Authors: Ľ. Tichá 1; E. Tomečková 2; J. Hornová 1; S. Niňajová 1; J. Birčák 1 Authors‘ workplace: 1. detská klinika Lekárskej fakulty Univerzity Komenského a Detskej fakultnej nemocnice, Bratislava prednostka doc. MUDr. M. Benedeková, PhD., mim. prof. 1; Oddelenie klinickej biochémie Detskej fakultnej nemocnice, Bratislava primárka MUDr. A. Behúlová, PhD. 2 Published in: Čes-slov Pediat 2006; 61 (10): 573-577. Category: Original Papers
Background: Anorexia nervosa (AN) is an eating disorder occurring mostly in adolescent girls. Final outcome of this life-threatening disorder may be affected by endocrine abnormalities due to long-term starvation.
Aims: The authors evaluated the relationship between indexes of body weight and endocrine parameters in adolescent patients with AN.
Patients and methods: In this study the authors investigated indexes of body weight – deficit of weight (%), body mass index SD in 32 girls with AN (age 15.33 ± 0.27) prior to refeeding, and after initiation of refeeding (age 15.70 ± 0.32) as well as in a control group of healthy girls (age 15.71 ± 0.46). They took samples of blood to determine growth hormone (GH), prolactin (PRL), thyrotropic hormone (TSH), triiodothyronine (T3), thyroxine (T4), adrenocorticotropic hormone (ACTH), dehydroepiandrosterone (DHEA), cortisol, 17-OH progesterone, follicle stimulating hormone, luteinizing hormone (LH), estradiol, progesterone, testosterone.
Results: Values of weight (%) were low in girls with AN, but they increased after refeeding, but they were lower than in control group (-28.78 ± 1.37, vs. -12.39 ± 1.70 vs. -4.14 ± 0.46 %, p <0.001). Increased concentrations were found for T3 (1.55 ± 0.05, vs.1.84 ± 0.12 nmol/l, p <0.05), LH (0.55 ± 0.12 U/l vs. 4.5 ± 1.11 U/l, p <0.005, vs. 3.65 ± 0.64, n.s.) and FSH (2.43 ± 0.55 vs. 4.87 ± 0.61 U/l, p <0.001 vs. 4.68 ± 0.41, n.s.) after refeeding, but they were lower than in control group. Decreased concentrations were found for cortisol (675.49 ± 69.03 vs. 505.28 ± 33.4, p <0.05) and progesterone (4.87 ± 0.75 vs. 3.36 ± 0.85, p <0.05) after refeeding.
Conclusion: These results demonstrated several endocrine changes in fasting patients with AN. These include increase frequency of low T3 syndrome, increased stimulation of the hypothalamus – hypophysis – adrenal axis. Low LH, FSH levels and their significant increase after refeeding can be a physiological answer of organism to increments of body weight. Additional studies are needed to evaluate the interaction of these hormonal changes with other endocrine parameters, levels of which are not correlated with the severity of the underlying disorder.
Key words: anorexia nervosa, endocrine abnormalities
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