Horm Metab Res 2019; 51(05): 302-308
DOI: 10.1055/a-0859-4285
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Relationships Between Thyroid Hormones, Insulin-Like Growth Factor-1 and Antioxidant Levels in Hypothalamic Amenorrhea and Impact on Bone Metabolism

Antonio Mancini
1  UOC Endocrinologia e Diabetologia, Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy
2  Istituto di Patologia Speciale Medica e Semeiotica Medica, Università Cattolica del Sacro Cuore, Rome, Italy
,
Edoardo Vergani
1  UOC Endocrinologia e Diabetologia, Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy
2  Istituto di Patologia Speciale Medica e Semeiotica Medica, Università Cattolica del Sacro Cuore, Rome, Italy
,
Carmine Bruno
1  UOC Endocrinologia e Diabetologia, Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy
2  Istituto di Patologia Speciale Medica e Semeiotica Medica, Università Cattolica del Sacro Cuore, Rome, Italy
,
Angelina Barini
3  Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy
4  Istituto di Biochimica e Biochimica Clinica, Università Cattolica del Sacro Cuore, Rome, Italy
,
Andrea Silvestrini
3  Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy
4  Istituto di Biochimica e Biochimica Clinica, Università Cattolica del Sacro Cuore, Rome, Italy
,
Elisabetta Meucci
3  Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy
4  Istituto di Biochimica e Biochimica Clinica, Università Cattolica del Sacro Cuore, Rome, Italy
,
Calogero Messana
5  UOC Ostetricia e Patologia Ostetrica, Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy
6  Istituto di Clinica Ostetrico e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
,
Daniela Romualdi
5  UOC Ostetricia e Patologia Ostetrica, Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy
6  Istituto di Clinica Ostetrico e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
,
Rosanna Apa
5  UOC Ostetricia e Patologia Ostetrica, Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy
6  Istituto di Clinica Ostetrico e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
,
Antonio Lanzone
5  UOC Ostetricia e Patologia Ostetrica, Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy
6  Istituto di Clinica Ostetrico e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
› Author Affiliations
Further Information

Publication History

received 15 November 2018

accepted 11 February 2019

Publication Date:
07 March 2019 (eFirst)

Abstract

Reduced bone mineral density (BMD) in Functional Hypothalamic Amenorrhea (FHA) is mainly related to hypoestrogenism, but other hormonal derangement (reduced conversion of T4–T3 and GH resistance) can play a role. These hormones are involved in antioxidant systems regulation. We evaluated the impact of hormonal alterations, with special focus on low T3 and IGF-1 levels, on antioxidant systems as a link with osteoporosis in FHA. Forty-three FHA patients, 15–34 years, with BMI range 17.3–23.4 kg/m2, were divided in 2 groups according to fT3 levels; group A (n=22), low fT3 (<2.4 pg/ml) and group B (n=21), normal fT3 (≥ 2.4 pg/ml). We evaluated hormonal parameters (fT3, fT4, TSH, IGF-1, FSH, LH, estradiol, DHEAS, testosterone, cortisol), bone metabolism (calcium, phosphorus, 25-OH Vitamin D, PTH, β-crosslaps, bone alkaline phosphatase) and total antioxidant capacity (TAC), expressed as LAG (latency time in radical species appearance using spectrophotometric method). BMD was assessed by DEXA. Group A patients exhibited significantly lower levels of IGF-1 (159.76±14.79 vs. 220.05±15.25 ng/ml) and osteocalcin (17.51±1.14 vs. 21.49±1.56 ng/ml); LAG values were significantly higher in A (66.33±1.74 s) vs. B (54.62±1.74 s). A significant direct correlation was found between both IGF-1 and fT3 with osteocalcin (r²=0.22, p=0.0049 and r²=0.34, p=0.0001, respectively). No difference in LAG between groups according to IGF-1 were found. These data show a correlation between altered bone turnover and low fT3, which is highly prevalent in FHA. Low fT3 levels may contribute to reduced BMD. Oxidative stress could be the link underlying different bone turnover pattern and endocrine dysfunction in FHA.

Supplementary Material