ECEESPE2025 ePoster Presentations Reproductive and Developmental Endocrinology (128 abstracts)
Circulating gut hormone concentrations in women presenting with menstrual disturbance
Bijal Patel 1 , Arthur Yeung 1 , Maria Phylactou 1 , Jovanna Tsoutsouki 1 , Kanyada Koysombat 1 , Megan Young 1 , Sandhi Nyunt 1 , Aaran Patel 1 , Aureliane Pierret 1 , Elisabeth Daniels 1 , Ambreen Qayum 1 , Agata Zielinska 1 , Yusra Omar 1 , Pei Eng 1 , Edouard G Mills 1 , Simon Hanassab 1 , Channa Jayasena 1 , Tricia Tan 1 , Anna Kowalka 1 , Sophie Clarke 1 , Alexander Comninos 1 , Ali Abbara 1 & Waljit Dhillo 1
1Imperial College London, London, United Kingdom
JOINT3375
Background: Polycystic Ovary Syndrome (PCOS) and Functional Hypothalamic Amenorrhoea (FHA) are the commonest causes of secondary amenorrhoea. PCOS is typically associated with increased bodyweight, appetite, insulin resistance, and metabolic dysfunction, whereas FHA is typically associated with lower body weight and decreased energy availability. Importantly, there are only limited inconsistent data describing gut hormone levels in these conditions and no direct comparisons. Ghrelin is reported to be reduced in PCOS and increased in FHA. Additionally, administration of ghrelin decreases LH pulsatility in healthy women, consistent with a possible causal role in FHA. GLP-1 is reported to be reduced or unchanged in PCOS. PYY3-36 is reported to be increased in FHA, and reduced or unchanged in PCOS. PYY1-36 is converted to the more active isoform PYY3-36 by the enzyme Dipeptidyl peptidase-4 (DPP4). Here, we provide the first direct comparison of levels of gut hormones in women with metabolically divergent causes of menstrual disturbance.
Methods: Fasting total ghrelin, total glucagon like peptide-1 (GLP-1), and peptide YY isoforms (PYY1-36, PYY3-36) were measured in women aged 18-35 years in the follicular phase who were healthy (n = 47), had PCOS (n = 73), or FHA (n = 44). Ghrelin (Merck Millipore) and GLP-1 (Mercodia) were measured by ELISA, whereas PYY1-36 and PYY3-36 by in-house LC-MS/MS (Acquity UPLC with TQ-S). Groups were compared by the Kruskal-Wallis Test with post hoc Dunn’s test.
Results: Mean (±SD) ghrelin levels were lower in PCOS (1004 ±572 pg/ml) than healthy women (1316 ±616; P = 0.0043), or in FHA (1369 ±570; P = 0.0012). However, this was predominantly due to higher BMI in PCOS, and levels did not differ in those with lean PCOS (BMI <25 kg/m2; P = 0.39). In PCOS, ghrelin was negatively correlated with the Ferriman-Gallwey score (r=-0.30, P = 0.015) and Free Androgen Index (FAI) (r=-0.6531, P <0.0001). PYY1-36 (pmol/l)was reduced in FHA (0.31 ±0.5) compared to PCOS (0.75 ±0.74; P = 0.0001), and even to those with lean PCOS (0.69 ±0.74; P = 0.0068). Neither ghrelin nor PYY1-36 correlated with other reproductive hormones. No changes were observed in PYY1-36 or GLP-1 between the groups.
Conclusion: This is the first study to directly compare gut hormone levels in patients presenting with menstrual disturbance due to PCOS or FHA. Ghrelin levels were lower in women with PCOS (albeit mainly due to bodyweight). However, PYY1-36 levels were higher in PCOS than FHA independent of bodyweight. Taken together, these data inform our understanding of the intricate coupling between reproductive function and metabolism in common reproductive disorders.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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