From b1e90b5c76b24ec508d12f4bb247a8bdf0be82ac Mon Sep 17 00:00:00 2001 From: kianpavy228961 Date: Thu, 2 Apr 2026 08:07:24 +0000 Subject: [PATCH] Add 'Anorexia nervosa and adrenal hormones: a systematic review and meta-analysis' --- ...al-hormones%3A-a-systematic-review-and-meta-analysis.md | 7 +++++++ 1 file changed, 7 insertions(+) create mode 100644 Anorexia-nervosa-and-adrenal-hormones%3A-a-systematic-review-and-meta-analysis.md diff --git a/Anorexia-nervosa-and-adrenal-hormones%3A-a-systematic-review-and-meta-analysis.md b/Anorexia-nervosa-and-adrenal-hormones%3A-a-systematic-review-and-meta-analysis.md new file mode 100644 index 0000000..809715d --- /dev/null +++ b/Anorexia-nervosa-and-adrenal-hormones%3A-a-systematic-review-and-meta-analysis.md @@ -0,0 +1,7 @@ +
+
AN also has dramatic effects on normal growth, bone turnover, nutrient metabolism, and appetite regulation. Appetite is modulated by the neuroendocrine system, and characteristic patterns of leptin and [notes.medien.rwth-aachen.de](https://notes.medien.rwth-aachen.de/29Gg6lE3SqWa3KbDj8HWiA/) ghrelin concentrations have been observed in anorexia nervosa. We performed a PubMed search of the English-language literature related to the pathophysiology of the endocrine disorders observed in anorexia nervosa, and we describe a case to illustrate these findings. Decreased DHEA-S levels could reflect changes in DHEA sulfotransferase and/or PAPSS2 activities.51 Whether the relatively higher DHEA levels are due in part to activation of the hypothalamic–pituitary–adrenal axis and ACTH stimulation, for example, is not known, and further study is needed to better understand this divergence between DHEA and DHEA-S levels in AN. Therefore, it is critical for clinicians to keep AN in the differential diagnosis of patients with cortisol excess, as not doing so may result in patients undergoing unnecessary evaluations/procedures and possible treatment, which potentially may result in more harm than benefit. First, cortisol assessments in patients with AN are elevated, and therefore, the biochemical assessment will be similar to that in patients with Cushing's syndrome. +Starvation leads to impaired pulsatility of gonadotropin-releasing hormone, which suppresses the secretion of gonadotropins, particularly LH, and leads to anovulation, prolonged follicular phase with luteal phase deficiency, and hypoestrogenism (7). Sexual orientation was not fully assessed in our patients, although the majority had reported being in heterosexual relationships. Similar to previously reported studies (13,14), depression, psychosis, and personality disorders were highly evident in our cohort, which parallels the high prevalence of comorbid psychiatric illness in females with AN. +We hypothesized that bone formation would increase and depressive symptoms and spatial cognition would improve with short-term physiological [testosterone purchase](https://gliderarch5.bravejournal.net/how-to-get-a-trt-prescription-and-buy-testosterone-online) administration. Anorexia nervosa (AN) is complicated by severe bone loss, cognitive function deficits, and a high prevalence of major depression. Males should be screened for AN if there is a history of weight loss, especially with co-existing psychiatric disorders or substance abuse, BMI below average for weight and height, symptoms of hypogonadism, or unexplained fragility fracture. The patients in this study have not followed-up, which limits our ability to determine if there has been additional improvement in symptoms or biochemical parameters. +However, recombinant human leptin also led to a 4.3% decrease in fat mass among the five individuals who completed the 3 month intervention, which limits the potential of leptin to be used as a therapy in women with anorexia nervosa. However, the diagnosis of anorexia nervosa can be difficult because patients with anorexia nervosa can be in denial of their disease and do not view their behaviour and issues with body image as abnormal. Amenorrhea was removed as a criterion due to a recognition that endocrine dysregulation in anorexia nervosa is variable, and that some women with low weight and all the psychiatric features of anorexia nervosa continue to have regular menses2. Serum levels of leptin, an anorexigenic adipokine, are suppressed and levels of ghrelin, an orexigenic gut peptide, are elevated in women with anorexia nervosa; however, levels of peptide YY, an anorexigenic gut peptide, are paradoxically elevated. Further studies are needed to determine whether recombinant human leptin may provide benefits to women with AN who have regained weight but remain amenorrheic. Changes in leptin levels likely have a role in the neuroendocrine adaptation to starvation, [http://amur.1gb.ua/user/tailpipe1](http://amur.1gb.ua/user/tailpipe1/) leading to changes in other hormone concentrations that may have a protective effect in this energy-deficient state (74). In contrast, plasma neuropeptide Y concentration in AN has been reported to be greater or equal to that of normal-weight women (72,73). +The 24-hour pooled serum cortisol measurement is a highly accurate measurement, as it provides a comprehensive measurement of total cortisol over the 24-hour period, but it is also challenging and time-consuming to implement. As this study only involved the analysis of data from previously published studies, ethics approval was not required. As different studies used varying units of measurement, these were standardized for each hormone.8,9 Extracted data included the name of the study, name of the first author, year(s) of study, year of publication, recruitment of cases and comparators, diagnostic criteria, baseline characteristics (age and BMI) of cases and comparators, method of hormone measurement, and means and SDs for each reported adrenal hormone. This finding is important to consider when evaluating low-weight women for disorders involving the adrenal axis, especially Cushing's syndrome. Means and standard deviations for each hormone were extracted from the studies to calculate a mean difference (MD). Regarding the comparison of CT and AN, hormone levels can help to distinguish between these two conditions if in doubt. +
\ No newline at end of file