Elevated PYY may contribute to reduced intake and decreased bone turnover in AN.

Despite outpatient follow-up, community-dwelling girls with AN continue to have lower fat and higher fiber intakes than do healthy adolescents, which results in lower calorie intakes. Nutritionally related hormones are associated with specific nutrient intakes.

A. Lower growth hormone and higher cortisol are associated with greater visceral adiposity, intramyocellular lipids, and insulin resistance in overweight girls. Am J Physiol Endocrinol Metab 295: E385-E392, 2008. First published June 10, 2008 doi:10.1152/ajpendo.00052.2008.-Although body composition, insulin sensitivity, and lipids are markedly altered in overweight adolescents, hormonal associations with these parameters have not been well characterized. Growth hormone (GH) deficiency and hypercortisolemia predispose to abdominal adiposity and insulin resistance, and GH secretion is decreased in obese adults. We hypothesized that low-peak GH on the GH-releasing hormone (GHRH)-arginine stimulation test and high cortisol in overweight adolescents would be associated with higher regional fat, insulin resistance, and lipids. We examined the following parameters in 15 overweight and 15 bone age-matched control 12-to 18-yr-old girls: 1) body composition using dual-energy X-ray absorptiometry and MR [visceral and subcutaneous adipose tissue at L4-L5 and soleus intramyocellular lipid ( 1 H-MR spectroscopy)], 2) peak GH on the GHRH-arginine stimulation test, 3) mean overnight GH and cortisol, 4) 24-h urinary free cortisol (UFC), 5) fasting lipids, and 6) an oral glucose tolerance test. Stepwise regression was the major tool employed to determine relationships between measured parameters. Log peak GH on the GHRH-arginine test was lower (P ϭ 0.03) and log UFC was higher (P ϭ 0.02) in overweight girls. Log mean cortisol (overnight sampling) was associated positively with subcutaneous adipose tissue and, with body mass index standard deviation score, accounted for 92% of its variability, whereas log peak GH and body mass index standard deviation score accounted for 88% of visceral adipose tissue variability and log peak GH for 34% of the intramyocellular lipid variability. Log mean cortisol was independently associated with log homeostasis model assessment of insulin resistance, LDL, and HDL and explained 49 -59% of the variability. Our data indicate that lower peak GH and higher UFC in overweight girls are associated with visceral adiposity, insulin resistance, and lipids. obesity; body composition; homeostasis model assessment of insulin resistance; lipids OBESITY IS A GLOBAL PROBLEM, and, according to recent estimates, 17% of US children and adolescents are overweight [body mass index (BMI) Ͼ95th percentile] and 16.5% are at risk for overweight (BMI between 85th and 95th percentiles) (11,19). Commensurate with the rising prevalence of overweight, the prevalence of type 2 diabetes is increasing, such that up to 30 -50% of all newly diagnosed children with diabetes are classified as having type 2 diabetes, in contrast to Ͻ5% before 1994 (13, 23). Although body composition and lipid profiles are markedly altered in overweight compared with normal-weight adolescents, associations of hormonal alterations with body composition and insulin sensitivity changes in overweight teenagers have not been well characterized.Disorders r...

Neuroendocrine abnormalities in anorexia nervosa (AN) include hypercortisolemia, hypogonadism, and hypoleptinemia, and neuroendocrine predictors of menstrual recovery are unclear. Preliminary data suggest that increases in fat mass may better predict menstrual recovery than leptin. High doses of cortisol decrease luteinizing hormone (LH) pulse frequency, and cortisol predicts regional fat distribution. We hypothesized that an increase in fat mass and decrease in cortisol would predict menstrual recovery in adolescents with AN. Thirty-three AN girls 12-18 y old and 33 controls were studied prospectively for 1 y. Body composition [dual energy x-ray absorptiometry (DXA)], leptin, and urinary cortisol (UFC) were measured at 0, 6, and 12 mo. Serum cortisol was measured overnight (every 30 min) in 18 AN subjects and 17 controls. AN subjects had higher UFC/cr·m 2 and cortisol area under curve (AUC), and lower leptin levels than controls. Leptin increased significantly with recovery. When menses-recovered AN subjects were compared with AN subjects not recovering menses and controls, menses-recovered AN subjects had higher baseline cortisol levels and greater increases in leptin than controls and greater increases in fat mass than AN subjects not recovering menses and controls (adjusted for multiple comparisons). In a logistic regression model, increasing fat mass, but not leptin, predicted menstrual recovery. Baseline cortisol level strongly predicted increases in the percentage of body fat. We demonstrate that 1) high baseline cortisol level predicts increases in body fat and 2) increases in body fat predict menses recovery in AN. (Pediatr Res 59: [598][599][600][601][602][603] 2006) A N, a model of severe undernutrition, is associated with hypogonadotropic hypogonadism resulting in primary or secondary amenorrhea or delayed menarche. Weight recovery occurs in up to 50% of adolescents with AN and should result in recovery of the hypothalamo-pituitary-gonadal (H-P-G) axis (1). However, a temporal association between weight gain and menstrual recovery is not always observed (2,3). Not all adolescents with AN who resume menses are weight recovered, and not all weight-recovered adolescents with AN resume menstrual function. In addition, neuroendocrine predictors of menstrual recovery are unclear.We have demonstrated higher cortisol (4) and lower leptin levels (3,5) in AN girls compared with healthy adolescents.Leptin is an adipocytokine, and leptin-deficient or -resistant mice (6,7) and humans with leptin and leptin receptor mutations (8,9) are hypogonadal. In a recent study, leptin administration was associated with resumption of menses in five of eight women with hypothalamic amenorrhea (10). These data suggest that leptin is an important regulator of the H-P-G axis and that an increase in leptin along with an increase in fat mass may predict recovery of the H-P-G axis in AN. Conversely, Golden et al. (11) observed no differences in fat mass between AN girls who recovered menses and those who did not.In add...