertal development and maturation of reproductive organs, increases LH secretion, and restores fertility, demonstrating the importance of leptin signaling in female reproduction (Donato et al 2011). Abnormal leptin levels have been reported in the peritoneal fluid in women with endometriosis (De Placido et al 2001, Wu et al 2002, Bedaiwy 2005. Additionally, in women with hypothalamic amenorrhea due to energy deficiency, leptin treatment resulted in the recovery of menstruation and corrected the abnormalities in gonadal, GH, and adrenal axes, further indicating the requirement of leptin in normal reproductive and neuroendocrine functions (Welt et al 2004, Chou et al 2011.…”