Abstract
Objectives
There is a complex interaction between the anti-müllerian hormone (AMH) and hypothalamic–pituitary–gonadal axis. However, the effect of gonadotropin-releasing hormone (GnRH) stimulation on AMH levels is not clearly known. In the study, we aimed to evaluate the effect of GnRH stimulation on AMH levels in central precocious puberty (CPP) and isolated premature thelarche (PT) groups.
Methods
Sixty-three girls with breast development before the age of 8 were enrolled in the study. GnRH test was performed on all subjects. Blood samples for follicle-stimulating hormone (FSH), luteinizing hormone (LH), and AMH levels were taken at basal, 40th, and 90th minute of GnRH test. Subjects were grouped as CPP and PT group.
Results
After GnRH stimulation, AMH levels increased significantly at the 40th minute and the stimulating effect of GnRH on AMH continued till the 90th minute (p: 0.0001). There was a positive correlation between basal and 90th-minute AMH levels (r: 479, p: 0.0001). The highest FSH, LH, and AMH times were significantly different after the GnRH stimulation (p: 0.001, p: 0.001, and p: 0.007). Although the CPP group had a lower basal AMH level than the PT group’s basal AMH level; AMH response to GnRH stimulation was not different (p>0.05).
Conclusions
In our study, which examined the effect of GnRH stimulation on AMH levels in early pubertal development disorders for the first time, GnRH stimulated AMH secretion rapidly, correlated with basal AMH. Basal AMH levels were lower in patients with CPP than in those with PT; however, the effect of GnRH stimulation on AMH levels was similar in both groups.
Funding source: Turkey Pediatric Endocrinology and Diabetes Society
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Research funding: This study was supported financially by Turkey Pediatric Endocrinology and Diabetes Society
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Author contributions: Surgical and Medical Practices: Nursel Muratoglu Sahin, Nursun Ozcan, Aslihan Arasli Yilmaz, Senay Savas Erdeve, Semra Cetinkaya; Concept: Nursel Muratoglu Sahin; Design: Nursel Muratoglu Sahin; Data Collection or Processing: Nursel Muratoglu Sahin, Nursun Ozcan, Aslihan Arasli Yilmaz, Senay Savas Erdeve, Semra Cetinkaya; Analysis or Interpretation: Nursel Muratoglu Sahin; Literature Search: Nursel Muratoglu Sahin; Writing: Nursel Muratoglu Sahin. All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Ethical approval: The research was conducted ethically in accordance with the World Medical Association Declaration of Helsinki. The local Ethical Committee at Kecioren EAH approved the study (project no: 2012-KAEK-15/1529). All of the participants and their parents received oral and written information before signing a consent form.
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