Abstract

Context: Diurnal TSH secretion is enhanced in obese premenopausal women. Dopamine inhibits TSH secretion through activation of dopamine D2 receptors (D2R). Dopamine D2R availability in the brain is reduced in obese humans in proportion to body adiposity. We hypothesized that deficient dopamine D2R signaling is involved in the enhanced TSH secretion associated with obesity.

Objective: The effect of short-term bromocriptine treatment on spontaneous TSH secretion in obese women was studied while body weight and caloric intake remained constant.

Design and Setting: We conducted a prospective, fixed-order, crossover study in a Clinical Research Center.

Participants: Seventeen obese women (body mass index, 33.2 ± 0.6 kg/m2) were studied twice in the early follicular phase of their menstrual cycle.

Intervention: Subjects were treated for 8 d with placebo and bromocriptine.

Main Outcome Measure(s): Blood was collected for 24 h at 10-min intervals, and TSH and leptin were analyzed with deconvolution and correlation techniques, approximate entropy, and cosine regression.

Results: Bromocriptine reduced 24-h TSH secretion (placebo, 29.8 ± 4.6 mU/liter · 24 h, vs. bromocriptine, 22.4 ± 3.7 mU/liter · 24 h; P = 0.001), whereas free T4 and total T3 concentrations did not change. Bromocriptine administration reduced the mesor and amplitude of the 24-h rhythm without resetting the phase. The regularity of the subordinate TSH pattern and synchrony between leptin and TSH were unaffected by bromocriptine.

Conclusion: Activation of dopamine D2R by bromocriptine reverses enhanced diurnal TSH secretion in obese women. Thus, reduced dopaminergic neuronal signaling might be involved in the perturbation of the thyrotrope hormonal axis in obese premenopausal women.

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