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Hormonal regulation of menstrual function in patients of reproductive age with acromegaly

https://doi.org/10.14341/omet10049

Abstract

Background: The frequency of menstrual disorders in patients with acromegaly is 40–84% and are caused by three main reasons – the development of normal or hypogonadotropic hypogonadism due to hyperprolactinemia or a mass effect of the tumor and direct effects of GH and IGF-1 on the reproductive system. Nevertheless the exact mechanisms of reproductive dysfunction are not clear now. Hypothalamic structures play significant role in the regulation of hypothalamic-pituitary-ovary axis, so it’s important to study key neuropeptides and evaluate their effects to the pathogenesis of ovarian dysfunction during excessive secretion of growth hormone.


Aim: The aim of the work is to study the hormonal regulation of menstrual function in patients of reproductive age with acromegaly in the active stage of the disease.


Material and methods: The study included patients with a confirmed diagnosis of acromegaly and healthy women, comparable in age and BMI. Blood serum samples were taken in the morning (8–9 hours) on an empty stomach for 3–5 days of the menstrual cycle or on any day with amenorrhea and frozen at -70°C. The hormonal study was carried out by an enzyme immunoassay, in the case of a kisspeptin, with the preliminary extraction of serum samples.


Results: The study included 31 patients with acromegaly and 15 healthy women. Between groups there was a statistically significant decrease in levels of LH (p = 0.001), FSH (p = 0.09), inhibin B (p = 0.003), and kisspeptin (p = 0.00005). The frequency of hyperprolactinemia in the cohort of patients was 51.6%. During the correlation analysis, a negative dependence of kisspeptin on the levels of GH and IGF-1 was detected (r = -0.54, p = 0.002 and r = -0.63, p = 0.0002).


Conclusions: The severity of the central depression of regulation of menstrual function in patients with acromegaly may be due to the degree of disease activity.

About the Authors

Svetlana Yu. Vorotnikova

Endocrinology research centre


Russian Federation

postgraduate student



Larisa K. Dzeranova

Endocrinology research centre


Russian Federation

Sc.D.



Irina V. Stanoevich

Endocrinology research centre


Russian Federation

Sc.D.



Ekaterina A. Pigarova

Endocrinology research centre


Russian Federation

PhD



Elena N. Andreeva

Endocrinology research centre


Russian Federation

Sc.D.



Larisa V. Nikankina

Endocrinology research centre


Russian Federation

PhD



Valery P. Masenko

National medical research center of cardiology


Russian Federation

ScD



References

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Supplementary files

1. Fig. 1. The first clinical manifestations of acromegaly in patients of reproductive age.
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2. Fig. 2. Correlation of levels of kisspeptin with levels of somatotropic hormone and insulin-like growth factor-1 in patients with acromegaly.
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Type Исследовательские инструменты
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3. Fig. 3. The level of kisspeptin in patients with an active stage of acromegaly.
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Type Исследовательские инструменты
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Review

For citations:


Vorotnikova S.Yu., Dzeranova L.K., Stanoevich I.V., Pigarova E.A., Andreeva E.N., Nikankina L.V., Masenko V.P. Hormonal regulation of menstrual function in patients of reproductive age with acromegaly. Obesity and metabolism. 2018;15(4):59-64. (In Russ.) https://doi.org/10.14341/omet10049

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ISSN 2071-8713 (Print)
ISSN 2306-5524 (Online)