Possible altered dopaminergic modulation of pituitary function in normal-menstruating women with insulin dependent diabetes mellitus (IDDM)

Djursing, Henning; Carstensen, Lisbeth; Hagen, Claus; Andersen, Anders Nyboe

doi:10.1530/acta.0.1070450

Cited by 25 publications

(9 citation statements)

References 17 publications

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“…The diabetic group had slightly but significantly lower serum PRL levels than the normal postmenopausal women, a finding consistent with recent investigations of premenopausal insulin-treated diabetic women, in whom we have demonstrated decreased basal serum PRL levels with evidence of reduced pituitary PRL secretory capacity, possibly caused by altered central dopaminergic activity (33).…”

Section: Discussionsupporting

confidence: 91%

Androgens and Estrogens in Postmenopausal Insulin-Treated Diabetic Women

Nyholm

Djursing

Hagen

et al. 1989

The Journal of Clinical Endocrinology & Metabolism

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Diabetic women may have an increased risk of developing endometrial carcinoma. Ovarian and adrenal activity seem to be factors in the genesis of this cancer. We have measured serum sex hormone-binding globulin (SHBG), free and bound fractions of estrogens and androgens, and gonadotropins in 20 consecutive postmenopausal insulin-treated diabetic women and 16 normal postmenopausal women. The diabetics were nonketoacidotic, without nephropathy and without proliferative retinopathy. The groups were comparable regarding age and percent ideal body weight. The diabetic group had significantly increased serum levels of estrone (P less than 0.001), estrone sulfate (P less than 0.05), 17 beta-estradiol (P less than 0.02), and SHBG (P less than 0.001). Levels of testosterone, delta 4-androstenedione, and dehydroepiandrosterone sulfate tended to be higher (not significantly) in the diabetics. FSH and LH levels were similar in the two groups, while serum PRL was significantly lower in the diabetic group (P less than 0.02). The hormonal changes in the diabetics were not related to control of the diabetes. We conclude that total estrogen levels are increased in postmenopausal women with insulin-treated diabetes mellitus. High SHBG levels in these patients tend to keep the free fractions of sex hormones within normal limits.

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Section: Discussionsupporting

confidence: 91%

Androgens and Estrogens in Postmenopausal Insulin-Treated Diabetic Women

Nyholm

Djursing

Hagen

et al. 1989

The Journal of Clinical Endocrinology & Metabolism

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“…In the light of this theory, our results indicated a progressive reduction in the dopaminergic tone in the control of TSH and PRL secretion in patients with IDDM. This explanation was in striking contrast with the well-known increase of dopaminer gic activity in diabetic patients [18,23,28]. To confirm a reduced dopaminergic tone in diabetics, dopamine infusion was expected to reduce basal TSH and PRL levels more in diabetics than in normal subjects.…”

Section: Discussionmentioning

confidence: 92%

“…33, 41, 42], IDDM seems to alter TSH and PRL secre tion simultaneously in euthyroid subjects; modifications of these hormones have been studied as an associated phenomenon and an altered dopaminergic control of pituitary function has been proposed as the likely cause of their disorder [18]. TSH and PRL responses to metoclopramide, an antidopaminergic agent, have been tested to prove this hypothesis [ 18], However, because of its interactions with other ncurotransmitters such as serotonin [20,21,26,34] or acetyl choline [3,12,19,25,26,43], mctoclopramide does not seem to be just an antagonist of dopamine. Furthermore, data in the litera ture describing TSH and PRL alterations in IDDM are scant and often contradictory, since decreased [9,18], increased [1,22] or unchanged [6,10,13,15,24,30,32,33,38,40,42] circulating levels of these hormones have been reported.…”

Section: Introductionmentioning

confidence: 99%

TSH and PRL Responses to Domperidone and TRH in Men with Insulin-Dependent Diabetes Mellitus of Different Duration

Coiro¹,

Butturini²,

Gnudi

et al. 1987

Horm Res

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The effect of domperidone, a specific blocker of dopamine receptors, on serum TSH and PRL levels was evaluated in 16 euthyroid men affected by insulin-dependent diabetes mellitus (IDDM) of different duration and in 7 age-matched normal controls. Diabetics were divided into 2 groups of 8 men according to the duration of their disease (group I: 1-9 years; group II: 11-18 years). Both groups had normal basal levels of TSH and PRL. Responses of these hormones to domperidone were similar in normal controls and in group I diabetics, whereas they were significantly reduced in patients of group II. When all 16 diabetics were studied together, a significant negative correlation was found between mean maximal peaks of TSH and PRL responses to domperidone and duration of diabetes. In order to evaluate whether the reduced effect of domperidone in diabetics was due to alterations of the dopaminergic control of TSH and PRL secretion, the domperidone test was repeated in 6 normal controls and in 6 diabetics of group II after infusion of dopamine (4 µg/kg/min for 2 h). Dopamine infusion induced parallel decreases in TSH and PRL concentrations, without modifying hormonal secretory patterns in response to domperidone. These data suggested that the reduced TSH and PRL responses to domperidone in diabetics were not due to alterations of the dopaminergic control of pituitary function but to a defect at the pituitary level. To test this hypothesis, TSH and PRL responses to TRH were evaluated in group I and group II diabetics and in normal controls. Results showed reduced TSH and PRL responses in diabetics of group II, but not in those of group I; when all 16 diabetics were studied together, a significant negative correlation was found between maximal peaks of TSH and PRL responses to TRH and duration of diabetes. These data indicate that the acute releasing pools of both TSH and PRL are reduced with time after the onset of IDDM.

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“…previous published data (6), and suggests that the menstrual dysfunction present in poorly controlled LDDM patients may reflect disturbances of the GnRH pulse generator rather than abnormalities in pituitary or ovarian function. An enhanced dopaminergic tone, present especially in poorly controlled diabetic women, has been proposed as a contributing factor in the GnRHaltered control (4,21,22).…”

Section: Discusssionmentioning

confidence: 99%