Is there a physiological role for gonadotrophin oligosaccharide heterogeneity in humans? III. Luteinizing hormone heterogeneity: a medical physiologist's perspective.

Clinical evidence for a physiological impact of luteinizing hormone (LH) isoforms includes their unequal in-vitro bioactivity and altered in-vivo LH kinetics. For example, alkaline LH isospecies emerge in an oestrogen-rich milieu, and show greater bioactivity in vitro along with more rapid metabolic removal in vivo. More acidic LH isotypes are predominant in eugonadal men with end-stage renal failure and in postmenopausal women. The relevance of changes in charge distribution in puberty to sexual maturation is not clear. Molecular LH variants may be associated with decreased testis size and reduced linear growth in boys, menstrual irregularity and/or subfertility in women, and possibly protect against polycystic ovarian syndrome (PCOS). This article summarises the provisional physiological implications of LH isotypes based on current evidence.