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Hypothalamic-pituitary-gonadal function in anorexia nervosa and bulimia
M J Devlin1, B T Walsh, J L Katz
1Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY.
Psychiatry Research
|April 1, 1989
Summary
Neuroendocrine abnormalities in anorexia nervosa (AN) and bulimia are not solely due to low weight. Hypothalamic-pituitary-gonadal (HPG) axis dysfunction persists even in normal-weight patients with eating disorders.
Area of Science:
- Neuroendocrinology
- Reproductive Health
- Eating Disorders Research
Background:
- Anorexia nervosa (AN) and bulimia nervosa are associated with neuroendocrine dysfunction.
- It remains unclear whether these abnormalities stem from starvation or are intrinsic to the disordered eating patterns.
Purpose of the Study:
- To investigate hypothalamic-pituitary-gonadal (HPG) axis function in patients with AN and bulimia.
- To differentiate the effects of emaciation from intrinsic endocrine defects in eating disorders.
Main Methods:
- Studied 9 AN patients, 12 normal-weight bulimia patients with oligomenorrhea, and 8 controls.
- Measured 24-hour luteinizing hormone (LH) secretion patterns.
- Administered gonadotropin-releasing hormone (GnRH) and estradiol stimulation tests.
Main Results:
- Both AN and bulimia patients showed fewer LH secretory spikes and lower mean LH levels than controls.
- Bulimic patients exhibited elevated LH responses to GnRH, while AN patients showed blunted responses.
- Both groups displayed diminished LH and FSH augmentative responses to estradiol stimulation.
Conclusions:
- HPG axis abnormalities in eating disorders are not solely due to low body weight.
- Factors beyond emaciation contribute to disturbed hypothalamic-pituitary function in AN and bulimia.
- Some normal-weight bulimia patients display HPG axis dysfunction similar to AN patients.