Nutrition and reproductive function

doi:10.1017/CBO9780511527036.007

6 - Nutrition and reproductive function

from Part I - Normal development

Published online by Cambridge University Press: 04 May 2010

Edited by

Jane MacDougall and

Howard S. Jacobs: Affiliation:
Royal Free and University College London School of Medicine, The Middlesex Hospital, London, UK
Adam H. Balen: Affiliation:
Leeds Teaching Hospitals, University Trust
Sarah M. Creighton: Affiliation:
University College London Hospitals
Melanie C. Davies: Affiliation:
University College London
Jane MacDougall: Affiliation:
Addenbrooke's Hospital, Cambridge
Richard Stanhope: Affiliation:
Great Ormond Street Hospital

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Summary

Introduction

Optimum fertility requires an adequate level of maternal nutrition. Women who conceive while underweight, usually it must be admitted through medical treatment, have a higher than normal risk of producing a premature child that is itself underweight (van der Spuy et al., 1988). Recent epidemiological studies have indicated that subnormal weight at birth is associated with an adverse pattern of health during adult life, particularly with respect to the development of metabolic and cardiovascular disorders (Barker, 1997). Clearly, then, risks to normal intrauterine development are greater during times of maternal starvation than when nutrition is normal. At the other end of the scale, obesity is associated with impaired health at all ages (Norman and Clark, 1998). Obesity impairs most aspects of fertility, causes insulin resistance and is a major determinant for the expression of polycystic ovary syndrome.

Role of leptin

We now understand that nutrition is regulated in large part by hormonal signals from fat cells interacting with the neuroendocrine system to control feeding and energy expenditure (Kalra et al., 1999). Leptin is a recently discovered cytokine, encoded by the ob gene, that is secreted by white fat cells in response to a number of influences (Mantzoros, 1999). Stimulation of hypothalamic leptin receptors suppresses neuropeptide Y production and thereby controls a variety of reproductive and vegetative functions. Much recent work has focused on factors determining circulating leptin concentrations in an attempt to understand better the influence of fat cell repletion, that is, of nutritional “status”, on reproductive function.

Information

Type: Chapter
Information: Paediatric and Adolescent Gynaecology
A Multidisciplinary Approach
, pp. 59 - 64

DOI: https://doi.org/10.1017/CBO9780511527036.007 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2004

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References

Adams, J, Franks, S, Polson, D W et al. (1985). Multifollicular ovaries: clinical and endocrine features and response to pulsatile gonadotropin releasing hormone. Lancet ⅱ, 1375–1379CrossRef Google Scholar

Audi, L, Mantzoros, C S, Vidal-Puig, A, Vargas, D, Gussinye, M, Carrascosa, A (1998). Leptin in relation to resumption of menses in women with anorexia nervosa. Mol Psychiatry 3, 544–547CrossRef Google Scholar PubMed

Balen, A H, Conway, G S, Kaltsas, G et al. (1995). Polycystic ovary syndrome: the spectrum of the disorder in 1741 patients. Hum Reprod 10, 2107–2111CrossRef Google Scholar PubMed

Barker, D J (1997). Fetal nutrition and cardiovascular disease in later life. Br Med Bull 53, 96–108CrossRef Google Scholar PubMed

Becker, A E, Grinspoon, S K, Klibanski, A, Herzog, D B (1999). Eating disorders. N Engl J Med 340, 1092–1098CrossRef Google Scholar PubMed

Biller, B M, Saxe, V, Herzog, D B, Rosenthal, D I, Holzman, S, Klibanski, A (1989). Mechanisms of osteoporosis in adult and adolescent women with anorexia nervosa. J Clin Endocrinol Metab 68, 548–554CrossRef Google Scholar PubMed

Biller, B M, Coughlin, J F, Saxe, V, Schoenfeld, D, Spratt, D I, Klibanski, A (1991). Osteopenia in women with hypothalamic amenorrhea: a prospective study. Obstet Gynecol 78, 996–1001Google Scholar PubMed

Boyar, R M, Katz, J, Finkelstein, J W et al. (1974). Anorexia nervosa. Immaturity of the 24-hour luteinizing hormone secretory pattern. N Engl J Med 291, 861–865CrossRef Google Scholar PubMed

Boyar, R M, Hellman, L D, Roffwarg, H et al. (1977). Cortisol secretion and metabolism in anorexia nervosa. N Engl J Med 296(4): 190–193CrossRef Google Scholar PubMed

Bray, G A (1997). Obesity and reproduction. [Review; 41 refs] Hum Reprod 12(Suppl. 1), 26–32CrossRef Google Scholar PubMed

Clement, K, Vaisse, C, Lahlou, N et al. (1998). A mutation in the human leptin receptor gene causes obesity and pituitary dysfunction. Nature 392, 398–401CrossRef Google Scholar PubMed

Crisp, A H, Stonehill, E (1971). Relation between aspects of nutritional disturbance and menstrual activity in primary anorexia nervosa. Br Med J 3, 149–151CrossRef Google Scholar PubMed

Davies, M C, Hall, M L, Jacobs, H S (1990). Bone mineral loss in young women with amenorrhoea. Br Med J 301, 790–793CrossRef Google Scholar PubMed

Dunaif, A (1997). Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. [Review; 277 refs.] Endocr Rev 18, 774–800Google Scholar PubMed

Eastell, R, Reid, D M, Compston, J et al. (1998). A UK Consensus Group on management of glucocorticoid-induced osteoporosis: an update. J Intern Med 244, 271–292CrossRef Google Scholar PubMed

Fishman, J, Boyar, R M, Hellman, L (1975). Influence of body weight on estradiol metabolism in young women. J Clin Endocrinol Metab 41, 989–991CrossRef Google Scholar PubMed

Goldin, B R, Adlercreutz, H, Gorbach, S L, Warram, J H, Dwyer, J T, Swenson, L, Woods, M N (1982). Estrogen excretion patterns and plasma levels in vegetarian and omnivorous women. N Engl J Med 307, 1542–1547CrossRef Google Scholar PubMed

Grinspoon, S K, Baum, H B, Peterson, S, Klibanski, A (1995). Effects of rhIGF-I administration on bone turnover during short-term fasting. J Clin Invest 96, 900–906CrossRef Google Scholar

Grinspoon, S, Gulick, T, Askari, H et al. (1996). Serum leptin levels in women with anorexia nervosa. J Clin Endocrinol Metab 81, 3861–3863Google Scholar PubMed

Gulekli, B, Davies, M C, Jacobs, H S (1994). Effect of treatment on established osteoporosis in young women with amenorrhoea. Clin Endocrinol 41, 275–281CrossRef Google Scholar PubMed

Hotta, M, Shibasaki, T, Masuda, A et al. (1986). The responses of plasma adrenocorticotropin and cortisol to corticotropin-releasing hormone (CRH) and cerebrospinal fluid immunoreactive CRH in anorexia nervosa patients. J Clin Endocrinol Metab 62, 319–324CrossRef Google Scholar PubMed

Jacobs, H S, Conway, G S (1999). Leptin, polycystic ovaries and polycystic ovary syndrome. Hum ReprodUpdate 5, 166–171Google Scholar PubMed

Jensen, J, Christiansen, C, Rodbro, P (1985). Cigarette smoking, serum estrogens, and bone loss during hormone-replacement therapy early after menopause. N Engl J Med 313, 973–975CrossRef Google Scholar PubMed

Kalra, S P, Dube, M G, Pu, S, Xu, B, Horvath, T L, Kalra, P S (1999). Interacting appetite-regulating pathways in the hypothalamic regulation of body weight. Endocr Rev 20, 68–100Google Scholar PubMed

Karlsson, C, Lindell, K, Svensson, E et al. (1997). Expression of functional leptin receptors in the human ovary. J Clin Endocrinol Metab 82, 4144–4148Google Scholar PubMed

Kiddy, D S, Hamilton-Fairley, D, Bush, A et al. (1992). Improvement in endocrine and ovarian function during dietary treatment of obese women with polycystic ovary syndrome. Clin Endocrinol 36, 105–111CrossRef Google Scholar PubMed

Klibanski, A, Biller, B M, Schoenfeld, D A, Herzog, D B, Saxe, V C (1995). The effects of estrogen administration on trabecular bone loss in young women with anorexia nervosa. J Clin Endocrinol Metab 80, 898–904Google Scholar PubMed

Lems, W F, Veen, G J, Gerrits, M I et al. (1998). Effect of low-dose prednisone (with calcium and calcitriol supplementation) on calcium and bone metabolism in healthy volunteers. Br J Rheumatol 37, 27–33CrossRef Google Scholar PubMed

Licinio, J, Mantzoros, C, Negrao, A B et al. (1997). Human leptin levels are pulsatile and inversely related to pituitary—adrenal function. NatMed 3, 575–579CrossRef Google Scholar PubMed

Licinio, J, Negrao, A B, Mantzoros, C et al. (1998). Synchronicity of frequently sampled, 24-h concentrations of circulating leptin, luteinizing hormone, and estradiol in healthy women. Proc Natl Acad Sci USA 95, 2541–2546CrossRef Google Scholar PubMed

Lucas, A R, Melton, J L III, Crowson, C S, O'Fallon, W M (1999). Long-term fracture risk among women with anorexia nervosa: a population-based cohort study. Mayo Clin Proc 74, 972–977CrossRef Google Scholar PubMed

Mantzoros, C S (1999). The role of leptin in human obesity and disease: a review of current evidence. Ann Intern Med 130, 671–680CrossRef Google Scholar PubMed

Mantzoros, C, Flier, J S, Lesem, M D, Brewerton, T D, Jimerson, D C (1997). Cerebrospinal fluid leptin in anorexia nervosa: correlation with nutritional status and potential role in resistance to weight gain. J Clin Endocrinol Metab 82, 1845–1851Google Scholar PubMed

Michnovicz, J J, Naganuma, H, Hershcopf, R J, Bradlow, H L, Fishman, J (1988). Increased urinary catechol estrogen excretion in female smokers. Steroids 52, 69–83CrossRef Google Scholar PubMed

Miller, K K, Klibanski, A (1999). Clinical review 106: amenorrheic bone loss. J Clin Endocrinol Metab 84, 1775–1783Google Scholar PubMed

Moshang, T J, Parks, J S, Baker, L, et al. (1975). Low serum triiodothyronine in patients with anorexia nervosa. J Clin Endocrinol Metab 40, 470–3CrossRef Google Scholar PubMed

Norman, R J, Clark, A M (1998). Obesity and reproductive disorders: a review. Reprod Fertil Dev 10, 55–63CrossRef Google Scholar PubMed

Polson, D W, Adams, J, Wadsworth, J, Franks, S (1988). Polycystic ovaries — a common finding in normal women. Lancet ⅰ, 870–872CrossRef Google Scholar

Poretsky, L, Cataldo, N A, Rosenwaks, Z, Giudice, L C (1999). The insulin-related ovarian regulatory system in health and disease [in process citation]. Endocr Rev 20, 535–582CrossRef Google Scholar

Russell, G F, Treasure, J, Eisler, I (1998). Mothers with anorexia nervosa who underfeed their children: their recognition and management. Psychol Med 28, 93–108CrossRef Google Scholar PubMed

Stefanis, N, Mackintosh, C, Abraha, H D, Treasure, J, Moniz, C (1998). Dissociation of bone turnover in anorexia nervosa. Ann Clin Biochem 35, 709–716CrossRef Google Scholar PubMed

Thomas, T, Gori, F, Khosla, S, Jensen, M D, Burguera, B, Riggs, B L (1999). Leptin acts on human marrow stromal cells to enhance differentiation to osteoblasts and to inhibit differentiation to adipocytes. Endocrinology 140, 1630–1638CrossRef Google Scholar PubMed

Spuy, Z M, Steer, P J, McCusker, M, Steele, S J, Jacobs, H S (1988). Outcome of pregnancy in underweight women after spontaneous and induced ovulation. Br Med J Clin Res Ed 296, 962–965CrossRef Google Scholar PubMed

Warren M P, Adashi E Y, Rock J A, Rosenwaks Z (eds.) (1996). Reproductive Endocrinology, Surgery, and Technology, Ch. 50, Eating Disorders and the Reproductive Axis. pp. 1039–1060. Lippincott-Raven, Philadelphia, PA

White, D M, Polson, D W, Kiddy, D et al. (1996). Induction of ovulation with low-dose gonadotropins in polycystic ovary syndrome: an analysis of 109 pregnancies in 225 women. J Clin Endocrinol Metab 81, 3821–3824Google Scholar PubMed

Zachow, R J, Magoffin, D A (1997). Direct intraovarian effects of leptin: impairment of the synergistic action of insulin-like growth factor-I on follicle-stimulating hormone-dependent estradiol-17 beta production by rat ovarian granulosa cells. Endocrinology 138, 847–850CrossRef Google Scholar PubMed

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