Age in men does not determine gonadotropin-releasing hormone's dose-dependent stimulation of luteinizing hormone secretion under an exogenous testosterone clamp.

Author(s): Iranmanesh A, Mulligan T, Veldhuis JD

Affiliation(s): Endocrine Section, Department of Medicine, Salem Veterans Affairs Medical Center, Salem, Virginia 24153, USA.

Publication date & source: 2010-06, J Clin Endocrinol Metab., 95(6):2877-84. Epub 2010 Mar 31.

Publication type: Randomized Controlled Trial; Research Support, N.I.H., Extramural

BACKGROUND: Aging is associated with a decline in incremental LH pulse amplitude, which could be due to decreased GnRH secretion or impaired GnRH action. HYPOTHESIS: Inconsistent published studies of GnRH action in older men may be due to disparate sex-steroid milieus. FACILITY: This study was conducted at a clinical translational-research unit. SUBJECTS: We studied 16 healthy men (8 young men and 8 older men). METHODS: An overnight transdermal testosterone (T) clamp was implemented before randomly ordered injections of 0, 2.5, 10, 25, 250, and 750 ng GnRH on separate days (96 study sessions). OUTCOMES: LH responses were quantified by variable-waveform deconvolution analysis. RESULTS: The T clamp maintained age-invariant mean concentrations of total, bioavailable, and free T, SHBG, LH, FSH, and prolactin. By two-way analysis of covariance, GnRH dose (P < 0.001) but not age (0.15 < or = P < or = 0.83) determined mean, peak, incremental, and pulsatile LH responses. Statistical power (median) was 95, 98, 90, and 99% to detect a 30% or greater age contrast at P < or = 0.05 in mean, peak, incremental, and pulsatile LH responses, and greater than 99% to detect a 30% or greater age contrast in bioavailable or total T concentrations. Higher GnRH doses (P < 0.001) abbreviated LH secretory bursts in both age groups. CONCLUSION: In the face of eugonadal concentrations of total, bioavailable, and free T, young and older men exhibit remarkably similar LH responses to a 300-fold dose range of exogenous GnRH. Accordingly, previously reported disparate effects of age on GnRH action may reflect in part age-discrepant sex-steroid milieus.