This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Although the association between obesity and reproductive disturbances has been described in medical literature, the prevalence of menstual irregularities in the morbidly obese female population has not been firmly established. Additionally, hormonal factors distinguishing obese women with menstual abnormalities from obese women who ovulate regularly are unknown. Recently, leptin has been found to play a role in inducing the onset of puberty and regulating the hypothalmic-pituitary-gonadal axis (HPG axis). Preliminary animal studies also suggest that ghrelin regulates LH secretion. A complicated interaction may exist between leptin, ghrelin, insulin, and the HPG axis. In obesity, levels of leptin and insulin are high and ghrelin levels are low. It is hypothesized that obesity can cause reproductive disturbances through the inhibitory effect of high leptin levels primarily on the hypothalamus, and through the interaction of leptin, ghrelin, and insulin. In this pilot study, the interplay between women, will be studied during surgery-induced weight loss. It is hypothesized that those morbidly obese women with menstrual dysfunction have higher levels of leptin, lower levels of ghrelin, and higher levels of insulin than obese women who cycle normally.
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