Twenty-Four Hour Sleep-Wake Pattern of Plasma Lh in Patients With Anorexia Nervosa

Abstract

The 24-h sleep-wake pattern of plasma LH was studied in 18 patients with severe weight loss. Sixteen patients had anorexia nervosa, one suffered from schizophrenia and one had a gastric ulcer. The age of the patients ranged from 13 to 31 years. Seventeen women and one boy participated in the study. Their weight ranged from 51 to 73 % of the ideal body weight (IBW) at the first 24-h study which was at one week after admission to the hospital. Blood was taken through an indwelling venous catheter every 30 min. The patients' weight increased under behavioural therapy and they were re-studied when they had gained approximately 10 % IBW and again prior to release from the psychiatric ward. The LH patterns were classified as infantile, pubertal or adult. All patients except for two had an iniantile pattern at the first study. Except for the two patients who had no anorexia nervosa, all developed a pubertal and/or an adult pattern. All patients whose weight was below 69 % IBW had an infantile LH pattern. Adult patterns were only seen when the body weight was greater than 80 % IBW. The increase of the average 24-h LH values was slower the older the patients were and the longer they had been anorectic.

Body fat distribution before and after weight gain in anorexia nervosa

“…It is well known that oestrogen and progesterone modify body fat distribution by increasing peripheral or subcutaneous fat deposition. 2 Changes in gonadal steriods have been found after a regain of body 27 and thus may be responsible for our ®ndings of a much higher increase in subcutaneous fat than in visceral fat in our subjects. In actual fact, we could not con®rm this very suggestive hypothesis because no information about gonadal steroids was available in our subjects.…”

The Actions of Prostaglandin E₂, Naloxone and Testosterone on Starvation-Induced Suppression of Luteinizing Hormone-Releasing Hormone and Luteinizing-Hormone Secretion

“…2 mm, o.d. 4 mm, [31]), which were either packed with crystalline T (Sigma Chemicals) or empty, in order to establish comparable blood T level [34]. Those animals that were to be sub jected to starvation received 1.6 cm long capsules, while the others got 2.6 cm long capsules.…”

“…3 ng/ml plasma) on LH secretion at the pituitary level. The stimulatory effect of PGE2 on LH release was completely suppressed by T in fed, as well as in castrated rats starved for 3 or 5 days.One of the most characteristic symptoms in anorexia nervosa is a depression of gonadotropin secretion, and as a consequence, loss of the menstrual cycle or of spermato genesis [8,14,31]. The pathophysiological mechanisms of this failure are unknown alterations in the hypothalamic function.…”

Metabolic Cues for the Onset of Puberty

“…And third, in many species, including humans, states of chronic un dernutrition can cause the activity of the adult reproduc tive axis to return to the prepubertal state [11][12][13][14][15], This is dramatically illustrated in girls suffering from the eat ing disorder, anorexia nervosa [7,16,17], During the period of low body weight anorexics typically have very low circulating LH and FSH concentrations with few apparent LH pulses, and a complete lack of cyclic ovar ian function. These reproductive functions are usually restored as the girls gain weight with refeeding, and the reawakening of the reproductive axis closely follows the pattern of normal reproductive development with puber ty, with an initial occurrence of nighttime pulses of LH [18,19]. The similarities between the pattern of re awakening of the reproductive axis during recovery from anorexia and the initial awakening of the reproductive axis at puberty again suggest that normal pubertal devel opment may be at least in part triggered by a 'metabolic cue'.…”