Skip to main content
SpringerLink
Log in

Hypothalamic amenorrhea and cardiovascular hormones: Changes of plasma calcitonin gene-related peptide and atrial natriuretic peptide levels

  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

Typical modifications of cardiovascular activity and water and salt homeostasis throughout female reproductive life are well known. Differences in plasma levels of calcitonin gene-related peptide (CGRP) and atrial natriuretic peptide (ANP) have been observed in conditions characterized by different estrogenic levels, suggesting a correlation between female reproductive function and these cardiovascular hormones. The aim of our study was to investigate in hypothalamic amenorrhea the relationship between estrogen deficiency and plasma ANP and CGRP response to adaptive tests (saline infusion test and upright posture test, respectively). Women with hypothalamic amenorrhea (aged 18–28 years) (n=6) and age-matched healthy controls (n=6) underwent both functional tests. Plasma CGRP and ANP levels were measured by specific radioimmunoassays before and in course of the tests. Basal plasma CGRP levels of amenorrheic patients did not significantly differ from those of normal women, while basal plasma ANP levels were significantly higher compared to controls (p<0.01). In amenorrheic women, plasma CGRP levels showed a significant increase in response to upright posture test, though lower than the increase observed in normal women. In contrast, saline infusion test determined a significant increase in plasma ANP levels only in control subjects. In women with hypothalamic amenorrhea, the altered response of CGRP and ANP to adaptive stimuli indicates a partial derangement in the control of the secretion of these cardiovascular hormones. Nevertheless, the differences between such modifications and those observed in other conditions of altered estrogenic levels, suggest that in amenorrheic women hypogonadism is not the major factor influencing CGRP and ANP response to adaptive stimuli.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Longo L. Maternal blood volume and cardiac output during pregnancy: a hypothesis of endocrinological control. Am. J. Physiol. 245: R720, 1983.

    PubMed  CAS  Google Scholar 

  2. Valenzuela G., Brace R., Longo L. Lymphatic and vascular response to fluid infusion in castrated and non-castatred sheep. Am J. Physiol. 252: R1114, 1997.

    Google Scholar 

  3. De Bold A., Borestein H., Veress A.T., Sonnenberg H. A rapid and potent natriuretic response to intravenous injection of atrial myocardial extracts in rats. Life Sci 28: 89, 1981.

    Article  PubMed  Google Scholar 

  4. Oshima T., Currie M., Geller D., Needleman P. An atrial peptide is a potent renal vasodilator substance. Circ. Res. 154: 612, 1984.

    Article  Google Scholar 

  5. Nicholls M., Richards A. Human studies with atrial natriuretic factor. Endocrin. Metab. Clin. North Am. 16: 19, 1987.

    Google Scholar 

  6. Ruskoaho H. Atrial natriuretic peptide: synthesis, release and metabolism. Pharmacol. Rev. 44: 479, 1992.

    PubMed  CAS  Google Scholar 

  7. Espiner E. Physiology of natriuretic peptide. J Int. Med. 235: 527, 1994.

    Article  CAS  Google Scholar 

  8. Kimura T., Abe K., Ota K., Omata K., Shoji M., Kudo K., Matsui K., Inoue M., Yasujima M., Yoshinaga K. Effects of acute water load, hypertonic saline infusion, and furosemide administration on atrial natriuretic peptide and vasopressin release in humans. J. Clin. Endocrinol. Metab. 62: 1003, 1986.

    Article  PubMed  CAS  Google Scholar 

  9. Clark B., Elahi D., Epstein F. The influence of gender, age and menstrual cycle on plasma atrial natriuretic peptide. J. Clin. Endocrinol. Metab. 70: 349, 1990.

    Article  PubMed  CAS  Google Scholar 

  10. Otzuki Y., Okamoto E., Iwata I., Nishino E., Mitsuda N., Mori M., Tagaki T., Sugita N., Tanizawa O. Changes in concentration of human atrial natriuretic peptide in normal pregnancy and toxaemia. J. Endocrinol. 114: 325, 1987.

    Article  Google Scholar 

  11. Merkouris R.W., Miller F.C., Catanzarite V., Rigg L.A., Quirk J.G., Vesely D.L. Increase in the plasma levels of the N-terminal and C-terminal portions of the prohormone of atrial natriuretic factor during normal pregnancy. Am J. Obstet. Gynecol. 162: 859, 1990.

    Article  PubMed  CAS  Google Scholar 

  12. Yoshimura T., Yoshimura M., Yasue H. Plasma concentration of atrial natriuretic peptide during normal pregnancy and the postpartum period. J. Endocrinol. 140: 393, 1994.

    Article  PubMed  CAS  Google Scholar 

  13. Tshopp F., Henke H., Peterman J. Calcitonin gene-related peptide and its binding sites in the human central nervous system and pituitary. Proc. Natl. Acad. Sci. USA 82: 248, 1997.

    Article  Google Scholar 

  14. Mulderry P., Ghatei M., Rodrigo K., Allen J.M., Rosenfeld M.G., Polak J.M., Bloom S.A. Calcitonin gene-related peptide in cardiovascular tissue of the rat. Neuroscience 14: 947, 1985.

    Article  PubMed  CAS  Google Scholar 

  15. Trasforini G., Margutti A., Vergnani L., Ambrosio M., Valentini A., Rossi R., Portaluppi F. Evidence that enhancement of cholinergic tone increases basal plasma levels of calcitonin gene-related peptide in normal man. J. Clin. Endocrinol. Metab. 78: 763, 1994.

    PubMed  CAS  Google Scholar 

  16. Trasforini G., Margutti A., Valentini A., Rossi R., Degli Uberti E.C. Interrelationship between calcitonin gene-related peptide and sympathoadrenomedullary system: effects of administration of epinephrine and norepinephrine in healthy men. Regul. Pept. 63: 56, 1996.

    Article  Google Scholar 

  17. Portaluppi F., Vergnani, I., Margutti A., Ambrosio M.R., Bondanelli M., Trasforini G., Rossi R., Degli Liberti E.C. Modulatory effect of the renin-angiotensin system on the plasma levels of calcitonin gene-related peptide in normal man. J. Clin. Endocrinol. Metab., 177: 816, 1993.

    Google Scholar 

  18. Girgis S., MacDonald D., Stevenson J., Bevis P.J., Lynch C., Wimalawansa S.J., Self C.H., Morris H.R., MacIntyre I. Calcitonin gene-related peptide: a potent vasodilator and major product of calcitonin gene. Lancet 2: 14, 1985.

    Article  PubMed  CAS  Google Scholar 

  19. Vesely M., Overton R.M., McCormick M.T., Schocken D.D. Atrial natriuretic peptide increase calcitonin gene-related peptide within human circulation. Metabolism 46: 818, 1997.

    Article  PubMed  CAS  Google Scholar 

  20. Valentini A., Petraglia F., De Vita D., Nappi C., Margutti A., Degli Liberti E. C., Genazzani A.R. Changes in plasma calcitonin gene-related peptide in postmenopausal women. Am. Obstet. Gynecol. 175: 638, 1996.

    Article  CAS  Google Scholar 

  21. Baranowska B., Wasilewska-Dziubinska E., Raditzikowska M., Plonowski A., Roguski K. Impaired response of atrial natriuretic peptide to acute water load in obesity and in anorexia nervosa. Eur. J. Endocrinol. 132: 147, 1995.

    Article  PubMed  CAS  Google Scholar 

  22. Brewerton T. Toward a unified theory of serotonin dysregulation in eating and related disorders. Psychoneuroendocrinology 20: 561, 1995.

    Article  PubMed  CAS  Google Scholar 

  23. Leibowitz S. Neurochemical-neuroendocrine systems in the brain controlling macronutrient intake and metabolism. Trends Neurosci. 15: 491, 1992.

    Article  PubMed  CAS  Google Scholar 

  24. Genazzani A.D., Gastaldi M., Volpe M., Petraglia F., Genazzani A.R. Spontaneous episodic release of adenohypophyseal hormones in hypothalamic amenorrhea. Gynecol. Endocrinol. 9: 325, 1995.

    Article  PubMed  CAS  Google Scholar 

  25. Yen S.S. Female hypogonadotropic hypogonadism. Hypothalamic amenorrhea syndrome. Endocrinol. Metab. Clin. North Am. 22: 29, 1997.

    Google Scholar 

  26. Golden N., Shenker J. Amenorrhea in anorexia nervosa: neuroendocrine control of hypothalamic disfunction. Intern. J. Eating. Dis. 16: 53, 1994.

    Article  CAS  Google Scholar 

  27. Nappi R., Petraglia F., Genazzani A., D’Ambrogio G., Zara C., Genazzani A.R. Hypothalamic amenorrhea: evidence for a central derangement of hypothalamic-pituitary-adrenal cortex axis activity. Fertil. Steril. 59: 57, 1993.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dipartimento di Ostetricia e Ginecologia, University of Pisa, Pisa, Italy

    F. Bernardi & A. R. Genazzani

  2. Dipartimento di Medicina Interna, University of Ferrara, Ferrara, Italy

    A. Valentini, A. Margutti & E. C. Degli Uberti

  3. Dipartimento di Scienze Cliniche, Cattedra di Ostetricia e Ginecologia, University of Udine, Pz. S. Maria della Misericordia, 33100, Udine, Italy

    M. Santuz & F. Petraglia M.D.

Authors
  1. F. Bernardi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Valentini
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Margutti
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Santuz
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. E. C. Degli Uberti
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. F. Petraglia M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. A. R. Genazzani
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bernardi, F., Valentini, A., Margutti, A. et al. Hypothalamic amenorrhea and cardiovascular hormones: Changes of plasma calcitonin gene-related peptide and atrial natriuretic peptide levels. J Endocrinol Invest 21, 251–256 (1998). https://doi.org/10.1007/BF03347311

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03347311

Key-words

Search

Navigation