The Impact of Metabolic Syndrome and Its Components on Female Sexual Dysfunction: A Narrative Mini-Review

Background

The impact of metabolic syndrome on female sexual dysfunction received modest consideration in clinical practice. The aim of the research was to analyze the international literature to determine the relationship between the metabolic syndrome, its components and female sexual disorders.

Methods

We identified relevant full-length papers by electronic databases as Index Medicus/Medline, Scopus, Life Science Journals, from 2005 to the present. Studies were searched using the following as search query: metabolic syndrome, female sexual dysfunction, obesity, systemic arterial hypertension, diabetes mellitus, dyslipidemia.

Results

Women with metabolic syndrome showed higher prevalence of sexual inactivity and low sexual desire, orgasm and satisfaction respect to women without metabolic syndrome. Particularly metabolic components as diabetes mellitus, dy-slipidemia, systemic arterial hypertension were strongly associated with lower sexual desire, activity and Female Sexual Function Index total score. In contrast, other studies showed no relationship.

Conclusion

Our study showed that in the clinical evaluation of women with metabolic syndrome routine inquiring about female sexual dysfunction should be recommended to ameliorate sexual function and quality of life. However more prospective and longitudinal studies on the sexual effects of metabolic syndrome should also be suggested to know the factors related to women's sexuality better.

Antiphospholipid antibodies in localized scleroderma: the potential role of screening tests for the detection of antiphospholipid syndrome

Introduction

The presence of antiphospholipid antibodies (aPL) is associated with infections, drugs and autoimmune disorders. Those antibodies are also detected in approximately 5–20% of the healthy population. The presence of aPL can lead to the occurrence of thrombotic events or abortion, which define the antiphospholipid syndrome (APS).

Aim

To evaluate the potential role of aPL in diagnosing APS in patients with localized scleroderma (LoS).

Material and methods

Serum samples from 45 patients with various forms of LoS were examined. They were screened with the commercially-available immunodot assay Anti-Phospholipid 10 Dot (GA Generic Assays GmbH, Dahlewitz, Germany). A number of clinical and laboratory parameters, especially APS symptoms, were assessed in patients with positive aPL: arterial and venous thrombotic events, obstetric complications, thrombocytopenia and neurological symptoms.

Results

The following profile of aPL IgG or IgM was obtained from patients with LoS: cardiolipin 15/45, phosphatidic acid 41/45, phosphatidyl-choline 0/45, -ethanolamine 6/45, -glycerole 1/45 (patient with Lyme disease), -inositol 7/45, -serine 14/45, annexin V 34/45, β2GPI 21/45, prothrombin 30/45. Antiphospholipid antibodies profile screening in these individuals revealed two cases of suspected secondary laboratory APS. However, no such clinical and laboratory parameters were found in other LoS patients with positive aPL. Similarly, no association was found between the presence of aPL and either thrombotic events or other APS symptoms.

Conclusions

Antiphospholipid antibodies are commonly found in patients with LoS but the exact role of these antibodies remains unclear. Clinical manifestations of APS are not frequently seen during LoS.

Low plasma antibodies specific for phosphatidylethanol in alcohol abusers and patients with alcoholic pancreatitis

Phosphatidylethanol (PEth) is a group of alcohol-modified phospholipids present in cell membranes after heavy drinking. Our aim was to demonstrate the presence of human plasma antibodies binding to PEth and to address their specificity and value in detecting subjects engaged in heavy alcohol consumption. Antibodies to PEth were analyzed in plasma from heavy drinkers (n=20), patients with alcoholic pancreatitis (n=58) and control subjects (n=24), using chemiluminescent immunoassay. Heavy drinkers and patients with alcoholic pancreatitis demonstrated significantly lower levels of plasma IgG, IgA and IgM titers to PEth compared with controls (P<0.001). The specificity of the antibodies to PEth was demonstrated with competitive liquid phase immunoassays and flow cytometry. The plasma IgG, but not IgA or IgM, titers to PEth in heavy drinkers correlated with the whole blood PEth concentration determined by liquid chromatography-mass spectrometry (r=0.655, P=0.002). Compared with traditional markers for alcohol abuse (aspartate aminotransferase, gamma-glutamyl transpeptidase and mean corpuscular volume), receiver operating characteristic curve analysis showed that a low plasma IgA to PEth had the highest area under the curve (AUC 0.940, P<0.001). In conclusion, plasma IgG, IgA and IgM antibodies binding specifically to PEth were found in subjects of all study groups. Subjects with heavy alcohol consumption showed markedly lower plasma immunoglobulin levels to PEth, potentially making them useful as a biomarker to distinguish heavy from moderate alcohol use.