[The clinical manifestations and endocrine changes of anorexia nervosa]

We analyzed the clinical manifestations and endocrine changes of 15 cases of anorexia nervosa. One male, aged 42, and 14 females, aged 14-26 were involved in the study. The precipitating causes were chronic psychiatric trauma (60%), strain (27%) and abnormal fear of being fat (13%). All showed clinical manifestations of hypometabolism and malnutrition. Body weight decreased by 36.3 +/- 11.6% on average and 93% of the patients had lost more than 20% of their original weight. All women patients over 16 years old had amenorrhea. The daily intake of grain was less than 150 gm and had decreased by more than 67% as compared with earlier intakes. Although the patients were very thin, 3/4 could maintain ordinary indoor activities. The patients with anorexia nervosa had obvious endocrine disturbances, such as low serum FSH, LH and Ts levels and high basal serum GH and midnight serum cortisol concentrations. The response of TSH to TRH and of FSH and LH to LHRH were delayed, but serum GH and PRL levels rose normally after stimulation. All of these changes are secondary to severe body weight loss or hypofunction of the hypothalamus.