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

VL - 176

SP - 379

EP - 391

JO - Acta Endocrinologica, Supplement

JF - Acta Endocrinologica, Supplement

SN - 0804-4635

IS - 4

ER -