Anorexia nervosa from an endocrinologist's point of view
Authors:
Novotná Dana 1; Móriová Barbora 2
Authors place of work:
Pediatrická klinika, Fakultní nemocnice Brno a Masarykova univerzita
1; Psychiatrická klinika, Fakultní nemocnice Brno a Masarykova univerzita
2
Published in the journal:
Čes-slov Pediat 2023; 78 (S3): 11-16.
Category:
Comprehensive Report
doi:
https://doi.org/10.55095/CSPediatrie2023/060
Summary
Anorexia nervosa is a complex psychiatric-metabolic-endocrine disease that has the highest mortality rate among psychiatric diseases. Almost all organs and systems are altered by this disease. Changes in the endocrine system mostly represent the body‘s adaptation to starvation, and after regaining the necessary weight and fat mass, they are spontaneously adjusted. However, it does not apply to all changes. There is a disorder of the hypothalamic-pituitary axis with manifestations of hypogonadotropic hypogonadism, hypercortisolemia, resistance to growth hormone, thyroid dysfunction, hyponatremia and hypooxytocinemia. The production of antidiuretic hormone can also be altered, and a bone metabolism disorder can be diagnosed relatively early and often persists even after recovering from anorexia nervosa. Recently, changes in the intestinal microbiome, lipid metabolism, cytokine production disorders with the development of autoimmunity, and immune function disorders have also been described.
Keywords:
anorexia nervosa, osteoporosis, hypothalamic dysfunction, euthyroid sick syndrome, food intake regulation
Zdroje
1. Navrátilová M, Kalendová M. Poruchy příjmu potravy – mentální anorexie a bulimie, nejzávažnější somatické a metabolické komplikace. Způsoby realimentace. Shrnutí 30leté praxe z metabolického pohledu internisty. Čes-slov Pediat 2019; 74 (5): 290–300.
2. Kohoutek J, Kocourková J. Vliv koronavirové epidemie na vývoj a léčbu poruch příjmu potravy v dětském a adolescentním věku. Psychiatr praxi 2021; 22(2): 116–118.
3. Datta N, Van Wye E, Citron K, et al. The COVID-19 pandemic and youth with anorexia nervosa: A retrospective comparative cohort design. Int J Eat Disord 2023; 56(1): 263–268.
4. Galmiche M, Déchelotte P, Lambert G, Tavolacci MP. Prevalence of eating disorders over the 2000-2018 period: a systematic literature review. Am J Clin Nutr 2019; 109(5): 1402–1413.
5. https://www.lf1.cuni.cz/poruchy-prijmu-potravy-v-cechach
6. Haines MS. Endocrine complication of anorexia nervosa. J Eating Disord 2023. doi: 10.1186/s40337-023-00744-9
7. Lawson EA, Miller KK. Anorexia nervosa: endocrine complications and their management. In: Barbieri RL, Yager J, Martin KA (eds). UptoDate. 2023. Dostupné na: https://www.uptodate.com/contents/anorexia-nervosa-endocrine-complications-and-their-management?csi=cac4ca4f-eb4f-4800-8967-4cc0b69964e6&source=contentShare
8. Miller KK. Endocrine dysregulation in anorexia nervosa update. J Clin Endocrinol Metab 2011; 96(10): 2939–2949.
9. Støving RK. Mechanisms in endocrinology: Anorexia nervosa and endocrinology: a clinical update. Eur J Endocrinol 2019; 180(1): R9–R27.
10. Dempfle A, Herpertz-Dahlmann B, Timmesfeld N, et al. Predictors of resumption menses in adolescent anorexia nervosa. BMC Psychiatry 2013; 13: 308.
11. Misra M, Klibanski A. Endocrine consequences of anorexia nervosa. Lancet Diabetes Endocrinol 2014; 2: 581–592.
12. Poncová R, Skřenková J, Fanta M. Poruchy příjmu potravy v ambulanci gynekologa pro děti a dospívající. Ceska Gynekol 2021; 86(1): 46–53.
13. Miller KK, Wexler TL, Zha AM, et al. Androgen deficiency: association with increased anxiety and depression symptom severity in anorexia nervosa. J. Clin Psychiatry 2007; (68): 959–963.
14. Saldanha N, Fisher M. Menstrual disorders in adolescents and young adults with eating disorders. Curr Probl Pediatr Adolesc Health Care 2022; 52: 101240.
15. Miller KK. Endocrine dysregulation in anorexia nervosa update. J Clin Endocrinol Metab 2011; 96(10): 2939–2949.
16. Miller KK. Endocrine effects of anorexia nervosa. Endocrinol Metab Clin North Am 2013; 42(3): 515–28.
17. Sjögren M. Endocrine disturbances in anorexia nervosa. In: Patel VB, Preedy VR (eds). Eating disorders. 1st ed. London: Springer 2023: 569–584.
18. Larson KR, Chaffin AT, Goodson ML, et al. Fibroblast growth factor-21 controls dietary protein intake in male mice. Endocrinology 2019; 160(5): 1069–1080.
19. Schorr M, Miller KK. The endocrine manifestations of anorexia nervosa: mechanisms and management. Nat Rev Endocrinol 2017; 13(3): 174–186.
20. Wronski ML, Tam FI, Seidel M, et al. Associations between pituitary-thyroid hormones and depressive symptoms in individuals with anorexia nervosa before and after weight-recovery. Psychoneuroendocrinology 2022; 137: 105630.
21. Bulik CM, Carroll IM, Mehler P. Reframing anorexia nervosa as a metabo-psychiatric disorder. Trends Endocrinol Metabolism 2021. doi: 10.1016/j.tem.2021.07.010
22. Tichá Ľ, Payer J, Killinger Z, Podracká Ľ. Porucha kostného metabolizmu pri mentálnej anorexii. Čes-slov Pediat 2016; 71(5–6): 287–292.
23. Thavaraputta S, Fazeli PK. Estrogen for the treatment of low bone mineral density in anorexia nervosa. J Psychiatr Brain Sci 2022; 7(3): e220004.
24. Misra M, Katzman D, Miller KK, et al. Physiologic estrogen replacement increases bone density in adolescent girls with anorexia nervosa. J Bone Miner Res 2011; 26(10): 2430–8.
25. Taquet M, Geddes JR, Luciano S, Harrison PJ. Incidence and outcomes of eating disorders during the COVID-19 pandemic. Br J Psychiatry 2021; 220(5): 1–3.
Štítky
Neonatology Paediatrics General practitioner for children and adolescentsČlánok vyšiel v časopise
Czech-Slovak Pediatrics
2023 Číslo S3
- What Effect Can Be Expected from Limosilactobacillus reuteri in Mucositis and Peri-Implantitis?
- The Importance of Limosilactobacillus reuteri in Administration to Diabetics with Gingivitis
Najčítanejšie v tomto čísle
- Anorexia nervosa from an endocrinologist's point of view
- Multiple endocrine neoplasia in childhood
- Current view on the diagnostics of growth hormone deficiency in childhood and adolescence
- Pubertal growth in children born small for gestational age (SGA) with persistent short stature (SGA-SS). Growth hormone treatment outcomes from data of the Czech countywide REPAR database