Correlations between carbohydrate metabolism and corticotrop axis parameters in anorexia nervosa

The hypercortisolism is one of the hormonal features of anorexia nervosa (AN) in the undernutrition phase. This abnormality seems to be related to the nutritional factors because the weight restoration leads to the normalization of cortisol. We have investigated glycemia, plasma insulin and C-peptide like markers of carbohydrate metabolism, and, also, adrenocorticotrope hormone (ACTH), beta-endorphins and cortisol in basal and dynamics conditions in 142 patients with AN. Insulin negatively correlated with the values of cortisol at 16:00 h (r=-0.28, P<0.05, N=45); 04:00 h (r=-0.29, P<0.01, N=38). C-peptide negatively correlated with the values of cortisol at 08:00 h (r=-0.36, P<0.05, N=36); 12:00 h (r=-0.49, P<0.01, N=36); 16:00 h (r=-0.38, P<0.02, N=36); 20:00 h (r=-0.39, P<0.02, N=36); 04:00 h (r=-0.51, P<0.01, N=31); urinary free cortisol (r=-0.42, P<0.01, N=35); dexamethasone suppression test (DST; r=-0.52, P<0.01, N=30). C-peptide negatively correlated with the values of ACTH at 08:00 h (r=-0.33, P<0.05, N=37); 24:00 h (r=-0.38, P<0.05, N=32); 04:00 h (r=-0.49, P<0.01, N=31); DST (r=-0.45, P<0.02, N=25). We did not identify correlations between carbohydrate metabolism indices and beta-endorphins. These findings suggest that the nutritional factors may cause or maintain the hormonal changes of corticotrop axis in the undernutrition states.