PPARA and fatty liver disease: 12 As a transcription factor regulating the expression of many genes that govern lipid metabolism, PPARα is also a drug target for hepatic steatosis. 13, 14 The depletion of serum PC(16:0/18:1) may affect lipid metabolism in POEMS syndrome patients by influencing PPARα‐regulated downstream gene expressions. In sterol lipid category, lower serum 5b‐pregnanediol level was also a main feature of POEMS syndrome patients. Pregnanediol was a metabolite of progesterone. As reported, hypogonadism is the most common endocrine abnormality in POEMS syndrome patients, in accordance with our results.15