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Cited by 153Hypothalamic control of reproductive hormonesPituitary Gland Disorders and TreatmentsGrowth Hormone and Insulin-like Growth Factors

The spectrum of abnormal patterns of gonadotropin-releasing hormone secretion in men with idiopathic hypogonadotropic hypogonadism: clinical and laboratory correlations

SPRATT, DANIEL I., CARR, DANIEL B., MERRIAM, GEORGE R., SCULLY, ROBERT E., RAO, P. NARASIMHA, CROWLEY, WILLIAM F.·1987·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jcem-64-2-283
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Abstract

Several lines of evidence indicate that hypothalamic-pituitary-gonadal activity varies among men with idiopathic hypogonadotropic hypogonadism (IHH). To test the hypothesis that a spectrum of abnormalities of GnRH secretion underlies the syndrome of IHH, we characterized the patterns of GnRH-induced gonadotropin secretion during periods of frequent sampling in 50 consecutive men with IHH and contrasted them with those in 20 normal men. The largest group of IHH patients (n = 42) had no detectable LH or FSH pulsations and could be categorized into 2 subsets according to the presence or absence of evidence of spontaneous puberty. The most severely affected subset (n = 32), who recalled no history of puberty, had testes with a mean volume of 3.3 +/- 0.5 (+/- SEM) ml, with a prepubertal appearance on biopsy, and often were anosmic (n = 17). The second subset of apulsatile IHH men (n = 10) had histories of partial or complete spontaneous sexual development with subsequent isolated loss of sexual function, testes with a mean volume of 13.3 +/- 1.9 ml (P less than 0.01 compared to the first subset), a pubertal or adult appearance of the testes on biopsy, and an intact sense of smell. In a second group of IHH patients (n = 3), LH was secreted predominantly in a nighttime pattern similar to that of normal children during early puberty. These men were aged 18-24 yr, had a mean testicular volume of 10.5 +/- 2.3 ml, pubertal changes on testicular biopsy, and an intact sense of smell. A third group of IHH men (n = 4) had LH pulses of abnormally low amplitude. Only one patient in this group had a history of spontaneous sexual development. The mean testicular volume of these patients was 5.6 +/- 1.9 ml, and the testes appeared prepubertal (n = 3) or pubertal (n = 1) on biopsy. In addition to these groups, another patient had apparent LH pulsations and nearly normal amplitude, but the LH was bioinactive and appeared to consist chiefly of alpha-subunit. Testing of other anterior pituitary hormone functions did not distinguish IHH men from normal men. However, those IHH patients with some evidence of endogenous GnRH secretion had higher basal and stimulated serum PRL levels than IHH men without such evidence (P less than 0.05), suggesting an influence of GnRH on PRL secretion.

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Authors
SPRATT, D. I., CARR, D. B., MERRIAM, G. R., SCULLY, R. E., RAO, P. N., & CROWLEY, W. F.
Affiliations
Massachusetts General Hospital (US)
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
1987-02
Volume
64
Issue
2
Pages
283-291
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jcem-64-2-283
OpenAlex
W2030071125
Cited by
153
References
33
Citations by year
2026: 1 · 2023: 3 · 2022: 5 · 2020: 2 · 2019: 5 · 2018: 2 · 2017: 5 · 2016: 4 · 2015: 3 · 2014: 2 · 2013: 2 · 2012: 3
FWCI
7.86
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Center for Research Resources (RR-1066)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD15788, R01HD015788, U54HD029164, P30HD028138, U54HD028138)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
Keywords
idiopathic hypogonadotropic hypogonadism, LH pulsatility, hypothalamic-pituitary-gonadal axis, testicular volume, anosmia, spontaneous puberty, LH alpha subunit, LH bioactivity, LH pulse amplitude, LH pulse frequency
MeSH terms
Adolescent, Adult, Follicle Stimulating Hormone, Humans, Hypogonadism, Luteinizing Hormone, Gonadotropin-Releasing Hormone, Male, Middle Aged, Pituitary Gland, Anterior, Testis

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