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This Article Full Text Full Text (PDF) All Versions of this Article: 286/4/E615    most recent 00377.2003v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (7) Citing Articles via Google Scholar Google Scholar Articles by van Dam, E. W. C. M. Articles by Pijl, H. Search for Related Content PubMed PubMed Citation Articles by van Dam, E. W. C. M. Articles by Pijl, H.

Retention of estradiol negative feedback relationship to LH predicts ovulation in response to caloric restriction and weight loss in obese patients with polycystic ovary syndrome

¹Department of Endocrinology and Metabolic Diseases, ²Department of General Internal Medicine, ³Department of Clinical Chemistry, ⁴Department of Obstetrics, Gynaecology and Reproductive Medicine, and ⁵Department of Radiology, Leiden University Medical Center, Leiden, 2300 RC; ⁶Department of Internal Medicine, Vrije Universiteit Medical Center, Amsterdam, 1007 MB The Netherlands; and ⁷General Clinical Research Center, Mayo Medical and Graduate Schools of Medicine, Mayo Clinic, Rochester, Minnesota 55905

Submitted 20 August 2003 ; accepted in final form 8 December 2003

The present study tests the hypothesis that specific endocrine, metabolic, and anthropometric features distinguish obese women with polycystic ovary syndrome (PCOS) who resume ovulation in response to calorie restriction and weight loss from those who do not. Fifteen obese (body mass index 39 ± 7 kg/m²) hyperandrogenemic oligoovulatory patients undertook a very low calorie diet (VLCD), wherein each lost 10% of body weight over a mean of 6.25 mo. Body fat distribution was quantitated by magnetic resonance imaging. Hormones were measured in the morning at baseline, after 1 wk of VLCD, and after 10% weight loss. To monitor LH release, blood was sampled for 24 h at 10-min intervals before intervention and after 7 days of VLCD. Responders were defined a priori as individuals exhibiting two or more ovulatory cycles in the course of intervention, as corroborated by serum progesterone concentrations 18 nmol/l followed by vaginal bleeding. At baseline, responders had a higher sex hormone-binding globulin (SHBG) concentration but were otherwise indistinguishable from nonresponders. Body weight, the size of body fat depots, and plasma insulin levels declined to a similar extent in responders and nonresponders. Also, SHBG increased, and the free testosterone index decreased comparably. However, responders exhibited a significant decline of circulating estradiol concentrations (from 191 ± 82 to 158 ± 77 pmol/l, means ± SD, P = 0.037) and a concurrent increase in LH secretion (from 104 ± 42 to 140 ± 5 U·l^-1·day^-1, P = 0.006) in response to 7 days of VLCD, whereas neither parameter changed significantly in nonresponders. We infer that evidence of retention of estradiol-dependent negative feedback on LH secretion may forecast follicle maturation and ovulation in obese patients with PCOS under dietary restriction.

fertility; ovarian cycle; sex hormones; body fat distribution; gonadotropins

This article has been cited by other articles:

				L. J Moran, M. Noakes, P. M Clifton, G. A Wittert, G. Williams, and R. J Norman Short-term meal replacements followed by dietary macronutrient restriction enhance weight loss in polycystic ovary syndrome Am. J. Clinical Nutrition, July 1, 2006; 84(1): 77 - 87. [Abstract] [Full Text] [PDF]