Pubertal development and gonadotrophic hormones among girls with type 1 diabetes mellitus

Background: As a chronic disease occurring in childhood, type 1 diabetes is a factor potentially affecting the pubertal development, including age at menarche

Aim of study: To investigate the effect of type 1 diabetes on pubertal development among adolescents; and to investigate their gonadotrophic hormonal profile

Subjects and Methods: Nineteen Egyptian girls aged [13.8- 21.6] years were recruited into the study. Assessment of Pubertal development according to Marshall and Tanner [1969] was performed; and age at menarche was evaluated. Auxological assessment [weight, height, and body mass index] were performed. Laboratory investigations were done, including HbAlc levels and Hormone assays [basal and post stimulation levels]: Serum follicle- stimulating hormone [FSH], luteinizing hormone [LH], and LH/ FSH ratio was calculated

Intervention: Girls underwent GnRH- analogue test with triptorelin [0.1 mg] administered subcutaneously

Results: The mean age at menarche [13.24+ 1.25] yrs, among the 17 [89.5%] postmenarcheal T1DM girls, showed no significant difference [P>0.05] from the normal population; but still 2 [10.5%] girls did not achieve menarche until after the study period was terminated. Moreover, there was a highly significant delay [P< 0.01] in their attainment of adult sexual maturity Tanner stage V [B5, PH5]. Only 3 [15.8%] T1DM girls, had achieved optimal metabolic control, at [< 7.5%], while the remaining 16 [84.2%] had a statistically significant insufficient metabolic control [9.93+ 1.96] [P<0.00]. Also it was found that basal and stimulated LH and FSH levels were significantly decreased in T1DM girls [P<0.000]

Conclusion: Type 1 diabetes could affect pubertal development of girls, in the form of delay in their attainment of adult sexual maturity stages, Tanner Breast stage [B5] and Tanner Pubic Hair development [PH5]; however, their age at menarche, is within the range of normal Egyptian girls. The disease could alter their growth development, with a decrease in their height than the normal population. LH and FSH were significantly decreased than normal reference ranges

Premature thelarche: clinical and laboratorial assessment by immunochemiluminescent assay

In order to establish cut-off limits and to distinguish isolated premature thelarche (IPT) from precocious puberty (PP), we evaluated data from 79 girls with premature thelarche, comparing basal and stimulated LH and FSH serum concentrations with those from 91 healthy girls. A GnRH stimulation test was performed in 10 normal girls and in 42 with premature thelarche. Comparison among groups was performed by Kruskal-Wallis and Dunn’s tests. LH values were significantly greater in girls with IPT than in control groups. Basal gonadotropin concentrations were higher in patients with PP than in controls, but not different from patients with IPT. Peak LH levels after GnRH stimulation distinguished those two groups, with a cut-off value of 4.0 IU/L, but still with minimal overlap. In conclusion, a girl with premature thelarche and LH peak value above 4.5 IU/L has, indeed, PP, but values between 3.5 and 4.5 IU/L point to careful follow-up.

Com o objetivo de estabelecer o valor de corte e distinguir telarca precoce isolada (TPI) de puberdade precoce (PP), avaliamos 79 meninas com telarca precoce, comparando as dosagens basais e pós-estímulo de LH e FSH com grupo-controle. O teste de estímulo com GnRH foi realizado em 10 meninas normais e em 42 com telarca precoce. Os testes de Kruskal-Wallis and Dunn foram usados na comparação dos grupos. Os níveis de LH foram significativamente mais elevados no grupo com TPI, quando comparados com controles. As gonadotrofinas basais foram mais elevadas naquelas com PP que nos controles, mas não diferiram do grupo com TPI. O pico de LH após GnRH distinguiu estes dois grupos, com valor de corte de 4,0 UI/L, apesar de pequena sobreposição. Concluímos que uma menina com telarca precoce e LH pós-estímulo acima de 4,5 UI/L apresenta PP, mas valores entre 3,5 e 4,5 UI/L requerem seguimento cuidadoso.

Efecto de la administración transvaginal de progesterona en mujeres climatéricas / Effect of the transvaginal administration of progesterone in climateric women

El propósito de este estudio prospectivo fue evaluar el efecto y aceptabilidad de óvulos de progesterona micronizada (PM) de 50 y 100 mg aplicados a 31 mujeres climatéricas sanas que iniciaban terapia hormonal de reemplazo (THR). Las pacientes se separaron por azar simple en tres grupos: 1 control (n=10) recibió estrógenos conjugados (EC) 0,625 mg más óvulos de 50 y 100 mg PM respectivamente los días 14, 16, 18, 20, 22 y 24 por dos ciclos. Los grupos eran estadísticamente similares (p<0,05). El aumento estadísticamente significativo en los niveles sanguíneos de progesterona (PROG) luego de su administración vaginal, similar al obtenido por vía enteral, sumado a un engrosamiento endometrial no significativo y un sangramiento sin diferencia en los tres grupos, plantea que nuestra alternativa terapéutica de óvulos de PM, tanto de 50 mg como de 100 mg, responde en forma similar que MPA (5 mg) secuencial continua clásica. Esto nos lleva a plantear la vía vaginal como alternativa en la administración de PROG en pacientes usuarias de THR

Progesterone administration to ovariectomized rats reduces water and salt intake induced by central administration of angiotensin II

We tested the effects of estradiol, progesterone and testosterone on water and salt intake induced by angiotensin II (ANG II) injected into the third ventricle of female Holtzman rats weighing 250-300 g. The water and salt ingestion observed after 120 min in the control experiments (injection of 0.5µl of 0.15 M NaCl into the third ventricle) was 1.6 ñ 0.3 ml (N = 10) and 0,3 ñ 0.1 ml (N = 8) in intact rats, respectively, and 1.4 ñ 0.3 ml (N = 10) and 0.2 ñ 0.1 (N = 8) in ovariectomized rats, respectively. ANG II injected in intact rats (4, 6, 12, 25, and 50 ng, icv, in 0,5 µl saline) induced an increase in water intake (4.3 ñ 0.6, 5.4 ñ 0.7, 7.8 ñ 0.8, 10.4 ñ 1.2, 11.2 ñ 1.4 ml/120 min, respectively) ( N = 43). The same doses of icv ANG II in intact increased the 3 per cent NaCl intake (0.9 ñ 0,2, 1.4 ñ 0,3, 2,3 ñ 0.4, 2,2 ñ 0,3, and 2.5 ñ 0.4 ml/120 min, respectively) (N = 42). When administered to ovariectomized rats ANG II induced comparable amounts of water intake (4.0 ñ 0.5, 4.8 ñ 0.6 ñ 0.7, 9.6 ñ 0.8, and 10.9 ñ 1.2 ml/120 min, respectively (

Saturnism in the male rat: endocrine effects

The effect of exposure to lead on endocrine function was studied in pubertal rats treated with 1.0 g/l lead acetate (PbAc) in drinkin water for 20 days (subacute group) or 9 months (chronic group) in addition to iv injections of PbAc (0.1mg/100g body weight) every 10(subacute group) or 15 days (chronic group). Although basal levels of testosterone were higher both in the plasma and in the testes of acuctely intoxicated animals, the ciruclating levels of lutinizing hormone (LH) were not affected in either group, nor was the LHRH content of the median eminence. The density of [125I]LH/hCG biding sites in testicular homogenates was reduced by saturnism in both groups. Howeverm the apparent affinity constant of the hormone-receptor complex significantly increased. These data can be viewed as the result of a mixture of specific lead toxicity (e.g., at the enzyme level) with other more general actions (e.g., at the level of the hypothalamus-pituitary-testicular axis)

Angiotensin II antiserum decreases luteinizing hormone-releasing hormone in the median eminence and preoptic aea of the rat

Ovariectomized female rats were sacrificed 3 h after intracerebroventricular microijnjection of normal rabbit serum (NRS), specific antiserum against angiotensin II (AB-AII) or atrial natriuretic factor (AB-ANF). AB-AII decreased plasma LH by 50% and LH-RH content by 70% in the median eminence and medial preoptic area, respectively, but did not change plasma FSH when compared to animals which receivede NRS. There was no difference in these parameters when the animals were injected with AB-ANF or NRS.These results indicate that endogenous AII plays a physiological role in LH release acting directly or indirectly through LH-RH neurons of the median eminence and medial peroptic area

Niveles circulantes de subunidad alfa de FSH-h, FSH y LH en sangre periferica durante el ciclo menstrual y despues de la estimulacion con hormona sintetica liberadora de gonadotropina (LH-RH) / Circulating levels of alpha subunit of human FSH-h, FSH y LH in peripheral blood during menstrual cycle and after stimulation with sinthetic releasing hormone

Las concentraciones de la subunidad alfa de FSH-h se midio en suero durante el ciclo menstrual normal y durante la administracion de LH-RH el primero y segundo dias de la menstruacion. En ciclos menstruales normales se encontro que la subunidad alta de la FSH-h circula en forma independiente y coincide su maxima produccion con el pico de LH y FSH a mitad del ciclo. La concentracion de esta durante la fase folicular no fue diferente de la observada durante la fase lutea del ciclo. La respuesta a la administracion de diferentes concentraciones de LH-RH (10 ug y 100 ug) es un incremento en los niveles circulantes de la subunidad alfa de FSH relacionados con el aumento que se produce en LH y FSH