The relationship between the individual components of the reproductive system and energy metabolic hormones in abnormal uterine bleeding in adolescence


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Objective. To investigate the effect of energy metabolic hormones on the activity of the components of the hypothalamic-pituitary-gonadal axis in female adolescents with abnormal uterine bleeding (AUB), by taking into account different body weights. Subjects and methods. A total of 166 female adolescents aged 13-18 years with AUB were examined. The patients were divided into groups according to their body mass index (BMI). Thirty-four patients were found to be underweight (Group 1); BMI in 75 patients was within the normal physiological range (Group 2); that in 57 patients was higher (Group 3). The examination algorithm included the quantification of luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, estradiol (E2), testosterone (T), cortisol, insulin, leptin, insulin-like growth factor 1 (IGF-1), and sex hormone-binding globulin (SHBG). Results. On the basis of a systematic analysis of the relationship of leptin and insulin to the levels of gonadotropins, sex steroids, SHBG, and IGF-1, the investigators built a model for the association of leptin and insulin with FSH, LH, T, E, IGF-1, and SHBG, by applying the factor analysis. The mechanisms whereby the energy status influenced the formation of reproductive function in puberty were shown to have their own characteristics related to BMI. Conclusion. Adolescent patients with AUB show several ways of an interaction between the energy balance control system and the reproductive system. The metabolic hormones leptin and insulin were ascertained to be involved in the feedback mechanisms for stimulating the synthesis of pituitary gonadotropins between the peripheral component of the endocrine system and its central component - the hypothalamus and pituitary gland. The energy metabolic hormones were found to have a significant impact on the activity of sex steroids through the regulatory mechanisms of their bioavailability, i.e. by influencing the synthesis of SHBG in the liver.

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作者简介

Victoria Dynnik

Institute of Child and Adolescent Health Care, National Academy of Medical Sciences of Ukraine

Email: viktorija-dynnik@yandex.ua,iozdp@iozdp.org.ua
Doctor of Medical Science, a Leading scientific fellow, Department of children’s gynecology, Secretary of the Academic Board

Mykola Shcherbina

Kharkiv National Medical University of the Ministry of Health of Ukraine

Doctor of Medical Science, Professor, Head of the Department of Obstetrics and Gynecology No.1

Oleksandra Dynnik

Kharkiv National Medical University of the Ministry of Health of Ukraine

Email: dynunja@rambler.ru
Post-graduate student of the Department of Obstetrics and Gynecology No.1

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