Attenuated pulsatile release of prolactin in men with insulin-dependent diabetes mellitus.

Pulsatile and circadian patterns of PRL release were studied in 11 insulin-dependent diabetic men by sampling blood every 10 min for 24 h and comparing the results to those obtained in 12 normal nondiabetic men. The diabetic men had a mean (+/- SE) 24-h serum PRL concentration of 5.5 +/- 0.42 micrograms/L, which was significantly lower than that in the nondiabetic men (9.3 +/- 0.86; P = 0.0008). Quantitative Cluster analysis of pulsatile PRL time series revealed a normal pulse frequency, but decreased maximal peak amplitude (6.6 +/- 0.5 vs. 11.8 +/- 1.1 micrograms/L; P = 0.0009), peak increment (2.6 +/- 0.24 vs. 4.0 +/- 0.3 micrograms/L; P = 0.009), peak area (126 +/- 15 vs. 192 +/- 19 micrograms/L.min; P = 0.03), and interpulse valley mean concentration (4.8 +/- 0.4 vs. 8.6 +/- 1.2 micrograms/L; P = 0.0007). PRL pulse incremental amplitude correlated significantly (r2 = 0.577; P = 0.007) and negatively with duration of disease. Fourier analysis disclosed a normal circadian rhythm of PRL release in diabetic men, with a mean circadian amplitude of 1.5 micrograms/L +/- 0.31, which peaked at 0201 h +/- 89 min (+/- SE). In summary, we have demonstrated significantly reduced mean 24-h serum PRL concentrations in men with poorly controlled insulin-dependent diabetes mellitus. The concomitant suppression of spontaneous PRL pulse amplitude, peak increment, and interpulse valley mean concentrations in the presence of normal pulse frequency is consistent with a reduced mass of PRL secreted per burst and/or accelerated metabolic clearance of PRL in men with type I diabetes mellitus.

Alterations in the pulsatile mode of growth hormone release in men and women with insulin-dependent diabetes mellitus.

The mechanisms responsible for the elevated levels of circulating GH observed in diabetes mellitus (DM) remain incompletely defined. To assess the episodic fluctuations in serum GH as a reflection of hypothalamic-pituitary activity, we accumulated GH concentration-time series in a total of 48 adult men and women with and without insulin-dependent DM by obtaining serum samples at 10-min intervals over 24 h. Significant pulses of GH release were subsequently identified and characterized by an objective, statistically based pulse detection algorithm (Cluster) and fixed circadian (24-h) periodicities of secretory activity, resolved using Fourier expansion time-series analysis. Compared to those in age-matched controls, integrated 24-h concentrations of GH were 2- to 3.5-fold higher in diabetic men (P = 0.002) and women (P = 0.0005). Both men and women with DM had over 50% more GH pulses per 24 h than their non-DM counterparts. In addition, maximal GH pulse amplitude was markedly elevated in the men and women with DM (P = 0.0019 and 0.0189, respectively). That the increase in maximal pulse amplitude was accounted for by greater baseline levels was documented by a higher interpulse valley mean GH concentration in the diabetics compared to the controls (P = 0.0437 and 0.0056, men and women, respectively) and the absence of any difference in incremental pulse amplitude for either sex (P greater than 0.05). DM men had larger GH pulse areas (P = 0.039) than control men, apparently accounted for by greater pulse width (P = 0.0037). Pulse areas in DM and non-DM women were indistinguishable. Time-series analysis revealed that the 24-h (circadian) rhythms of serum GH concentrations exhibited significantly increased amplitudes in the diabetic group as a whole (compared to the controls, P = 0.011). However, the times of maximal GH concentrations (acrophases) were not significantly different. As a group, serum insulin-like growth factor-I was lower in DM vs. non-DM individuals (P = 0.0014), although when separated by sex this difference did not reach statistical significance in women (P = 0.317). The present data confirm the higher circulating levels of GH previously reported to occur in individuals with poorly controlled DM. The altered frequency of GH pulses together with enhanced interpulse GH concentrations and an amplified circadian GH rhythm are compatible with hypothalamic dysfunction associated with dysregulation of somatostatin and/or GHRH secretion.(ABSTRACT TRUNCATED AT 400 WORDS)

Alterations in luteinizing hormone secretory activity in women with insulin-dependent diabetes mellitus and secondary amenorrhea.

To investigate hypothalamic and/or pituitary abnormalities in women with poorly controlled insulin-dependent diabetes mellitus (IDDM) and secondary amenorrhea, we measured serum LH every 10 min for 24 h and for 2 additional h after the administration of exogenous GnRH in 8 women with IDDM and amenorrhea and compared these to data from 15 eumenorrheic nondiabetic women. LH pulses were characterized by the pulse detection algorithm Cluster, and secretory episodes were evaluated using the multiple parameter deconvolution procedure Deconv. Cluster analysis revealed fewer LH pulses per 24 h (14.3 +/- 1.2 vs. 19.9 +/- 0.6; P < 0.001; mean +/- SEM), a greater peak width (63 +/- 4.9 vs. 44 +/- 2.2 min; P < 0.01), and greater peak area (136 +/- 17 vs. 89 +/- 13 IU/L.min; P < 0.01) in the diabetic women. Analysis with Deconv revealed fewer LH secretory episodes per 24 h in the diabetic women (14.4 +/- 0.9 vs. 20.4 +/- 0.5; P < 0.001) and no statistical difference in LH half-lives. The IDDM women responded to a 10-micrograms GnRH bolus with LH pulses of larger total (51 +/- 15.9 vs. 15 +/- 1.4 IU/L; P < 0.01) and incremental (29 +/- 7.6 vs. 9 +/- 1.2; P < 0.001) amplitude. In summary, we observed that amenorrheic diabetic women have fewer LH pulses/secretory episodes than normal women. However, they respond well to exogenous GnRH, suggesting that compromise of the GnRH pulse generator, rather than pituitary dysfunction, is responsible for their menstrual dysfunction.

Specific physiological regulation of luteinizing hormone secretory events throughout the human menstrual cycle: new insights into the pulsatile mode of gonadotropin release.

Abstract To investigate the physiological regulation of luteinizing hormone (LH) secretory events and the endogenous clearance of this hormone, we applied multiple-parameter deconvolution analysis to serum LH concentration-time series obtained from normal women during three phases of the menstrual cycle. The number of significant LH secretory bursts (/24 h) was maximal in the late follicular (LF) phase (27 +/- 1.6; mean +/- SEM), minimal in the mid-luteal (ML) phase (10 +/-1.0) and intermediate in the early follicular (EF) phase (18 +/- 1.4). Similarly, the half-duration of the secretory impulse (min) was different at each phase of the cycle with values of 6.5+/-1.0, 3.5+/-0.9 and 11 +/- 1.1 during the EF, LF and ML phases, respectively. In contrast, there were no cycle-dependent differences in the LH half-life or in the total daily secretion of LH. When maximal secretory impulse amplitudes were examined, a putative bimodal distribution was found in the ML but not the EF or LF phases. The amplitudes for the large ML impulses, the LF and EF impulses and the small ML impulses were 0.95 +/- 0.05, 070 +/- 0.03, 0.43 +/- 0.02 and 0.26 +/- 0.02, respectively. The mass (mlU/ml) of hormone secreted within bursts was minimal in the LF phase (2.1 +/- 0.1), maximal in the large ML impulses (10.2 +/- 0.5) and intermediate in the EF (2.8 +/- 0.1) and small ML (3.1 +/-0.3) secretory impulses. There was no evidence of tonic (i.e. inter-secretory burst) LH secretion during any phase of the menstrual cycle. The early morning hours of the EF phase were characterized by fewer secretory bursts of greater amplitude. During the ML phase, autocorrelation analysis of inter-secretory burst intervals revealed a negative association indicating that high frequency events both precede and follow secretory pauses. In addition, secretory burst amplitude and both the preceding and following inter-secretory burst interval was correlated to secretory burst amplitude. These new data on the nature of regulated LH secretion indicate that specific facets of spontaneous LH secretory events are controlled throughout the menstrual cycle. Such observations offer a basis for defining altered secretory dynamics in a variety of pathophysiologic situations.

Nature of gonadotropin-releasing hormone self-priming of luteinizing hormone secretion during the normal menstrual cycle.

To investigate further the nature of the gonadotropin-releasing hormone self-priming effect on luteinizing hormone release, we administered two submaximal doses of gonadotropin-releasing hormone 2 hours apart to women at three stages of the menstrual cycle and analyzed the resultant luteinizing hormone secretory episodes with deconvolution analysis. When the characteristics of the secretory episodes associated with the second gonadotropin-releasing hormone challenge were compared with those associated with the first, both an enhanced maximal secretory rate and mass of luteinizing hormone secreted was demonstrable at each phase of the cycle. No differences in the luteinizing hormone secretory event half-duration were detected when the responses to the first and second gonadotropin-releasing hormone doses were compared. These data confirm the gonadal hormone milieu-associated self-priming effect of gonadotropin-releasing hormone on luteinizing hormone release and indicate that it is the rate with which luteinizing hormone molecules are discharged from the pituitary gland, rather than the duration of the secretory episode itself, that provides for the self-priming effect.