Serum leptin levels in males with delayed puberty during short-term pulsatile GnRH administration

Leptin may be a possible trigger for puberty. In normal males, it has been shown that leptin increases from the pre-pubertal to the early pubertal sta ge, and then declines in the late pubertal stage. We examined leptin levels in six male adolescents (mean age 16.3+/-0.6 yr; range 14.2-17.6 yr) with delayed puberty (constitutional delay of puberty no.=2; idiopathic hypogona dotropic hypogonadism no.=4) during 120 days of subcutaneous pulsatile GnRH administration. A group of subjects in pre-puberty (no.=11), early-puberty (n=10) and mid-puberty (no.=7) were evaluated as controls. Morning blood s amples were taken for determination of leptin, testosterone, LH and FSH lev els. In delayed puberty subjects blood samples were taken every 30 days aft er the start of GnRH administration. At each examination BMI and testicular volume were evaluated. A followup examination was performed in the 6 patie nts 1.3-7.5 yr after the end of the 120 days of GnRH therapy. At baseline e valuation in delayed puberty mean leptin levels were 11.3+/-2.0 mu g/l (med ian 11.3 mu g/l; range 4.7-17.3 mu g/l) and were higher than those found in pre-puberty (p=0.04) and mid-puberty (p=0.001). During GnRH administration there was no change in BMI and leptin levels but there was an increase in gonadotrophin levels, testosterone and testicular volume. One hundred and t wenty days after, mean serum leptin were 10.1+2.1 mu g/l (median 9.1 mu g/l ; range 3.4-16.8 mu g/l). At the end of the study, leptin levels were highe r in delayed puberty than in mid-puberty (p=0.002). At the follow-up examin ation leptin levels were 4.3+/-1.3 mu g/l (median 3.4 mu g/l; range 1.4-9.1 mu g/l) (p=0.03 vs end of 120 days GnRH therapy) while testosterone and BM I were not changed. In conclusion 120-day pulsatile GnRH administration ind uced in males with delayed puberty physiological-like pubertal changes but not the decline in leptin levels reported during the progression of puberty . Therefore, in males with delayed puberty an impairment in the phenomenon of leptin decline associated with progression of puberty could be suggested . However after retrospective diagnosis of pubertal delay and long-term the rapy in subjects with idiopathic hypogonadotropic hypogonadism leptin revel s declined. These data seem to indicate that time more than increase in tes tosterone levels and testicular volume is the determinant of leptin decline at puberty. (J. Endocrinol. Invest. 22: 6-11, 1999) (C)1999, Editrice Kurt is.