Correlations between carbohydrate metabolism and corticotrop axis parameters in anorexia nervosa

Mocanu, Veronica; Vergély, N.; Voitellier, Patricia; Rachidi-Kousa, Alla; Estour, Bruno

doi:10.1016/s0928-4680(03)00008-7

Cited by 2 publications

(3 citation statements)

References 55 publications

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“…The link between nutritional status and cortisol secretion is additionally corroborated by cross-correlational analyses between cortisol and leptin (15,45) and between insulin and leptin secretion (15), where changes in cortisol levels follow changes in leptin, and changes in leptin follow changes in insulin levels. In AN, an inverse correlation between plasma cortisol and insulin levels has been reported (46).…”

Section: Discussionmentioning

confidence: 97%

Alterations in Cortisol Secretory Dynamics in Adolescent Girls with Anorexia Nervosa and Effects on Bone Metabolism

Misra

Miller

Almazan

et al. 2004

The Journal of Clinical Endocrinology & Metabolism

221

170

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Anorexia nervosa (AN) is associated with low bone density in adolescents and adults. Hypercortisolemia has been reported in adults with this disorder and has been hypothesized to be a factor in bone loss. However, the secretory dynamics of cortisol in adolescents with AN and the contribution of alterations in cortisol secretion to bone metabolism in AN have not been examined. We examined the dynamics of cortisol secretion by Cluster and deconvolutional analysis in 23 girls with AN and 21 healthy adolescents of comparable age and maturity. Cortisol sampling was performed every 30 min for 12 h overnight. Twenty-four-hour urinary free cortisol (UFC) and creatinine (cr) were obtained for all subjects. The surface area (SA) of the subjects was calculated. Markers of bone turnover (type 1 procollagen, osteocalcin, and N-telopeptide) were examined. Subjects with AN were prospectively followed over 1 yr, and those who recovered weight (defined as a 10% increase in body mass index) were again studied. On Cluster analysis, girls with AN had significantly higher mean cortisol (8.6 +/- 2.0 vs. 5.9 +/- 1.1 microg/dl; P < 0.0001), nadir cortisol (5.5 +/- 2.3 vs. 3.4 +/- 1.2 microg/dl; P = 0.0008), valley mean cortisol (7.0 +/- 2.7 vs. 4.7 +/- 1.5 microg/dl; P = 0.001), peak amplitude (12.6 +/- 4.4 vs. 7.8 +/- 3.0 microg/dl; P = 0.0004), peak area (652 +/- 501 vs. 340 +/- 238 microg/dl; P = 0.02), and total area under the curve (6112 +/- 1467 vs. 4117 +/- 802 microg/dl; P < 0.0001) than healthy adolescents. On deconvolutional analysis, the frequency of nocturnal secretory bursts (7.0 +/- 1.2 vs. 5.8 +/- 1.3 /12 h; P = 0.001), total nocturnal pulsatile cortisol secretion (69.3 +/- 14.7 vs. 53.9 +/- 11.1 microg/dl; P = 0.0003), and total cortisol secretion (89.6 +/- 18.8 vs. 71.2 +/- 17.6 microg/dl; P = 0.002) were significantly higher in girls with AN than in healthy controls. Cortisol half-life trended higher in girls with AN. However, basal cortisol secretion and approximate entropy did not differ between the groups. UFC/cr and UFC/cr.SA were significantly higher in girls with AN than in controls [0.050 +/- 0.028 vs. 0.036 +/- 0.017 (P = 0.04) and 0.035 +/- 0.020 vs. 0.023 +/- 0.012 (P = 0.03)]. Six of 23 girls with AN had UFC/cr.SA values that were more than 2 sd above those in healthy controls. An inverse correlation was noted between measures of cortisol concentration as well as pulsatile secretion and measures of nutritional status (body mass index, fat mass, leptin, insulin, and IGF-I). An oral glucose load suppressed cortisol levels in healthy adolescents, but not in AN patients. Weight recovery was associated with a significant decrease in the number of secretory bursts. In girls with AN, strong inverse correlations were noted between levels of cortisol (mean, nadir, and total area under the curve) and levels of markers of bone formation (C-terminal propeptide of type 1 procollagen and osteocalcin). Conversely, in healthy controls, cortisol values did not predict levels of markers of bone turnover. Adolescent girls with...

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Section: Discussionmentioning

confidence: 97%

Alterations in Cortisol Secretory Dynamics in Adolescent Girls with Anorexia Nervosa and Effects on Bone Metabolism

Misra

Miller

Almazan

et al. 2004

The Journal of Clinical Endocrinology & Metabolism

221

170

View full text Add to dashboard Cite

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“…It is known that insulin plays an important role in the hormonal control of metabolic adaptation during fasting [ 90 ]. Contrary to the increased glucagon levels, insulin levels are lower during fasting [ 2 , 3 ] and in patients with AN [ 15 , 16 , 17 , 18 , 19 , 84 , 85 , 86 , 139 ], and insulin levels negatively correlate with cortisol levels [ 86 ]. It has been suggested that the synthesis of very low-density lipoprotein (VLDL), a triacylglycerol-rich particle, is increased in hepatocytes in response to reduced insulin action under fasting conditions [ 76 ].…”

Section: Resultsmentioning

confidence: 99%

“…Fasting ↑Glucagon [64][65][66][67][68][69] Fasting benefits [37] ↑Glycogenolysis [70][71][72] ↓Glycogenesis [35] ↓Insulin [73,74] ↑Glucagon ↓Insulin ↑Glycogenolysis ↑Lipolysis ↑Ketogenesis [75] ↑Gluconeogenesis ↑Amino acids oxidation ↑Ureagenesis [76,77] ↓Insulin ↑Cortisol ↓Leptin [34,78] ↑Lipolysis [79] ↑Proteolysis [80] Starvation ↑Glucagon [15,81,82] ↑Lipolysis ↑Ketogenesis [83] ↓Insulin [19,[84][85][86][87][88][89] ↑Fatty acid oxidation ↑Ketogenesis [90] ↑Lipolysis ↑Gluconeogenesis [16] ↑Competition for energy resources [91] ↓Glucagon [92] ↑Insulin sensitivity [93] Fasting and Starvation ↑Glucagon ↓Insulin ↓T 3 [38] ↓TRH [97,98] Fasting's benefits [39] ↓Leptin leading to ↓T 3 [99] Starvation ↓T 3 [17,[22][23][24][25]…”

Section: Pancreas (Glucagon and Insulin)mentioning

confidence: 99%

Adaptive Effects of Endocrine Hormones on Metabolism of Macronutrients during Fasting and Starvation: A Scoping Review

Karimi,

Yanovich,

Elbarbry

et al. 2024

Metabolites

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Food deprivation can occur for different reasons. Fasting (<24 h duration) occurs to meet religious or well-being goals. Starvation (>1-day duration) occurs when there is intentional (hunger strike or treatment of a medical condition) or unintentional (anorexia nervosa, drought, epidemic famine, war, or natural disaster) food deprivation. A scoping review was undertaken using the PubMed database to explore 1805 abstracts and review 88 eligible full-text articles to explore the adaptive relationships that emerge between cortisol, insulin, glucagon, and thyroid hormones on the metabolic pathways of macronutrients in humans during fasting and starvation. The collected data indicate that fasting and starvation prime the human body to increase cortisol levels and decrease the insulin/glucagon ratio and triiodothyronine (T3) levels. During fasting, increased levels of cortisol and a decreased insulin/glucagon ratio enhance glycogenolysis and reduce the peripheral uptake of glucose and glycogenesis, whereas decreased T3 levels potentially reduce glycogenolysis. During starvation, increased levels of cortisol and a decreased insulin/glucagon ratio enhance lipolysis, proteolysis, fatty acid and amino acid oxidation, ketogenesis, and ureagenesis, and decreased T3 levels reduce thermogenesis. We present a potential crosstalk between T3 and the above hormones, including between T3 and leptin, to extend their adaptive roles in the metabolism of endogenous macronutrients during food deprivation.

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Correlations between carbohydrate metabolism and corticotrop axis parameters in anorexia nervosa

Cited by 2 publications

References 55 publications

Alterations in Cortisol Secretory Dynamics in Adolescent Girls with Anorexia Nervosa and Effects on Bone Metabolism

Alterations in Cortisol Secretory Dynamics in Adolescent Girls with Anorexia Nervosa and Effects on Bone Metabolism

Adaptive Effects of Endocrine Hormones on Metabolism of Macronutrients during Fasting and Starvation: A Scoping Review

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