Cortisol Secretion and Metabolism in Anorexia Nervosa

ROBERT M. BOYAR; Leon D. Hellman; Howard P. Roffwarg; Jack L. Katz; Barnett Zumoff; John F. O’Connor; H. Leon Bradlow; David K. Fukushima

doi:10.1056/nejm197701272960403

Abstract

We studied cortisol secretion and metabolism in 10 women with anorexia nervosa. The 24-hour mean plasma cortisol concentration was 8.9 mug per deciliter (controls, 4.9) (P less than 0.01). Secretory patterns showed normal circadian rhythms. Cortisol half-life was prolonged from 60 to 78 minutes (P less than 0.01), and metabolic clearance rate was decreased from 359 to 177 liters per day (P less than 0.001). Cortisol production was normal (19.4 mg per day). Urinary cortisol was slightly elevated in two of five patients. These findings, as well as the increased tetrahydrocortisol/tetrahydrocortisone ratio (1.2 vs 0.65, P less than 0.01), also appear in hypothyroid patients. Thyroid-function studies showed normal total and free thyroxine and thyrotropin, but low plasma tri-iodothyronine levels (52.7+/-13.2 vs. 137.8+/-24.1 ng per deciliter in the controls, P less than 0.001). In five additional patients with anorexia nervosa studied before and after short-term tri-iodothyronine administration, metabolic abnormalities decreased as plasma tri-iodothyronine levels rose to or above normal.

Keywords

EndocrinologyInternal medicineAnorexia nervosaMedicineHydrocortisoneCircadian rhythmMetabolic clearance rateMetabolismTriiodothyronineHormoneEating disordersPharmacokineticsPsychiatry

MeSH Terms

AdolescentAdultAnorexia NervosaCircadian RhythmFemaleHalf-LifeHumansHydrocortisoneMetabolic Clearance RateTetrahydrocortisolTetrahydrocortisoneThyrotropinThyroxineTriiodothyronine

Related Publications

Alterations in the Hypothalamic-Pituitary-Ovarian and the Hypothalamic-Pituitary-Adrenal Axes in Athletic Women*

Anne B. Loucks , Joseph F. Mortola , L. GIRTON +1 more

The functional integrity of the hypothalamic-pituitary-ovarian and hypothalamic-pituitary-adrenal axes was assessed by determining pulsatile LH, ACTH, and cortisol secretion dur...

1989 The Journal of Clinical Endocrinology... 479 citations

Restoration of insulin responsiveness in skeletal muscle of morbidly obese patients after weight loss. Effect on muscle glucose transport and glucose transporter GLUT4.

Jacqueline Friedman , G. Lynis Dohm , Nancy Leggett-Frazier +4 more

A major defect contributing to impaired insulin action in human obesity is reduced glucose transport activity in skeletal muscle. This study was designed to determine whether th...

1992 Journal of Clinical Investigation 185 citations

Twenty-four-hour profiles and pulsatile patterns of insulin secretion in normal and obese subjects.

K. S. Polonsky , Bruce D. Given , Eve Van Cauter

The pattern of endogenous insulin secretion over a 24-h period, which included three mixed meals, was evaluated in 14 normal volunteers and 15 obese subjects. Insulin secretory ...

1988 Journal of Clinical Investigation 752 citations

Plasma Acylation-Stimulating Protein, Adiponectin, Leptin, and Ghrelin before and after Weight Loss Induced by Gastric Bypass Surgery in Morbidly Obese Subjects

May Faraj , Peter J. Havel , Steve Phélis +3 more

We examined fasting plasma insulin, acylation-stimulating protein (ASP), leptin, adiponectin, ghrelin, and metabolic/cardiovascular risk profile before and 15 +/- 6 months after...

2003 The Journal of Clinical Endocrinology... 505 citations

Metabolic effects of metformin on glucose and lactate metabolism in noninsulin-dependent diabetes mellitus.

Kenneth Cusi , Agostino Consoli , Ralph A. DeFronzo

Metformin is a biguanide that has been shown to effectively lower plasma glucose levels in subjects with noninsulin-dependent diabetes mellitus (NIDDM). However, its mechanism o...

1996 The Journal of Clinical Endocrinology... 419 citations

Publication Info

Year: 1977
Type: article
Volume: 296
Issue: 4
Pages: 190-193
Citations: 281
Access: Closed

External Links

Download PDF (Free) View on DOI.org PubMed Semantic Scholar

Social Impact

Altmetric

Cortisol Secretion and Metabolism in Anorexia Nervosa

PlumX Metrics

Social media, news, blog, policy document mentions

Citation Metrics

281

OpenAlex

Influential

218

CrossRef

Cite This

APA Style

                            
                                
                                    ROBERT M. BOYAR, 
                                
                                    Leon D. Hellman, 
                                
                                    Howard P. Roffwarg
                                
                                et al.
                            
                            (1977). 
                            Cortisol Secretion and Metabolism in Anorexia Nervosa. 
                            New England Journal of Medicine
                            , 296
                            (4)
                            , 190-193.
                            https://doi.org/10.1056/nejm197701272960403
                        

Identifiers

DOI: 10.1056/nejm197701272960403
PMID: 831089

Data Quality

Data completeness: 81%