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Biomedical subjects

D C Cumming

Publications and source records attributed to D C Cumming.

At least 55 records · Page 3Linked to original sources
PubMed1986

Are anorexic tendencies prevalent in the habitual runner?

To investigate whether runners displayed any of the abnormalities characteristic of patients with anorexia nervosa, we conducted a cross sectional study of 31 high mileage, 18 low mileage runners and 18 non-running controls. Subjects completed a personal data questionnaire, the Jackson Personality Inventory (JPI) and the Eating Attitudes Questionnaire (EAT), underwent a body image test and a blood sample was obtained for measurement of reproductive, thyroid and adrenal hormones. High mileage runners scored significantly higher infrequency scores on the JPI than sedentary controls but there was no evidence of psychopathology. The high mileage runners also significantly overestimated waist width and there were small but statistically significant differences in EAT scores between controls and the runner groups. Ten of 49 runners had EAT scores beyond two standard deviations above the mean of non-running controls. Serum total, free and non-specifically bound testosterone and prolactin levels were significantly lower in high mileage runners than controls. LH, FSH, cortisol and thyroid hormones were not significantly different. There were no significant differences in any hormone between low mileage runners and controls. displayed no clear abnormalities characteristic of patients with anorexia The results suggested that running may have a chronic effect on serum testosterone and prolactin levels in high mileage but not low mileage runners. Although there was no significant evidence of anorexia nervosa on testing the runners with EAT, the overestimation of waist size provided some evidence of a distortion of body image in the high mileage runners. Runners displayed no clear abnormalities characteristic of patients with anorexia nervosa.

Adolescent↗
PubMed1986

Reproductive hormone increases in response to acute exercise in men.

The increase in serum testosterone levels generally observed with intense, short-term exercise remains unexplained since most investigators have not reported any increase in the levels of luteinizing hormone, the pituitary glycoprotein most responsible for testicular steroidogenesis. Hemoconcentration and decreased metabolic clearance have been suggested as mechanisms to explain the exercise-associated testosterone increase. Such non-specific mechanisms should apply to other steroid hormones as well as to testosterone. To investigate whether the exercise-induced changes in other steroid hormones were similar to that of testosterone, we measured serum levels of testosterone, androstenedione, dehydroepiandrosterone, and cortisol as well as gonadotropins, luteinizing hormone and follicle-stimulating hormone, and prolactin at 5-15 min intervals throughout progressive maximal intensity exercise on a cycle ergometer. Significant increases were observed with all hormones with exercise. The increase in serum testosterone began prior to exercise, peaked at 20 min after the beginning of exercise, and fell to baseline within 10 min. The serum luteinizing hormone increase was synchronous with that of testosterone, suggesting that gonadotropin stimulation was not responsible for the testosterone increment. The increments in serum cortisol, androstenedione, dehydroepiandrosterone, and prolactin levels were simultaneous but began 25-30 min after that of testosterone in all subjects. These findings, therefore, suggest that, contrary to previous evidence, the exercise-associated increase in serum testosterone results predominantly from a specific mechanism, presumably involving increased testicular production without gonadotropin stimulation.

Adult↗
PubMed1985

The effect of acute exercise on pulsatile release of luteinizing hormone in women runners.

Endurance exercise has been associated with reproductive dysfunction. We have previously suggested that pulsatile release of luteinizing hormone is impaired at rest in normal menstruating runners compared with sedentary women. To determine whether acute exercise had any effect on pulsatile release of luteinizing hormone we investigated serum luteinizing hormone levels in six normal menstruating runners at rest and after 60 minutes of running exercise. Exercise induced an increment in circulating luteinizing hormone levels greater than the change in hematocrit. The luteinizing hormone pulse frequency, calculated as the number of luteinizing hormone pulses per 6 hours, was reduced after exercise compared with values obtained at rest. There was no significant difference in pulse amplitude or area under the 6-hour curve between resting and postexercise situations. These data suggest that acute exercise has an inhibitory effect on luteinizing hormone pulsatile release at the hypothalamic level in eumenorrheic runners that is in addition to the previously described effect of training.

Adult↗
PubMed1985

The late luteal phase in infertile women: comparison of simultaneous endometrial biopsy and progesterone levels.

Endometrial biopsy specimens were obtained from 107 normally menstruating infertile women 2 to 3 days before the anticipated onset of menses and were day-dated according to histologic criteria. A simultaneous blood sample was obtained for measurement of progesterone (P) and beta-subunit of human chorionic gonadotropin. Of 98 biopsies which could be accurately dated, 56 were in-phase (IP) and 42 were out-of-phase (OOP). Mean serum P levels were significantly lower in women with OOP biopsies undertaken more than 4 days before the onset of menses. A sharp decline in serum P levels was observed in women with IP but not OOP biopsies, so that on the final premenstrual day serum P levels were significantly higher than normal in women with OOP biopsies. Pregnancy continued without interruption in two of six patients who underwent biopsy in the cycle of conception. One patient had an ectopic pregnancy; and the three remaining pregnant patients, all with subnormal P values, aborted. The study suggests that there is a high frequency of minor abnormalities in luteal function in normally menstruating, infertile women for whom tubal and male factors were normal. The frequency of subclinical pregnancy (2 of 107) was lower than anticipated from earlier studies.

Adult↗
PubMed1985

Defects in pulsatile LH release in normally menstruating runners.

Intense physical exercise has been associated with reproductive dysfunction and menstrual cycles may be abnormal in a majority of women with a heavy training load. To determine whether training influenced pulsatile LH release, we measured LH pulse frequency, LH pulse amplitude and area under the curve over six hours during the early follicular phase of the menstrual cycle in four sedentary women and six eumenorrheic women runners with a training volume of at least 32 km per week. All three LH variables were significantly lower in runners than in controls. These data suggest that there is a central inhibition of the hypothalamic-pituitary-gonadal axis in eumenorrheic runners.

Adult↗
PubMed1985

Non-sex hormone-binding globulin-bound testosterone as a marker for hyperandrogenism.

Recent evidence suggests that the biologically active testosterone includes both the free and albumin-bound fractions, while the sex hormone-binding globulin (SHBG)-bound steroid dissociates less readily. To examine the significance of the non-SHBG-bound testosterone (i.e. free plus albumin bound) in hyperandrogenism, we obtained single blood samples from 17 normal women, 20 regularly menstruating but hirsute women, and 20 oligoamenorrheic hirsute women. Each serum sample was analyzed for total testosterone by RIA, SHBG-binding capacity was determined by protein precipitation with 50% saturated (NH4)2SO4, and albumin was measured by colorimetry. Non-SHBG-bound and free testosterone and the testosterone to SHBG molar ratio were then calculated. Non-SHBG-bound testosterone was also assayed using differential protein precipitation. There were significant differences among the groups in the mean values of all variables (all P less than 0.05) except albumin. Measurement and calculation of serum non-SHBG-bound testosterone produced similar results, suggesting that the binding equation is valid. There was considerable overlap between normal (control mean +/- 2 SD) and abnormal subjects in all variables except non-SHBG-bound testosterone, for which only 3 regularly menstruating and 2 oligoamenorrheic hirsute subjects were in the normal range. As total testosterone levels increased, there was a significant increase in the ratio of non-SHBG-bound testosterone to free testosterone. These data suggest that albumin becomes increasingly more important in testosterone binding as the total serum testosterone level increases and that non-SHBG-bound testosterone may be the optimal marker to identify hyperandrogenism in hirsute women.

Amenorrhea↗
PubMed1984

Reduced serum testosterone and prolactin levels in male distance runners.

To investigate whether endurance running in men produced basal hormonal changes similar to those reported in women, we obtained blood samples from 31 men running at least 64 km each week and 18 sedentary controls for measurement of levels of total testosterone, non-sex hormone-binding globulin-bound and free testosterone, luteinizing hormone, follicle-stimulating hormone, prolactin, and cortisol. The mean levels of total and nonspecifically bound testosterone as well as prolactin were significantly lower than in controls, although levels remained within the physiological range. Other hormone levels were similar in both groups. The lowered testosterone and prolactin levels parallel the changes reported in women runners.

Adolescent↗
PubMed1984

Lack of consistency in the indirect methods of estimating percent body fat.

Several studies have emphasized the relationship between body composition and the initiation and/or maintenance of cyclic ovarian function in women. A number of methods of indirectly calculating percent body fat have been used, but there is no clear evidence that the various calculations produce consistent results. We therefore compared five different ways of estimating the "percent body fat" in a total of 18 young women, including 6 normal control subjects who did not exercise, 6 regularly menstruating runners, and 6 amenorrheic runners. There was considerable individual variation in the estimates of body fat; and significant differences among groups were found by some, but not all, methods of calculation. It is suggested that because of the inconsistency of estimates, the use of the term "percent body fat" is misleading and that opposite conclusions may result from the use of different methods of calculating body fat in the same groups of individuals.

Adipose Tissue↗
PubMed1984

Evidence for decreased endogenous dopamine and opioid inhibitory influences on LH secretion in polycystic ovary syndrome.

The inhibitory role of the dopaminergic and opioidergic mechanisms in the control of LH secretion in patients with polycystic ovary syndrome (PCO) was evaluated. The administration of an opiate receptor antagonist, naloxone, of a dopamine receptor antagonist, metoclopramide, or of human synthetic beta h-endorphin, were unable to alter LH secretory activity in patients with PCO. Since identical doses of these antagonists and the opiate agonist have elicited respectively a rise and fall of LH levels in normal cycling women, these findings suggest that an underlying hypothalamic component of defect in endogenous dopamine and opioid control may be responsible for the inappropriate gonadotrophin secretion in this syndrome.

Depression, Chemical↗
PubMed1983

Acute suppression of circulating testosterone levels by cortisol in men.

The effect of acute activation of the ACTH-adrenal axis on circulating testosterone (T) levels was investigated. Elevation of circulating cortisol resulting from insulin-induced hypoglycemia or the administration of hydrocortisone was followed by a rapid decrease in serum T levels, without accompanying changes in LH or PRL. These findings suggest that hypercortisolism of endogenous or exogenous sources suppresses T secretion by a direct action on the testis. This adrenal-testicular axis may have biological implications on the reproductive adaptation to stress.

Adult↗
PubMed1983

Exercise and reproductive function in women.

Recent studies have documented that women engaged in strenuous exercise programs may develop reproductive defects, including delayed menarche, shortened luteal phase, and amenorrhea. The etiological bases for these abnormalities have not been determined, but physical, hormonal, nutritional, psychological, and environmental factors may be involved and may differ in importance in affected individuals. The consequences of the altered reproductive function associated with exertion will not be identified until prospective long-term investigations are conducted. In the absence of data to the contrary, however, we currently believe that exercise-associated defects in reproduction are not serious and may be reversed by changes in life-style.

Amenorrhea↗
PubMed1983

Probable amniotic fluid embolism after first-trimester pregnancy termination. A case report.

A patient collapsed immediately after dilatation and curettage for pregnancy termination. Disseminated intravascular coagulation supervened rapidly. Although the diagnosis of amniotic fluid embolism has remained unproven, it is the most likely explanation for the chain of events. We recommend rupture of the membranes prior to curettage or the administration of an oxytocic agent.

Abortion, Induced↗
PubMed1982

Treatment of hirsutism with spironolactone.

Clinical and endocrine evaluations of 39 patients with hirsutism were performed to determine the effectiveness and site(s) of action of an antiandrogenic compound, spironolactone. Treatment with spironolactone at a dose of 200 mg/day resulted in a clear beneficial effect on the quantity and quality of facial hair growth in 19 of 20 patients with moderate to severe hirsutism. Regression of hirsutism in terms of diameter, density, and the rate of facial hair growth was noticeable within two months. The maximal effect was observed at six months and was maintained at 12 months of treatment. Spironolactone was equally effective in reducing hirsutism in women with polycystic ovary syndrome and idiopathic hirsutism. These clinical observations were associated with a prompt and sustained reduction in levels of androgen of ovarian origin without affecting levels of adrenal androgen and cortisol. Apart from diuresis, which was limited to the first few days of treatment, there were no discernible side effects the one year of this study. Our results indicate that spironolactone is a highly effective and safe agent for the treatment of hirsutism through its inhibitory action on both ovarian androgen secretion and peripheral androgen action.

Amenorrhea↗
PubMed1982

Evidence for an influence of the ovary on circulating dehydroepiandrosterone sulfate levels.

Circulating dehydroepiandrosterone sulfate (DS) declines in old age, falling to almost undetectable levels after the seventh decade. Since an accelerated decrease occurs after the menopause, we sought to determine whether ovarian factors may influence adrenal DS secretion independent of chronological age. DS, cortisol, and estradiol levels were compared in subjects grouped according to age, ovarian function, and estrogen replacement. Our data show that premature ovarian failure and ovariectomy in young as well as in postmenopausal subjects precipitate an earlier decline in DS levels. There were no accompanying changes in cortisol levels and no correlations among levels of DS, cortisol, and estradiol. Long term estrogen replacement (over 10 yr) in postmenopausal women over age 65 had no beneficial effect on the age-related DS decline. We suggest that ovarian factors separate from estrogen-mediated effects significantly influence the reduction of DS levels independent of age.

Adult↗
PubMed1981

Significance of intrauterine adhesions detected hysteroscopically in eumenorrheic infertile women and role of antecedent curettage in their formation.

The increasing use of hysteroscopy as a diagnostic tool in the infertile woman has shown that intrauterine adhesions are of more concern, especially in eumenorrheic women, than previously was recognized. Their significance is not yet clear. This study was designed to compare the incidence of such lesions detected hysteroscopically in 235 women with otherwise unexplained infertility with their incidence in a group of 31 potentially fertile women. The outcome after treatment was recorded. The effect of curettage in the production of these adhesions was examined. The incidence of adhesions in the infertile group was considerably greater than in the potentially fertile group (p less than 0.05). A 50% pregnancy rate was achieved by lysis of adhesions. An antecedent history of curettage was associated with a significantly higher incidence of adhesion formation than that found in noncuretted patients (p less than 0.0005).

Adolescent↗