Spontaneous endogenous pulsatile release of kisspeptin is temporally coupled with luteinizing hormone in healthy women

Objective To evaluate the presence of a spontaneous pulsatile release of kisspeptin and whether it is temporally coupled to LH pulses. Design Experimental study. Setting Academic medical center. Patient(s) Thirty young healthy eumenorrheic women aged 20-37 years were included in the study group. All subjects were white women admitted to the Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland. Intervention(s) Kisspeptin, FSH, LH, E2, PRL, and insulin were evaluated in all subjects at baseline. Main Outcome Measure(s) All women underwent a pulsatility study measuring LH and kisspeptin plasma concentrations to assess the spontaneous episodic secretion of both hormones, sampling every 10 minutes for 2 hours from 9:00 to 11:00 a.m. for a total of 12 blood samples. Detection and specific concordance (SC) algorithms were used to detect pulses and their concordance. Result(s) A significant endogenous secretory pattern was demonstrated for both LH and kisspeptin over the 2-hour duration of the study (2.4 ± 0.1 peaks/2 h). The computation of the SC index showed for the first time that kisspeptin and LH are cosecreted and temporally coupled at time "0," and their peaks occur at the same point in time. Conclusion(s) The present study provides evidence supporting the hypothesis that kisspeptin is highly relevant in the regulation and modulation of reproductive functions in humans

How to treat anorexia nervosa? – case report

Anorexia nervosa is an eating disorder characterized by low body weight and body image distortion with obsessive fear of gaining weight. It is a complex condition involving psychological, neuroendocrine, hormonal and metabolic components. The following is a case report of a young patient diagnosed as anorexia nervosa and primary amenorrhea, without the development of secondary female characteristics. Hormonal examination confirmed hypothalamic origin of the described disorders. There was an important impairment in the mood sphere (Beck's Depression Inventory and Hamilton Depression Rating Scale) of this young woman. Densitometry of lumbar spine revealed significant bone loss (diagnozed as osteoporosis) in this patient. All of the abovementioned examinations were repeated after one and a half years of hormonal treatment (estrogen-progestins). A return of normal menstrual cycle (with ovulation function) and normal hormonal profile have been observed. After one and a half years of treatment the patient had regular feeding patterns and none of the anorexia nervosa symptons have been found. A significant improvement in Beck's Depression Inventory and Hamilton Depression Rating Scale was found after one and a half years of hormonal treatment. The patient was also characterized by important increase of bone mass density – osteopenia was described by the densitometry of the lumbar spine

the facial expression of emotions recognition in patients with polycystic ovary syndrome

Background. A facial expression of emotions recognition is one of the basic psychological abilities. Sex steroids are able to strongly modulate the process of interpretation of facial expressions, as it has been shown in Turner syndrome patients.Objective. The aim of this study was the assessment of ability to interpret the facial emotions in women with polycystic ovary syndrome (PCOS).Methods. Participants completed a visual emotional task in which they were asked to recognize the emotion expressed of 80 randomly chosen facial expressions from NimStim set (Tottenham et al., 2009). With dedicated software we were able to assess the accuracy of patients facial emotion recognition (in comparison to NimStim validation set) and time required to provide the answer. Patients with psychotic personality have been excluded using Eysenck Personality Questionnaire (EPQ). All the patients underwent also hormonal tests including gonadotropins, estradiol and androgen concentrations.Patients. 80 women diagnosed with PCOS and hyperandrogenemia were included to the study. The control group consisted of 60 healthy, euovulatory women matched by age.Intervention. Each patient underwent visual emotional and EPQ tasks using specifically designed software.Main outcome measures. The accuracy rate (AR) and time required to recognize emotion (TE) of following emotions: anger, disgust, fear, happiness, sadness, surprise, calm and neutral has been measured.Results. Patients with PCOS showed significantly reduced AR for calm (0.76¬+/-0.09) and surprise (0.67+/-0.18) emotions in comparison to controls (0.81+/-0.09, 0.79+/-0.08 respectively). The TE for the anger was higher in PCOS group. Estradiol concentrations showed a statistic tendency (p=0.07) for correlation with TE for the happiness in controls. Conclusions. In this study we showed for the first time that patients affected by hyperandrogenism shows signs of disturbed recognition of facial expression of emotions

Metabolic Profile of Patients with Premature Ovarian Insufficiency

Premature ovarian insufficiency (POI) is hypogonadism associated with amenorrhea, increased levels of gonadotropins, and hypoestrogenism. Deficiency of estrogens may contribute to higher risk of cardiovascular diseases and death. POI patients present several risk factors for the development of cardiovascular diseases (CVD): endothelial dysfunction, abnormal lipid profile, insulin resistance, and insulin action disturbances. Therefore, patients present a higher risk of developing metabolic syndrome. Materials and methods: Follicle stimulating hormone (FSH), luteinizing hormone (LH), 17β-estradiol (E2), prolactin (PRL), testosterone (T), dehydroepiandrosterone sulfate (DHEA-S), thyroid stimulating hormone (TSH), thyroxine (fT4), fasting serum glucose and insulin concentrations, homeostatic model for insulin resistance (HOMA-IR), and lipid profiles were assessed in 56 women (mean age: 30.7 ± 6.9) suffering from POI diagnosed according to European Society of Human Reproduction and Embryology (ESHRE) criteria and 68 healthy age-and-weight matched women (mean age: 27.3 ± 4.5). Results: After regression analysis with BMI and age correction, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) serum concentrations were found to be significantly higher in the POI group, when compared to healthy subjects, whilst triglycerides, glucose, insulin serum concentrations, HOMA-IR, as well as systolic (SBP) and diastolic blood pressure (DBP) did not differ significantly between both groups. A significant positive correlation was identified between TC and LDL-C levels, regardless of BMI and age, whilst SBP correlated only with serum glucose concentration. Additionally, FSH correlated positively with fasting serum glucose concentration after BMI and age correction. Conclusions: Certain metabolic parameters appeared to correlate with POI and these correlations persisted after correction for BMI and age. More research is required to determine the influence of absent ovulatory function on metabolic profiles in POI women. This information may additionally help in early identification of CVD risk factors in those patients

The facial expression of emotions recognition in patients with polycystic ovary syndrome

Background. A facial expression of emotions recognition is one of the basic psychological abilities. Sex steroids are able to strongly modulate the process of interpretation of facial expressions, as it has been shown in Turner syndrome patients.Objective. The aim of this study was the assessment of ability to interpret the facial emotions in women with polycystic ovary syndrome (PCOS).Methods. Participants completed a visual emotional task in which they were asked to recognize the emotion expressed of 80 randomly chosen facial expressions from NimStim set (Tottenham et al., 2009). With dedicated software we were able to assess the accuracy of patients facial emotion recognition (in comparison to NimStim validation set) and time required to provide the answer. Patients with psychotic personality have been excluded using Eysenck Personality Questionnaire (EPQ). All the patients underwent also hormonal tests including gonadotropins, estradiol and androgen concentrations.Patients. 80 women diagnosed with PCOS and hyperandrogenemia were included to the study. The control group consisted of 60 healthy, euovulatory women matched by age.Intervention. Each patient underwent visual emotional and EPQ tasks using specifically designed software.Main outcome measures. The accuracy rate (AR) and time required to recognize emotion (TE) of following emotions: anger, disgust, fear, happiness, sadness, surprise, calm and neutral has been measured.Results. Patients with PCOS showed significantly reduced AR for calm (0.76¬+/-0.09) and surprise (0.67+/-0.18) emotions in comparison to controls (0.81+/-0.09, 0.79+/-0.08 respectively). The TE for the anger was higher in PCOS group. Estradiol concentrations showed a statistic tendency (p=0.07) for correlation with TE for the happiness in controls. Conclusions. In this study we showed for the first time that patients affected by hyperandrogenism shows signs of disturbed recognition of facial expression of emotions

Modulatory effects of l-carnitine plus l-acetyl-carnitine on neuroendocrine control of hypothalamic functions in functional hypothalamic amenorrhea (FHA)

Functional hypothalamic amenorrhea (FHA) is a relatively frequent disease due to the combination of metabolic, physical, or psychological stressors. It is characterized by the low endogenous GnRH-induced gonadotropin secretion, thus triggering the ovarian blockade and a hypoestrogenic condition. Up to now various therapeutical strategies have been proposed, both using hormonal treatment as well as neuroactive compounds. Since carnitine, namely l-acetyl-carnitine (LAC), has been demonstrated to be effective in the modulation of the central hypothalamic control of GnRH secretion, we aimed to evaluate whether a combined integrative treatment for 12\u2009weeks of LAC (250\u2009mg/die) and l-carnitine (500\u2009mg/die) was effective in improving the endocrine and metabolic pathways in a group of patients (n\u2009=\u200927) with FHA. After the treatment, interval mean LH plasma levels increased while those of cortisol and amylase decreased significantly. When patients were subdivided according to baseline LH levels, only hypo-LH patients showed the significant increase of LH plasma levels and the significant decrease of both cortisol and amylase plasma levels. The increased 17OHP/cortisol ratio, as index of the adrenal activity, demonstrated the reduced stress-induced adrenal activity. In conclusion, our data sustain the hypothesis that the integrative administration of LAC plus l-carnitine reduced both the metabolic and the neuroendocrine impairment of patients with FHA

Mood disorders and quality of life in polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) affects 5-10% of the population of women. The exact etiology of PCOS remains unclear, but it is believed to result from complex interactions between genetic, behavioral and environmental factors. The spectrum of its symptoms such as hirsutism, skin problems, obesity and finally infertility has a huge negative impact on the individuals' psychological and interpersonal functioning. PCOS symptoms can lead to significant deterioration in quality of life and be highly stressful negatively affecting psychological well-being and sexuality. Fear symptoms like palpitation, being out of breath and tension might be caused by many somatic diseases. Moreover, detection and continuous thinking about illness can lead to significant negative impact on individual functioning in society. PCOS may be a factor potentially favoring the occurrence of mood disorders and depression. Biological, social and psychological consequences of PCOS among women of reproductive age are opening a new perspective on management of women's health in these patients

CHEK2 Mutation in Patient with Multiple Endocrine Glands Tumors. Case Report

Background: Many studies show the occurrence of several multiple endocrine neoplasia syndromes caused by different mutations, for example, in MEN1 and RET genes. Nevertheless, there are less common mutations causing multiple endocrine glands tumors. Examples of such mutations are CHEK2 gene mutations, causing breast, kidney, gastric, colorectal, prostate, lung, ovarian, and thyroid cancers. Case description: In 2005, a 30-year-old woman was admitted to the hospital due to uncontrolled hypertension and obesity. Performed tests have shown ACTH (adrenocorticotropic hormone)—independent micronodular adrenal hyperplasia (AIMAH) as a cause. In 2010, the further diagnostic analysis revealed Cushing’s disease caused by ACTH-secreting pituitary microadenoma. Additionally, in 2011, the patient underwent the strumectomy of multinodular struma. Papillary thyroid carcinoma was found in the excised tissue. In 2018, transvaginal ultrasonography revealed a tumor of the right ovary. After a performed hysterectomy with bilateral salpingo-oophorectomy, the histopathology result has shown female adnexal tumors of probable Wolffian origin (FATWO) located in the broad ligament of the uterus. Due to the history of multiglandular diseases, the patient was referred to genetic testing. We found a positive pathogenic mutation in CHEK2-suppressor gene involved in DNA repair, cell cycle arrest, and apoptosis in response to DNA damage. Conclusion: CHEK2 variants may predispose to a range of endocrine glands tumors, including those identified in our patient. Multiple endocrine glands tumors, as in the presented patient, are a serious problem of public health, due to numerous hospitalizations and necessary repeated surgical treatments. Moreover, the association between CHEK2 and ovarian cancer can be a serious problem with reproductive health