A review of endocrine changes in anorexia nervosa

Anorexia nervosa is a syndrome of unknown etiology. It is associated with multiple endocrine abnormalities. Hypothalamic monoamines (especially serotonin), neuropeptides (especially neuropeptide Y and cholecystokinin) and leptin are involved in the regulation of human appetite, and in several ways t...

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Bibliographic Details
Published in:Journal of psychiatric research 1999-03, Vol.33 (2), p.139-152
Main Authors: Støving, R.K, Hangaard, J, Hansen-Nord, M, Hagen, C
Format: Article
Language:English
Subjects:
Adult and adolescent clinical studies
Anorexia nervosa
Anorexia Nervosa - metabolism
Biological and medical sciences
Eating behavior disorders
Female
Humans
Hypothalamo-Hypophyseal System - metabolism
Hypothalamus - metabolism
Medical sciences
Pituitary Diseases - diagnosis
Pituitary Diseases - metabolism
Pituitary Gland, Anterior - metabolism
Pituitary Gland, Posterior - metabolism
Pituitary-Adrenal System - metabolism
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
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Summary:Anorexia nervosa is a syndrome of unknown etiology. It is associated with multiple endocrine abnormalities. Hypothalamic monoamines (especially serotonin), neuropeptides (especially neuropeptide Y and cholecystokinin) and leptin are involved in the regulation of human appetite, and in several ways they are changed in anorexia nervosa. However, it remains to be clarified whether the altered appetite regulation is secondary or etiologic. Increased secretion of corticotropin-releasing hormone and proopiomelanocortin seems to be secondary to starvation, however, there is evidence that it may maintain and intensify anorexia, excessive physical activity and amenorrhea. Hypothalamic amenorrhea, which is a diagnostic criterion in anorexia nervosa, is not solely related to the low body weight and exercise. Growth hormone resistance with low production of insulin-like growth factor I and high growth hormone secretion reflect the nutritional deprivation. The nutritional therapy of patients with anorexia nervosa might be improved by administering an anabolic agent such as growth hormone or insulin-like growth factor I. So far none of the endocrine abnormalities have proved to be primary, however, there is increasing evidence that some of these might participate in a vicious circle.
ISSN:0022-3956
1879-1379
DOI:10.1016/S0022-3956(98)00049-1