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Athar F, Karmani M, Templeman N. Metabolic hormones are integral regulators of female reproductive health and function. Biosci Rep 2024; 44:BSR20231916. [PMID: 38131197 PMCID: PMC10830447 DOI: 10.1042/bsr20231916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 11/29/2023] [Accepted: 12/21/2023] [Indexed: 12/23/2023] Open
Abstract
The female reproductive system is strongly influenced by nutrition and energy balance. It is well known that food restriction or energy depletion can induce suppression of reproductive processes, while overnutrition is associated with reproductive dysfunction. However, the intricate mechanisms through which nutritional inputs and metabolic health are integrated into the coordination of reproduction are still being defined. In this review, we describe evidence for essential contributions by hormones that are responsive to food intake or fuel stores. Key metabolic hormones-including insulin, the incretins (glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1), growth hormone, ghrelin, leptin, and adiponectin-signal throughout the hypothalamic-pituitary-gonadal axis to support or suppress reproduction. We synthesize current knowledge on how these multifaceted hormones interact with the brain, pituitary, and ovaries to regulate functioning of the female reproductive system, incorporating in vitro and in vivo data from animal models and humans. Metabolic hormones are involved in orchestrating reproductive processes in healthy states, but some also play a significant role in the pathophysiology or treatment strategies of female reproductive disorders. Further understanding of the complex interrelationships between metabolic health and female reproductive function has important implications for improving women's health overall.
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Affiliation(s)
- Faria Athar
- Department of Biology, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
| | - Muskan Karmani
- Department of Biology, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
| | - Nicole M. Templeman
- Department of Biology, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
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Notbohm HL, Moser F, Goh J, Feuerbacher JF, Bloch W, Schumann M. The effects of menstrual cycle phases on immune function and inflammation at rest and after acute exercise: A systematic review and meta-analysis. Acta Physiol (Oxf) 2023; 238:e14013. [PMID: 37309068 DOI: 10.1111/apha.14013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 05/27/2023] [Accepted: 06/07/2023] [Indexed: 06/14/2023]
Abstract
The immune system plays an important role in mediating exercise responses and adaptations. However, whether fluctuating hormone concentrations across the menstrual cycle may impact these processes remains unknown. The aim of this systematic review with meta-analysis was to compare baseline concentrations as well as exercise-induced changes in immune and inflammatory parameters between menstrual cycle phases. A systematic literature search was conducted according to the PRISMA guidelines using Pubmed/MEDLINE, ISI Web of Science, and SPORTDiscus. Of the 159 studies included in the qualitative synthesis, 110 studies were used for meta-analysis. Due to the designs of the included studies, only the follicular and luteal phase could be compared. The estimated standardized mean differences based on the random-effects model revealed higher numbers of leukocytes (-0.48 [-0.73; -0.23], p < 0.001), monocytes (-0.73 [-1.37; -0.10], p = 0.023), granulocytes (-0.85 [-0.1.48; -0.21], p = 0.009), neutrophils (-0.32 [-0.52; -0.12], p = 0.001), and leptin concentrations (-0.37 [-0.5; -0.23], p = 0.003) in the luteal compared to the follicular phase at rest. Other parameters (adaptive immune cells, cytokines, chemokines, and cell adhesion molecules) showed no systematic baseline differences. Seventeen studies investigated the exercise-induced response of these parameters, providing some indications for a higher pro-inflammatory response in the luteal phase. In conclusion, parameters of innate immunity showed cycle-dependent regulation at rest, while little is known on the exercise responses. Due to a large heterogeneity and a lack of cycle phase standardization among the included studies, future research should focus on comparing at least three distinct hormonal profiles to derive more specific recommendations for exercise prescription.
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Affiliation(s)
- H L Notbohm
- Department of Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - F Moser
- Department of Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - J Goh
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, Singapore
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, Singapore
- Centre for Healthy Longevity, National University Health System (NUHS), Singapore, Singapore
| | - J F Feuerbacher
- Department of Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - W Bloch
- Department of Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - M Schumann
- Department of Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, Germany
- Division of Training and Movement Science, University of Potsdam, Potsdam, Germany
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Ihalainen JK, Löfberg I, Kotkajuuri A, Kyröläinen H, Hackney AC, Taipale-Mikkonen RS. Influence of Menstrual Cycle or Hormonal Contraceptive Phase on Energy Intake and Metabolic Hormones-A Pilot Study. ENDOCRINES 2021; 2:79-90. [PMID: 33959726 PMCID: PMC8096184 DOI: 10.3390/endocrines2020008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Sex hormones are suggested to influence energy intake (EI) and metabolic hormones. This study investigated the influence of menstrual cycle (MC) and hormonal contraceptive (HC) cycle phases on EI, energy availability (EA), and metabolic hormones in recreational athletes (eumenorrheic, NHC = 15 and monophasic HC-users, CHC = 9). In addition, 72-h dietary and training logs were collected in addition to blood samples, which were analyzed for 17β-estradiol (E2), progesterone (P4), leptin, total ghrelin, insulin, and tri-iodothyronine (T3). Measurements were completed at four time-points (phases): Bleeding, mid-follicular (FP)/active 1, ovulation (OVU)/active 2, mid-luteal (LP)/inactive in NHC/CHC, respectively. As expected, E2 and P4 fluctuated significantly in NHC (p < 0.05) and remained stable in CHC. In NHC, leptin increased significantly between bleeding and ovulation (p = 0.030) as well as between FP and OVU (p = 0.022). No group differences in other measured hormones were observed across the MC and HC cycle. The mean EI and EA were similar between phases, with no significant differences observed in macronutrient intake over either the MC or HC. While the MC phase might have a small, but statistically significant effect on leptin, the findings of the present study suggest that the MC or HC phase does not significantly alter ad libitum EI or EA in recreational athletes.
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Affiliation(s)
- Johanna K. Ihalainen
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - Ida Löfberg
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - Anna Kotkajuuri
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - Heikki Kyröläinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - Anthony C. Hackney
- Department of Exercise & Sport Science-Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Ritva S. Taipale-Mikkonen
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014 Jyväskylä, Finland
- Sports Technology Unit, Faculty of Sport and Health Sciences, University of Jyväskylä, 88610 Vuokatti, Finland
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Salem AM. Variation of Leptin During Menstrual Cycle and Its Relation to the Hypothalamic-Pituitary-Gonadal (HPG) Axis: A Systematic Review. Int J Womens Health 2021; 13:445-458. [PMID: 34007218 PMCID: PMC8121381 DOI: 10.2147/ijwh.s309299] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/19/2021] [Indexed: 12/23/2022] Open
Abstract
Recently, adipose tissue has been identified as endocrine organ in addition to its action as energy store; it produces a large number of biologically active mediators known as adipocytokines. Significantly, adipocytokines were found to be involved in the physiology of many body functions, including reproduction. The role of body weight, body fat compositions, and nutrition has been largely investigated using animal models and human studies. Malnutrition and/or abnormal body weight may induce disturbances in fertility, puberty, pregnancy, and menstrual cycles. Leptin was the first discovered adipocytokine, and a large body of data over the last 25 years has shown that leptin is not only a molecule that reflects energy stores in the body, but is also an important cytokine involved in many physiological functions, such as inflammatory response, insulin sensitivity, bone metabolism, immunity, and most importantly, reproductive function. Leptin controls the normal physiology of the female reproductive system; it interacts with the hypothalamic–pituitary–gonadal (HPG) axis by a complex mechanism that connects energy homeostasis with reproduction. However, observational studies have demonstrated inconsistent results about leptin variation during normal menstrual cycle, and the mechanisms involved in the interplay between leptin and the hormones of the HPG axis are largely unknown. This review focuses on leptin variation during normal menstrual cycles and its relation to the hypothalamic–pituitary–gonadal axis, and the effect of overweight/obesity on leptin during menstrual cycle is further reviewed.
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Affiliation(s)
- Ayad Mohammed Salem
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Ahmadi S, Pishva H, Eshraghian MR, Hedayati M. UCP2, SHBG, Leptin, and T3 Levels are Associated with Resting Energy Expenditure in Obese Women. Endocr Metab Immune Disord Drug Targets 2019; 20:234-241. [PMID: 31340742 DOI: 10.2174/1871530319666190723154147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 04/17/2019] [Accepted: 05/15/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the association of Sex Hormone Binding Globulin (SHBG) with leptin, Triidothyronine (T3), and Uncoupling Protein 2 (UCP2) in obese women with low and normal Resting Energy Expenditure (REE) and to determine the role of these factors in the regulation of REE in obese women. METHOD A total 49 subjects (25-50 years old) were selected. Anthropometric and body composition parameters and resting energy expenditure were measured. Fasting circulating leptin, T3, SHBG and UCP2 levels were measured. Subjects were divided into three groups: Group І (BMI>30 and low resting energy expenditure, 16 subjects), group II (BMI>30 and normal resting energy expenditure, 17 subjects), and group ІІІ (control group, 16 non-obese subjects). RESULT It was found that obese subjects who had higher SHBG and leptin levels were at risk for high levels of UCP2. A significant association was found between T3 and REE. Obese subjects with higher concentrations of UCP2 and SHBG had decreased resting energy expenditure. A significant association was observed between SHBG and leptin in group І (r=0.90, p<0.0001) and group ІІ (r=0.83, p<0.0001). Moreover, a significant association was found between T3 and SHBG in group І (r=-0.69, P=0.003). CONCLUSION Changes of the UCP2, leptin, and thyroid hormone (T3) levels may be related to SHBG levels. Thus, lower leptin and T3 levels may decrease SHBG in obese women. Therefore, lower SHBG, leptin, T3 and UCP2 levels may decrease the REE level in obese women.
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Affiliation(s)
- Somaye Ahmadi
- Department of Cellular-Molecular Nutrition, School of Nutrition Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamideh Pishva
- Department of Cellular-Molecular Nutrition, School of Nutrition Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad R Eshraghian
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Hedayati
- Cellular-Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University, Tehran, Iran
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Le G, Novotny SA, Mader TL, Greising SM, Chan SSK, Kyba M, Lowe DA, Warren GL. A moderate oestradiol level enhances neutrophil number and activity in muscle after traumatic injury but strength recovery is accelerated. J Physiol 2018; 596:4665-4680. [PMID: 30035314 PMCID: PMC6166067 DOI: 10.1113/jp276432] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 07/09/2018] [Indexed: 12/18/2022] Open
Abstract
KEY POINTS The female hormone oestrogen may protect muscle from injury by reducing inflammation but this is debatable. In this study, the inflammatory response of injured muscle from oestrogen-replete mice was comprehensively compared to that from oestrogen-deficient mice. We show that oestrogen markedly promotes movement of neutrophils, an inflammatory white blood cell type, into muscle over the first few days after injury but has only a minor effect on the movement of macrophages, another inflammatory cell type. Despite the enhancement of inflammation by oestrogen in injured muscle, we found strength in oestrogen-replete mice to recover faster and to a greater extent than it does in oestrogen-deficient mice. Our study and others indicate that lower doses of oestrogen, such as that used in our study, may affect muscle inflammation and injury differently from higher doses. ABSTRACT Oestrogen has been shown to protect against skeletal muscle injury and a reduced inflammatory response has been suggested as a possible protective mechanism. There are, however, dissenting reports. Our objective was to conduct an unbiased, comprehensive study of the effect of oestradiol on the inflammatory response following muscle injury. Female C57BL6/J mice were ovariectomized and supplemented with and without oestradiol. Tibialis anterior muscles were freeze injured and studied primarily at 1-4 days post-injury. Oestradiol supplementation increased injured muscle gene expression of neutrophil chemoattractants (Cxcl1 and Cxcl5) and to a lesser extent that of monocyte/macrophage chemoattractants (Ccl2 and Spp1). Oestradiol markedly increased gene expression of the neutrophil cell surface marker (Ly6g) but had less consistent effects on the monocyte/macrophage cell surface markers (Cd68, Cd163 and Cd206). These results were confirmed at the protein level by immunoblot with oestradiol increasing LY6G/C content and having no significant effect on CD163 content. These findings were confirmed with fluorescence-activated cell sorting counts of neutrophils and macrophages in injured muscles; oestradiol increased the proportion of CD45+ cells that were neutrophils (LY6G+ ) but not the proportion that were macrophages (CD68+ or CD206+ ). Physiological impact of the oestradiol-enhanced neutrophil response was assessed by strength measurements. There was no significant difference in strength between oestradiol-supplemented and -unsupplemented mice until 2 weeks post-injury; strength was 13-24% greater in supplemented mice at 2-6 weeks post-injury. In conclusion, a moderate level of oestradiol supplementation enhances neutrophil infiltration in injured muscle and this is associated with a beneficial effect on strength recovery.
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Affiliation(s)
- Gengyun Le
- Divisions of Rehabilitation Science and Physical Therapy, Department of Rehabilitation MedicineUniversity of Minnesota Medical SchoolMinneapolisMNUSA
| | - Susan A. Novotny
- Divisions of Rehabilitation Science and Physical Therapy, Department of Rehabilitation MedicineUniversity of Minnesota Medical SchoolMinneapolisMNUSA
| | - Tara L. Mader
- Divisions of Rehabilitation Science and Physical Therapy, Department of Rehabilitation MedicineUniversity of Minnesota Medical SchoolMinneapolisMNUSA
| | - Sarah M. Greising
- Divisions of Rehabilitation Science and Physical Therapy, Department of Rehabilitation MedicineUniversity of Minnesota Medical SchoolMinneapolisMNUSA
| | - Sunny S. K. Chan
- Lillehei Heart InstituteUniversity of MinnesotaMinneapolisMNUSA
- Department of PediatricsUniversity of MinnesotaMinneapolisMNUSA
| | - Michael Kyba
- Lillehei Heart InstituteUniversity of MinnesotaMinneapolisMNUSA
- Department of PediatricsUniversity of MinnesotaMinneapolisMNUSA
| | - Dawn A. Lowe
- Divisions of Rehabilitation Science and Physical Therapy, Department of Rehabilitation MedicineUniversity of Minnesota Medical SchoolMinneapolisMNUSA
| | - Gordon L. Warren
- Department of Physical TherapyGeorgia State UniversityAtlantaGAUSA
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Rafique N, Salem AM, Latif R, ALSheikh MH. Serum leptin level across different phases of menstrual cycle in normal weight and overweight/obese females. Gynecol Endocrinol 2018; 34:601-604. [PMID: 29268651 DOI: 10.1080/09513590.2017.1419173] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
We compared serum leptin levels during various phases of menstrual cycle and its correlation with serum estradiol between normal weight and overweight/obese young females. Fifty-six young females with normal menstrual cycle were grouped into 26 normal weight and 30 overweight/obese subjects. Serum leptin and estradiol levels were measured during early follicular, pre-ovulatory and luteal phases of menstrual cycle in both groups using ELISA technique. Serum leptin levels were significantly different across different phases of menstrual cycle with a steady increment from follicular phase (9.97 ± 5.48 ng/dl) through pre-ovulatory phase (11.58 ± 6.49 ng/dl) with their peaks in luteal phase (12.52 ± 6.39 ng/dl, p < .001). Same pattern of change during menstrual phases was observed when the normal weight and overweight/obese group were analyzed separately. Serum leptin levels were significantly higher in overweight/obese group compared to normal weight subjects. In any of the study groups, leptin levels were not found to be correlated with estradiol level during different phases of menstrual cycle.
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Affiliation(s)
- Nazish Rafique
- a Department of Physiology , College of Medicine, Imam Abdulrahman Bin Faisal University , Dammam , Saudi Arabia
| | - Ayad M Salem
- a Department of Physiology , College of Medicine, Imam Abdulrahman Bin Faisal University , Dammam , Saudi Arabia
| | - Rabia Latif
- a Department of Physiology , College of Medicine, Imam Abdulrahman Bin Faisal University , Dammam , Saudi Arabia
| | - Mona H ALSheikh
- a Department of Physiology , College of Medicine, Imam Abdulrahman Bin Faisal University , Dammam , Saudi Arabia
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Catteau A, Caillon H, Barrière P, Denis MG, Masson D, Fréour T. Leptin and its potential interest in assisted reproduction cycles. Hum Reprod Update 2015; 22:320-41. [PMID: 26663219 DOI: 10.1093/humupd/dmv057] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 11/17/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Leptin, an adipose hormone, has been shown to control energy homeostasis and food intake, and exert many actions on female reproductive function. Consequently, this adipokine is a pivotal factor in studies conducted on animal models and humans to decipher the mechanisms behind the infertility often observed in obese women. METHODS A systematic PubMed search was conducted on all articles, published up to January 2015 and related to leptin and its actions on energy balance and reproduction, using the following key words: leptin, reproduction, infertility, IVF and controlled ovarian stimulation. The available literature was reviewed in order to provide an overview of the current knowledge on the physiological roles of leptin, its involvement in female reproductive function and its potential interest as a prognostic marker in IVF cycles. RESULTS Animal and human studies show that leptin communicates nutritional status to the central nervous system and emerging evidence has demonstrated that leptin is involved in the control of reproductive functions by acting both directly on the ovaries and indirectly on the central nervous system. With respect to the clinical use of leptin as a biomarker in IVF cycles, a systematic review of the literature suggested its potential interest as a predictor of IVF outcome, as high serum and/or follicular fluid leptin concentrations have correlated negatively with cycle outcome. However, these preliminary results remain to be confirmed. CONCLUSION Leptin regulates energy balance and female reproductive function, mainly through its action on hypothalamic-pituitary-ovarian function, whose molecular and cellular aspects are progressively being deciphered. Preliminary studies evaluating leptin as a biomarker in human IVF seem promising but need further confirmation.
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Affiliation(s)
- A Catteau
- Service de médecine et biologie du développement et de la reproduction, Hôpital mère et enfant, CHU de Nantes, Nantes, France Faculté de médecine, Université de Nantes, Nantes, France
| | - H Caillon
- Laboratoire de biochimie, Institut de biologie, CHU de Nantes, Nantes, France
| | - P Barrière
- Service de médecine et biologie du développement et de la reproduction, Hôpital mère et enfant, CHU de Nantes, Nantes, France Faculté de médecine, Université de Nantes, Nantes, France INSERM UMR 1064 - ITUN, CHU de Nantes, Nantes, France
| | - M G Denis
- Faculté de médecine, Université de Nantes, Nantes, France Laboratoire de biochimie, Institut de biologie, CHU de Nantes, Nantes, France INSERM UMR 913, Nantes, France
| | - D Masson
- Faculté de médecine, Université de Nantes, Nantes, France Laboratoire de biochimie, Institut de biologie, CHU de Nantes, Nantes, France INSERM UMR 913, Nantes, France
| | - T Fréour
- Service de médecine et biologie du développement et de la reproduction, Hôpital mère et enfant, CHU de Nantes, Nantes, France Faculté de médecine, Université de Nantes, Nantes, France INSERM UMR 1064 - ITUN, CHU de Nantes, Nantes, France Clínica EUGIN, 08029 Barcelona, Spain
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Gonçalves HF, Zendron C, Cavalcante FS, Aiceles V, Oliveira MAP, Manaia JHM, Babinski MA, Ramos CF. Leptin, its receptor and aromatase expression in deep infiltrating endometriosis. J Ovarian Res 2015; 8:53. [PMID: 26242176 PMCID: PMC4523920 DOI: 10.1186/s13048-015-0180-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 07/17/2015] [Indexed: 12/03/2022] Open
Abstract
Background The aim of this study was to evaluate the leptin levels in the serum and peritoneal fluid (PF) and the protein expression in three different peritoneal ectopic implants in patients who underwent surgery for deep infiltrating endometriosis. Methods All patients had been treated at the Department of Gynecology of the Pedro Ernesto University Hospital, Rio de Janeiro. The study group consisted of 15 patients who underwent surgery for adnexal masses and infertility, while the control group consisted of ten women who underwent surgery for tubal ligation. Peritoneal fluid and samples tissues were collected during surgery. Serum samples were obtained before anesthesia. In this study, the leptin levels in the serum and peritoneal fluid (PF) were evaluated by ELISA. The protein expression of leptin and its receptors (ObR) and aromatase enzyme were evaluated by Western blot analysis of the intestine, uterosacral ligament and vaginal septum in the ectopic implants. The t-test and one-way ANOVA with Holm-Sìdak post-test were used, and p < 0.05 was considered to be statistically significant. Results Compared to the controls, the serum leptin levels (control = 14.7 ng/mL ± 2.63, endometriosis = 19.2 ng/mL ± 1.84, p < 0.0001) were increased, while in PF, there was no difference (control = 6.68 ng/mL ± 0.43, endometriosis = 7.71 ng/mL ± 0.59, p = 0.18). Comparing women with and without ovarian implants, the leptin levels in both the serum and PF were significantly higher in women without ovarian implants (serum: with ovarian implant = 15.85 ± 1.99; without ovarian implant = 23.14 ± 2.60; ng/mL, p = 0.04; PF: with ovarian implant = 4.28 ± 1.30; without ovarian implant = 11.18 ± 2.98;ng/mL, p = 0.048). The leptin, ObR and aromatase protein expression levels were increased in lesions in the vaginal septum and were decreased in the intestine lesions. Conclusion This study reports several interesting associations between the leptin levels in serum, peritoneal fluid, and tissue samples and the localization of the ectopic endometrium. Although this study does not provide a clear picture of the role of leptin in the development and progression of peritoneal implants, it contributed new data that might be useful to elucidating the enigma that is the role of leptin in endometriosis disease.
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Affiliation(s)
- Helder F Gonçalves
- Laboratory of Morphometry, Metabolism and Cardiovascular Disease, Biomedical Center, Institute of Biology, Department of Anatomy, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Carolina Zendron
- Department of Gynecology, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fernanda S Cavalcante
- Laboratory of Morphometry, Metabolism and Cardiovascular Disease, Biomedical Center, Institute of Biology, Department of Anatomy, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Verônica Aiceles
- Laboratory of Morphometry, Metabolism and Cardiovascular Disease, Biomedical Center, Institute of Biology, Department of Anatomy, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Jorge Henrique M Manaia
- Departament of Morfology, Biomedical Institute, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Márcio A Babinski
- Departament of Morfology, Biomedical Institute, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Cristiane F Ramos
- Laboratory of Morphometry, Metabolism and Cardiovascular Disease, Biomedical Center, Institute of Biology, Department of Anatomy, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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El-Haggar SM, Mostafa TM. Cardiovascular risk in Egyptian healthy consumers of different types of combined oral contraceptives pills: A comparative study. Endocrine 2015; 49:820-7. [PMID: 25539793 DOI: 10.1007/s12020-014-0507-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 12/05/2014] [Indexed: 12/18/2022]
Abstract
This study aimed to evaluate the associated cardiovascular risk in Egyptian healthy consumers of different types of combined oral contraceptives pills (COCPs) via determination of lipids profiles, Castelli index I, leptin, adiponectin, and resistin concentrations as cardiovascular risk factors. In this cross-sectional study, the study groups consisted of control group that represented by 30 healthy married women who were not on any contraceptive mean or any hormonal therapy and had normal menstrual cycles, group two consisted of 30 women who were users of Levonorgesterl 0.15 mg plus Ethinylestradiol 0.03 mg as 21 days cycle, group three consisted of 30 women who were users of Gestodene 0.075 mg plus Ethinylestradiol 0.03 mg as 21 days cycle, and group four consisted of 30 women who were users of Drospirenone 3 mg plus Ethinylestradiol 0.03 mg as 21 days cycle. One-way analysis of variance followed by LSD post hoc test was used for comparison of variables. P value <0.05 was considered to be significant. The comparison of the studied groups revealed that COCPs containing levonorgestrel plus ethinylestradiol resulted in significantly lower adiponectin level, and significantly higher leptin and resistin levels with more atherogenic lipid profile presented by significantly higher LDL-C, significantly lower HDL-C concentrations, and significantly higher atherogenic index. Formulation containing ethinylestradiol combined with gestodene neither altered adipose tissue function nor showed deleterious effect on lipid panel. Formulation containing ethinylestradiol combined with drospirenone resulted in significantly higher HDL-C and adiponectin concentrations. In conclusion, the uptake of COCPs containing levonorgestrel plus ethinylestradiol is associated with high cardiovascular risk since this formulation showed significantly lower adiponectin concentration, significantly higher leptin, resistin, and atherogenic index as compared to other studied groups. By contrast, the formulations containing ethinylestradiol combined with third generation progestin gestodene or fourth generation progestin drospirenone are associated with low cardiovascular risk since they neither altered adipose tissue function nor impaired lipoprotein metabolism as experienced by their favorable effect on leptin, adiponectin, and resistin, with non-changed atherogenic index, higher HDL-C levels and lower LDL-C levels as compared to levonorgestrel plus ethinylestradiol formulation.
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Affiliation(s)
- Sahar M El-Haggar
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tanta University, Tanta, Egypt,
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Elliott SA, Ng J, Leow MKS, Henry CJK. The influence of the menstrual cycle on energy balance and taste preference in Asian Chinese women. Eur J Nutr 2014; 54:1323-32. [DOI: 10.1007/s00394-014-0812-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Accepted: 12/02/2014] [Indexed: 11/27/2022]
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Ahrens K, Mumford SL, Schliep KC, Kissell KA, Perkins NJ, Wactawski-Wende J, Schisterman EF. Serum leptin levels and reproductive function during the menstrual cycle. Am J Obstet Gynecol 2014; 210:248.e1-9. [PMID: 24215851 DOI: 10.1016/j.ajog.2013.11.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 10/18/2013] [Accepted: 11/05/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the role of leptin on reproductive hormones and ovulation. STUDY DESIGN The BioCycle Study (2005-2007) followed 259 healthy premenopausal women not using hormonal contraceptives for ≤2 menstrual cycles (n = 509 cycles). Serum leptin, estradiol, progesterone, luteinizing hormone (LH), follicle-stimulating hormone, and testosterone were measured ≤8 times per cycle. The association of time-varying leptin and reproductive hormones over the cycle was estimated with the use of linear mixed models that were adjusted for percent body fat and age with inverse probability weighting for time-varying physical activity, caloric intake, and other reproductive hormones. The odds ratio for sporadic anovulation (n = 42 cycles) was estimated with the use of generalized linear models that were adjusted for percent body fat and age. RESULTS Geometric mean serum leptin levels increased from menses to the late luteal phase (16.7-20.4 ng/mL; P < .01), with a mid-cycle peak (21.7 ng/mL) at the time of the LH surge (P < .01). A 10% higher leptin level across the menstrual cycle was associated with higher estradiol levels (2.2%; 95% CI, 1.5-3.0), luteal progesterone levels (2.1%; 95% CI, 0.5-3.7), ovulatory LH levels (1.2%; 95% CI, 0-2.3), testosterone levels (0.6%; 95% CI, 0.3-0.9), and lower follicle-stimulating hormone levels (-0.7%; 95% CI, -1.1 to -0.4). Leptin at the time of the expected LH surge was moderately inversely associated with sporadic anovulation (per log increase in leptin; adjusted odds ratio, 0.58; 95% CI, 0.28-1.22). CONCLUSION The association that was observed between leptin level and reproductive function points to a possible relationship between serum leptin level and enhanced fertility.
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McNeil J, Doucet É. Possible factors for altered energy balance across the menstrual cycle: a closer look at the severity of PMS, reward driven behaviors and leptin variations. Eur J Obstet Gynecol Reprod Biol 2012; 163:5-10. [DOI: 10.1016/j.ejogrb.2012.03.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2011] [Revised: 02/09/2012] [Accepted: 03/05/2012] [Indexed: 11/26/2022]
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Capobianco G, de Muro P, Cherchi GM, Formato M, Lepedda AJ, Cigliano A, Zinellu E, Dessole F, Gordini L, Dessole S. Plasma levels of C-reactive protein, leptin and glycosaminoglycans during spontaneous menstrual cycle: differences between ovulatory and anovulatory cycles. Arch Gynecol Obstet 2010; 282:207-13. [PMID: 20306065 DOI: 10.1007/s00404-010-1432-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2009] [Accepted: 03/09/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE To assess the plasma levels of the inflammatory markers such as C-reactive protein (CRP), leptin, and glycosaminoglycans (GAGs) during the menstrual cycle. METHODS Eighteen healthy volunteers were divided into two groups according to the presence of ovulatory or anovulatory menstrual cycles. Blood samples were collected at different time points: at the menstrual phase (days 2-3), periovulatory phase (days 12-13), and luteal phase (days 23-24). CRP and leptin concentrations were measured by enzyme immunoassay. GAGs were isolated using ion-exchange chromatography on DEAE-Sephacel and quantified as hexuronate. The structural characterization of chondroitin sulfate (CS) isomers was performed by fluorophore-assisted carbohydrate electrophoresis (FACE). RESULTS In the women with ovulatory cycles, plasma GAG levels differed significantly during menstrual cycle, with increased values at the periovulatory with respect to the menstrual phase. No significant differences in CRP and leptin concentrations were observed through the menstrual cycle in both the examined cycles, but inter-group analysis revealed significant differences of CRP and leptin levels between the ovulatory and anovulatory cycles with higher values at periovulatory phase in the ovulatory cycles. CONCLUSIONS There are no fluctuations of both total GAG concentration and CS isomer content during menstrual cycle in the anovulatory cycles. A significant correlation between CRP and gonadotrophins was found. There is no significant difference in CRP across the menstrual cycle among ovulatory cycles, but there is a trend toward higher CRP at the periovulatory than the other phases, consistent with the significant difference in CRP between ovulatory and anovulatory cycles at the periovulatory phase. Both the trend and the significant result suggest an elevation in CRP with ovulation. These observations provide additional evidences to the hypothesis that the ovulation is an inflammatory-like phenomenon.
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Affiliation(s)
- Giampiero Capobianco
- Gynecologic and Obstetric Clinic, University of Sassari, Viale San Pietro 12, 07100 Sassari, Italy.
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Van Vugt DA. Brain imaging studies of appetite in the context of obesity and the menstrual cycle. Hum Reprod Update 2009; 16:276-92. [DOI: 10.1093/humupd/dmp051] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Thalassaemia and aberrations of growth and puberty. Mediterr J Hematol Infect Dis 2009; 1:e2009003. [PMID: 21415985 PMCID: PMC3033154 DOI: 10.4084/mjhid.2009.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2009] [Accepted: 07/26/2009] [Indexed: 01/19/2023] Open
Abstract
Endocrine dysfunction in Thalassaemia major (TM) is a common and disturbing complication, which requires prompt recognition and treatment. The contribution of the underlying molecular defect in TM to the development of endocrinopathies is significant because the patients with the more severe genetic defects have a greater rate of iron loading through higher red cell consumption. TM patients frequently present delay of growth and puberty with reduction of final height. The pathogenesis of growth failure is multifactorial and is mainly due to chronic anemia and hypoxia, chronic liver disease, zinc and folic acid deficiency, iron overload, intensive use of chelating agents, emotional factors, and endocrinopathies (hypogonadism, delayed puberty, hypothyroidism) and GH-IGF-1 axis dysregulation. Although appropriate iron chelation therapy can improve growth and development, TM children and adolescents treated intensively with desferrioxamine remain short as well, showing body disproportion between the upper and lower body segment. Body disproportion is independent of pubertal or prepubertal period of greater height gain. Treatment with recombinant GH (rhGH) is recommended when GH deficiency is established, and even so, the therapeutic response is often non satisfactory. Growth acceleration is mostly promoted with sex steroids in children with associated pubertal delay. Sexual complications in TM, which include Delayed Puberty, Arrested Puberty and Hypogonadism, present the commonest endocrine complication. Iron deposition on gonadotroph cells of the pituitary leads to disruption of gonadotrophin production which is proven by the poor response of FSH and LH to GnRH stimulation. In the majority of patients gonadal function is normal as most women with Amenorrhea are capable of achieving pregnancy with hormonal treatment and similarly men with azoospermia become fathers. Secondary Hypogonadism appears later in life, and is manifested in women as Secondary Amenorrhea and in men as decline in sexual drive and azzoospermia. The damage to the hypothalamus and pituitary is progressive, even when intensive chelating therapy is given and the appearance of Hypogonadism in both sexes is often unavoidable. Close follow up and proper management is crucial for every patient with TM. Early recognition of growth disturbance and prevention of hypogonadism by early and judicious chelation therapy is mandatory for the improvement of their quality of life. Patients with TM can now live a better life due to modern advances in their medical care and our better understanding in the pathogenesis, manifestation and prevention of endocrine complications.
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Petzel M, Stejskal D, Jedelsky L, Kadalova L, Safarcik K. THE INFLUENCE OF ESTRADIOLE AND TIBOLONE ADMINISTRATION ON LEPTIN LEVELS IN WOMEN WITH SURGICALLY INDUCED MENOPAUSE. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2008; 152:101-5. [DOI: 10.5507/bp.2008.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Towhidi A, Masoumi R, Moeini MM, Solgi H, Moravej H. The relationship between plasma leptin and FSH concentrations with ovulation rate in Iranian native sheep. Pak J Biol Sci 2007; 10:363-7. [PMID: 19070042 DOI: 10.3923/pjbs.2007.363.367] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this study was to determine the relationship between plasma leptin and FSH concentration in Iranian sheep. Forty female Mehraban and Sanjabi sheep were used. All ewes were cyclic and synchronized with cloprestenol. The ewes were divided into two breed groups: Mehraban breed (n = 20) and Sanjabi breed (n = 20), feeding at maintenance level. On the first and second days of estrus cycle, blood samples were collected from the jugular vein. Ovulation number was determined by endoscopy 7 days after the second injection. Mean Plasma leptin concentrations on second day (4.74 +/- 0.15 and 4.68 +/- 0.10 ng mL(-1)) were significantly higher than those on first day (2.64 +/- 0.11 and 2.56 +/- 0.04 ng mL(-1)) for Mehraban and Sanjabi sheep, respectively (p<0.01). Mean plasma FSH concentrations on second day (2.75 +/- 0.17 and 2.74 +/- 0.15 ng mL(-1)) were also significantly greater than those on first day (1.19 +/- 0.05 and 1.19 +/- 0.04 ng mL(-1)) for Mehraban and Sanjabi ewes, respectively (p<0.01). In the present study, positive relationship has been shown between plasma Leptin and FSH concentrations (p<0.01) in Mehraban and Sanjabi sheep. Ovulation rate had a significant difference between Mehraban (1.20 +/- 0.33) and Sanjabi (1.07 +/- 0.1) ewes. Significant differences were not observed between concentrations of FSH and leptin with ovulation rate in both breeds (p < or = 0.01).
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Affiliation(s)
- A Towhidi
- Department of Animal Science, Faculty of Agronomy and Animal Science, University of Tehran, P.O. Box 31587-4111 Karaj, Iran
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Skordis N, Michaelidou M, Savva SC, Ioannou Y, Rousounides A, Kleanthous M, Skordos G, Christou S. The impact of genotype on endocrine complications in thalassaemia major. Eur J Haematol 2006; 77:150-6. [PMID: 16800840 DOI: 10.1111/j.1600-0609.2006.00681.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The clinical severity in thalassaemia major (TM) depends on the underlying mutations of the beta-globin gene and the degree of iron overload. OBJECTIVE The aim of the study was to investigate the impact of genotype on the development of endocrine complications in TM in our center. SUBJECTS AND METHODS 126 (62 males, 64 females) thalassaemic patients of Greek Cypriot origin with a mean age of 31.2 (17-68) yr were included in the study. All patients, who were on the standard treatment protocol, were subsequently divided into two groups according to their genotype, group A (92): TM with no mitigating factor and group B (34): TM carrying one or more mitigating factors in the beta- and/or alpha-globin genes. Iron overload calculation was based on the amount of red cell consumption and the mean ferritin level over a 12-year period. Statistical analysis was performed with the SPSS program. RESULTS Patients in group A, who were consuming larger amounts of blood on transfusions, were more likely to develop hypogonadism (P = 0.001) compared with patients in group B, despite their similar mean ferritin levels. The incidence of other endocrinopathies (short stature, hypothyroidism, and diabetes mellitus) was similar in the two groups. The prevalence of hypothyroidism in splenectomized patients was significantly higher (P = 0.005), whereas the presence of hypogonadism, impaired glucose homeostasis and insulin resistance, although more frequent, was not statistically significant. The clinical severity of TM had no impact on bone mineral density (BMD) in both men and women. BMD was only influenced by gonadal function. CONCLUSIONS This study demonstrates that the underlying genetic defect in TM is a contributing factor for gonadal dysfunction, because the patients with the more severe defects have a greater rate of iron loading through higher red cell consumption.
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Affiliation(s)
- Nicos Skordis
- Pediatric Endocrine Unit, Makarios Hospital, Nicosia, Cyprus.
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Budak E, Fernández Sánchez M, Bellver J, Cerveró A, Simón C, Pellicer A. Interactions of the hormones leptin, ghrelin, adiponectin, resistin, and PYY3-36 with the reproductive system. Fertil Steril 2006; 85:1563-81. [PMID: 16759918 DOI: 10.1016/j.fertnstert.2005.09.065] [Citation(s) in RCA: 155] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2005] [Revised: 09/16/2005] [Accepted: 09/16/2005] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To summarize the effects of novel hormones (leptin, ghrelin, adiponectin, resistin, and PYY3-36) secreted from adipose tissue and the gastrointestinal tract that have been discovered to exert different effects on several reproductive functions, such as the hypothalamic-pituitary-gonadal axis, embryo development, implantation physiology, and clinically relevant conditions. DESIGN A MEDLINE computer search was performed to identify relevant articles. RESULT(S) Leptin and ghrelin exert important roles on body weight regulation, eating behavior, and reproduction, acting on the central nervous system and target reproductive organs. As a marker of adequate nutritional stores, these hormones may act on the central nervous system to initiate the complex process of puberty and maintain normal reproductive function. In addition, leptin and ghrelin and their receptors are involved in reproductive events such as gonadal function, embryo development, and embryo-endometrial interaction. CONCLUSION(S) Leptin and ghrelin and other adipose tissue-secreted hormones have significant effects on reproduction. Acting through the brain, these hormones may serve as links between adipose tissue and the reproductive system to supply and regulate energy needs for normal reproduction and pregnancy. Future studies are needed to further clarify the role of these hormones in reproductive events and other related gynecological conditions.
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Affiliation(s)
- Erdal Budak
- Instituto Valenciano de Infertilidad, University of Valencia, Valencia, Spain
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Al-Harithy RN, Al-Doghaither H, Abualnaja K. Correlation of leptin and sex hormones with endocrine changes in healthy Saudi women of different body weights. Ann Saudi Med 2006; 26:110-5. [PMID: 16761447 PMCID: PMC6074149 DOI: 10.5144/0256-4947.2006.110] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/01/2005] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND A relationship between estrogen and leptin has been described during the follicular phase of both spontaneous menstrual cycles and cycles stimulated with exogenous follicle-stimulating hormone (FSH), which suggest that leptin has either a direct effect on or is regulated by gonadal steroids in the human ovary. To examine the changes in plasma leptin levels during the menstrual cycle, we studied the association between plasma leptin and reproductive hormones in young, healthy Saudi women. SUBJECTS AND METHODS Sixty-five young women between 19 to 39 years of age, with a normal menstrual cycle, were grouped into 33 overweight and obese females of BMI >25 kg/m2, and 32 lean females of BMI <25 kg/m2. Anthropometrics measurements were made at the time of the collection. Samples were analyzed for leptin, progesterone, estradiol (E2), FSH, luteinizing hormone (LH), cortisol, and testosterone concentrations. RESULTS Overweight and obese women, compared with lean, tended to have a significantly higher plasma leptin levels (11.38 +/- 4.06 vs. 6.22 +/- 2.87 ng/mL; P=0.05). In overweight and obese subjects, circulating leptin concentrations showed a directcorrelation with BMI (r=0.53; P=0.002), hip circumference (r=0.32; P=0.005), waist-hip ratio (r=0.37; P=0.042), weight (r=0.41; P=0.021), and E2 on day 3 (r=0.35; P=0.048). In all correlation analyses, leptin levels did not correlate with cortisol or testosterone. In lean subjects, a bivariate correlation analysis showed that plasma leptin concentrations were directly correlated to hip circumference (r=0.43; P=0.012). Moreover, a direct correlation was found with progesterone on day 10 (r=0.43; P=0.014) and E2 on day 24 (r=0.47; P=0.007). CONCLUSION There is a link between plasma leptin and progesterone concentrations during the menstrual cycle, and the variation in circulating estradiol concentrations may have an influence on circulating leptin in female subjects.
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Affiliation(s)
- Rowyda N Al-Harithy
- Department of Biochemistry, King Abdulaziz University, Jeddah, Saudi Arabia.
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Leptin. GYNAKOLOGISCHE ENDOKRINOLOGIE 2006. [DOI: 10.1007/s10304-005-0135-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Leminen R, Raivio T, Ranta S, Oehler J, von Hertzen H, Jänne OA, Heikinheimo O. Late follicular phase administration of mifepristone suppresses circulating leptin and FSH - mechanism(s) of action in emergency contraception? Eur J Endocrinol 2005; 152:411-8. [PMID: 15757858 DOI: 10.1530/eje.1.01884] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Low dose mifepristone (RU486) is highly effective in emergency post-coital contraception (EC), although the mechanism(s) of action remains unclear. We studied the endocrine actions of 10 mg mifepristone administered orally as a single dose to eight healthy volunteers (aged 20-45 years) during the late follicular phase. METHODS Serum levels of LH, FSH, oestradiol, progesterone, leptin, mifepristone, cortisol, and gluco-corticoid bioactivity (GBA) were measured before and 1, 2, 4 and 8 h after ingestion of mifepristone on cycle day 10 or 11 (study day 1), and follow-up was continued for 10 days. Ovarian ultrasonography was performed on study days 1 and 7. Similar measurements were carried out during a control cycle. RESULTS Mifepristone postponed ovulation, as evidenced by a 3.4+/-1.1 day (means+/-s.d.) delay (P < 0.005) in the LH surge and 3.6+/-4.0 day prolongation of the treatment cycle (P = 0.08). During the mifepristone cycle, an LH surge was displayed by five subjects when serum mifepristone levels had declined to 9.5+/-7.1 nmol/l. During the day of mifepristone administration, circulating GBA (P < 0.001) and leptin (P < 0.001) levels declined. On the day after mifepristone administration, mean serum FSH and leptin levels were lower than pretreatment values (3.8+/-1.8 IU/l vs 5.2+/-1.1 IU/l, n = 7, P < 0.05; 28.9+/-6.7 microg/l vs 33.2+/-9.0 microg/l, n = 7, P < 0.05 respectively), and the corresponding difference in the mean serum oestradiol concentration was borderline (452+/-252 pmol/l vs 647+/-406 pmol/l, n = 7, P = 0.056). In contrast to the control cycle, individual leptin levels declined during the follow-up after ingestion of mifepristone (n = 8, P < 0.01). CONCLUSIONS These data showed that the commonly employed dose of mifepristone for EC delays ovulation and prolongs the menstrual cycle, when given during the late follicular phase. The mechanism of action of mifepristone may include a reduction of FSH secretion via a decrease in circulating leptin.
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Affiliation(s)
- Riikka Leminen
- Department of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland
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Gürbüz B, Yalti S, Ficicioglu C, Taşdemir S. The relation of serum and follicular fluid leptin and ovarian steroid levels in response to induction of ovulation in in vitro fertilization cycles. Eur J Obstet Gynecol Reprod Biol 2005; 118:214-8. [PMID: 15653206 DOI: 10.1016/j.ejogrb.2004.04.038] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2003] [Revised: 02/22/2004] [Accepted: 04/13/2004] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Leptin restores energy homeostasis and regulates appetite and body weight by communicating the energy status to the central nervous system. Although there is strong evidence that leptin affects reproduction, its role in the control of reproductive physiology is little understood. STUDY DESIGN We studied leptin concentrations in the serum and follicular fluid of 65 women undergoing ovarian hyperstimulation for in vitro fertilization (IVF). Fasting serum samples were collected (1) on the 3rd day of the cycle before IVF and (2) at the time of oocyte retrieval. Serum concentrations of leptin, estradiol (E2), progesterone, FSH, LH, prolactin, total testosterone, DHEA-SO4, and TSH and follicular fluid concentrations of leptin, E2, and progesterone were measured. RESULTS Serum leptin values increased on average by 66.4% over basal leptin levels on the day of oocyte pick-up (OPU). A positive correlation between leptin increase and body mass index was observed. The serum leptin level was similar to that in follicular fluid o the day of OPU. E2 levels increased 34.5-fold with controlled ovarian hyperstimulation. There was a negative correlation between the increase in leptin levels and in E2 levels (P <0.05) and in the number of oocytes harvested (P <0.05). CONCLUSION The significant increase in serum leptin levels during controlled ovarian hyperstimulation indicates a possible role of leptin in reproductive function. The increase in leptin levels is negatively correlated with ovarian response evaluated by E2 production and number of oocytes retrieved. This might be due to the reduced ovarian response through negative feedback of leptin to the ovaries at high levels.
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Affiliation(s)
- Birgül Gürbüz
- Reproductive Endocrinology and IVF Department, Zeynep Kamil Women and Children Diseases Training and Research Hospital, Bağdat Cd., No. 167/4, Selamiçeşme, Istanbul, Turkey.
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Shibahara H, Hirano Y, Suzuki T, Takamizawa S, Suzuki M. Serum leptin concentrations in patients with severe ovarian hyperstimulation syndrome during in vitro fertilization–embryo transfer treatment. Fertil Steril 2004; 82:579-85. [PMID: 15374699 DOI: 10.1016/j.fertnstert.2004.02.111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2003] [Revised: 02/09/2004] [Accepted: 02/09/2004] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To investigate the changes in serum leptin concentration in the conception cycle of severe ovarian hyperstimulation syndrome (OHSS). DESIGN Prospective longitudinal study of 66 IVF-ET cycles between May 2000 and June 2002. SETTING Infertility outpatient clinic at a Japanese medical school. PATIENT(S) Infertile patients undergoing IVF-ET cycles at the infertility outpatient clinic were divided into three groups consisting of group 1 (conception-cycle patients with severe OHSS, n = 9), and group 2 (conception cycle, non-OHSS, n = 28), and group 3 (nonconception cycle, non-OHSS, n = 29). INTERVENTION(S) Blood samples were collected at five different periods. Period I, on the first day of ovarian stimulation with FSH; period II, at hCG administration before oocyte retrieval; period III, 7 days after oocyte retrieval; period IV, 14 days after oocyte retrieval; and period V, 21 days after oocyte retrieval. MAIN OUTCOME MEASURE(S) Serum leptin concentration. RESULT(S) The serum leptin concentration was low in the OHSS group compared with that of the non-OHSS groups in all serum samples, with significant levels at periods III (vs. groups 2 and 3; P<.05) and IV (vs. group 3; P<.01). A twofold increase of leptin concentration from period I to period II (P<.05) was observed in all groups. CONCLUSION(S) The change pattern in serum leptin concentration might provide a great contribution to the pathophysiology development of OHSS patients during assisted reproductive treatment.
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Jahanfar S, Maleki H, Mosavi AR, Jahanfar M. Leptin and its association with polycystic ovary syndrome: a twin study. Gynecol Endocrinol 2004; 18:327-34. [PMID: 15497495 DOI: 10.1080/09513590410001667256] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrinopathy with symptoms such as obesity, insulin resistance and hyperandrogenemia. PCOS might be the result of a genetic disorder. Genetic discrepancy in the production of leptin, a product of the obesity gene, may lead to various endocrinopathies such as PCOS. The objective of this study was first, to ascertain the incidence of PCOS, using the gold standard; second, to ascertain the genetic property of leptin; and third, to evaluate the association between leptin concentration and PCOS. A total of 154 Tehran-resident female-female twins were studied. They included 48 pairs of monozygotic (MZ) and 29 pairs of dyzygotic (DZ) twins, aged 15-45 years. Clinical, ultrasound and biochemical findings were used to diagnose PCOS. The incidence of PCOS using biochemical and clinical features was 16.2%. The correlation coefficient between serum leptin levels of MZ twins was higher than that of the DZ twins. The serum level of leptin was similar between subjects with or without PCOS, irrespective of their zygosity. It was concluded that the incidence of PCOS is high among twins, and that leptin is likely to be genetically determined, although the effect of environmental factors cannot be denied. This study did not find any association between the diagnosis of PCOS and leptin level. However, the link between the two may lie with other entities such as eating disorders and/or obesity.
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Affiliation(s)
- S Jahanfar
- Department of Obstetrics and Gynecology, Iran University of Medical Science, Iran
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Geisthövel F, Jochmann N, Widjaja A, Horn R, Brabant G. Serum pattern of circulating free leptin, bound leptin, and soluble leptin receptor in the physiological menstrual cycle. Fertil Steril 2004; 81:398-402. [PMID: 14967380 DOI: 10.1016/j.fertnstert.2003.06.020] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2003] [Revised: 06/19/2003] [Accepted: 06/19/2003] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the serum pattern of free leptin, bound leptin, and soluble leptin receptor throughout the physiological menstrual cycle. DESIGN Prospective observational study. SETTING Tertiary care center for gynecological endocrinology and reproductive medicine and a university research laboratory. PATIENT(S) Thirty regularly cycling volunteers (age, 29 +/- 4.2 years). INTERVENTION(S) Blood sampling was performed at different phases (early and mid follicular phase, preovulatory phase, and early and late luteal phase) of three consecutive menstrual cycles; each phase of the menstrual cycle was investigated twice. MAIN OUTCOME MEASURE(S) Free leptin, bound leptin, soluble leptin receptor, LH, E(2), P, vaginal ultrasound. RESULT(S) A peak of serum free leptin levels was found in the late luteal phase followed by a significant drop in the early follicular phase and again by a continuous increase up to the next luteal peak. There were no significant alterations in serum bound leptin and soluble leptin receptor levels. CONCLUSION(S) The present study shows that there are significant circacyclic fluctuations of free leptin levels with the highest concentrations in the late luteal phase and the lowest levels in the early follicular phase, which suggests that circulating free leptin is up-regulated by the C(21)-steroid (P). Circulating bound leptin and soluble leptin receptor are not altered by the cyclic hormone status. The significant rise of the leptin bioequivalent, free leptin, in the late luteal phase might be of importance for the luteal-follicular and the luteal-preimplantatory functional shift.
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Affiliation(s)
- Franz Geisthövel
- Center for Gynecological Endocrinology and Reproductive Medicine, Freiburg im Breisgau, Germany.
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Abstract
A number of hormones, including hypothalamic neuropeptides acting as neurotransmitters and neuromodulators in the CNS, are involved in the physiologic regulation of breathing and participate in adjustment of breathing in disease. In addition to central effects, some hormones also control breathing at peripheral chemoreceptors or have local effects on the lungs and airways. Estrogen and progesterone seem to protect from sleep-disordered breathing, whereas testosterone may predispose to it. Progesterone and thyroxine have long been known to stimulate respiration. More recently, several hormones such as corticotropin-releasing hormone and leptin have been suggested to act as respiratory stimulants. Somatostatin, dopamine, and neuropeptide Y have a depressing effect on breathing. Animal models and experimental human studies suggest that also many other hormones may be involved in respiratory control.
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Affiliation(s)
- Tarja Saaresranta
- Department of Pulmonary Diseases, Turku University Central Hospital, Kiinamyllynkatu 4-8, FIN-20520 Turku, Finland.
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29
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Volek JS, Gómez AL, Love DM, Weyers AM, Hesslink R, Wise JA, Kraemer WJ. Effects of an 8-week weight-loss program on cardiovascular disease risk factors and regional body composition. Eur J Clin Nutr 2002; 56:585-92. [PMID: 12173568 DOI: 10.1038/sj.ejcn.1601362] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To determine the influence of weight loss on multiple cardiovascular disease (CVD) risk factors. DESIGN Overweight women (n = 12; mean 44.2% fat) and men (n = 10; mean 30.7% fat) participated in an 8 week weight-loss program that included dietary, exercise, multi-vitamin/mineral supplementation, and behavior modification components. Measurement of total and regional body composition assessed using dual energy X-ray absorptiometry (DEXA), circumferences and blood sampling for total cholesterol, LDL cholesterol, HDL cholesterol, triacylglycerols, homocysteine, insulin and leptin were performed before and after the weight loss intervention. RESULTS Subjects increased their physical activity and decreased their energy intake, resulting in a mean decrease in body mass of - 4.3 +/- 3.4 kg in women and -4.7 +/- 3.1 kg in men. Fat accounted for 88 and 58% of the decrease in body mass in men and women, respectively. Proportionally, men lost significantly more fat mass from the trunk region compared to women. Serum total and LDL cholesterol were significantly decreased in men (-11 and -14%, respectively) but not women (-3 and -3%, respectively) and there were no changes in HDL cholesterol and triacylglycerols. Serum leptin was significantly decreased (-36%) and highly correlated to fat mass (r= 0.839). There were no changes in serum insulin and plasma homocysteine. CONCLUSIONS These data indicate that short-term weight loss resulting from reducing percentage energy from fat, increasing physical activity and vitamin/mineral supplements including folic acid has a favorable effect on regional body composition and total and LDL cholesterol with minimal effects on HDL cholesterol, triacylglycerols, homocysteine and insulin and the effects are greater in men compared to women. Supplementation with folic acid or emphasis on folic acid-rich foods may be an important component of a weight loss program to prevent increases in homocysteine.
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Affiliation(s)
- J S Volek
- The Human Performance Laboratory, The University of Connecticut, Storrs 06269-1110, USA.
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30
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Tsai EM, Yang CH, Chen SC, Liu YH, Chen HS, Hsu SC, Lee JN. Leptin affects pregnancy outcome of in vitro fertilization and steroidogenesis of human granulosa cells. J Assist Reprod Genet 2002; 19:169-76. [PMID: 12036084 PMCID: PMC3455655 DOI: 10.1023/a:1014889928191] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE This study was to examine the serum leptin levels in the prediction of pregnancy outcomes in women receiving ovarian hyperstimulation. Effect of leptin on the steroidogenesis was evaluated for granulosa cell (GC) culture in vitro. METHOD Serum levels of leptin and estradiol were measured on Day 2, the time of hCG administration and oocyte retrieval in 50 women undergoing long-course GnRH agonist ovarian hyperstimulation. The production of estrogen and progesterone in granulosa cell culture were detected after administration of leptin at the absence or presence of FSH 1 mIU. RESULTS Leptin levels at the time of hCG injection were significantly lower in the pregnant women than in those without pregnancy. Estradiol concentrations were not correlated with leptin levels during the time of hCG injection and oocyte retrieval. High leptin concentration suppressed both basal estradiol and progesterone productions in GC. Leptin in high doses suppressed estradiol production, but did not alter progesterone production of GC in the presence of FSH. CONCLUSIONS Serum leptin levels may be predictive of IVF pregnancy outcome with the effect on intraovarian progesterone/estradiol ratio during the follicular phase. Significantly low serum leptin levels were noted in the pregnant women than in the nonpregnant women.
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Affiliation(s)
- Eing-Mei Tsai
- Department of Obstetrics and Gynaecology, Kaohsiung Medical University Hospital, Taiwan
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31
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Abstract
OBJECTIVE To review recent advances in understanding the role of leptin in the physiology and pathophysiology of reproduction, with a focus on relevant clinical situations. DESIGN A MEDLINE computer search was performed to identify relevant articles. RESULT(S) Leptin, an adipocyte hormone important in regulating energy homeostasis, interacts with the reproductive axis at multiple sites, with stimulatory effects at the hypothalamus and pituitary and inhibitory actions at the gonads. More recently, leptin has been shown to play a role in other target reproductive organs, such as the endometrium, placenta, and mammary gland, with corresponding influences on important physiologic processes such as menstruation, pregnancy, and lactation. As a marker of whether nutritional stores are adequate, leptin may act in concert with gonadotropins and the growth hormone axis to initiate the complex process of puberty. Conditions in which nutritional status is suboptimal, such as eating disorders, exercise-induced amenorrhea, and functional hypothalamic amenorrhea, are associated with low serum leptin levels; and conditions with excess energy stores or metabolic disturbances, such as obesity and polycystic ovarian syndrome, often have elevated serum or follicular fluid leptin levels, raising the possibility that relative leptin deficiency or resistance may be at least partly responsible for the reproductive abnormalities that occur with these conditions. CONCLUSION(S) Leptin may act as the critical link between adipose tissue and the reproductive system, indicating whether adequate energy reserves are present for normal reproductive function. Future interventional studies involving leptin administration are expected to further clarify this role of leptin and may provide new therapeutic options for the reproductive dysfunction associated with states of relative leptin deficiency or resistance.
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Affiliation(s)
- Stergios Moschos
- Division of Endocrinology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA
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32
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Abstract
Since its discovery in 1994, leptin, a protein hormone synthesized and secreted by adipose tissue, has been shown to regulate feed intake in several species including sheep and pigs. Although a nimiety of information exists regarding the physiological role of leptin in rodents and humans, the regulation and action of leptin in domestic animals is less certain. Emerging evidence in several species indicates that leptin may also affect the hypothalamo-pituitary-gonadal axis. Leptin receptor mRNA is present in the anterior pituitary and hypothalamus of several species, including sheep. In rats, effects of leptin on GnRH, LH and FSH secretion have been inconsistent, with leptin exhibiting both stimulatory and inhibitory action in vivo and in vitro. Evidence to support direct action of leptin at the level of the gonad indicates that the leptin receptor and its mRNA are present in ovarian tissue of several species, including cattle. These leptin receptors are functional, since leptin inhibits insulin-induced steroidogenesis of both granulosa and thecal cells of cattle in vitro. Leptin receptor mRNA is also found in the testes of rodents. As with the ovary, these receptors are functional, at least in rats, since leptin inhibits hCG-induced testosterone secretion by Leydig cells in vitro. During pregnancy, placental production of leptin may be a major contributor to the increase in maternal leptin in primates but not rodents. However, in both primates and rodents, leptin receptors exist in placental tissues and may regulate metabolism of the fetal-placental unit. As specific leptin immunoassays are developed for domestic animals, in vivo associations may then be made among leptin, body energy stores, dietary energy intake and reproductive function. This may lead to a more definitive role of leptin in domestic animal reproduction.
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Affiliation(s)
- L J Spicer
- Department of Animal Science, Oklahoma State University, Stillwater, Oklahoma 74078, USA.
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33
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Unkila-Kallio L, Andersson S, Koistinen HA, Karonen SL, Ylikorkala O, Tiitinen A. Leptin during assisted reproductive cycles: the effect of ovarian stimulation and of very early pregnancy. Hum Reprod 2001; 16:657-62. [PMID: 11278213 DOI: 10.1093/humrep/16.4.657] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Leptin may have a role in human reproduction. The impact of IVF and of very early pregnancy on serum leptin concentrations was studied in 66 infertile patients, of whom 19 became pregnant. Ovarian suppression was accompanied by a fall in leptin concentrations (21 +/- 4%, mean +/- SE; P < 0.01) from the mid-luteal phase, and ovarian stimulation by a rise (76 +/- 8%; P < 0.0001) from suppression. The mid-luteal concentration of leptin after stimulation was 28 +/- 7% higher than that during the preceding normal cycle (P < 0.001). Concentrations of leptin and oestradiol were related before treatment, at ovarian suppression and at 8 days after oocyte retrieval. In addition, the rises in leptin and oestradiol concentrations during stimulation were correlated, but only in those patients who became pregnant (r = 0.69; P = 0.001). Women with a successful pregnancy had higher concentrations of leptin (18.7 +/- 4.8 microg/l) at 12 days after embryo transfer than those who had miscarriages (10.0 +/- 1.9 microg/l; P < 0.001), or those failing to become pregnant (11.6 +/- 1.2 microg/l; P < 0.0001). We concluded that leptin concentrations are influenced by ovarian function and that the relationship between leptin and oestrogen (but not a single leptin concentration), may be an important factor for the outcome of IVF.
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Affiliation(s)
- L Unkila-Kallio
- Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, Haartmaninkatu 2, FIN-00290 Helsinki, Finland
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34
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Kristensen K, Pedersen SB, Richelsen B. Interactions between sex steroid hormones and leptin in women. Studies in vivo and in vitro. Int J Obes (Lond) 2000; 24:1438-44. [PMID: 11126340 DOI: 10.1038/sj.ijo.0801428] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To investigate the associations between sex hormones and leptin. In addition, to investigate the direct effect of sex hormones by incubations of human subcutaneous adipose tissue explants, in vitro. DESIGN Cross-sectional study and an experimental in vitro study. SUBJECTS 36 women (age, 23-65 y; body mass index, BMI, 19-65 kg/m2) participated in the cross-sectional study. Subcutaneous abdominal biopsies were taken from nine women (age, 28 - 46 y; BMI, 25.5-36.0 kg/m2) for the in vitro study. MEASUREMENTS Fat distribution parameters (by dual-energy X-ray absorptiometry and anthropometry), sex hormones, leptin and insulin. RESULTS Leptin correlated significantly with most estimates of adipose tissue mass (r= 0.5 - 0.9, P< 0.05). However, when the study group was divided in three equal groups (non-obese, obese, and very-obese) it revealed that the correlation predominantly was found in non-obese. In simple correlation analysis leptin was significantly associated with estimates of adipose tissue, insulin and several sex hormones. However, in multiple regression analysis only insulin (partial correlation coefficient = 0.55, P < 0.004) and percentage fat mass (partial correlation coefficient = 0.72, P<0.001) were significantly and independently correlated with leptin without any independent effect of sex hormones. These findings were in agreement with the in vitro studies where neither estrogen nor androgens (testosterone or DHT) affected subcutaneous adipose tissue leptin production. Dexamethasone (10nM) stimulated adipose tissue leptin production 3-fold (P < 0.001). CONCLUSION In regression analysis, where both insulin and measurements of fat mass were taken into account, androgens or estrogens did not independently contribute to the variation in leptin levels. Estrogens and androgens had no direct effects on adipose tissue leptin production in vitro. Thus, the sexual dimorphism evident in serum leptin is not likely to be due to a direct influence of sex hormones on leptin production in females.
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Affiliation(s)
- K Kristensen
- Department of Endocrinology and Metabolism, Aarhus University Hospital, Aarhus Amtssygehus, Denmark.
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35
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Kronfeld-Schor N, Zhao J, Silvia BA, Bicer E, Mathews PT, Urban R, Zimmerman S, Kunz TH, Widmaier EP. Steroid-dependent up-regulation of adipose leptin secretion in vitro during pregnancy in mice. Biol Reprod 2000; 63:274-80. [PMID: 10859269 DOI: 10.1095/biolreprod63.1.274] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Circulating leptin levels are elevated during the later stages of pregnancy in mammals, suggesting that maternal leptin may play a role in maintenance of pregnancy and/or preparation for parturition and lactation. The regulation and source of circulating leptin during pregnancy remains undetermined, but leptin mRNA levels increase in adipose tissue during this time in some species. Considerable controversy exists whether placenta is also a leptin-secreting tissue during pregnancy. Here, we directly demonstrate that leptin secretion rates from mouse adipose tissue in vitro are decreased during early pregnancy and up-regulated during late pregnancy and lactation. Changes in leptin secretion rates in vitro paralleled those of circulating leptin in vivo during gestation. Subcutaneous implants of estradiol or corticosterone into lactating mice for 48 h stimulated adipose leptin secretion rates in vitro to the level of that in pregnant mice. However, corticosterone, but not estradiol, increased leptin secretion when added to isolated adipose tissue in vitro. Placentae obtained at two stages of pregnancy did not secrete leptin in vitro, either when acutely isolated or when dissociated into cells for long-term cultures. Placental tissue (or cells) secreted progesterone, however, demonstrating placental viability. We conclude that hyperleptinemia during late pregnancy in mice primarily results from corticosterone-dependent up-regulation of leptin secretion from adipose tissue, and that the placenta does not contribute to leptin secretion. The initial decrease in leptin secretory rates from adipose tissue during early pregnancy may facilitate energy storage for the subsequent, increased metabolic demands of later pregnancy and lactation.
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Affiliation(s)
- N Kronfeld-Schor
- Department of Biology, Boston University, Boston, Massachusetts 02215, USA
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36
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Gower BA, Nagy TR, Goran MI, Smith A, Kent E. Leptin in postmenopausal women: influence of hormone therapy, insulin, and fat distribution. J Clin Endocrinol Metab 2000; 85:1770-5. [PMID: 10843150 DOI: 10.1210/jcem.85.5.6602] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Whether use of hormone-replacement therapy (HRT) influences menopause-related changes in body weight is unclear. HRT may affect energy balance by influencing synthesis of the adipocyte-derived hormone leptin. The objectives of this study were to: 1) identify factors influencing circulating leptin in postmenopausal women; 2) determine whether HRT influences serum leptin after adjusting for confounding factors; and, 3) identify potential independent effects of HRT or leptin on resting energy expenditure (REE). Subjects were 54 postmenopausal women, 45-55 yr old, 35 of whom used HRT (estrogen plus progestin). Total and regional body composition and fat distribution were determined by dual-energy x-ray absorptiometry and computed tomography; fasting serum leptin and insulin, by RIA; and REE, by indirect calorimetry. Stepwise multiple linear regression analysis indicated that serum leptin could best be predicted from total fat mass, fasting serum insulin, and total lean mass [log leptin = 1.08 x log fat mass) + (0.46 x log insulin) + (-1.25 x log lean mass) + 1.88; model R2 = 0.78, P < 0.001]. Multiple linear regression analysis indicated that visceral fat was independently related to leptin (parameter estimate = 0.23, P < 0.05), after adjusting for s.c. abdominal fat and leg fat, as well as lean mass and insulin. After adjusting for total fat mass, total lean mass, and fasting insulin, serum leptin did not differ between users and nonusers of HRT (21.7 +/- 1.0 vs. 20.2 +/- 1.3 ng/mL, P = 0.369, adjusted mean +/- SE, respectively). Serum estradiol was inversely correlated with (adjusted) leptin in non-HRT users (r = -0.50), suggesting that ovarian senescence may lead to an increase in leptin. Multiple linear regression analysis indicated that REE (adjusted for fat mass, fat-free mass, and ethnicity) was not associated with leptin (P = 0.298) or hormone use status (P = 0.999; 1323 +/- 31 vs. 1316 +/- 42 kcal/day, adjusted mean +/- SE for users and nonusers, respectively). These results indicate that, in postmenopausal women: 1) total fat mass, lean mass, and fasting insulin, but not HRT, are significant determinants of serum leptin; 2) visceral and s.c. fat contribute to serum leptin; and, 3) neither HRT nor leptin is independently related to REE.
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Affiliation(s)
- B A Gower
- University of Alabama at Birmingham, Department of Nutrition Sciences, University of Alabama Obesity Research Center, 35294-3360, USA.
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37
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Takeuchi T, Tsutsumi O. Basal leptin concentrations in women with normal and dysfunctional ovarian conditions. Int J Gynaecol Obstet 2000; 69:127-33. [PMID: 10802080 DOI: 10.1016/s0020-7292(00)00178-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To determine whether leptin is involved in ovarian function. METHODS Fasting serum samples were obtained from 20 women with normal menstrual cycles who were either obese or non-obese: 12 non-obese patients with polycystic ovary syndrome (PCOS), 8 obese patients with PCOS, 10 patients with stress-related hypothalamic amenorrhea, and 8 patients with weight loss-related hypothalamic amenorrhea. RESULTS Serum leptin levels were strongly related to body mass index (BMI) in each group, but there was no difference in the mean serum leptin levels among the BMI-matched study groups. A significant difference in the mean serum leptin levels was found between the non-obese and obese control groups (P<0.001) and between the non-obese and obese PCOS groups (P<0.001). CONCLUSIONS These findings indicate that circulating leptin levels in women with normal menstrual cycles and those with ovarian dysfunction are strongly related to BMI. Leptin does not appear to be primarily involved in regulating ovarian function.
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Affiliation(s)
- T Takeuchi
- Department of Obstetrics and Gynecology, Branch Hospital, Faculty of Medicine, University of Tokyo, Tokyo, Japan
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38
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Lindheim SR, Sauer MV, Carmina E, Chang PL, Zimmerman R, Lobo RA. Circulating leptin levels during ovulation induction: relation to adiposity and ovarian morphology. Fertil Steril 2000; 73:493-8. [PMID: 10689001 DOI: 10.1016/s0015-0282(99)00578-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To assess serum leptin levels based on body habitus and ovarian morphology during controlled ovarian hyperstimulation. DESIGN Prospective analysis. SETTING University IVF program. PATIENT(S) Women undergoing IVF-ET were divided into two groups, obese ovulatory women (n = 6; mean (+/-SD) body mass index, 30.1 +/- 0.6 kg/m(2)) and lean ovulatory women (n = 20); mean (+/- SD) body mass index 22.0 +/- 0.2 kg/m(2)). Lean women were categorized further according to whether they had polycystic-appearing ovaries (n = 8) or normal-appearing ovaries (n = 12). INTERVENTION(S) Controlled ovarian hyperstimulation and IVF. MAIN OUTCOME MEASURE(S) Serum estradiol, testosterone, and leptin. RESULT(S) Mean (+/- SD) leptin levels were significantly higher before and after GnRH agonist down-regulation in obese women (41.7 +/- 5.2 pg/mL and 36.1 +/- 5.8 pg/mL, respectively) compared with lean women (8.4 +/- 1.0 pg/mL and 6.9 +/- 1.1 pg/mL, respectively). Mean (+/- SD) leptin levels increased significantly in both groups (54.5 +/- 5.1 pg/mL and 11.7 +/- 1.2 pg/mL, respectively), and the mean (+/-SD) percentage increase was similar (55% +/- 18% and 54.8% +/- 17%, respectively). Mean (+/-SD) leptin levels were similar in women with polycystic-appearing and normal-appearing ovaries before controlled ovarian hyperstimulation, but increased significantly in women with polycystic-appearing ovaries afterward (14.7 +/- 1.8 pg/mL and 9.3 +/- 1.0 pg/mL, respectively). CONCLUSION(S) Significant increases in leptin levels occur during controlled ovarian hyperstimulation, suggesting that leptin plays a role in follicular growth and maturation. The exaggerated response in women with polycystic-appearing ovaries reflects either a greater number of recruited follicles or a predisposition of adipocytes to leptin production.
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Affiliation(s)
- S R Lindheim
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Columbia University, College of Physicians and Surgeons, New York, New York, USA
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Al-Shoumer KA, Vasanthy BA, Makhlouf HA, Al-Zaid MM. Leptin levels in Arabs with primary hyperthyroidism. Ann Saudi Med 2000; 20:113-8. [PMID: 17322705 DOI: 10.5144/0256-4947.2000.113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The aim of this report was to study leptin status in hyperthyroid men and women (prior to and after medical treatment) and in matched controls in Arabs. SUBJECTS AND METHODS Twenty-nine hyperthyroid patients (19 women and 10 men) and 32 controls (20 women and 12 men) matched for age, ethnic status and body mass index (BMI) were studied. The patients were studied at the time of diagnosis and six months after antithyroid treatment with carbimazole-titrating dose, which rendered them euthyroid. On each study occasion, the subjects fasting blood was collected for the measurement of leptin, glucose, insulin and C-peptide. RESULTS Fasting leptin level was significantly lower in women with hyperthyroidism at baseline (mean+/-SEM, 15.8+/-2.9 microg/L, P=0.01), and after six months of antithyroid treatment (13.4+/-1.7 microg/L, P=0.004) than in control women (25.6+/-2.7 microg/L), but the difference was not significant in the men. Women in each group had significantly higher leptin concentrations than men (patients: 15.8+/-2.9 vs. 4.9+/-0.9 microg/L, P=0.009; controls: 25.67+/-2.7 vs. 7.9+/-1.4 microg/L, P=0.0005). The differences in women leptin remained significant even when expressed in relation to BMI. Baseline fasting glucose (P=0.01), insulin (P=0.007), and C-peptide (P=0.02) were significantly higher in the patients than controls. After six months of antithyroid therapy, fasting glucose, insulin and C-peptide levels were similar in the patients and controls. Within the patients, baseline leptin concentrations correlated positively with BMI (rho=0.65, P=0.02) and negatively with free T3 (rho=0.62, P=0.03). It neither demonstrated an association with baseline nor with six-month values of fasting glucose, insulin and C-peptide. CONCLUSION Leptin concentration is decreased in Arab women with hyperthyroidism. Six months of antithyroid therapy is not associated with alterations in leptin levels.
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Affiliation(s)
- K A Al-Shoumer
- Division of Endocrinology and Metabolic Medicine, Department of Medicine, Kuwait University, Safat, Kuwait.
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40
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Mantzoros CS, Cramer DW, Liberman RF, Barbieri RL. Predictive value of serum and follicular fluid leptin concentrations during assisted reproductive cycles in normal women and in women with the polycystic ovarian syndrome. Hum Reprod 2000; 15:539-44. [PMID: 10686193 DOI: 10.1093/humrep/15.3.539] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Leptin is an adipocyte-derived hormone which plays a central role in the regulation of body weight and energy homeostasis and in signalling to the brain that adequate energy stores are available for reproduction. Although leptin may affect reproduction by regulating the hypothalamic-pituitary-gonadal axis, recent in-vitro observations indicate that leptin may also have direct intra-ovarian actions. Leptin concentrations were measured in women who succeeded in becoming pregnant within three cycles of in-vitro fertilization (IVF) or gamete intra-fallopian transfer (n = 53), in women who failed to become pregnant within three cycles (n = 50), and in women with polycystic ovarian syndrome (PCOS) (n = 22). It was found that lower follicular fluid leptin concentrations were a marker of assisted reproduction treatment success in normal women. Women with PCOS had higher leptin concentrations than women without such a diagnosis, but this was due to their higher body mass index (BMI). After adjustment for age and BMI, women with PCOS who became pregnant tended to have lower mean follicular fluid leptin concentrations than women with PCOS who did not succeed at becoming pregnant. Further studies exploiting the strengths of the IVF model are needed to assess whether the prognostic role for follicular fluid leptin in human reproduction is independent of other factors, and to elucidate the underlying mechanisms.
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Affiliation(s)
- C S Mantzoros
- Division of Endocrinology, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
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41
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Schubring C, Blum WF, Kratzsch J, Deutscher J, Kiess W. Leptin, the ob gene product, in female health and disease. Eur J Obstet Gynecol Reprod Biol 2000; 88:121-7. [PMID: 10690668 DOI: 10.1016/s0301-2115(99)00150-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Leptin is a recently discovered hormone which is involved in the regulation of body weight. It provides a molecular basis for the lipostatic theory of the regulation of energy balance. White adipose tissue is the main site of leptin synthesis and there is some evidence of ob gene expression in brown fat. Leptin seems to play a key role in the control of body fat stores by coordinated regulation of feeding behaviour, metabolic rate, autonomic nervous system regulation and body energy balance in rodents, primates and humans. Apart from the function of leptin in the central nervous system on the regulation of energy balance, it may well be one of the hormonal factors that signal the body's readiness for sexual maturation and reproduction to the brain. During late pregnancy and at birth when maternal fat stores have been developed leptin levels are high. Leptin could then be a messenger molecule signaling the adequacy of the fat stores for reproduction and maintenance of pregnancy. At later stages of gestation leptin could signal the expansion of fat stores in order to prepare the expectant mother for the energy requirements of full term gestation, labour and lactation. This overview focuses on those topics of leptin research which are of particular interest in reproductive medicine and gynecology.
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Stock SM, Sande EM, Bremme KA. Leptin levels vary significantly during the menstrual cycle, pregnancy, and in vitro fertilization treatment: possible relation to estradiol. Fertil Steril 1999; 72:657-62. [PMID: 10521105 DOI: 10.1016/s0015-0282(99)00321-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the influence of sex steroids on leptin levels in patients with conditions in which the steroid levels are increased. DESIGN Prospective study. SETTING A hospital unit for reproductive medicine and a maternal care unit affiliated with the hospital and hospital staff. PATIENT(S) Thirteen women with regular menstrual cycles, 29 women with normal pregnancies, and 25 women undergoing IVF treatment. INTERVENTION(S) Blood samples were obtained during days 1-3, 6-8, 13-15, and 22-25 of the menstrual cycle in regularly cycling women and during gestational weeks 13, 20, 28, 32, and 36 and 7-13 weeks after birth in pregnant women. In women undergoing IVF treatment, blood samples were collected after E2 suppression, after ovarian stimulation, and at the time of ovum pickup. MAIN OUTCOME MEASURE(S) Serum levels of leptin, E2, and progesterone. RESULT(S) Leptin levels varied during the menstrual cycle and were elevated during pregnancy, with a peak during week 28. In the IVF group, leptin levels increased throughout the treatment cycle. Body mass index correlated positively with leptin levels in all three groups, and the maternal weight gain from weeks 13-32 tended to correlate with the rise in leptin levels. Estradiol levels correlated positively with leptin levels during E2 suppression. Negative correlations existed between the pregnancy-induced increases in E2 and leptin levels from weeks 13-32, and between the levels after birth. Leptin levels and progesterone levels did not correlate in any of the groups. CONCLUSION(S) Modest elevations of leptin levels were observed during IVF treatment and pregnancy. The increase in the IVF group indicates that factors other than body fat mass (possibly E2) also are of importance for the regulation of leptin levels.
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Affiliation(s)
- S M Stock
- Department of Women and Child Health, Karolinska Hospital, Stockholm, Sweden.
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43
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Elbers JM, de Roo GW, Popp-Snijders C, Nicolaas-Merkus A, Westerveen E, Joenje BW, Netelenbos JC. Effects of administration of 17beta-oestradiol on serum leptin levels in healthy postmenopausal women. Clin Endocrinol (Oxf) 1999; 51:449-54. [PMID: 10583311 DOI: 10.1046/j.1365-2265.1999.00813.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Women have higher leptin levels than men at a certain degree of adiposity. The role of oestrogens in the regulation of serum leptin levels remains inconclusive. The aim of the present study was to investigate the effect of unopposed oestrogen replacement therapy, during two months, on serum leptin levels in postmenopausal women. DESIGN A double-blind, placebo-controlled, randomized study. SUBJECTS Twenty-five healthy postmenopausal women were studied (mean (+/- SD) age: 52.9 +/- 2.7 years, range of age: 48.7-57.4 years; mean body mass index (BMI): 26.4 +/- 4.2 kg/m2, range of BMI: 21.0-39.0 kg/m2). Twelve of these women were treated with 2 mg 17beta-oestradiol daily, and 13 postmenopausal women received placebo. MEASUREMENTS Before and at the end of a 2-month study period, anthropometric and bio-electrical impedance measurements were performed, and fasting blood samples were taken, to determine serum levels of sex hormones and leptin. RESULTS During the 2-month study period, body weight had increased significantly in the placebo group compared with the treatment group, but no significant changes were observed in percentage of body fat or the amount of body fat in kg between the groups. Following administration of 17beta-estradiol, the median leptin level increased from 17.6 microg/l to 24.1 microg/l after 2 months (P = 0. 008 compared with baseline). This increase was significantly different from the placebo group (P = 0.019), which showed no change in circulating leptin levels. CONCLUSION This study demonstrates that unopposed oestrogen replacement therapy during 2 months in postmenopausal women slightly, but significantly, increases total serum leptin levels. This observation suggests a role for oestrogens in the regulation of leptin.
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Affiliation(s)
- J M Elbers
- Department of Endocrinology, Academic Hospital Vrije Universiteit, Amsterdam, The Netherlands
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Bützow TL, Moilanen JM, Lehtovirta M, Tuomi T, Hovatta O, Siegberg R, Nilsson CG, Apter D. Serum and follicular fluid leptin during in vitro fertilization: relationship among leptin increase, body fat mass, and reduced ovarian response. J Clin Endocrinol Metab 1999; 84:3135-9. [PMID: 10487676 DOI: 10.1210/jcem.84.9.6004] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The satiety factor leptin is expressed in several reproductive tissues, but its role in the control of reproductive physiology is not well understood. We studied leptin concentrations in the sera and follicle fluids of 52 women [body fat mass percentage (BFM%) range, 19.6-38.8%] undergoing pituitary down-regulation and ovarian hyperstimulation for in vitro fertilization (IVF) treatment. Fasting serum samples were collected 1) at maximal suppression before the initiation of gonadotropin treatment, 2) at maximal ovarian hyperstimulation, 3) at the time of oocyte retrieval, and 4) 16 days later when all subjects were under exogenous luteal support using 600 mg progesterone daily. Follicular fluid (FF) was obtained at oocyte retrieval from two representative preovulatory follicles in both ovaries. During ovarian hyperstimulation there was a significant 60% increase in serum leptin concentrations from 10.9 +/- 1.1 (SEM) to 15.7 +/- 1.5 ng/mL (P < 0.01) between suppression and maximal hyperstimulation, demonstrating that the ovarian functional state can affect serum leptin concentrations. A serum leptin increase of 22-198% during ovarian hyperstimulation was evident in 43 subjects, whereas in 9, leptin concentrations remained unchanged. A positive correlation between leptin change and BFM% (r = 0.55; P < 0.0005) was observed in the 43 leptin responders. The follicular fluid leptin level was similar to that in serum. In separate linear regression analysis, BFM% contributed to 59-64%, body mass index to 46-56%, and weight to 46-55% (all P < 0.001) of the variability in leptin concentrations at the 4 time points. The 20-fold increase in serum estradiol concentrations during IVF was not significantly correlated with changes in leptin concentrations. On the contrary, the relative serum leptin increase was negatively associated with the ovarian response to hyperstimulation, as revealed by the numbers of follicles (b = -0.28; r2 = 8.1%; P < 0.05) and oocytes retrieved (b = -0.39; r2 = 15.2%; P < 0.01). This relationship was further reflected in a positive correlation between the percent increases in leptin and FSH concentrations (r = 0.39; P < 0.01). The significant relationship of high leptin and reduced ovarian response was also maintained when the cumulative dose of FSH was used as a covariable. Reduced ovarian response was not a function of body mass index, BFM%, basal leptin levels, or insulin concentrations. Fasting serum insulin concentrations remained unchanged in response to IVF, but were positively correlated to serum leptin concentrations at all four time points. Our data suggest that leptin production may be influenced by the ovarian functional state. During IVF a high relative leptin increase is associated with adiposity and a reduced ovarian response. These observations support the possibility that high leptin concentrations might reduce ovarian responsiveness to gonadotropins. Hence, leptin might explain in part why obese individuals require higher amounts of gonadotropins than lean subjects to achieve ovarian hyperstimulation.
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Affiliation(s)
- T L Bützow
- The Family Federation of Finland, Helsinki.
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Watanobe H, Suda T. A detailed study on the role of sex steroid milieu in determining plasma leptin concentrations in adult male and female rats. Biochem Biophys Res Commun 1999; 259:56-9. [PMID: 10334915 DOI: 10.1006/bbrc.1999.0718] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We examined the effects of sex steroid milieu on plasma leptin levels in adult male and female rats. Since the body weight is known to influence leptin concentrations, the hormone was measured in rats with a very similar body weight (about 250 g) throughout this study. Plasma leptin levels were significantly higher in female than in male rats. Orchidectomy (ODX) caused a significant rise in leptin, and replacement of a physiological dose of testosterone (T) completely abolished the effect of ODX. Since the effect of tamoxifen (estrogen antagonist) coadministered with T on leptin levels in ODX rats was the same as that of T alone, it was suggested that the suppressive effect of T on leptin may be mediated by the androgenic potency of T, but not by its aromatized product, estradiol. In female rats, plasma leptin concentrations did not change significantly during the estrous cycle. Furthermore, leptin levels were not affected either by ovariectomy alone or by the administration after ovariectomy of physiological doses of estradiol, progesterone, or both. This is the first study to demonstrate in rats with a very similar body weight the existence of a clear sexual difference in plasma leptin levels, and also a suppressive action of T on the adipocyte hormone concentrations.
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Affiliation(s)
- H Watanobe
- Third Department of Internal Medicine, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8216, Japan.
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