PMID- 36170883
OWN - NLM
STAT- MEDLINE
DCOM- 20230117
LR  - 20230117
IS  - 1473-0766 (Electronic)
IS  - 0951-3590 (Linking)
VI  - 38
IP  - 11
DP  - 2022 Nov
TI  - The influence of estro-progestin therapy on neurohormonal activity in functional 
      hypothalamic amenorrhea.
PG  - 997-1002
LID - 10.1080/09513590.2022.2128103 [doi]
AB  - Background: Functional hypothalamic amenorrhea (FHA) is a chronic endocrine 
      disorder caused by the abnormal pulsatile secretion of neurohormones in the 
      hypothalamus. Secretion of GnRH is regulated by kisspeptin/neurokinin B/dynorphin 
      (KNDy) neurons. These neurons produce, among other neurohormones, neurokinin B 
      (NKB) which regulates the coordinated stimulation or inhibition of GnRH secreting 
      neurons. Aim of the study: Assessment and comparison of serum NKB in patients 
      with FHA at baseline, and following 6 months of estrogen-progestagen therapy. 
      Materials and methods: Fifty-five patients with functional hypothalamic 
      amenorrhea were included in the study group. Serum concentrations of neurokinin B 
      (NKB), follicle stimulating hormone (FSH), luteinizing hormone (LH), 
      17-beta-estradiol (E2), prolactin (PRL), cortisol, testosterone (T), 
      dehydroepiandrosterone sulfate (DHEA-S), thyroid-stimulating hormone (TSH), free 
      thyroxine (fT4), fasting glucose and insulin, as well as lipid profile were 
      measured at baseline. At the time of diagnosis, patients with FHA were prescribed 
      a course of 2 mg 17-beta-estradiol and 10 mg dydrogesterone for duration of 
      6 months. Serum NKB was then reassessed following treatment at 6 months. Results: 
      At baseline, the FHA group was found to have a decreased serum NKB concentration 
      when compared to a healthy control group. Following 6 months of sequential 
      estrogen-progestogen hormone therapy, this study did not find any statistically 
      significant difference in serum NKB concentration in the treatment arm compared 
      to baseline. Conclusions: For the first time, NKB secretion has been studied in 
      patients with FHA. A significantly lower level of serum NKB was observed in these 
      patients at baseline, when compared to a control group. After 6 months of 
      combination estrogen-progesterone therapy, no significant changes in NKB levels 
      were observed in these patients. These findings, for the first time in the 
      literature, provide insight into the perceived benefit of HRT, calling into 
      question its benefit in addressing the underlying etiopathogenetic contributors 
      of FHA. These new findings may contribute to more targeted and appropriate 
      treatment of such patients in the future.
FAU - Szeliga, Anna
AU  - Szeliga A
AD  - Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 
      Poznan, Poland.
FAU - Podfigurna, Agnieszka
AU  - Podfigurna A
AD  - Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 
      Poznan, Poland.
FAU - Bala, Gregory
AU  - Bala G
AD  - Appletree Medical Tree, Ottawa, Canada.
FAU - Meczekalski, Blazej
AU  - Meczekalski B
AUID- ORCID: 0000-0002-0761-5775
AD  - Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 
      Poznan, Poland.
LA  - eng
PT  - Journal Article
DEP - 20220928
PL  - England
TA  - Gynecol Endocrinol
JT  - Gynecological endocrinology : the official journal of the International Society 
      of Gynecological Endocrinology
JID - 8807913
RN  - 86933-75-7 (Neurokinin B)
RN  - 0 (Progestins)
RN  - 33515-09-2 (Gonadotropin-Releasing Hormone)
RN  - 0 (Estrogens)
RN  - 4TI98Z838E (Estradiol)
RN  - 0 (Neurotransmitter Agents)
RN  - 0 (Kisspeptins)
SB  - IM
MH  - Female
MH  - Humans
MH  - *Neurokinin B
MH  - *Progestins/therapeutic use
MH  - Amenorrhea
MH  - Gonadotropin-Releasing Hormone
MH  - Estrogens
MH  - Estradiol
MH  - Neurotransmitter Agents
MH  - Kisspeptins
OTO - NOTNLM
OT  - Functional hypothalamic amenorrhea
OT  - KNDy
OT  - estro-progestin
OT  - neurokinin B
OT  - 功能性下丘脑垂体性闭经
OT  - 强啡肽
OT  - 神经激肽B
OT  - 雌孕激素
EDAT- 2022/09/29 06:00
MHDA- 2023/01/18 06:00
CRDT- 2022/09/28 19:02
PHST- 2022/09/29 06:00 [pubmed]
PHST- 2023/01/18 06:00 [medline]
PHST- 2022/09/28 19:02 [entrez]
AID - 10.1080/09513590.2022.2128103 [doi]
PST - ppublish
SO  - Gynecol Endocrinol. 2022 Nov;38(11):997-1002. doi: 10.1080/09513590.2022.2128103. 
      Epub 2022 Sep 28.