PDF(Pubmed)
Abstract：
BACKGROUND: In functional hypothalamic amenorrhea (FHA), luteinizing hormone and follicle-stimulating hormone levels show high interindividual variability, which significantly limits their diagnostic value in differentiating FHA from polycystic ovary syndrome (PCOS). Our aim was to profile the LH:FSH ratio in a large sample of patients with well-defined FHA.
METHODS: This observational study included all consecutive patients with FHA presenting to the Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, between January 2017 and August 2023. The main parameters of interest were the LH level, the FSH level, and the LH:FSH ratio. In a subgroup analysis, we compared the LH:FSH ratio of patients with PCO morphology (PCOM) on ultrasound with that of patients without PCOM.
RESULTS: A total of 135 patients were included. Only a minority of patients revealed FSH and LH levels ≤ 2.0 mIU/mL (13% and 39%, respectively). Most patients (81.5%) had an LH:FSH ratio ≤ 1.0, while a minority (2.2%) had a ratio ≥ 2.1. The LH:FSH ratio was similar in patients with and without PCOM.
CONCLUSIONS: In a well-defined FHA sample, the LH:FSH ratio was ≤ 1 in most patients. The LH:FSH ratio may prove useful in distinguishing FHA from PCOS but needs further investigation.
METHODS: This observational study included all consecutive patients with FHA presenting to the Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, between January 2017 and August 2023. The main parameters of interest were the LH level, the FSH level, and the LH:FSH ratio. In a subgroup analysis, we compared the LH:FSH ratio of patients with PCO morphology (PCOM) on ultrasound with that of patients without PCOM.
RESULTS: A total of 135 patients were included. Only a minority of patients revealed FSH and LH levels ≤ 2.0 mIU/mL (13% and 39%, respectively). Most patients (81.5%) had an LH:FSH ratio ≤ 1.0, while a minority (2.2%) had a ratio ≥ 2.1. The LH:FSH ratio was similar in patients with and without PCOM.
CONCLUSIONS: In a well-defined FHA sample, the LH:FSH ratio was ≤ 1 in most patients. The LH:FSH ratio may prove useful in distinguishing FHA from PCOS but needs further investigation.
摘要：
背景：在功能性下丘脑闭经（FHA）中，促黄体生成素和促卵泡激素水平显示出高度的个体差异，这极大地限制了它们在区分FHA和多囊卵巢综合征（PCOS）方面的诊断价值。我们的目的是在大量明确的FHA患者样本中分析LH：FSH比率。
方法：这项观察性研究包括所有到妇科内分泌和生殖医学部就诊的FHA患者，维也纳医科大学,2017年1月至2023年8月。感兴趣的主要参数是LH水平，FSH水平,和LH:FSH比率。在亚组分析中，我们比较了有PCO形态（PCOM）的患者与没有PCOM的患者的LH：FSH比值。
结果：共纳入135例患者。只有少数患者显示FSH和LH水平≤2.0mIU/mL（13％和39％，分别)。大多数患者（81.5%）的LH：FSH比值≤1.0，而少数患者（2.2%）的比值≥2.1。有和没有PCOM的患者的LH：FSH比率相似。
结论：在明确定义的FHA样本中，大多数患者的LH:FSH比值≤1.LH：FSH比值可能有助于区分FHA和PCOS，但需要进一步研究。
方法：这项观察性研究包括所有到妇科内分泌和生殖医学部就诊的FHA患者，维也纳医科大学,2017年1月至2023年8月。感兴趣的主要参数是LH水平，FSH水平,和LH:FSH比率。在亚组分析中，我们比较了有PCO形态（PCOM）的患者与没有PCOM的患者的LH：FSH比值。
结果：共纳入135例患者。只有少数患者显示FSH和LH水平≤2.0mIU/mL（13％和39％，分别)。大多数患者（81.5%）的LH：FSH比值≤1.0，而少数患者（2.2%）的比值≥2.1。有和没有PCOM的患者的LH：FSH比率相似。
结论：在明确定义的FHA样本中，大多数患者的LH:FSH比值≤1.LH：FSH比值可能有助于区分FHA和PCOS，但需要进一步研究。
