title: Pulsatile luteinizing hormone amplitude and progesterone metabolite excretion are reduced in obese women.
abstract: BACKGROUND
  Female obesity is linked to abnormal menstrual cycles, infertility, reproductive wastage, and deficient LH, FSH, and progesterone secretion.
  
  
  OBJECTIVE
  To elucidate the reproductive defects associated with obesity, we sampled 18 eumenorrheic (nonpolycystic ovary syndrome) women with a mean +/- sem body mass index of 48.6 +/- 1.4 kg/m2 with daily, first morning voided urine collections, seven of whom also had early follicular phase 12-h, every 10-min blood sampling to assess LH pulses. Daily hormones were compared with 11 eumenorrheic, normal-weight controls. A separate control group of 12 eumenorrheic, normal-weight women was used for the LH pulse studies.
  
  
  METHODS
  Assays for LH (serum and urine) and FSH, and estradiol and progesterone metabolites (estrone conjugate and pregnanediol glucuronide; urine) were performed. Daily hormones were meaned and normalized to a 28-d cycle length. LH pulsations were determined using two objective methods. Group means were compared using t tests.
  
  
  RESULTS
  Reduced whole-cycle mean, normalized pregnanediol glucuronide was observed in obese (38.2 +/- 2.1 microg/mg creatine) compared with normal-weight women (181.3 +/- 35.1 microg/mg creatine; P = 0.002), without significant differences in LH, FSH, or estrone conjugate. Early follicular phase LH pulse frequency did not differ from normal-weight women, but both amplitude and mean LH were dramatically reduced in obese women (0.8 +/- 0.1 and 2.0 +/- 0.3 IU/liter) compared with controls (1.6 +/- 0.2 and 3.4 +/- 0.2 IU/liter; P < 0.01).
  
  
  CONCLUSIONS
  A novel defect in the amplitude but not the frequency of LH pulsations appears to underlie the reproductive phenotype of obesity. The deficit in pregnanediol glucuronide appears to exceed the deficit in LH. The patterns of hypothalamic-pituitary-ovarian axis function unique to the obese state differ from other abnormal reproductive states.
authors: Department of Obstetrics, Gynecology, and Women's Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York 10461, USA.
authors: Akas
authors: A
authors: Jain
authors: Alex J
authors: AJ
authors: Polotsky
authors: Dana
authors: D
authors: Rochester
authors: Sarah L
authors: SL
authors: Berga
authors: Tammy
authors: T
authors: Loucks
authors: Gohar
authors: G
authors: Zeitlian
authors: Karen
authors: K
authors: Gibbs
authors: Hanah N
authors: HN
authors: Polotsky
authors: Sophia
authors: S
authors: Feng
authors: Barbara
authors: B
authors: Isaac
authors: Nanette
authors: N
authors: Santoro
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002940:Circadian Rhythm / Q000502:physiology; D005260:Female; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood* / Q000652:urine*; D008597:Menstrual Cycle / Q000378:metabolism; D009765:Obesity / Q000378:metabolism*; D011374:Progesterone / Q000652:urine*; D011673:Pulsatile Flow; D012098:Reproduction / Q000502:physiology
chemical_list: D011374:Progesterone; D007986:Luteinizing Hormone