Estimation of adipose tissue indicators in functional hypothalamic amenorrhea
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.Chernukha G.E., Tabeeva G.I., Gusev D.V., Kuznetsov S.Yu.
Keywords
functional hypothalamic amenorrhea
energy balance
adipose tissue
leptin
Supplementary Materials
- Table 1. Distribution of surveyed women by BMI
- Table 2. Parameters of the composition of the body of patients with functional hypothalamic amenorrhea and women of the control group
- Fig. 1. ROC analysis, assessment of the diagnostic significance of the fat component% Total Fat, BMI (a) and leptin (b) in functional hypothalamic amenorrhea
- Fig. 2. Relationship% Total Fat with serum leptin levels in patients with functional hypothalamic amenorrhea
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Received 14.04.2017
Accepted 28.04.2017
About the Authors
Chernukha Galina E., Professor, MD, Head of the Department of Gynecological Endocrinology, National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4Tabeyeva Gyuzal I., Ph.D., Senior Researcher of the Department of Gynecological Endocrinology, National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79031997282. E-mail: doctor.gtab@gmail.com
Gusev Dmitry V., postgraduate student of the Department of Gynecological Endocrinology, National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4
Kuznetsov Sergey Yu., doctor obstetrician-gynecologist of the department of gynecological endocrinology, National Medical Research Center of Obstetrics, Gynecology,
and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4
For citations: Chernukha G.E., Tabeeva G.I., Gusev D.V., Kuznetsov S.Yu. Estimation of adipose tissue indicators in functional hypothalamic amenorrhea. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (2): 74-80. (in Russian)
https://dx.doi.org/10.18565/aig.2018.2.74-80
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