Hair-Based Assessment of Sex Steroid Hormones in Patients with Anorexia Nervosa

Abstract

Anorexia nervosa (AN) is a complex psychiatric disorder accompanied by a variety of endocrine effects. Altered levels of the sex steroid hormones progesterone and dehydroepiandrosterone (DHEA) have been shown to occur in patients with AN using short-term hormonal measurement methods based on blood, saliva, and urine samples. However, since sex steroid hormone levels fluctuate during the menstrual cycle, these measurement methods require a great deal of effort due to the need to collect multiple samples in order to correctly determine the basal level of sex hormones. In contrast, hair-based assessments provide a marker of accumulated longer-term hormone exposure using a single, non-invasive sample. The aim of this study was to investigate sex steroid hormone levels via hair-based assessments in acutely underweight AN in comparison with healthy, age-matched, female control participants. Additionally, we compared progesterone and DHEA hair levels longitudinally during inpatient treatment in AN. Collected hair samples were analyzed using liquid chromatography-mass spectrometry (LC-MS/MS) to determine a monthly hormone level of progesterone and DHEA. Our results indicate that DHEA hair hormone levels were similar across groups but progesterone was suppressed in underweight AN compared with healthy controls. In the longitudinal design, no significant change in hair hormone levels during partial weight restoration in patients with AN was observed. Our findings suggest that hair analysis can be used to detect suppressed progesterone levels in severe AN, and that progesterone does not increase during short-term weight restoration.

The Leptin-to-Adiponectin Ratio in Inflammation

“…Given that it is still unclear if all methods for quantifying leptin and adiponectin yield similar results, additional studies are needed to make this determination. Finally, various previous human studies have measured leptin and adiponectin in plasma/serum, saliva, hair, and/or urine [30,31,[64][65][66][67][68][69][70][71][72][73][74]. There may be methods that would allow the comparison of levels of leptin and adiponectin across sample types, but additional studies are needed to explore this possibility.…”

“…Leptin and adiponectin are hormones made and released by adipocytes in adipose tissue that current literature describes as being mediators of inflammation and influencers of chronic diseases [25][26][27][28][29]. Leptin and adiponectin can be detected in tissue samples [30] however, they are most frequently measured in blood samples for clinical studies [29,31]. The proinflammatory actions of leptin are varied and include 1) inducing monocytes and macrophages to synthesize eicosanoids, 2) triggering of natural killer cell cytotoxicity, 3) stimulating chemotaxis in neutrophils, 4) activating proinflammatory cytokine production in B cells, and 5) promoting Th1-cell immune responses (Th1 cells secrete tumor necrosis factor (TNF)-α, lymphotoxin, and interleukin (IL)-2) [19,[32][33][34][35].…”