The Starvation State and Functional Hypopituitarism

Perloff, William H.; Lasché, Eunice M.; Nodine, John H.; Schneeberg, Norman G.; Vieillard, Carol B.

doi:10.1001/jama.1954.03690330011004

Cited by 66 publications

(15 citation statements)

References 12 publications

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“…Patients with malnutrition due to eating disorders such as anorexia nervosa and bulim ia conceive less often [21]. The explanation is again unclear but it may be due to the func tional hypopituitarism associated with these conditions [22], Weight loss is associated with a diminished concentration of gonadotrophin and oestrogens which improve on weight gain in these patients. Atrophy of reproductive or gans has also been associated with malnutri tion [23], It has been suggested that endocrine abnormalities in coeliac patients are likely to be related to the disease rather than the gener al effect of poor nutrition [10].…”

Section: Malnutritionmentioning

confidence: 99%

Infertility, Obstetric and Gynaecological Problems in Coeliac Sprue

Sher

Venkataraman

Probert

et al. 1994

Dig Dis

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There is now substantial evidence that coeliac sprue is associated with infertility both in men and women. In women it can also lead to delayed menarche, amenorrhoea, early menopause, recurrent abortions, and a reduced pregnancy rate. In men it can cause hypogonadism, immature secondary sex characteristics and reduce semen quality. The real mechanism by which coeliac sprue produces these changes is unclear, but factors such as malnutrition, iron, folate and zinc deficiencies have all been implicated. In addition in men gonadal dysfunction is believed to be due to reduced conversion of testosterone to dihydrotestosterone caused by low levels of 5α-reductase in coeliac sprue. This leads to derangement of the hypothalamicpituitary axis. Hyperprolactinaemia is seen in 25% of coeliac patients, which causes impotence and loss of libido. Gluten withdrawal and correction of deficient dietary elements can lead to a return of fertility both in men and women.

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Section: Malnutritionmentioning

confidence: 99%

Infertility, Obstetric and Gynaecological Problems in Coeliac Sprue

Sher

Venkataraman

Probert

et al. 1994

Dig Dis

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“…The urinary excretion levels of the 17-hydroxycortico-(l7-OHCS) and 17-keto-steroids may be normal but are usually diminished in patients with AN (Bell, Harkness, Loraine, & Russell, 1966;Bliss & Migeon, 1957;Danowski, Livstone, Gonzales, Jung, & Khurana, 1972;Emanuel, 1956;Garfinkel et al, 1975;Perloff, Lasche, Nodine, Schneebert, & Vieillard, 1954;Pops & Schwabe, 1968;Seidensticker & Tsagournis, 1968;Warren & Vande Wiele, 1973). Despite this the plasma concentration of cortisol in patients with AN is actually elevated: In fact, the morning and evening levels of cortisol are usually higher than in healthy subjects, as are the 24-hour mean plasma cortisol concentrations (Alvarez, Dimas, Castro, Rossman, Vanderlaan, & Vanderlaan, 1972;Aro et al, 1977;Bethge et al, 1970;Danowski et al, 1972;Doerr et al, 1980;Frankel &Jenkins, 1975;Garfinkel et al, 1975;Hurd et al, 1977;Landon, Greenwood, Stamp, & Winn, 1966;Marks & Bannister, 1963;Marks, Howorth, & Greenwood, 1965;Swigar, Kolakowska, & Quinlan, 1979;Walsh, Katz, Levin, Kream, Fukushima, Hellman, Weiner, & Zumoff, 1978;Warren & Vande Wiele, 1973).…”

Section: Urinary Levels Of 17-hydroxycortico-and 1 7-keto-steroids Anmentioning

confidence: 99%

The Physiology of eating disorders

Weiner¹

1985

Int. J. Eat. Disord.

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This article summarizes current understanding of the pathophysiology of anorexia nervosa. Evidence is reviewed of alterations in hypothalamic‐pitui‐tary‐thyroid mechanisms, catecholamine metabolism, and endogenous opioid activity. It is concluded that once weight loss and starvation occur, the usual mechanisms for release and inhibition of various regulators of eating behavior change, and a new set of regulating mechanisms is instituted. Thus, despite an increased body of knowledge, understanding of the origins of anorexia nervosa still eludes us.

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“…Reduced food intake is known to be associated with reproductive dysfunction in humans (1,2), and rats (3)(4)(5). Several kinds of endogenous sugar acids found in rat blood have been reported to be involved in control of food intake (6,7).…”

Section: Introductionmentioning

confidence: 99%

The endogenous feeding suppressant, 2-buten-4-olide, impairs the pulsatile secretion of luteinizing hormone through endogenous opioid peptides

Kaji

Saito

Shitsukawa

et al. 1998

European Journal of Endocrinology

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Objective: To clarify the mechanism of the suppressive effect of 2-buten-4-olide (2-B4O), an endogenous feeding suppressant, on the pulsatile secretion of luteinizing hormone (LH), by studying whether endogenous opioid peptides are involved in this suppressive effect. Methods: Using ovariectomized (ovx) rats, blood samples were taken every 6 min for 2 h after administration of 2-B4O or saline into the third cerebroventricle (3V) and sequential i.v. injection of naloxone (0.5 mg/kg per h) or saline. Rats were divided into three experimental groups: group 1: 3V saline þ i.v. saline (control); group 2: 3V 2-B4O þ i.v. saline; group 3: 3V 2-B4O+i.v. naloxone. Serum LH concentrations were determined by double-antibody RIA. To determine whether 2-B4O affected the biosynthetic activity of the opioidergic neurons within the ovx rat arcuate nucleus, we measured the concentrations of pro-opiomelanocortin (POMC) mRNA, a precursor of b-endorphin, in the rostral arcuate nucleus using non-radioactive in situ hybridization and a computerized image-analysis system. Results: 2-B4O significantly suppressed the pulse frequency of LH (group 2: 1.5 Ϯ 0.33 pulses/2 h, group 1: 2.43 Ϯ 0.2 pulses/2 h; P < 0.05), but naloxone blocked its suppressive effect and restored the pulse frequency (group 3: 3.29 Ϯ 0.36 pulses/2 h, group 2: 1.5 Ϯ 0.33 pulses/2 h; P < 0.01). There were no significant changes in the mean LH concentrations and amplitude. Furthermore, 2-B4O significantly stimulated the expression of POMC mRNA in the rostral arcuate nucleus. Conclusion: These results suggest that 2-B4O may impair the pulsatile secretion of LH by activating the opioid pathway within the hypothalamus.

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The Starvation State and Functional Hypopituitarism

Cited by 66 publications

References 12 publications

Infertility, Obstetric and Gynaecological Problems in Coeliac Sprue

Infertility, Obstetric and Gynaecological Problems in Coeliac Sprue

The Physiology of eating disorders

The endogenous feeding suppressant, 2-buten-4-olide, impairs the pulsatile secretion of luteinizing hormone through endogenous opioid peptides

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