title: Blunted sleep-related luteinizing hormone rise in healthy premenarcheal pubertal girls with elevated body mass index.
abstract: OBJECTIVE
  Our objective was to determine whether excessive adiposity is associated with alteration of the normal hormonal changes of early pubertal girls.
  
  
  METHODS
  Healthy 6.4- to 9.5-yr-old, prepubertal (PRE, n = 20) and 9.4- to 13.0-yr-old pubertal premenarcheal volunteers (PUB, n = 20) were divided into excessive-weight (EW) or normal-weight (NW) groups according to the 85th percentile body mass index. INTERVENTIONS AND SETTING: Overnight blood sampling; GnRH agonist (GnRHag), low-dose ACTH, oral glucose tolerance tests, and pelvic ultrasonograms were performed in our Clinical Research Center.
  
  
  RESULTS
  EW girls were similar in age and baseline and ACTH- and GnRHag-stimulated androgen levels to stage-matched NW girls. However, the sleep-related LH rise was blunted in EW-PUB girls compared with NW-PUB girls. The sleep-related rise of mean LH in EW-PUB [0.68 +/- 0.35 (sem) U/liter] was insignificant, less than that of NW-PUB (2.1 +/- 0.45, P < 0.05) and not significantly different from that of PRE girls (0.08+/-0.03). EW-PUB had slower LH pulse frequency and a lower rise in LH pulse amplitude during sleep than NW-PUB girls (both P < 0.05). Overnight FSH patterns paralleled LH patterns, whereas estradiol levels were similar in stage-matched NW and EW groups, differing between stages as expected. Early morning and peak LH, FSH, and estradiol responses to GnRHag were similar in EW-PUB and NW-PUB and significantly greater than those of PRE girls.
  
  
  CONCLUSIONS
  Healthy EW-PUB girls have significantly blunted sleep-related LH production. These data suggest that excess adiposity, in the absence of sex steroid excess, may subtly suppress hypothalamic-pituitary-gonadal function in premenarcheal pubertal girls.
authors.affiliation: Section of Adult and Pediatric Endocrinology, Diabetes, and Metabolism, The University of Chicago Pritzker School of Medicine, Chicago, Illinois 60637, USA. bbordini@peds.bsd.uchicago.edu
authors.forename: Brian
authors.initials: B
authors.lastname: Bordini
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Littlejohn
authors.forename: Robert L
authors.initials: RL
authors.lastname: Rosenfield
mesh_terms: D000293:Adolescent; D000324:Adrenocorticotropic Hormone / Q000097:blood; D015992:Body Mass Index; D002648:Child; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D007987:Gonadotropin-Releasing Hormone / Q000097:blood; D006062:Gonadotropins; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood*; D008297:Male; D009765:Obesity / Q000097:blood*; D050177:Overweight / Q000097:blood*; D011627:Puberty / Q000502:physiology*; D012890:Sleep / Q000502:physiology*; D014851:Wakefulness
chemical_list: D006062:Gonadotropins; D007987:Gonadotropin-Releasing Hormone; D000324:Adrenocorticotropic Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone