Blood Levels Low With CF for Two Hormones Tied to Fertility, Weight
Study of serum kisspeptin and POMC levels in 38 patients, children to adults
Blood levels of two hormones, kisspeptin and proopiomelanocortin, are lower in people with cystic fibrosis (CF) — beginning in childhood and continuing through adulthood — than in healthy people, a study found.
These reduced concentrations may be associated with lower body weight, delayed puberty and poorer fertility in CF patients, the scientists suggested.
“To our knowledge this is the first report to describe the levels of KISS [kisspeptin] and POMC [proopiomelanocortin] in CF,” the researchers wrote. “Both KISS and POMC appear to be involved in the regulation of many life processes in CF, including nutrition and reproduction.”
The study, “Serum kisspeptin and proopiomelanocortin in cystic fibrosis: a single study,” was published in the journal Scientific Reports.
Kisspeptin levels typically higher in fertile than infertile men
Biomarkers, such as hormones found in the blood, are growing in interest due to their potential for better diagnosis and a more accurate prognosis (likely course) of diverse diseases, including CF.
Despite current CF therapies, nutritional deficiencies — up to the level of malnutrition — still can be common in patients. As people with CF are living longer due to treatments like CFTR modulators, moreover, their sexual and reproductive health is increasingly important.
“Therefore, much research has focused on hormones in CF to provide novel insights into the body’s energy homeostasis [balance] and fertility,” the scientists wrote.
Levels of two hormones, kisspeptin and POMC, have not been described in CF so far. Kisspeptin dysregulation has been implicated in obesity, puberty, and pregnancy, while the lack of POMC is also related to obesity and the insufficient production of other hormones.
Researchers in Poland assessed blood serum levels of kisspeptin and POMC in CF patients. They also investigated a possible relationship between these hormone levels and clinical parameters, such as age and body mass index (BMI, a measure of body fat).
The study enrolled 38 CF patients (mean age of 19.58, range of 10 to 39; 44.7% female) attending a hospital’s CF clinic in Rzeszow. All had at least one F508del mutation, the most common CF-causing mutation. Sixteen people (mean age of 19.25, range of 10 to 38; 62.5% female) with no CF diagnosis or medical history were recruited as healthy controls.
Results showed significantly lower BMI, weight, and lung function in CF patients compared with controls. Adults with CF also had noted infertility problems in their medical history, and none had children.
Blood levels during fasting of both kisspeptin and POMC were significantly lower in CF patients than in controls — a mean of 1.76 vs. 2.27 nanograms (ng)/mL for kisspeptin and 6.25 vs. 14.74 ng/mL for POMC.
These findings were similar across patients by age: those younger than 15 years old, those between ages 15 and 18, and adults.
Notably, higher kisspeptin levels previously were reported in healthy young people with precocious puberty. “However, puberty is delayed in people with CF and is considered one of the common clinical features of the disease, which may be related to the decreased KISS level,” the researchers noted.
Hormones likely involved in ‘many life processes in CF, including nutrition and reproduction.’
No differences in these hormones’ levels were found when comparing males and females within either study group.
Researchers then looked at blood levels of these hormones separately.
Kisspeptin levels were similar among females with and without CF. Higher kisspeptin levels in healthy females “may be associated with a higher number of [kisspeptin] neurons in the female hypothalamus and increased [kisspeptin] production in the ovaries and adipose tissues,” the researchers wrote, so that “the lack of difference in [kisspeptin] levels may be due to low body fat and ovarian dysfunction in females with CF.”
Among males, kisspeptin levels were lower in CF patients. Levels of kisspeptin are typically higher in fertile men than in infertile men, the team noted.
Both males and females with CF had significantly reduced POMC levels compared with their healthy counterparts.
Kisspeptin levels also were found to negatively correlate with the BMI of CF patients, meaning that lower concentrations of kisspeptin associate with a higher BMI.
Both hormones’ levels also were negatively correlated with age and the systemic inflammation marker C-reactive protein, with lower hormone levels associated with more advanced age and more inflammation. No association was found between the levels of kisspeptin and POMC, or between levels of these hormones and lung function.
This study “describes for the first time that circulating levels of KISS and POMC in patients with CF differ from those in healthy subjects,” the researchers wrote, which “may be associated with lower body weight and delayed puberty in patients with CF.”
Among study limitations, they added, were its small number of participants was low and differences between the CF and control groups. Patients also had a lower body weight than controls, and other reproductive hormones were not analyzed.
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