Higher ghrelin and lower leptin secretion are associated with lower LH secretion in young amenorrheic athletes compared with eumenorrheic athletes and controls

Abstract

Amenorrhea is common in young athletes and is associated with low fat mass. However, hormonal factors that link decreased fat mass with altered gonadotropin pulsatility and amenorrhea are unclear. Low levels of leptin (an adipokine) and increased ghrelin (an orexigenic hormone that increases as fat mass decreases) impact gonadotropin pulsatility. Studies have not examined luteinizing hormone (LH) secretory dynamics in relation to leptin or ghrelin secretory dynamics in adolescent and young adult athletes. We hypothesized that 1) young amenorrheic athletes (AA) would have lower LH and leptin and higher ghrelin secretion than eumenorrheic athletes (EA) and nonathletes and 2) higher ghrelin and lower leptin would be associated with lower LH secretion. This was a cross-sectional study. We examined ghrelin and leptin secretory patterns (over 8 h, from 11 PM to 7 AM) in relation to LH secretory patterns in AA, EA, and nonathletes aged 14-21 yr. Ghrelin and leptin were assessed every 20 min and LH every 10 min. Groups did not differ for age, bone age, or BMI. However, fat mass was lower in AA than in EA and nonathletes. AA had lower LH and higher ghrelin pulsatile secretion and AUC than nonathletes and lower leptin pulsatile secretion and AUC than EA and nonathletes. Percent body fat was associated positively with LH and leptin secretion and inversely with ghrelin. In a regression model, ghrelin and leptin secretory parameters were associated independently with LH secretory parameters. We conclude that higher ghrelin and lower leptin secretion in AA related to lower fat mass may contribute to altered LH pulsatility and amenorrhea.

Exercise, Training, and the Hypothalamic-Pituitary-Gonadal Axis in Men and Women

“…There is consistent evidence that amenorrheic athletes with normal lean body mass and BMI have lower body fat and percent body fat than eumenorrheic athletes and nonathletes [93,94] . Leptin, an anorexigenic hormone, declines with low energy availability [95,96] and, as expected, is lower in amenorrheic athletes compared to eumenorrheic athletes and nonathletes [74,93] . Conversely, there is evidence that adiponectin increases with reduced energy [89,91] ; however, findings in amenorrheic athletes are inconsistent.…”

“…In one study, alterations in LH release were described in 78% of athletes with amenorrhea [73] . When evaluating secretion of LH in amenorrheic athletes, eumenorrheic athletes, and nonathletic controls aged 14-21 years, overnight secretory LH pulse height, total pulsatile secretion, and area under the concentration time curve (AUC) were lower in athletes with amenorrhea versus nonathletes [74] . In a study examining LH pulsatility in eumenorrheic, sedentary women, subjects were energy restricted from diet alone versus those energy restricted predominantly by increasing exercise.…”

Decreased luteinizing hormone pulse frequency is associated with elevated 24-hour ghrelin after calorie restriction and exercise in premenopausal women

“…Welt et al (45) administered human recombinant leptin to eight women with FHA and demonstrated an increase in LH pulsatility. Additionally, Ackerman et al (2) recently demonstrated that elevated ghrelin and suppressed leptin concentrations were associated with suppressed LH secretion in young, exercising women. However, leptin 24-h concentrations were not measured in the current study.…”

Participation in sports in relation to adolescent growth and development

“…Higher ghrelin and lower leptin secretion (related to lower FM) is associated with lower luteinizing hormone (LH) secretion in amenorrheic athletes compared to eumenorrheic athletes (32). Some studies have suggested that young female athletes have a higher prevalence of menstrual disorders (33,34) and that premenstrual syndrome (PMS) increases in prevalence with duration and intensification of competitive exercises in girls and young women (35).…”