[HTML][HTML] Divergent responses to kisspeptin in children with delayed puberty
JCI insight, 2018•ncbi.nlm.nih.gov
BACKGROUND. The neuropeptide kisspeptin stimulates luteinizing hormone (LH) secretion
in healthy adults but not in adults with idiopathic hypogonadotropic hypogonadism. We
hypothesized that, in children presenting with delayed or stalled puberty, kisspeptin would
elicit LH secretion in those children found on detailed nighttime neuroendocrine profiling to
have evidence of emerging reproductive endocrine function. METHODS. Eleven boys and
four girls were admitted overnight to assess LH secretion at baseline, after a single …
in healthy adults but not in adults with idiopathic hypogonadotropic hypogonadism. We
hypothesized that, in children presenting with delayed or stalled puberty, kisspeptin would
elicit LH secretion in those children found on detailed nighttime neuroendocrine profiling to
have evidence of emerging reproductive endocrine function. METHODS. Eleven boys and
four girls were admitted overnight to assess LH secretion at baseline, after a single …
Abstract
BACKGROUND. The neuropeptide kisspeptin stimulates luteinizing hormone (LH) secretion in healthy adults but not in adults with idiopathic hypogonadotropic hypogonadism. We hypothesized that, in children presenting with delayed or stalled puberty, kisspeptin would elicit LH secretion in those children found on detailed nighttime neuroendocrine profiling to have evidence of emerging reproductive endocrine function.
METHODS. Eleven boys and four girls were admitted overnight to assess LH secretion at baseline, after a single intravenous bolus of kisspeptin, and after a single intravenous bolus of gonadotropin-releasing hormone (GnRH). Subjects then received exogenous pulsatile GnRH for 6 days and returned for a second visit to measure responses to kisspeptin and GnRH after this pituitary “priming.” Responses to kisspeptin and GnRH were also measured in 5 healthy men.
RESULTS. Of the 15 children with delayed/stalled puberty, 6 exhibited at least one spontaneous LH pulse overnight; all of these subjects had clear responses to kisspeptin, as did one additional subject. Seven subjects had no response to kisspeptin, and one subject exhibited an intermediate response. In the children who responded to kisspeptin, the responses had features comparable to those of adult men.
CONCLUSION. In this first report of kisspeptin administration to pediatric subjects to our knowledge, children with delayed/stalled puberty showed a wide range of responses, with some showing a robust response and others showing little to no response. Further follow-up will determine whether responses to kisspeptin predict future pubertal entry for children with delayed puberty.
TRIAL REGISTRATION. ClinicalTrials. gov
NCT01438034 and
NCT01952782.
FUNDING. NIH Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01 HD043341, R01 HD090071, P50 HD028138), NIH National Center for Advancing Translational (UL1 TR001102), NIH National Institute of Diabetes and Digestive and Kidney Diseases (T32
ncbi.nlm.nih.gov