Anorexia nervosa and adrenal hormones: a systematic review and meta-analysis.
DHEA
DHEA-S
aldosterone
anorexia nervosa
cortisol
progesterone
testosterone
Journal
European journal of endocrinology
ISSN: 1479-683X
Titre abrégé: Eur J Endocrinol
Pays: England
ID NLM: 9423848
Informations de publication
Date de publication:
01 Sep 2023
01 Sep 2023
Historique:
received:
14
04
2023
revised:
02
07
2023
accepted:
08
08
2023
pmc-release:
05
09
2024
medline:
14
9
2023
pubmed:
5
9
2023
entrez:
5
9
2023
Statut:
ppublish
Résumé
Anorexia nervosa is a primary psychiatric disorder characterized by self-induced negative energy balance. A number of hormonal responses and adaptations occur in response to starvation and low body weight including changes in adrenocortical hormones. Our objective was to systematically review adrenocortical hormone levels in anorexia nervosa. We searched MEDLINE and EMBASE for studies that reported at least one adrenocortical hormone, including dehydroepiandrosterone (DHEA), DHEA-sulphate (DHEA-S), progesterone, 17-hydroxyprogesterone, pregnenolone, cortisol (serum, urine, cerebrospinal fluid, and hair sample), aldosterone, androstenedione, and testosterone in patients with anorexia nervosa and normal-weight healthy controls from inception until October 2021. Means and standard deviations for each hormone were extracted from the studies to calculate a mean difference (MD). A pooled MD was then calculated by combining MDs of each study using the random-effects model. We included a total of 101 studies with over 2500 females with anorexia nervosa. Mean cortisol levels were significantly higher in anorexia nervosa as compared to normal-weight controls for multiple forms of measurement, including morning cortisol, 12-hour and 24-hour pooled serum cortisol, 24-hour urine cortisol, and after an overnight dexamethasone suppression test. In contrast, mean serum total testosterone and DHEA-S levels were significantly lower among patients with anorexia nervosa. Women with anorexia nervosa have higher cortisol levels and lower DHEA-S and testosterone levels compared to women without anorexia nervosa. This finding is important to consider when evaluating low-weight women for disorders involving the adrenal axis, especially Cushing's syndrome.
Identifiants
pubmed: 37669399
pii: 7260772
doi: 10.1093/ejendo/lvad123
pmc: PMC10498414
doi:
Substances chimiques
Hydrocortisone
WI4X0X7BPJ
Aldosterone
4964P6T9RB
Progesterone
4G7DS2Q64Y
Dehydroepiandrosterone Sulfate
57B09Q7FJR
Types de publication
Meta-Analysis
Systematic Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
S64-S73Subventions
Organisme : NICHD NIH HHS
ID : R01 HD099139
Pays : United States
Organisme : NIH HHS
ID : R01 HD099139
Pays : United States
Informations de copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of European Society of Endocrinology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Déclaration de conflit d'intérêts
Conflict of interest: P.K.F. is a consultant for Regeneron and Xeris Pharmaceuticals.
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