Down Syndrome Abstract
of the Month: Feb 2000
Gonadal function in young women with Down syndrome
Angelopoulou N; Souftas V; Sakadamis A; Matziari C; Papameletiou V
Int J Gynaecol Obstet 1999 Oct;67(1):15-21
Department of Physical Education and Sports Science, Aristotle University of Thessaloniki, Greece.
Abstract:
OBJECTIVE: Investigations suggest an increased incidence of gonadal dysfunction in patients with Down syndrome. New features, Alzheimer disease and osteoporosis emerge in these individuals. Therefore, hormonal investigation in persons with Down syndrome is pursued.METHODS: Thirteen females with trisomy 21 (23.65 +/- 3.23 years old) participated in the study. Ultrasound studies were performed to explore the internal genitals. Blood samples were taken for the determination of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), prolactin (PRL), dehydroepiandrosterone sulfate (DHEA- S), testosterone (T) and 17-hydroxyprogesterone (17-OHP).
RESULTS: The patients were at stage V of sexual development. Ultrasonography demonstrated normal uterine and ovarian size and endometrial thickness as well. The ovaries of all patients contained follicles of normal distribution and various sizes. The mean concentrations of FSH, DHEA-S and E2 were normal. The level of PRL was significantly higher than that of the controls, but within the normal lab range. The levels of LH, T and 17-OHP were significantly elevated, compared to those of the control group.
CONCLUSIONS: Our data produce new information on the gonadal function of Down syndrome women. Specific studies on pituitary-gonadal and pituitary-adrenal axis function are needed.
My comments: "Stage V" of sexual development (that's the Roman Numeral V, not the letter) means the women were fully adult in both primary and secondary sexual characteristics. The average age of menarche was 12.2 years. The researchers found everything to be normal except for the hormone levels of lutenizing hormone, testosterone (T) and 17-hydroxyprogesterone. Lutenizing hormone is made in the pituitary, testosterone in females is made in the adrenal glands, as is the hormone 17-OHP.
The bottom line: previously, many researchers have argued that ovarian dysfunction is common in Down syndrome. This report seems to implicate the entire connection between the ovaries, pituitary and adrenal glands instead.