Anorexia Nervosa: Immaturity of the 24-Hour Luteinizing Hormone Secretory Pattern

Abstract

Nine women (17 to 23 years of age) with primary anorexia nervosa associated with amenorrhea had measurements of plasma luteinizing hormone concentrations at 20-minute intervals for 24 hours. Eight of the nine showed age-inappropriate secretory patterns that resembled those found in prepubertal and pubertal children. The finding of an "immature" luteinizing hormone pattern suggests that a "regression" (in the patients with secondary amenorrhea) or an "arrest" (in the patients with primary amenorrhea) of the luteinizing hormone secretory "program" occurs in this disorder. One patient had a spontaneous remission, with return of body weight to normal, associated with a maturational change from the early pubertal luteinizing hormone pattern found during her illness to one characteristic of postmenarchal girls, indicating the reversibility of this abnormality. The finding of a relation between body weight and the maturity of the luteinizing hormone pattern supports the hypothesis that a "critical body weight" is an important factor in the initiation of menarche. (N Engl J Med 291: 861 -865, 1974)