J Clin Endocrinol Metab 43: 1418, 1976
HUMAN PUBERTY:
24-HOUR ESTRADIOL PATTERNS IN PUBERTAL GIRLS
R.M. Boyar? R.H.K. Wu, H. Roffwarg, S. Kapen, E.D. Weitzman, L. Hellman and J.W. Finkelstein, Departments of Oncology, Psychiatry and Neurology, Montefiore Hospital and Medical Center, Bronx, New York 10467. ABSTRACT: Plasma luteinizing hormone, follicle-stimulating hormone, and estradiol were measured at 20-minute intervals for 24-hours in seven pubertal premenarchal girls whose sleep was monitored polygraphically. A circadian variation in plasma estradiol was demonstrated with the highest values occurring during the day (1400-1600 hours) and lowest values during sleep, a time when gonadotropin secretion was augmented. The onset of human puberty can avoid inter-assay variability. The be identified precisely by measuring 24-hour mean estradiol levels were plasma LH and FSH during sleep (1-3). calculated by averaging the indiviThis initial CNS phase of puberty dual 72 determinations. The mean occurs in late prepubertal children sleep and equivalent waking values prior to the onset of clinical puwere calculated by averaging the berty and is responsible for stimusamples that fell within these reslating the Leydig cell to synthesize pective periods. Student's t test and secrete testosterone in pubertal was used to assess the statistical boys (4-6). The present study was significance between the mean E2 undertaken to determine the relationasleep compared to the mean E2 awake. ship between the augmented sleep Pubertal stage was assigned accordassociated LH and FSH secretory epiing to the criteria of Tanner (12). sodes in pubertal girls and estradiol Results secretion. The results of this study show that estradiol secretion The 24-hour mean E2 levels in does not rise simultaneously with these subjects varied from 66.6 to gonadotropin secretion during sleep, 160.6 pg/ml (mean 100 pg/ml). The but instead reaches a maximum in the age, pubertal stage and estradiol midafternoon (1400-1600 hours) at a levels during sleep, waking and the time when gonadotropin secretion complete 24-hour period are shown in is minimal. Table 1. All seven subjects had significantly higher mean E2 levels Materials and Methods during waking compared with sleep. Seven pre-menarchal pubertal Each of the subjects showed 24girls, ages 9 6 to 164, were admitted hour LH, FSH and estradiol patterns to the sleep laboratory of Montefiore that were similar to subject 5 Hospital and Medical Center, Bronx, (Fig.l). For this subject, the New York for a 24-hour, 20-minute interval plasma sampling study. The technique for plasma sampling and polygraphic monitoring has been published in detail (7). Sleep stages were scored according to standardized criteria (8). All seven subjects showed augmented gonadotropin secretion during sleep. The subjects were allowed to sleep from 1100 to 0700 hours. Informed consent was obtained from the parents. Plasma LH (9), FSH (10) and estradiol (11) were measured by radioimmunoassay. The samples from each subject's 24-hour study were assayed in the same run to ITOO
Submitted September 1, 1976.
2100
OKX>
CLOCK TIME Fig.l. LH, FSH and E2 secretory patterns in Subject 5.
1418 The Endocrine Society. Downloaded from press.endocrine.org by [${individualUser.displayName}] on 20 May 2015. at 23:42 For personal use only. No other uses without permission. . All rights reserved.
1419
RAPID COMMUNICATIONS Table 1. Subject
1 2 3 4 5 6 7
Twenty-four Hour Mean (SD) and Sleep-Wake E2 Levels (pg/ml) in Pubertal Girls. Pubertal 24-Hour Mean E2 Sleep E2 Waking E2 Age Stage 96 14.9 93 ± 24.6 48* ± 67.6 ± 27.3 P2 102 6 3.8*± 11.5 107 ±18.5 85.5 ± 24.5 P2 66.6 ± 26.2 15.7 47* ± 90 ± 18 104 ?2 127 135* ± 20.9 187 ± 25.9 160.6 ± 36.3 P4 137 148
84.9 ±25.3 102 ±24.7
p
3 P3
64* ± 14.3
112 ± 23.3
88* ± 18.9 120 ± 22.9 132 ± 27 20.9 118* ± 143 ± 29.8 P4 *Mean estradiol level during sleep significantly lower than mean estradiol during equivalent waking period 12 hours shifted (P
HUMAN PUBERTY:
24-HOUR ESTRADIOL PATTERNS IN PUBERTAL GIRLS
R.M. Boyar? R.H.K. Wu, H. Roffwarg, S. Kapen, E.D. Weitzman, L. Hellman and J.W. Finkelstein, Departments of Oncology, Psychiatry and Neurology, Montefiore Hospital and Medical Center, Bronx, New York 10467. ABSTRACT: Plasma luteinizing hormone, follicle-stimulating hormone, and estradiol were measured at 20-minute intervals for 24-hours in seven pubertal premenarchal girls whose sleep was monitored polygraphically. A circadian variation in plasma estradiol was demonstrated with the highest values occurring during the day (1400-1600 hours) and lowest values during sleep, a time when gonadotropin secretion was augmented. The onset of human puberty can avoid inter-assay variability. The be identified precisely by measuring 24-hour mean estradiol levels were plasma LH and FSH during sleep (1-3). calculated by averaging the indiviThis initial CNS phase of puberty dual 72 determinations. The mean occurs in late prepubertal children sleep and equivalent waking values prior to the onset of clinical puwere calculated by averaging the berty and is responsible for stimusamples that fell within these reslating the Leydig cell to synthesize pective periods. Student's t test and secrete testosterone in pubertal was used to assess the statistical boys (4-6). The present study was significance between the mean E2 undertaken to determine the relationasleep compared to the mean E2 awake. ship between the augmented sleep Pubertal stage was assigned accordassociated LH and FSH secretory epiing to the criteria of Tanner (12). sodes in pubertal girls and estradiol Results secretion. The results of this study show that estradiol secretion The 24-hour mean E2 levels in does not rise simultaneously with these subjects varied from 66.6 to gonadotropin secretion during sleep, 160.6 pg/ml (mean 100 pg/ml). The but instead reaches a maximum in the age, pubertal stage and estradiol midafternoon (1400-1600 hours) at a levels during sleep, waking and the time when gonadotropin secretion complete 24-hour period are shown in is minimal. Table 1. All seven subjects had significantly higher mean E2 levels Materials and Methods during waking compared with sleep. Seven pre-menarchal pubertal Each of the subjects showed 24girls, ages 9 6 to 164, were admitted hour LH, FSH and estradiol patterns to the sleep laboratory of Montefiore that were similar to subject 5 Hospital and Medical Center, Bronx, (Fig.l). For this subject, the New York for a 24-hour, 20-minute interval plasma sampling study. The technique for plasma sampling and polygraphic monitoring has been published in detail (7). Sleep stages were scored according to standardized criteria (8). All seven subjects showed augmented gonadotropin secretion during sleep. The subjects were allowed to sleep from 1100 to 0700 hours. Informed consent was obtained from the parents. Plasma LH (9), FSH (10) and estradiol (11) were measured by radioimmunoassay. The samples from each subject's 24-hour study were assayed in the same run to ITOO
Submitted September 1, 1976.
2100
OKX>
CLOCK TIME Fig.l. LH, FSH and E2 secretory patterns in Subject 5.
1418 The Endocrine Society. Downloaded from press.endocrine.org by [${individualUser.displayName}] on 20 May 2015. at 23:42 For personal use only. No other uses without permission. . All rights reserved.
1419
RAPID COMMUNICATIONS Table 1. Subject
1 2 3 4 5 6 7
Twenty-four Hour Mean (SD) and Sleep-Wake E2 Levels (pg/ml) in Pubertal Girls. Pubertal 24-Hour Mean E2 Sleep E2 Waking E2 Age Stage 96 14.9 93 ± 24.6 48* ± 67.6 ± 27.3 P2 102 6 3.8*± 11.5 107 ±18.5 85.5 ± 24.5 P2 66.6 ± 26.2 15.7 47* ± 90 ± 18 104 ?2 127 135* ± 20.9 187 ± 25.9 160.6 ± 36.3 P4 137 148
84.9 ±25.3 102 ±24.7
p
3 P3
64* ± 14.3
112 ± 23.3
88* ± 18.9 120 ± 22.9 132 ± 27 20.9 118* ± 143 ± 29.8 P4 *Mean estradiol level during sleep significantly lower than mean estradiol during equivalent waking period 12 hours shifted (P
