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ATP generation on the other hand may be inadequate due to impaired substrate utilization due to insulin resistance and mitochondrial dysfunction [14]

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The criteria for participation were: amenorrhea for 6+ months and not pregnant normal development no markers of metabolic disease weight stable for the last 12 months (noted that subjects were 5-9% below ideal weight) normal adrenal and thyroid hormones Patients were divided into two groups 10 patients with LH less than 3 IU/mL (average of 0.9 +/- 0.1) and 10 with LH greater than 3 IU/mL (average of 7.1 +/- 1.5)