Estimation of adipose tissue indicators in functional hypothalamic amenorrhea


Дәйексөз келтіру

Толық мәтін

Ашық рұқсат Ашық рұқсат
Рұқсат жабық Рұқсат берілді
Рұқсат жабық Рұқсат ақылы немесе тек жазылушылар үшін

Аннотация

Objective. To investigate the amount of adipose tissue, the nature of its distribution, and serum leptin levels in patients with functional hypothalamic amenorrhea (FHA), by determining the threshold values of the indicators that are informative for the diagnosis of adipose tissue deficiency and hypoleptinemia. Subjects and methods. Clinical and laboratory examinations were made in 134 women of reproductive age. A study group consisted of 75 patients with FHA (mean age, 26.4±5.2 years; mean body mass index (BMI) was 20.1±2.17 kg/m2); a control group included 59 healthy women (mean age, 27.8±4.1 years; mean BMI, 24.2±5.6 kg/m2). The examination involved the determination of luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E2), and leptin and the estimation of adipose tissue content by dual-energy X-ray absorptiometry (DXA). Results. Normogonadotropic amenorrhea was diagnosed in 20% of the patients; hypogonadotropic amenorrhea with a low LH level in 60%, that concurrent with a low FSH level in 20%. Underweight in terms of BMI was diagnosed in 28% of the patients with FHA and in 25.4% of the healthy women in the control group. %Total Fat was of the greatest diagnostic value for FHA. Its threshold for the diagnosis of adipose tissue deficiency was 30% (AUC, 0.75 (0.71 to 0.81; 95% CI). Moderate deficiency (%Total Fat <20%) is 4.6 times more frequently encountered in FHA and is significant for its development (OR = 5.45; 95% CI; p = 0.0046). The threshold of leptin in FHA was 4.8 ng/ml; hypoleptinemia was found in 83%. Conclusion. In FHA for the diagnosis of body composition and for the quantification of adipose tissue, it is preferable to use DXA for the identification of its latent deficiency. Unlike BMI, latent adipose tissue deficiency, as evidenced by DXA, and hypoleptinemia suggest that there is decreased energy availability and a negative energy balance in FHA.

Толық мәтін

Рұқсат жабық

Авторлар туралы

Galina Chernukha

National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov

Professor, MD, Head of the Department of Gynecological Endocrinology

Gyuzal Tabeeva

National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov

Email: doctor.gtab@gmail.com
Ph.D., Senior Researcher of the Department of Gynecological Endocrinology

Dmitry Gusev

National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov

postgraduate student of the Department of Gynecological Endocrinology

Sergey Kuznetsov

National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov

doctor obstetrician-gynecologist of the department of gynecological endocrinology

Әдебиет тізімі

  1. Practice Committee of American Society for Reproductive Medicine. Current evaluation of amenorrhea. Fertil. Steril. 2008; 90(5, Suppl.): S219-5.
  2. Frisch R.E., McArthur J.W. Menstrual cycles: Fatness as a determinant of minimum weight for height necessary for their maintance or onset. Science. 1974; 185(4155): 949-51.
  3. Frisch R.E. Fatness, menarche, and female fertility. Perspect. Biol. Med. 1985 Summer; 28(4): 611-33.
  4. Miller K.K., Grinspoon S., Gleysteen S., Grieco K.A., Ciampa J., Breu J. et al. Preservation of neuroendocrine control of reproductive function despite severe undernutrition. J. Clin. Endocrinol. Metab. 2004; 89(9): 4434-8.
  5. Winkler L.A., Frölich J.S., Schulpen M., Stßving R.K. Body composition and menstrual status in adults with a history of anorexia nervosa-at what fat percentage is the menstrual cycle restored? Int. J. Eat. Disord. 2017; 50(4): 370-7.
  6. Mayer L.E., Roberto C.A., Glasofer D.R., Etu S.F., Gallagher D., Wang J. et al. Does percent body fat predict outcome in anorexia nervosa? Am. J. Psychiatry. 2007; 164(6): 970-2.
  7. Wauters M., Considine R.V., Chagnon M., Mertens I., Rankinen T., Bouchard C., Van Gaal L.F. Leptin levels, leptin receptor gene polymorphisms, and energy metabolism in women. Obes. Res. 2002; 10(5): 394-400.
  8. Yu W.H., Kimura M., Walczewska A., Karanth S., McCann S.M. Role of leptin in hypothalamic-pituitary function. Proc. Natl. Acad. Sci. USA. 1997; 94(3): 1023-8.
  9. Ballauff A., Ziegler A., Emons G., Sturm G., Blum W.F., Remschmidt H., Hebebrand J. Serum leptin and gonadotropin levels in patients with anorexia nervosa during weight gain. Mol. Psychiatry. 1999; 4(1): 71-5.
  10. Мазаева Н.А. Жировая ткань, лептин и нервная анорексия. Психиатрия и психофармакотерапия. Журнал им. П.Б. Ганнушкина. 2008; 2: 18-28.
  11. Micklesfield L.K., Goedecke J.H., Punyanitya M., Wilson K.E., Kelly T.L. Dual-energy X-ray performs as well as clinical computed tomography for the measurement of visceral fat. Obesity (Silver Spring). 2012; 20(5): 1109-14.
  12. Punpilai S., Sujitra T., Ouyporn T., Teraporn V., Sombut B. Menstrual status and bone mineral density among female athletes. Nurs. Health Sci. 2005; 7(4): 259-65.
  13. Окороков П.Л., Васюкова О.В., Воронцов А.В. Методы оценки количества и распределения жировой ткани в организме и их клиническое значение. Проблемы эндокринологии. 2014; 60(3): 53-8.
  14. Worth Health Organization. Physical status: the use sand interpretation of anthropometry. (Tech. Rep. Series 854.) Geneva: World Health Organization; 1995.
  15. Albanese C.V. Clinical applications of body composition measurements using DXA. J. Clin. Densitom. 2003 Summer; 6(2): 75-85.
  16. Gordon C.M., Ackerman K.E., Berga S.L., Kaplan J.R., Mastorakos G., Misra M. et al. Functional hypothalamic amenorrhea: An Endocrine Society Clinical Practice Guideline. J. Clin. Endocrinol. Metab. 2017; 102(5): 1413-39.
  17. Сметник А.А., Сметник В.П., Гависова А.А., Донников А.Е., Иванец Т.Ю., Юренева С.В. Неинструментальный метод скрининга низкой минеральной плотности кости у женщин со вторичной аменореей. Акушерство и гинекология. 2014; 8: 59-64.
  18. Grinspoon S., Thomas L., Miller K., Pitts S., Herzog D., Klibanski A. Changes in regional fat redistribution and the effects of estrogen during spontaneous weight gain in women with anorexia nervosa. Am. J. Clin. Nutr. 2001; 73(5): 865-9.
  19. Чернуха Г.Е., Блинова И.В., Шевцова В.Л. Роль жировой ткани в генезе эндокринно-метаболических нарушений у больных с синдромом поликистозных яичников и нормальной массой тела. Проблемы репродукции. 2007; 4: 29-34.
  20. Kitano T., Kitano N., Inomoto T., Futatsuka M. Evaluation of body composition using dual energy X-ray absorptiometry, skinfold thickness and bioelectrical impedance analysis in Japanese female college students. J. Nutr. Sci. Vitaminol. (Tokyo). 2001; 47(2): 122-5.
  21. Gupta N., Balasekaran G., Govindaswamy V., Hwa C.Y., Shun L.M. Comparison of body composition with bioelectric impedance (BIA) and dual energy X-ray absorptiometry (DEXA) among Singapore Chinese. J. Sci. Med. Sport. 2010; 14(1): 33-5.
  22. Bruni V., Dei M., Morelli C., Schettino M.T., Balzi D., Nuvolone D. Body composition variables and leptin levels in functional hypothalamic amenorrhea and amenorrhea related to eating disorders. J. Pediatr. Adolesc. Gynecol. 2011; 24(6): 347-52.
  23. Warren M.P., Voussoughian F., Geer E.B., Hyle E.P., Adberg C.L., Ramos R.H. Functional hypothalamic amenorrhea: hypoleptinemia and disordered eating. J. Clin. Endocrinol. Metab. 1999; 84(3): 873-7.
  24. Chan J.L., Matarese G., Shetty G.K., Raciti P., Kelesidis I., Aufiero D. et al. Differential regulation of metabolic, neuroendocrine, and immune function by leptin in humans. Proc. Natl. Acad. Sci. USA. 2006; 103(22): 8481-6.

Қосымша файлдар

Қосымша файлдар
Әрекет
1. JATS XML
Жүктеу

© Bionika Media, 2018

Осы сайт cookie-файлдарды пайдаланады

Біздің сайтты пайдалануды жалғастыра отырып, сіз сайттың дұрыс жұмыс істеуін қамтамасыз ететін cookie файлдарын өңдеуге келісім бересіз.< / br>< / br>cookie файлдары туралы< / a>