Clinical Significance of Serum Leptin Level in Adolescent Patients with Menstrual Abnormalities / 대한산부인과학회잡지

ABSTRACT

OBJECTIVES: Leptin is known as an endocrinologic mediator which acts on the hypothalamic- pituitary-ovarian axis. This study was undertaken to evaluate whether the serum leptin level affects the menstrual cycles of adolescents and to analyze the clinical features of adolescents with abnormal serum leptin levels. METHODS: Seventeen normal controls and 118 patients with menstrual abnormalities were included in this study. The ages of patients ranged from 15 to 25 years. Patients with menstrual abnormality were divided into five subgroups according to the etiologies group I; premature ovarian failure(n=8), group II; primary amenorrhea without congenital structural abnormality(n=14), group III; oligomenorrhea(n=12), group IV; secondary amenorrhea(n=53), group V; dysfunctional uterine bleeding(n=31). After collection of blood samples, the serum leptin levels were measured with a radioimmunoassay kit. The serum leptin level and the corrected leptin level(leptin/body mass index(BMI)) were compared and the clinical features of those with abnormal leptin concentration (>mean+standard deviation, RESULTS: The serum leptin level was closely correlated with BMI in both the control and the patient group(r=0.730, 0.737 p<0.01). There were no significant differences in the serum leptin level, BMI and leptin/BMI among the control group and the patient group and the subgroups. The most common clinical manifestation in those with abnormal leptin level was secondary amenorrhea. In particular, most of the secondary amenorrhea patients had a history of sudden weight loss of more than 5kg within a 3 month period.

CONCLUSION:

From our results, seeing as there were wide variantion of individual serum leptin levels(mean+/-SD 9.59+/-6.07), and as minor change of serum leptin level did not seem to affect the menstrual cycle, but sudden change or extreme value of serum leptin levels might cause menstrual abnormalities. Therefore serum leptin may play a permissive role rather than a regulatory role in the adolescent menstrual cycle.