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Increased cerebrospinal fluid levels of GABA, testosterone and estradiol in women with polycystic ovary syndrome
- Source :
- Human Reproduction. 32:1450-1456
- Publication Year :
- 2017
- Publisher :
- Oxford University Press (OUP), 2017.
-
Abstract
- STUDY QUESTION Do cerebrospinal fluid (CSF) concentrations of gamma-aminobutyric acid (GABA), testosterone (T) and estradiol (E2) differ in women with polycystic ovary syndrome (PCOS) as compared to eumenorrheic, ovulatory women (EW)? SUMMARY ANSWER Women with PCOS displayed higher CSF levels of GABA and E2, and possibly T, than EW. WHAT IS KNOWN ALREADY The chronic anovulation characteristic of PCOS has been attributed to increased central GnRH drive and resulting gonadotropin aberrations. Androgens are thought to regulate GABA, which in turn regulates the neural cascade that modulates GnRH drive. STUDY DESIGN, SIZE, DURATION This cross-sectional observational study included 15 EW and 12 non-obese women with PCOS who consented to a lumbar puncture in addition to 24 h of serum blood collection at 15-min intervals. PARTICIPANTS/MATERIALS, SETTING, METHODS In total, 27 women were studied at a the General Clinical Research Center (GCRC) at the University of Pittsburgh. Serum analytes included T, E2 and androstenedione. CSF analytes included GABA, glutamate, glucose, T and E2. MAIN RESULTS AND THE ROLE OF CHANCE Women with PCOS had higher CSF GABA as compared to EW (9.04 versus 7.04 μmol/L, P < 0.05). CSF glucose and glutamate concentrations were similar between the two groups. CSF T was 52% higher (P = 0.1) and CSF E2 was 30% higher (P < 0.01) in women with PCOS compared to EW. Circulating T was 122% higher (P < 0.01) and circulating E2 was 75% higher (P < 0.01) in women with PCOS than in EW. LIMITATIONS REASONS FOR CAUTION The study is limited by its small sample size and the technical limitations of measuring CSF analytes that are pulsatile and have short half-lives. WIDER IMPLICATIONS OF THE FINDINGS Women with PCOS displayed significantly higher circulating levels of T and E2, significantly higher CSF levels of E2, and higher levels of CSF testosterone, although the latter was not statistically significant. A better understanding of the central milieu informs our understanding of the mechanisms mediating increased the GnRH drive in PCOS and lends a new perspective for understanding the presentation, pathogenesis and potential health consequences of PCOS, including gender identity issues. STUDY FUNDING/COMPETING INTEREST(S) No conflicts of interest. The study was funded by NIH grants to SLB (RO1-MH50748, U54-HD08610) and NIH RR-00056 to the General Clinical Research Center of the University of Pittsburgh. TRIAL REGISTRATION NUMBER NCT01674426.
- Subjects :
- Adult
0301 basic medicine
medicine.medical_specialty
CSF glucose
medicine.drug_class
Glutamic Acid
030209 endocrinology & metabolism
Gonadotropin-releasing hormone
Hospitals, University
Anovulation
Young Adult
03 medical and health sciences
0302 clinical medicine
Cerebrospinal fluid
Internal medicine
medicine
Humans
Testosterone
Androstenedione
gamma-Aminobutyric Acid
Estradiol
business.industry
Rehabilitation
Reproducibility of Results
Obstetrics and Gynecology
Pennsylvania
medicine.disease
Polycystic ovary
Up-Regulation
Cross-Sectional Studies
Glucose
030104 developmental biology
Endocrinology
Reproductive Medicine
Original Article
Female
Gonadotropin
business
Polycystic Ovary Syndrome
Subjects
Details
- ISSN :
- 14602350 and 02681161
- Volume :
- 32
- Database :
- OpenAIRE
- Journal :
- Human Reproduction
- Accession number :
- edsair.doi.dedup.....b9f88ed89386e3541d9dbd9f9141f220