Usdan Lisa S, Khaodhiar Lalita, Apovian Caroline M
Section of Endocrinology, Diabetes, and Nutrition Boston University School of Medicine, Boston, MA, USA.
Endocr Pract. 2008 Nov;14(8):1055-63. doi: 10.4158/EP.14.8.1055.
To describe the hormonal adaptations and alterations 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.
Anorexia nervosa is a devastating disease with a variety of endocrine manifestations. The effects of starvation are extensive and negatively affect the pituitary gland, thyroid gland, adrenal glands, gonads, and bones. Appetite is modulated by the neuroendocrine system, and characteristic patterns of leptin and ghrelin concentrations have been observed in anorexia nervosa. A thorough understanding of refeeding syndrome is imperative to nutrition rehabilitation in these patients to avoid devastating consequences. Although most endocrinopathies associated with anorexia nervosa reverse with recovery, short stature, osteoporosis, and infertility may be long-lasting complications. We describe a 20-year-old woman who presented with end-stage anorexia nervosa whose clinical course reflects the numerous complications caused by this disease.
The effects of severe malnutrition and subsequent refeeding are extensive in anorexia nervosa. Nutrition rehabilitation is the most appropriate treatment for these patients; however, it must be done cautiously.
描述神经性厌食症的激素适应性变化。
我们在PubMed上检索了与神经性厌食症中观察到的内分泌紊乱病理生理学相关的英文文献，并描述了一个病例以阐明这些发现。
神经性厌食症是一种具有多种内分泌表现的破坏性疾病。饥饿的影响广泛，对垂体、甲状腺、肾上腺、性腺和骨骼产生负面影响。食欲由神经内分泌系统调节，在神经性厌食症中已观察到瘦素和胃饥饿素浓度的特征性模式。对于这些患者的营养康复，透彻了解再喂养综合征至关重要，以避免毁灭性后果。尽管与神经性厌食症相关的大多数内分泌病变在康复后会逆转，但身材矮小、骨质疏松和不孕可能是长期并发症。我们描述了一名患有终末期神经性厌食症的20岁女性，其临床病程反映了该疾病引起的众多并发症。
严重营养不良及随后再喂养的影响在神经性厌食症中广泛存在。营养康复是这些患者最合适的治疗方法；然而，必须谨慎进行。
