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Titolo:
IMMUNOREACTIVE AND BIOACTIVE LUTEINIZING-HORMONE IN PUBERTAL PATIENTSWITH CHRONIC-RENAL-FAILURE
Autore:
SCHAEFER F; VELDHUIS JD; ROBERTSON WR; DUNGER D; SCHARER K; BARRATT TM; HAMILL G; LEDERMAN S; TROMPETER RS; PERFUMO F; REES L; FINE RN; RIGDEN S; GEARY D; POSTLETHWAITHE R; MICHALK D;
Indirizzi:
UNIV HEIDELBERG,CHILDRENS HOSP,DIV PEDIAT NEPHROL,IM NEUENHEIMER FELD150 D-69120 HEIDELBERG GERMANY UNIV VIRGINIA,CTR HLTH SCI,DIV ENDOCRINOL & METAB,INTERDISCIPLINARY GRAD BIOPHYS PROGRAM CHARLOTTESVILLE VA 22903 NSF SCI CTR BIOL TIMING CHARLOTTESVILLE VA 00000 UNIV MANCHESTER,HOPE HOSP,CLIN BIOCHEM SECT SALFORD M6 8HD LANCS ENGLAND JOHN RADCLIFFE HOSP,DEPT PEDIAT OXFORD OX3 9DU ENGLAND CHILDRENS HOSP,SCH MED HANNOVER GERMANY HOSP SICK CHILDREN LONDON WC1N 3JH ENGLAND IST GIANNINA GASLINI I-16148 GENOA ITALY ROYAL FREE HOSP LONDON NW3 2QG ENGLAND UNIV CALIF LOS ANGELES,CTR HLTH SCI LOS ANGELES CA 90024 EVELINA CHILDRENS HOSP LONDON ENGLAND HOSP SICK CHILDREN TORONTO M5G 1X8 ON CANADA ROYAL MANCHESTER CHILDRENS HOSP MANCHESTER LANCS ENGLAND UNIV COLOGNE,CHILDRENS HOSP W-5000 COLOGNE GERMANY
Titolo Testata:
Kidney international
fascicolo: 5, volume: 45, anno: 1994,
pagine: 1465 - 1476
SICI:
0085-2538(1994)45:5<1465:IABLIP>2.0.ZU;2-1
Fonte:
ISI
Lingua:
ENG
Soggetto:
FOLLICLE-STIMULATING-HORMONE; EXPERIMENTAL UREMIA; GONADOTROPIN-SECRETION; POSTMENOPAUSAL WOMEN; PEAK-DETECTION; ALPHA-SUBUNIT; PULSE SIGNAL; MEN; CHILDREN; TRANSPLANTATION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
56
Recensione:
Indirizzi per estratti:
Citazione:
F. Schaefer et al., "IMMUNOREACTIVE AND BIOACTIVE LUTEINIZING-HORMONE IN PUBERTAL PATIENTSWITH CHRONIC-RENAL-FAILURE", Kidney international, 45(5), 1994, pp. 1465-1476

Abstract

Disturbed pulsatile LH secretion has been suggested to play a role inthe etiology of delayed puberty and disturbed reproductive function in chronic renal failure (CRF), but interpretation of gonadotropin secretion from plasma concentration measurements is confounded by alterations in hormone metabolic clearance. To simultaneously investigate LH secretion and clearance in children, we performed multiple-parameter deconvolution analysis of 11-hour over night serum LH concentration-timeseries of bioactive (bio-LH) and immunoreactive (i-LH) hormone in 36 pubertal patients (18 boys) with various degrees of CRF and 10 healthycontrols matched for sex and pubertal stage. Twelve patients receivedconservative treatment for advanced but compensated CRF, 12 were treated by dialysis, and 12 were studied after successful renal transplantation. We observed that: (1) the mean (+/- SE) plasma half-lives of bio-LH and i-LH were increased in the dialysis group (155 +/- 47 and 201+/- 31 min) and in the patients on conservative treatment (148 +/- 45and 135 +/- 70 min) compared to controls (59 +/- 28 and 63 +/- 21 min; all P < 0.05). The plasma half-life of bio-LH in patients on conservative treatment or after renal transplantation was inversely correlated with glomerular filtration rate (GFR) (r = -0.70; P < 0.0001). (2) Pulsatile bio-LH production rate was independently affected by pubertalstage (P = 0.018) and treatment status (P = 0.017), increasing acrosspubertal stages and being significantly lower in dialysis patients (20 +/- 4 IU/liter 11 hr) and patients on conservative treatment (28 +/- 9) than in controls (43 +/- 9; all P < 0.05). In patients on conservative treatment or after transplantation, a significant positive correlation between pulsatile bio-LH production rate was observed (r = 0.53; P < 0.008). Pulsatile i-LH secretion rate was significantly reducedonly in dialysis patients (15 +/- 34 vs. 46 +/- 18; P < 0.05). (3) The reduction of pulsatile i-LH and/or bio-LH production rates was attributable to a halving of the LH mass secreted per burst in patients on conservative (bio-LH: 4.9 +/- 1.9 IU/liter) and dialysis treatment (bio-LH: 3.2 +/- 0.7, i-LH: 2.4 +/- 0.6 IU/liter) versus controls (bio-LH: 6.9 +/- 1.3, i-LH: 5.4 +/- 2.1 IU/liter), whereas the LH pulse frequency was not different between controls and treatment groups. (4) The relative contribution of apparent basal LH release to total secretion rates was higher (25 +/- 11%) in patients on dialysis than in controls(6.8 +/- 3.9%; P < 0.0.05). (5) Mean plasma concentrations of i-LH, but not bio-LH, were significantly elevated in the uremic children. Thereduction of mean bio-LH/i-LH ratio in the uremic children was due tothe relative increase in basal i-LH secretion, resulting in a significant reduction of the bio-LH/i-LH ratio of total LH secretion rates inpatients on conservative treatment (1.14 +/- 0.2 vs. 2.2 +/- 0.2) anddialysis (1.5 +/- 0.24), whereas the bio-LH/i-LH ratio of plasma half-lives was similar (dialysis) to controls or even increased (conservative treatment). In the transplant patients, none of the secretory and clearance characteristics was significantly different from controls. In conclusion, the secretory pattern of LH in uremic pubertal children is characterized by a distinct increase in plasma half-life, and a reduction of the LH secretion rate compatible with deficient GnRH signal strength and/or pituitary responsiveness. Possibly due to accumulationof as yet undefined immunoreactive but biologically inactive LH fragments, apparent basal secretion of i-LH but not bio-LH is relatively increased in dialyzed patients, resulting in a disproportionate increaseof i-LH compared to bio-LH mean plasma concentrations.

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Documento generato il 28/09/20 alle ore 14:27:25