Psychopathological features and endocrine and metabolic profile in patients with functional hypothalamic amenorrhea


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Objective. To assess the mental status of patients with functional hypothalamic amenorrhea (FHA) and the relationship of the mental status to the endocrine and metabolic profile. Subjects and methods. A total of 104 women (mean age, 25,8 ± 4,2 years; body mass index (BMI), 20.1 ± 1.9 kg/m2) with FHA were examined. A psychiatric interview was performed; the plasma levels of hormones and neurotransmitters and the body’s composition were assessed. Results. Mental disorders were found in 94% of patients with FHA; 35% of them had eating disorders (EDs), there were anxiety disorders (25%), depression (D) (20%), and bipolar spectrum disorders (BSDs) (13%). Hypoleptinemia was detected in 80%. Patients with EDs or BSDs had higher cortisol levels; those with D had lower serotonin levels. The content of adipose tissue ranged from 11 to 37%. Its deficiency was present in 76% of patients with FHA, especially in those with EDs and BSDs. Conclusion. FHA is associated with mental disorders, EDs, energy imbalance, and hypoleptinemia. The suppressed hypothalamus-pituitary-ovarian axis in FHA is evidently a consequence of metabolic adaptation to energy deficiency.

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作者简介

Galina Chernukha

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

Email: c-galina1@yandex.ru
MD, professor

Alexey Bobrov

Moscow Research Institute of Psychiatry - V. Serbsky National Medical Research Centre for Psychiatry and Narcology; Russian National Research Medical University. N.I. Pirogov

MD, head of the Department

Dmitry Gusev

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

Email: doctor.dgusev@gmail.com
postgraduate student

Guzyal Tabeeva

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

Email: 8 (495) 963-76-84.E-mail: bobrov2004@yandex.ru
PhD, senior researcher

Taisiya Nikitina

V. Serbsky National Medical Research Centre for Psychiatry and Narcology

Email: doctorip@mail.ru
PhD, researcher

Irina Agamamedova

V. Serbsky National Medical Research Centre for Psychiatry and Narcology

Email: agama6@yandex.ru
PhD, psychotherapist

参考

  1. 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.
  2. Чернуха Г.Е., Табеева Г.И., Гусев Д.В., Шмаков Р.Г. Кисспептин и репродуктивная система. Доктор.Ру. 2017; 3: 73-8.
  3. Reifenstein E.C. Jr. Psychogenic or hypothalamic amenorrhea. Med. Clin. North Am. 1946; 30: 1103-14.
  4. Prokai D., Berga S.L. Neuroprotection via reduction in stress: altered menstrual patterns as a marker for stress and implications for long-term neurologic health in women. Int. J. Mol. Sci. 2016;17(12). pii: E2147. doi: 10.3390/ijms17122147.
  5. Williams N.I., Berga S.L., Cameron J.L. Synergism between psy- chosocial and metabolic stressors: impact on reproductive func- tion in cynomolgus monkeys. Am. J. Physiol. Endocrinol. Metab. 2007; 293(1): E270-6.
  6. Ackerman K.E., Patel K.T., Guereca G., Pierce L., Herzog D.B., Misra M. Cortisol secretory parameters in young exercisers in relation to LH secretion and bone parameters. Clin. Endocrinol. (Oxford). 2013; 78(1): 114-9.
  7. Ackerman K.E., Slusarz K., Guereca G., Pierce L., Slattery M., Mendes N. et al. Higher ghrelin and lower leptin secretion are associated with lower LH secretion in young amenorrheic athletes compared with eumenorrheic athletes and controls. Am. J. Physiol. Endocrinol. Metab. 2012; 302(7): E800-6.
  8. Scheid J.L., De Souza M.J., Hill B.R., Leidy H.J., Williams N.I. Decreased luteinizing hormone pulse frequency is associated with elevated 24-hour ghrelin after calorie restriction and exercise in premenopausal women. Am. J. Physiol. Endocrinol. Metab. 2013; 304(1): E109-16.
  9. Michopoulos V., Embree M., Reding K., Sanchez M.M., Toufexis D., Votaw J.R. et al. CRH receptor antagonism reverses the effect of social subordination upon central GABAA receptor binding in estradiol- treated ovariectomized female rhesus monkeys. Neuroscience. 2013; 250: 300-8.
  10. Oyola M.G., Handa R.J. Hypothalamic-pituitary-adrenal and hypothalamic-pituitary-gonadal axes: sex differences in regulation of stress responsivity. Stress. 2017; 20(5): 476-94.
  11. Russel G. Premenstrual tension and “psychogenic” amenorrhea: psychophysical interaction. J. Psychosom. Res. 1972; 16: 279-87.
  12. Fioroni L., Fava M., Genazzani A.D., Facchinetti F., Genazzani A.R. Life events impact in patients with secondary amenorrhea. J. Psychosom. Res. 1994; 38(6): 617-22.
  13. Marcus M.D., Loucks T.L., Berga S.L. Psychological correlates of functional hypothalamic amenorrhea. Fertil. Steril. 2001; 76(2): 310-6.
  14. Nappi R.E., Facchinetti F. Psychoneuroendocrine correlates of secondary amenorrhea. Arch. Womens Ment. Health 2003; 6(2): 83-9.
  15. Nappi R.E., Neri I., Veneroni F., Polatti F., Piccinini F., Facchinetti F. Pituitary LH reserve suggests high risk of bulimia in amenorrheic women. Psychoneuroendocrinology. 2001; 26(7): 721-30.
  16. Reynolds-May M.F., Kenna H.A., Marsh W., Stemmte P.G., Wang P., Ketter T.A., Rasgon N.L. Evaluation of reproductive function in women treated for bipolar disorder compared to healthy controls. Bipolar Disord. 2014: 16(1): 37-47.
  17. Kim H.K., Kim H.S., Kim S.J. Association of anxiety, depression, and somatization with menstrual problems among North Korean women defectors in South Korea. Psychiatry Investig. 2017; 14(6): 727-33.
  18. Fava G.A., Trombini G., Grandi S., Bernardi M., Evangelisti L.P., Santarsiero G., Orlandi C. Depression and anxiety associated with secondary amenorrhea. Psychosomatics. 1985; 25(12): 905-8.
  19. Бронфман С.А., Агарков В.А., Кудаева Л.М., Божко С.А., Лаукарт Е.Б., Цветкова У.Н. Эффективность краткосрочной психодинамической психотерапии в лечении функциональных расстройств менструального цикла у пациенток раннего репродуктивного возраста. Сибирский вестник психиатрии и наркологии. 2012; 5: 65-70.
  20. Bailly N., Maitre I., Van Wymelbeke V. Relationships between nutritional status, depression and pleasure of eating in aging men and women. Arch. Gerontol. Geriatr. 2015; 61(3): 330-6.
  21. Iwasa T., Matsuzaki T., Yano K., Mayila Y., Yanagihara R., Yamamoto Y. et al. Effects of low energy availability on reproductive functions and their underlying neuroendocrine mechanisms. J. Clin. Med. 2018; 7(7). pii: E166.
  22. Trexler E.T., Smith-Ryan A.E., Norton L.E. Metabolic adaptation to weight loss: implications for the athlete. J. Int. Soc. Sports Nutr. 2014; 11(1): 7.
  23. Milter K.K., Parulekar M.S., Schoenfeld E., Anderson E., Hubbard J., Klibanski A., Grinspoon S.K. Decreased leptin levels in normal weight women with hypothalamic amenorrhea: the effects of body composition and nutritional intake. J. Clin. Endocrinol. Metab. 1998; 83(7): 2309-12.
  24. 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. Endocrino.l Metab. 1999; 84(3): 873-7.
  25. Москвичева Ю.Б., Гусев Д.В., Табеева Г.И., Чернуха Г.Е. Оценка питания, состава тела и особенности диетологического консультирования пациенток с функциональной гипоталамической аменореей. Вопросы питания. 2018; 87(1): 85-91.
  26. Tomiyama A.J., Schamarek I., Lustig R.H., Kirschbaum C., Puterman E., Havel P.J., Epel E.S. Leptin concentrations in response to acute stress predict subsequent intake of comfort foods. Physiol. Behav. 2012; 107(1): 34-9.
  27. Deuschle M., Blum W.F., Englaro P., Schweiger U., Weber B., Pflaum C.D., Heuser I. Plasma leptin in depressed patients and healthy controls. Horm. Metab. Res. 1996; 28(12): 714-7.

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