Acute effects of testosterone infusion on the serum luteinizing hormone profile in eumenorrheic and polycystic ovary syndrome adolescents.
BACKGROUND
Little is known about the neuroendocrine effects of androgens on the GnRH-LH unit in females.


OBJECTIVE
Our objective was to evaluate androgen negative feedback on the GnRH-LH axis in eumenorrheic and polycystic ovary syndrome (PCOS) adolescents.


METHODS
We conducted a prospective, longitudinal, randomized, double-blind study at a pediatric endocrinology clinical research center.


METHODS
Seven nonobese PCOS adolescents and seven matched controls (C) were studied in the early follicular phase of three consecutive menstrual cycles or in three consecutive months.


METHODS
Pulsatile LH release was determined during saline [baseline (B)] and constant testosterone (T) infusions: low dose (T-LD) 0.75 and high dose (T-HD) 2.5 mg/12 h iv. Blood samples were drawn every 20 min overnight.


METHODS
LH (immunofluorometric assay) and T (electrochemiluminescence immunoassay) were determined at B, and during both T-LD and T-HD. LH profiles were analyzed by deconvolution and approximate entropy analyses.


RESULTS
On T-LD, C and PCOS serum T levels increased 2- to 3-fold vs. B. On T-HD, T values doubled in both groups vs. T-LD. Controls on T-LD had greater 12-h pulsatile LH secretion rate (P < 0.05 vs. B) and on T-HD had lower mean, pulsatile, basal LH release and LH approximate entropy (vs. B, P < 0.05). PCOS did not respond to T-LD. High-dose T did not alter mean LH in PCOS but increased pulsatile and reduced basal LH secretion.


CONCLUSIONS
PCOS adolescents have impaired suppression of pulsatile LH secretion rate consistent with reduced androgen negative feedback. Attenuation of T feedback in nonobese adolescents with PCOS extends the pathophysiology of this syndrome.
Ropelato
María Gabriela
MG
División de Endocrinología, Centro de Investigaciones Endocrinológicas, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires C1425EFD, Argentina. gropelato@cedie.org.ar
Rudaz
María Cecilia García
MC
Escobar
María Eugenia
ME
Bengolea
Sonia Viviana
SV
Calcagno
María Luján
ML
Veldhuis
Johannes D
JD
Barontini
Marta
M
D000293:Adolescent; D004311:Double-Blind Method; D025461:Feedback, Physiological; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D007986:Luteinizing Hormone / Q000097:blood* / Q000378:metabolism; D011085:Polycystic Ovary Syndrome / Q000378:metabolism*; D011446:Prospective Studies; D013739:Testosterone / Q000097:blood / Q000494:pharmacology*
D013739:Testosterone; D007986:Luteinizing Hormone