Hormonal Profile Heterogeneity and Short-Term Physical Risk in Restrictive Anorexia Nervosa

Abstract

The hormonal response to undernutrition is heterogeneous in a large population with restrictive AN. In clinical practice, metanephrines, GH, and/or cortisol data could be used as important predictors for severe short-term outcome.

Physical activity: benefit or weakness in metabolic adaptations in a mouse model of chronic food restriction?

“…As demonstrated by Dos Santos et al (21), female rats submitted to treadmill exercise and a 50% food restriction led to interruption of estrous cyclicity, as we observed in our study where the physical activity was voluntary. In AN patients, even if amenorrhea was not considered as a criterion in the DSM-5 anymore, disruption of cycles is currently observed in restrictive AN patients (24,42). Disruption of the estrous cycle as well as reduction of the size of ovaries was observed here in FR and FRW mice along all the protocols.…”

“…In AN, patients also display numerous endocrine alterations that can contribute directly or indirectly to maintain and exacerbate the disease (24,66). Data related to the understanding of how hormones might contribute to the worsening of the patients are currently lacking.…”

“…These high-risk conducts are also observed in restrictive anorexia nervosa (AN) with 35-80% of patients who present excessive physical activity associated with a severe chronic food restriction (14,15), even if this last parameter has been omitted from the diagnostic criteria currently used (1,2). Beside severe weight loss and metabolic disturbances, AN is also associated with endocrine alterations, reproductive dysfunctions, osteopenia, and osteoporosis (24,29,30,40,41,42,43,47). The prevalence of AN has increased drastically within recent decades and is currently the third-largest cause of chronic illness in teenagers (35,44).…”

Wide impairment of cerebral serotoninergic activity but inter-individual heterogeneity in bulimia nervosa patients: a pilot [18F]MPPF/PET study

“…Parameters related to nutritional status including IGF-1, free T3, leptin and percentage of fat mass were assessed in BN group using previously described techniques (Estour et al 2010).…”

Changes in salivary cortisol levels as a prognostic predictor in children with anorexia nervosa

“…The present study revealed an inverse association between baseline cortisol AUC level and SD for body weight, indicating that higher basal cortisol secretion could be indicative of severity of illness. Estour's large cohort study (210 young females with AN) suggested that cortisol could be used as an important prognostic predictor, with increased levels of cortisol in AN patients who developed critical states during the 3 months (Estour et al, 2010). The HPA axis is essential for maintaining homeostasis in stress processing and adaptation to the environment, thus cortisol is used as a biomarker of psychological stress and related mental or physical disease (Hellhammer et al, 2009;Sjörs et al, 2010).…”