Altered pulsatile gonadotropin signaling in nutritional deficiency in the male.
Reproduction cannot occur without adequate nutrition. Diets that are nutritionally inadequate delay and disrupt the pubertal development of the reproductive processes of immature experimental animals and humans, and impair the function of the hypothalamic-pituitary-gonadal axis in adults. Although there is a general understanding of the linkages between nutrition and reproduction, there is a lack of detailed knowledge of the exact mechanisms that couple these two systems. The major effects of malnutrition on the hypothalamic-pituitary-gonadal axis reported in the literature are, for the most part, manifested as reduced gonadotropin secretion. Malnutrition results in decreased circulating gonadotropin concentrations. These changes in the reproductive system are associated with impaired gonadal function and subsequent secondary sex organ atrophy and lead, ultimately, to poor reproduction. Decreased hypothalamic release of gonadotropin-releasing hormone (GnRH) has been proposed as the most important etiologic factor for the fasting-induced suppression of pituitary-testicular function. In the human, hypogonadism and infertility develop in both sexes during chronic malnutrition. Most studies on the effects of malnutrition on the reproductive hormones have been performed in women, perhaps because malnutrition in women is promptly accompanied by amenorrhea, whereas in men hypogonadism develops gradually and becomes clinically evident only during more severe malnutrition. With the advent of sensitive assays for measuring reproductive hormones and of modern computerized methods for analyzing the pulsatile secretion of these hormones, however, the function of the hypothalamic-pituitary-testicular axis has been scrutinized and it has, indeed, been observed that this system is disturbed even during acute malnutrition. Here, we review the effects of malnutrition on reproductive function, especially on the pulsatile pattern of LH secretion, in humans and in experimental animals.
Bergendahl
M
M
The Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Virginia Health Sciences Center, Charlottesville, VA 22908, USA.
Veldhuis
J D
JD