262 



HYPOPHYSIS AND GONADOTROPHIC HORMONES 



of personal security and absence of other 

 than hunger-induced anxieties are to be 

 compared with either mass starvation or the 

 exigencies of war deprivations. 



That many of the findings in experimental 

 animals are applicable to man is suggested 

 by the high incidence of impaired repro- 

 ductive functions in women during states 

 of chronic malnutrition (Keys, 1946; Keys, 

 Brozcc, Henschel, Michelson and Taylor, 

 1950; Samuels, 1948; Gillman and Gillman, 

 1951; Zubiran and Gomez-Mont, 1953). 



One of the better documented studies of 

 the endocrine aspects of chronic malnutri- 

 tion in man is being made in Mexico by 

 Zubiran and Gomez-Mont. In 1953 they re- 

 ported on 529 adult subjects, all with a long 

 history of undernourishment, and 195 au- 

 topsies of subjects suffering the effects of 

 starvation. Estrogenic activity as measured 

 by estrogen excretion and by vaginal smears 

 was found to be absent in a high percentage 

 of cases in women of menstrual age. The 

 number in which menstruation had ceased 

 was ecjually high. These evidences of the 

 severity of the disturbances of ovarian func- 

 tion were fully borne out by examination of 

 ovaries at autopsy after prolonged starva- 

 tion. The ovaries were extremely small and 

 atrophic and not infrequently absent. 



It is pertinent also that Zubiran and 

 Gomez-Mont, contrary to the work of Bis- 

 kind (1946) and of Lloyd and Williams 

 ( 1948) , found no evidence of hyperestrogen- 

 ism in patients with impaired liver function. 

 Their data show clearly that the excretion 

 of urinary estrogen is low in a high percent- 

 age of cases during chronic malnutrition, 

 irrespective of the presence of cirrhosis or 

 the extent of liver impairment. During re- 

 covery, however, these workers often found 

 a transitory increase in estrogen excretion 

 sometimes of great magnitude. In males, 

 such increases usually preceded the appear- 

 ance of gynecomastia which generally out- 

 lasted the period of heightened estrogen 

 titers. Zubiran and Gomez-Mont believe 

 that unawareness of the effect of refeeding 

 on estrogen production may furnish an ex- 

 planation for most of the reported cases of 

 hyperestrogenism which have been attrib- 

 uted to liver damage and tlie failure to in- 

 activate estrogen. 



2. Vitamin Deficiencies 



Gonadal dysfunctions of varying severity 

 are also noted in animals fed diets deficient 

 in one or another of the various B vitamins 

 (thiamine, Drill and Burrill, 1944; imn- 

 tothenic acid, Figge and Allen, 1942; ribo- 

 flavin, Warkany and Schraffenberger, 1944; 

 pyridoxine, Emerson and Evans, 1940, Nel- 

 son and Evans, 1951; biotin, Okey, Pen- 

 charz and Lepkovsky, 1950; and B12 , Hart- 

 man, Dryden and Gary, 1949; the references 

 cited are inter alia). In each instance the 

 data suggest an impairment of the secretion 

 of gonadotrophins and there is considerable 

 agreement that this, in turn, is attributable 

 to the accompanying inanition rather than 

 to any specific vitamin deficiency per se. 

 With respect to pituitary hormone content, 

 Wooten, Nelson, Simpson and Evans, 

 (1955) reported finding a striking increase 

 in gonadotrophic potency in vitamin Be- 

 deficient rats. In terms of the separate gon- 

 adotrophins they found a 3- to 4-fold in- 

 crease in FSH and little or no change in 

 LH or LTH. With respect to vitamin E, 

 it has been established that in rats and 

 guinea pigs a deficiency of this factor in- 

 jures the seminiferous tubules and causes 

 resorption of embryos. Inconsistent findings 

 have been reported with respect to the pitui- 

 tary gonadotrophic potency in vitamin E- 

 deficient rats: an increase was noted by 

 P'an, van Dyke, Kaunitz and Slanetz 

 (1949), and no change by Biddulph and 

 Meyer (1941). The defects produced by ab- 

 sence of vitamin E are in the gonads and 

 are not correctable by administration of 

 gonadotrophin (Mason, 1933; Drummond, 

 Noble and Wright, 1939; Ershoff, 1943). 

 Despite extensive study, the effect of vita- 

 min A deficiency on pituitary gonadotrophin 

 content has not yet been clearly defined (for 

 a review of literature see Ershoff, 1952). 



3. Deficiencji in Intake of Protein or of Spe- 



cific Amino Acids 



The effect of protein deprivation on hy- 

 poi)hyseal functions has been lately re-ex- 

 amined by Leathern (1958) and is dis- 

 cussed in his chapter. He has empha- 

 sized the importance of a lal>ile body 

 proteni i-eser\-e and the biologic value of 



