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MECHANISMS IN ENDOCRINOLOGY: Anorexia nervosa and endocrinology: a clinical update
Abstract
Anorexia nervosa is a syndrome, that is collections of symptoms, which is not defined by its etiology. The severe cases are intractable. The syndrome is associated with multiple, profound endocrine alterations which may be adaptive, reactive or etiologic. Adaptive changes potentially may be inappropriate in clinical settings such as inpatient intensive re-nutrition or in a setting with somatic comorbidity. Electrolyte levels must be closely monitored during the refeeding process, and the need for weight gain must be balanced against potentially fatal refeeding complications. An important focus of clinical research should be to identify biomarkers associated with different stages of weight loss and re-nutrition combined with psychometric data. Besides well-established peripheral endocrine actions, several hormones also are released directly to different brain areas, where they may exert behavioral and psychogenic actions that could offer therapeutic targets. We need reliable biomarkers for predicting outcome and to ensure safe re-nutrition, however, first of all we need them to explore the metabolism in anorexia nervosa to open new avenues with therapeutic targets. A breakthrough in our understanding and treatment of this whimsical disease remains. Considering this, the aim of the present review is to provide an updated overview of the many endocrine changes in a clinical perspective.
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“However, more prolonged fasting for 5 days almost doubles cortisol production rates (46) and chronic energy deprivation (eg, anorexia nervosa is associated with an activation of the HPA axis from corticotrophin releasing hormone hypersecretion) (12,47).”
From Dysregulation of the Hypothalamic-Pituitary-Testicular Axis due to Energy Deficit (2021) · cites this paper as [47]
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“which may be an appropriate adaptive response to starvation to prevent further hypoglycemia [75].”
BackgroundDysregulation of the Hypothalamic-Pituitary-Testicular Axis due to Energy Deficit
Grossmann, M., & Wittert, G. A. (2021) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgab517 · Cited by 24
Metadata
- Authors
- Støving, R. K.
- Affiliations
- 1Nutrition Clinic, Center for Eating Disorders, Odense University Hospital
- Venue
- European Journal of Endocrinology
- Publisher
- Oxford University Press (OUP)
- Published
- 2019-01
- Volume
- 180
- Issue
- 1
- Pages
- R9-R27
- ISSN
- 0804-4643
- 1479-683X
- Cited by
- 70
- References
- 27
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