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The hypothalamic pituitary adrenal function in mal nutrition a comparison between psycho somatic diseases treated with fasting therapy and anorexia nervosa


, : The hypothalamic pituitary adrenal function in mal nutrition a comparison between psycho somatic diseases treated with fasting therapy and anorexia nervosa. Folia Endocrinologica Japonica 55(6): 739-760

The hypothalamic-pituitary-adrenal axis was investigated in 33 patients with various psychosomatic diseases treated with fasting therapy for 11 days, and a comparative study was made between this group and13 young women with anorexia nervosa. The administration of dexamethasone failed to suppress cortisol [F] levels to a normal range in 14 of 33 patients during fasting. The normal circadian rhythm of plasma F was abolished in 9 of 21 patients during fasting. Plasma F concentrations were significantly elevated at any given time of the day, especially in the dexamethasone nonsuppressive patients. The excretion of urinary 17-OHCS [17-hydroxycorticosteroids] and 17-KS [17-kelosteroids] in the 24-h samples after the oral administration of metopirone was significantly higher in fasting patients as compared with non-fasting patients. The response of plasma ACTH to metopirone showed a nonsignificant increase. The circadian rhythm of ACTH responsiveness to metopirone administration was normal in patients during fasting. The plasma F response to .beta.1-24 ACTH 0.25 mg i.m. was significantly higher in fasting than in non-fasting patients. The basal urinary 17-OHCS and 17-KS in the 24-h sample displayed a biphasic fluctuation with the peaks at 3 and 6 days after the initiation of fasting. The F metabolic clearance rate in fasting patients was prolonged as compared with that in non-fasting patients. After refeeding, pituitary adrenal functions returned to normal in all patients. Anorexia nervosa patients, non-suppressive to dexamethasone, demonstrated elevated plasma F levels and normal responses to metopirone and ACTH, with a decreased excretion of urinary 17-OHCS and 17-KS. High levels of plasma F in both fasting and anorexia nervosa were caused by abnormalities of the negative feedback mechanism and prolongation of F metabolic clearance rate. Patients exposed to fasting revealed an adrenocortical hyperfunction.


Accession: 006689071

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Related references

Suzuki, M.; Kamijo, K., 1979: Studies on the hypothalamic-pituitary-adrenal function in a state of malnutrition: a comparison between psychosomatic diseases treated with fasting therapy and anorexia nervosa. Nihon Naibunpi Gakkai Zasshi 55(6): 739-760

Landon, J.; Greenwood, F.C.; Stamp, T.C.; Wynn, V., 1966: The plasma sugar, free fatty acid, cortisol, and growth hormone response to insulin, and the comparison of this procedure with other tests of pituitary and adrenal function. II. In patients with hypothalamic or pituitary dysfunction or anorexia nervosa. Journal of Clinical Investigation 45(4): 437-449

Cavagnini F.; Invitti C.; Dubini A.; Danesi L.; Silvestri G.; Passamonti M.; Magella A.; Morabito F., 1987: Hypothalamic pituitary adrenal function in anorexia nervosa and obesity. D'agata, R And G P Chrousos (Ed ) Serono Symposia Publications From Raven Press, Vol 40 Recent Advances in Adrenal Regulation And Function Xx+311p Raven Press: New York, New York, Usa Illus 137-150

Anonymous, 1987: Abnormal hypothalamic-pituitary-adrenal function in anorexia nervosa. New England Journal of Medicine 316(4): 219-220

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