Barbagallo Federica, Cannarella Rossella, Garofalo Vincenzo, Marino Marta, La Vignera Sandro, Condorelli Rosita A, Tiranini Lara, Nappi Rossella E, Calogero Aldo E
Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy.
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH 44125, USA.
Biomedicines. 2023 Dec 9;11(12):3260. doi: 10.3390/biomedicines11123260.
Since its discovery, much attention has been drawn to irisin's potential role in metabolic and reproductive diseases. This narrative review summarizes and updates the possible role played by this fascinating molecule in different physiological (puberty and menopause) and pathological (polycystic ovary syndrome (PCOS), functional hypothalamic amenorrhea (FHA), endometriosis, and gestational diabetes) conditions that can affect women throughout their entire lives. Irisin appears to be an important factor for the hypothalamic-pituitary-gonadal axis activation, and appears to play a role in the timing of puberty onset. Serum irisin levels have been proposed as a biomarker for predicting the future development of gestational diabetes (GDM). Its role in PCOS is still controversial, although an "irisin resistance" mechanism has been hypothesized. In addition to its impact on metabolism, irisin also appears to influence bone health. Irisin levels are inversely correlated with the prevalence of fractures in postmenopausal women. Similar mechanisms have also been postulated in young women with FHA. In clinical settings, further controlled, prospective and randomized clinical trials are needed to investigate the casual relationship between irisin levels and the conditions described and, in turn, to establish the role of irisin as a prognostic/diagnostic biomarker or a therapeutic target.
自发现以来，鸢尾素在代谢和生殖疾病中的潜在作用备受关注。本叙述性综述总结并更新了这种迷人分子在不同生理（青春期和更年期）和病理（多囊卵巢综合征（PCOS）、功能性下丘脑性闭经（FHA）、子宫内膜异位症和妊娠期糖尿病）状况下可能发挥的作用，这些状况会影响女性一生。鸢尾素似乎是下丘脑 - 垂体 - 性腺轴激活的重要因素，且似乎在青春期启动时间方面发挥作用。血清鸢尾素水平已被提议作为预测妊娠期糖尿病（GDM）未来发展的生物标志物。其在PCOS中的作用仍存在争议，尽管已假设存在“鸢尾素抵抗”机制。除了对代谢的影响外，鸢尾素似乎还会影响骨骼健康。鸢尾素水平与绝经后女性骨折患病率呈负相关。在患有FHA的年轻女性中也推测有类似机制。在临床环境中，需要进一步进行对照、前瞻性和随机临床试验，以研究鸢尾素水平与所述状况之间的因果关系，进而确定鸢尾素作为预后/诊断生物标志物或治疗靶点的作用。
