de Rosa G, Corsello S M, de Rosa E, Della Casa S, Ruffilli M P, Grasso P, Pasargiklian E
Exp Clin Endocrinol. 1983 Aug;82(2):160-72. doi: 10.1055/s-0029-1210272.
The main objective of the study was to evaluate the endocrinological picture of anorexia. The sample consisted of 23 anorectic patients (20 females, 3 males) with a control group of 10 normal females and 5 normal males. All participants underwent a work-up which included testing for hypothalamic, hypophyseal, thyroidal, adrenal, gonadal functioning and glucose metabolism. Our results revealed a reduced urinary output and low serum levels of gonadotropins with different responses to LHRH correlating with the stage of the illness. We found reduced urinary estrogens and elevated testosterone levels in females. Males demonstrated a reduction of testosterone. While basal prolactinemia was normal in both sexes, males showed an exaggerated response to TRH. The thyroid function study in anorectic patients revealed a decrease in T3 and in free T3 and an increase in reverse T3. Free T4 was slightly increased with normal T4 levels. Basal TSH was normal with a delayed peak after TRH. We also noticed in the anorectic population reduced basal glucose levels with a flat glucose curve; reduced insulin levels with a slight increase after glucose administration; elevated basal GH with a fair response to L-Dopa; elevated serum cortisol with loss of circadian rhythm and slightly inhibited by dexamethasone. In addition, both noradrenalin and VMA were reduced. We concluded that the multiple endocrine abnormalities found are consistent with hypothalamic dysfunction. The etiology of this dysfunction remains for the endocrinologist highly controversial.
该研究的主要目的是评估厌食症的内分泌情况。样本包括23名厌食症患者（20名女性，3名男性），并设有一个由10名正常女性和5名正常男性组成的对照组。所有参与者都接受了一系列检查，包括对下丘脑、垂体、甲状腺、肾上腺、性腺功能以及葡萄糖代谢的检测。我们的研究结果显示，尿量减少，促性腺激素血清水平降低，且对促黄体生成素释放激素（LHRH）的反应因疾病阶段而异。我们发现女性尿雌激素减少，睾酮水平升高。男性则表现为睾酮水平降低。虽然男女两性的基础催乳素血症均正常，但男性对促甲状腺激素释放激素（TRH）的反应过度。对厌食症患者的甲状腺功能研究显示，三碘甲状腺原氨酸（T3）和游离T3减少，反三碘甲状腺原氨酸增加。游离甲状腺素（Free T4）略有升高，甲状腺素（T4）水平正常。基础促甲状腺激素（TSH）正常，对TRH的反应峰值延迟。我们还注意到，厌食症患者群体的基础血糖水平降低，血糖曲线平稳；胰岛素水平降低，葡萄糖给药后略有升高；基础生长激素升高，对左旋多巴有良好反应；血清皮质醇升高，昼夜节律消失，地塞米松对其有轻微抑制作用。此外，去甲肾上腺素和香草扁桃酸（VMA）均减少。我们得出结论，所发现的多种内分泌异常与下丘脑功能障碍一致。这种功能障碍的病因在内分泌学家中仍极具争议。
