Mehmet Kürşat DERİCİ, Engin YILDIRIM, Emre DEMİR, Omer Yavuz SİMSEK

Is there a relationship between serum kisspeptin levels and endometrial polyps in women with premenopausal status

Aim: Endometrial polyps are frequently associated with abnormal uterine bleeding. The kispeptin family is one of the peptidesthat play a role in reproductive functions and whose expression varies in various uterine pathologies. The aim of the study was todetermine the relationship between serum Kisspeptin levels and endometrial polyps in women with premenopausal status.Material and Methods: The blood was collected prior to endometrial sampling from women admitted to the hospital due to abnormaluterine bleeding. According to the pathology results, patients were identified as polyp group (n=38) (endometrial polyps) and controlgroup (n=50) (normal endometrial findings). Kisspeptin-54 levels were determined by ELISA method from serum obtained fromvenous blood.Results: There were no difference was found between the patients’ age, body mass index, gravida, para, abortus and the numberof living children were compared (p>0.05). There was no statistically significant difference between the groups in terms of folliclestimulating hormone, luteinizing hormone and thyroid stimulating hormone values (p>0.05). Plasma kisspeptin (1.84±0.93 ng/dLand 1.32±0.47 ng/dL, p= 0.008) and estradiol (90.34±13.02 pg/mL and 81.75±12.36 pg/mL, p=0.002) levels were significantly higherin the polyp group than in the control group. After the Receiver Operating Characteristic (ROC) analysis the area under the curve(AUC) was 1.26 (p= 0.08), (95% CI, 0.550-0.782). The sensitivity value was 0.684 (0.512-0.819), the specificity was 0.620 (0.471-0.750).Conclusion: The serum Kisspeptin-54 and estradiol levels were found higher in patients with endometrial polyps.

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1. Peterson WF, Novak ER. Endometrial polyps. Obstet Gynecol 1956;8:40-9.
2. Lieng M, Istre O, Qvigstad E. Treatment of endometrial polyps: a systematic review. Acta Obstet Gynecol Scand 2010;89:992-1002.
3. Yanaihara A, Yorimitsu T, Motoyama H, et al. Location of endometrial polyp and pregnancy rate in infertility patients. Fertil Steril 2008;90:180-2.
4. Jovanovic AS, Boynton KA, Mutter GL. Uteri of women with endometrial carcinoma contain a histopathological spectrum of monoclonal putative precancers, some with microsatellite instability. Cancer Res 1996;56:1917-21.
5. Pal L, Niklaus AL, Kim M, et al. Heterogeneity in endometrial expression of aromatase in polyp-bearing uteri. Hum Reprod 2008;23:80-4.
6. Dal Cin P, Vanni R, Marras S, et al. Four cytogenetic subgroups can be identified in endometrial polyps. Cancer Res 1995;55:1565-8.
7. Kotani M, Detheux M, Vandenbogaerde A, et al. The metastasis suppressor gene KiSS-1 encodes kisspeptins, the natural ligands of the orphan G proteincoupled receptor GPR54. J Biol Chem 2001;276:34631-6.
8. Tena-Sempere M. The roles of kisspeptins and G proteincoupled receptor-54 in pubertal development. Curr Opin Pediatr 2006;18:442-7.
9. Dhillo WS, Chaudhri OB, Thompson et, et al. Kisspeptin-54 stimulates gonadotropin release most potently during the preovulatory phase of the menstrual cycle in women. J Clin Endocrinol Metab 2007;92:3958-66.
10. Baba T, Kang HS, Hosoe Y, et al. Menstrual cyclic change of metastin/GPR54 in endometrium. Med Mol Morphol. Epub 2015;48:76-84.
11. Kolioulis I, Zafrakas M, Grimbizis G, et al. Immunohistochemical expression pattern of metastasis suppressor KISS-1 protein in adenomyosis lesions and normal endometrium. Eur J Obstet Gynecol Reprod Biol 2017;210:64-8.
12. Inal ZO, Inal HA, Kucukosmanoglu I, et al. Assessment of endometrial sampling and histopathological results: analysis of 4,247 cases. Eurasian J Med 2017;49:44-7.
13. Inal HA, Ozturk Inal ZH, Tonguc E, et al. Comparison of vaginal misoprostol and dinoprostone for cervical ripening before diagnostic hysteroscopy in nulliparous women. Fertil Steril 2015;103:1326-31.
14. Kauffman AS, Clifton DK, Steiner RA. Emerging ideas about kisspeptin- GPR54 signaling in the neuroendocrine regulation of reproduction. Trends Neurosci 2007;30:504- 11.
15. Maia H Jr, Maltez A, Calmon LC, et al. Histopathology and steroid receptors in endometrial polyps of postmenopausal patients under hormone replacement therapy. Gynaecol Endoscopy 1998;7:267-72.
16. McGurgan P, Taylor LJ, Duffy SR, et al. Are endometrial polyps from pre-menopausal women similar to postmenopausal women? An immunohistochemical comparison of endometrial polyps from pre- and post-menopausal women. Maturitas 2006;54:277-84.
17. Alcin E, Özcan M, Ayar A, et al. Effects of peripheral administration of kisspeptin on pubertal maturation and serum leptin levels in female rats. Turkiye Klinikleri J of Med Sci 2011;31:1477-83.
18. Makri A, Msaouel P, Petraki C, KISS1/KISS1R expression in eutopic and ectopic endometrium of women suffering from endometriosis. In Vivo 2012;26:119-27.
19. Brown RE, Imran SA, Ur E, et al. KiSS-1 mRNA in adipose tissue is regulated by sex hormones and food intake. Mol Cell Endocrinol. 2008;281:64-72.
20. Seminara SB, Messager S, Chatzidaki EE, et al. The GPR54 gene as a regulator of puberty. N Engl J Med 2003;349:1614- 27.
21. Jamil Z, Fatima SS, Arif S, et al. Kisspeptin and embryo implantation after ICSI. Reprod Biomed Online. 2017;34:147- 53.
22. Jeon YE, Lee KE, Jung JA, et al. Kisspeptin, leptin, and retinol-binding protein 4 in women with polycystic ovary syndrome. Gynecol Obstet Invest 2013;75:268-74.
23. Gorkem U, Togrul C, Arslan E, et al. Is there a role for kisspeptin in pathogenesis of polycystic ovary syndrome? Gynecol Endocrinol. 2018;34:157-60.
24. Richard N, Galmiche G, Corvaisier S, et al. KiSS-1 and GPR54 genes are co-expressed in rat gonadotrophs and differentially regulated in vivo by oestradiol and gonadotrophin-releasing hormone. J Neuroendocrinol 2008;20:381-93. 1257