The relationship between the individual components of the reproductive system and energy metabolic hormones in abnormal uterine bleeding in adolescence
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.Dynnik V.A., Shcherbina N.A., Dynnik A.A.
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, E2, 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.
Keywords
abnormal uterine bleeding
hormonal status
leptin
insulin
relationships
puberty age
Supplementary Materials
- Fig. 1. Mean values of the eigenvalues of Factor 1 in patients with AMC and different body weight
- Fig. 2. Mean values of the eigenvalues of Factor 3 in AMC patients with different body weight
- Fig. 3. Average values of the eigenvalues of Factor 4 in girls with AMC and different body weights
- Table 1. Statistical indicators of hormones in patients with abnormal uterine bleeding and various body weight
- Table 2. The structure of the factor model of the relationship between leptin and insulin with pituitary gonadotropins, sex steroids, insulin-like growth factor-1 and globulin binding sex steroids , in patients with abnormal uterine bleeding
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Received 19.05.2017
Accepted 23.06.2017
About the Authors
Dynnik Victoria Oleksandrovna, Doctor of Medical Science, a Leading scientific fellow, Department of children’s gynecology,Secretary of the Academic Board of the SI Institute for Children and Adolescents Health Care of the NAMS of Ukraine.
61153, Ukraine, Kharkiv, Prosp. Jubilee 52-A. Tel.: (0572) 62-70-71; +380509736361. E-mail: viktorija-dynnik@yandex.ua
Shcherbina Mykola Oleksandrovich, Doctor of Medical Science, Professor, Head of the Department of Obstetrics and Gynecology No.1,
Kharkiv National Medical University of the Ministry of Health of Ukraine. 61032, Ukrain, Kharkiv, Malinovskogo str. 4. Tel.: (057) 712-00-82
Dynnik Oleksandra Oleksyivna, Post-graduate student of the Department of Obstetrics and Gynecology No.1, Kharkiv National Medical University
of the Ministry of Health of Ukraine. 61032, Ukrain, Kharkiv, Malinovskogo str. 4. Tel.: (057) 7333-23-52; +380505938542. Е‑mail: dynunja@rambler.ru
For citations: Dynnik V.A., Shcherbina N.A., Dynnik A.A. The relationship between the individual components of the reproductive system and energy metabolic hormones in abnormal uterine bleeding in adolescence. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (2): 102-7. (in Russian)
https://dx.doi.org/10.18565/aig.2018.2.102-107
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