The relationships of the pituitary-gonadal regulation link of the menstrual cycle and hormones of energy metabolism in adolescents with abnormal uterine bleeding at different times of menstrual disorders debut

The objective: to study the relationship between gonadotropic, steroid, metabolic hormones and sex steroid-binding globulin (SSBG) at different times of the debut of abnormal uterine bleeding (AUB) in adolescents relative to menarche based on the development of a mathematical model.Materials and methods. 200 adolescent girls with AUB were examined. They were divided into groups depending on the time of onset of uterine bleeding relative to menarche. The blood serum concentration of gonadotropic, steroid hormones, insulin, leptin, and SSBG was determined. The comparison group consisted of 45 girls of the same age with a normal menstrual cycle. The variance and regression analyses of the obtained data were performed using the application program package Statgraphics Plus for Windows 5.0 and SPSS-17.Results. The formation of uterine bleeding in adolescent girls occurs on the background of increased levels of luteinizing hormone, estradiol, and testosterone, and the highest rates are observed in patients with AUB that occurred after previous disorders of the oligomenorrhea type.The sensitivity of the reproductive axis to energy-regulating hormones, which depends on the time of disease debut, has been proven. There is a relationship between gonadotropic hormones, energy metabolism hormones, steroid hormones.Menstrual dysfunction with menarche or in the first year of the menstrual cycle formation, regardless of the type of disorder (AUB or oligomenorrhea), is accompanied by identical changes in hormonal and metabolic status and is formed on the background of immaturity of the pituitary-gonadal system components. AUB which occurs after 2 or more years of normal menstrual function, is formed on the background of a more mature relationship between estradiol and follicle-stimulating hormone, and insulin, interacting with luteinizing hormone, modulates mainly the production of testosterone, which contributes to the prolongation of the period of anovulatory cycles, which in the future can contribute to the formation of polycystic ovary syndrome.Conclusions. The variability of gonadotropic hormone production in AUB during puberty is determined with a high degree of significance (p < 0.001) by leptin, insulin, SSBG and steroid hormones. This indicates the sensitivity of the reproductive axis to available energy and demonstrates that the level of energy hormones affects not only the production of gonadotropins, but is also associated with ovarian function. Moreover, the features of the associative relationships of pituitary hormones depend on the time of the debut of menstrual disorders.