State of the sympathetico-adrenal system in patients with hypothalamic pubertal syndrome

The role of the sympathetico-adrenal system in the pathogenesis of arterial hypertension in pubertal hypothalamic syndrome was studied in 29 males with pubertal hypothalamic syndrome and 13 healthy subjects, aged 15-23 years. The activity of the sympathetico-adrenal system was assessed in terms of the plasma dopamine, noradrenaline, and adrenaline concentrations as determined by HPLC using a high-sensitivity detector. Patients with stable arterial hypertension had significantly reduced levels of adrenaline, probably because of loss of phenylethanol methyltransferase activity, which may demonstrate that the sympathetico-adrenal system is not involved in the genesis and maintenance of arterial hypertension in pubertal hypothalamic syndrome. Patients with a body mass index of more than 35.0 kg/m2 had significant reductions in noradrenaline levels, evidently because of loss of tyrosine hydroxylase, whose activity is regulated by corticotrophin. Catecholamine levels were independent of the duration of illness, the duration of hypertension, or the stage of obesity.