TY - JOUR
T1 - Dynamic GnRH and hCG testing
T2 - establishment of new diagnostic reference levels
AU - Bang, A. Kirstine
AU - Nordkap, Loa
AU - Almstrup, Kristian
AU - Priskorn, Lærke
AU - Petersen, Jørgen Holm
AU - Rajpert-De Meyts, Ewa
AU - Andersson, Anna-Maria
AU - Juul, Anders
AU - Jørgensen, Niels
N1 - © 2017 European Society of Endocrinology.
PY - 2017/4/1
Y1 - 2017/4/1
N2 - OBJECTIVE: Gonadotropin-releasing hormone (GnRH) and human chorionic gonadotropin (hCG) stimulation tests may be used to evaluate the pituitary and testicular capacity. Our aim was to evaluate changes in follicular-stimulating hormone (FSH), luteinizing hormone (LH) and testosterone after GnRH and hCG stimulation in healthy men and assess the impact of six single nucleotide polymorphisms on the responses.DESIGN: GnRH and hCG stimulation tests were performed on 77 healthy men, 18-40 years (reference group) at a specialized andrology referral center at a university hospital. The potential influence of the tests was illustrated by results from 45 patients suspected of disordered hypothalamic-pituitary-gonadal axis.METHODS: Baseline, stimulated, relative and absolute changes in serum FSH and LH were determined by ultrasensitive TRIFMA, and testosterone was determined by LC-MS/MS.RESULTS: For the reference group, LH and FSH increased almost 400% and 40% during GnRH testing, stimulated levels varied from 4.4 to 58.8 U/L and 0.2 to 11.8 U/L and FSH decreased in nine men. Testosterone increased approximately 110% (range: 18.7-67.6 nmol/L) during hCG testing. None of the polymorphisms had any major impact on the test results. Results from GnRH and hCG tests in patients compared with the reference group showed that the stimulated level and absolute increase in LH showed superior identification of patients compared with the relative increase, and the absolute change in testosterone was superior in identifying men with Leydig cell insufficiency, compared with the relative increase.CONCLUSIONS: We provide novel reference ranges for GnRH and hCG test in healthy men, which allows future diagnostic evaluation of hypothalamic-pituitary-gonadal disorders in men.
AB - OBJECTIVE: Gonadotropin-releasing hormone (GnRH) and human chorionic gonadotropin (hCG) stimulation tests may be used to evaluate the pituitary and testicular capacity. Our aim was to evaluate changes in follicular-stimulating hormone (FSH), luteinizing hormone (LH) and testosterone after GnRH and hCG stimulation in healthy men and assess the impact of six single nucleotide polymorphisms on the responses.DESIGN: GnRH and hCG stimulation tests were performed on 77 healthy men, 18-40 years (reference group) at a specialized andrology referral center at a university hospital. The potential influence of the tests was illustrated by results from 45 patients suspected of disordered hypothalamic-pituitary-gonadal axis.METHODS: Baseline, stimulated, relative and absolute changes in serum FSH and LH were determined by ultrasensitive TRIFMA, and testosterone was determined by LC-MS/MS.RESULTS: For the reference group, LH and FSH increased almost 400% and 40% during GnRH testing, stimulated levels varied from 4.4 to 58.8 U/L and 0.2 to 11.8 U/L and FSH decreased in nine men. Testosterone increased approximately 110% (range: 18.7-67.6 nmol/L) during hCG testing. None of the polymorphisms had any major impact on the test results. Results from GnRH and hCG tests in patients compared with the reference group showed that the stimulated level and absolute increase in LH showed superior identification of patients compared with the relative increase, and the absolute change in testosterone was superior in identifying men with Leydig cell insufficiency, compared with the relative increase.CONCLUSIONS: We provide novel reference ranges for GnRH and hCG test in healthy men, which allows future diagnostic evaluation of hypothalamic-pituitary-gonadal disorders in men.
KW - Adolescent
KW - Adult
KW - Chorionic Gonadotropin/blood
KW - Female
KW - Follicle Stimulating Hormone/blood
KW - Genotype
KW - Gonadotropin-Releasing Hormone/blood
KW - Humans
KW - Hypothalamo-Hypophyseal System/drug effects
KW - Luteinizing Hormone/blood
KW - Male
KW - Orchiectomy
KW - Pituitary Diseases/blood
KW - Pituitary Function Tests/methods
KW - Reference Standards
KW - Retrospective Studies
KW - Semen/chemistry
KW - Testosterone/blood
KW - Young Adult
U2 - 10.1530/eje-16-0912
DO - 10.1530/eje-16-0912
M3 - Journal article
C2 - 28077499
SN - 0804-4635
VL - 176
SP - 379
EP - 391
JO - European Journal of Endocrinology. Supplement
JF - European Journal of Endocrinology. Supplement
IS - 4
ER -
