Assessment of Hypothalamic Pituitary Axis: Gonadotrophic Releasing Hormone Test in a Sample of Egyptian Children and Adolescents with Autism Spectrum Disorders

Abstract

Autism Spectrum Disorders comprise an extremely heterogeneous class of neurodevelopmental disorders. Consonant with the heterogeneity of ASDs is the multiplicity of proposed causative factors, with candidates including genetic, hormonal, immunologic, and early life stress factors. Autism affects males more than females, occurring at a ratio at least 3:1. This sex difference may reflect a male vulnerability to develop autism, as individuals with autism tend to display a hypermasculine profile on many cognitive tasks. Testicular androgens have a central role in human male development. In prenatal life, increased testicular androgens around 4–6 weeks gestation masculinize the genitalia and initiate the sexual differentiation of the brain through hormonally dependent, sex-specific changes in the ultrastructure of the developing central nervous system (e.g., cell proliferation, cell death, patterns of cell migration, dendritic branching). A series of clinical studies have examined androgen metabolites in patients diagnosed with an ASD. These studies have revealed hormonal patterns consistent with significantly elevated androgen levels in patients diagnosed with an ASD relative to controls. In light of evidence revealing significantly elevated androgen levels in subjects diagnosed with an ASD, and a significant relationship between elevated androgens and ATs, it was previously hypothesized that treatments specifically targeting elevated androgen levels in subjects diagnosed with an ASD might significantly improve ATs. Our study aimed at studying the male hormones (FSH, LH and total testosterone) in male autistic children after GnRH stimulation and correlate these levels with autistic severity and aggressiveness. This cross-sectional study was conducted in 30 male autistic children diagnosed according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM V) in pediatric psychiatry clinic in pediatric hospital, Ain Shams University over three months period. All studied patients were subjected to the following: Complete medical history, Clinical examination, Psychiatric assessment, Bone age assessment, tanner pubertal staging and laboratory investigation including FSH, LH and testosterone levels.