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cross-sectional study:

Luteinizing hormone and


insulin resistance in
menopausal women
AUTHOR MENTOR

Sran Pandurevi asist. dr Ljiljana Marina

ENDOCRINOLOGY, DIABETES AND OBESITY


CLINIC
Menopause?

Copyright 2016 Maricor/Maricar


Menopause
A rare natural phenomenon
Hypothalamus-pituitary-ovarian axis
Adaptation to altered hormonal status in menopause
1. hypothalamus (nc. arcuatus)
- GNRH
+

- + 2. anterior pituitary
- FSH
- LH

3. ovary
- ESTROGENS
- PROGESTINS
- INHIBINS
Davis SR, Lambrinoudaki I, Lumsden M, Mishra GD, Pal L, Rees M, et al. Menopause. Nat Rev Dis Prim
[Internet]. 2015;1:15004. Available from: http://www.nature.com/articles/nrdp20154
adrenal Proven correlation
gland between LH and IR:
+
INSr insulin adrenal incidentalomas
+ PCOS
LHhCGr LH No data among healthy
menopausal women
hyperplasia
Aim

Testing the correlation: LH and IR in healthy menopausal women:

1. LH and IR indices

2. LH/FSH ratio and IR indices


LH/FSH ratio

Ratio of absolute values of LH and FSH

Increased in 50% of PCOS cases

Progressively falls in menopause

Unclear relationship with IR


Study group
35 women
in menopause >1y
no conditions that would affect hormonal status
no medication that would affect hormonal status
Admitted at the Obesity, reproductive and metabolic disorders
ward of the Endocrinology clinic, Clinical center of Serbia
Cross-sectional study
Workup
Physical exam
Chest X-ray, abdominal US
Labs
LH
FSH
estradiol
testosterone
DHEAS
morning serum cortisol
OGTT
Workup
IR indices
HOMA-IR
Matsuda
LH/FSH ratio
Group stats
Age: 59,606,44
BMI: 26,933,57 kg/m2
Menopause duration: 9,705,55 y
Results
No correlation between LH and HOMA/Matsuda IR indices
(p > 0,05)
Negative correlation between LH/FSH and menopause duration
(r = -0,352, p = 0,044)
Negative correlation between LH/FSH and serum cortisol
(r = -0,387, p = 0,035)
Positive correlation between testosterone and Matsuda index
(r = 0,381, p = 0,05)
Conclusion
Menopause second most important biological event in women :)
No correlation between LH and IR
requires further research
LH and cortisol
Serum cortisol not specific enough -> 24h urine cortisol
Negative correlation between testosterone and IR
benefit for women treated for menopausal effects

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