Fertility and Sterility
Volume 94, Issue 1 , Pages 221-229, June 2010

Impact of fatness, insulin, and gynecological age on luteinizing hormone secretory dynamics in adolescent females

  • Josephine Z. Kasa-Vubu, M.D.

      Affiliations

    • Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
    • Corresponding Author InformationReprint requests: Josephine Z. Kasa-Vubu, M.D, M.S., Department of Pediatrics, Endocrine Division, University of Michigan Medical Center, Ann Arbor, MI 48019-0718 (FAX: 734-615-3353).
    • ,
  • Vandana Jain, M.D.

      Affiliations

    • Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
    • ,
  • Kathy Welch, M.S.

      Affiliations

    • Center for Statistical Consultation and Research, University of Michigan, Ann Arbor, Michigan

Received 12 July 2008; received in revised form 19 February 2009; accepted 25 February 2009. published online 27 April 2009.

Objective

To study the link between fatness and gonadotropin secretion. Overweight status is linked to polycystic ovary syndrome (PCOS) in adolescents. We postulated that heavier adolescents without symptoms would secrete LH with: [1] increased pulse frequency (LHPF) and [2] exaggerated integrated concentrations (LHAUC).

Design

Cross-sectional.

Setting

General clinical research center.

Patient(s)

Eighty-seven postmenarcheal cyclic adolescents from lean to overweight recruited during the follicular phase.

Intervention(s)

Luteinizing hormone sampling: [1] every 10 minutes/24 hours; [2] at 20-minute intervals after a GnRH challenge.

Main Outcome Measure(s)

The LHPF and LHAUC (calculated by the CLUSTER algorithm). Hormonal and metabolic covariates included percent body fat (PercentBF), insulin-like growth factor-I (IGF-I), fasting insulin, and the insulin resistance index HOMA-IR. The SAS software was used for analyses.

Result(s)

The PercentBF and younger gynecological age predicted faster LHPF. Fatness was negatively linked to LHAUC, which was best predicted by PercentBF and IGF-1 in multivariate modeling (R2 = 0.25). The PercentBF and insulin predicted a lower 20-minute LH response to GnRH.

Conclusion(s)

[1] Higher adiposity and younger gynecological age predict rapid LHPF. [2] The early years after menarche represent a vulnerable window for an exaggerated LHPF with weight gain. [3] In healthy adolescents, higher adiposity is linked to lower LHAUC, thereby preserving pituitary stores.

Key Words: Fatness, insulin, testosterone, LH, FSH, GnRH stimulation, adolescents

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 J.Z.K.-V. has nothing to disclose. V.J. has nothing to disclose. K.W. has nothing to disclose.

 Supported by 1K23DK065995 award (J.K.-V.), and General Clinical Research Center Grant M01-RR-0042. This work also used the Chemistry Laboratory of the Michigan Diabetes Research and Training Center funded by NIH5P60 DK20572 from the National Institute of Diabetes and Digestive and Kidney Diseases.

PII: S0015-0282(09)00499-3

doi:10.1016/j.fertnstert.2009.02.072

Fertility and Sterility
Volume 94, Issue 1 , Pages 221-229, June 2010

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