Calcaterra Valeria, Magenes Vittoria Carlotta, Fratangeli Nadia, Nigro Giulia, Fabiano Valentina, Mendolicchio Leonardo, Zuccotti Gianvincenzo
Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, Pavia, Italy.
Pediatric Department, Buzzi Children's Hospital, Milan, Italy.
Front Pediatr. 2024 Dec 12;12:1415061. doi: 10.3389/fped.2024.1415061. eCollection 2024.
In patients affected by anorexia nervosa (AN) different endocrine abnormalities have been described, but, among them, hypothalamic-pituitary-adrenal (HPA) dysfunction, although associated to important side effects, is underestimated and has no therapeutical options. We present a narrative literature review to investigate the HPA axis in patients with AN, in order to highlight HPA dysfunction and its effects. We also described the crucial role of HPA monitoring, and to consider eventual therapeutic and preventive strategies in AN patients. The literature now available demonstrates that women and girls suffering from AN have higher measures of cortisol and lower levels of androgens as compared to controls. These endocrinological disturbances have deleterious effects on the subjects, both from the physical and from the psychological point of view. It's fundamental for physicians to consider these aspects when assessing AN patients. The mechanisms behind the adrenocortical dysfunctions in eating disorders patients remain an open question and there are no available treatments, thus research on this issue would be extremely useful and highly necessary, especially in the pediatric field.
在神经性厌食症（AN）患者中，已描述了不同的内分泌异常情况，但其中下丘脑-垂体-肾上腺（HPA）功能障碍尽管伴有重要的副作用，却未得到充分重视且尚无治疗选择。我们进行了一项叙述性文献综述，以研究AN患者的HPA轴，从而突出HPA功能障碍及其影响。我们还描述了HPA监测的关键作用，并考虑AN患者可能的治疗和预防策略。现有文献表明，与对照组相比，患有AN的女性和女孩皮质醇水平较高，雄激素水平较低。这些内分泌紊乱对患者的身体和心理都有有害影响。医生在评估AN患者时考虑这些方面至关重要。饮食失调患者肾上腺皮质功能障碍背后的机制仍是一个悬而未决的问题，且尚无可用的治疗方法，因此针对这一问题的研究将极其有用且非常必要，尤其是在儿科领域。
