Steroid metabolism and excretion in severe anorexia nervosa: effects of refeeding  

Oleh:

Wassif, Wassif S. ; McLoughlin, Declan M. ; Vincent, Royce P. ; Conroy, Simon P. ; Russell, Gerald F.M. ; Taylor, Norman F.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The American Journal of Clinical Nutrition vol. 93 no. 05 (May 2011), page 911-917 .
Topik: Obesity; Eating Disorders
Fulltext: Am J Clin Nutr-2011-Wassif-911-7.pdf (202.93KB)

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Perpustakaan FK Nomor Panggil: A07.K.2011.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Background: To our knowledge, changes in steroid metabolism in subjects with anorexia nervosa (AN) after weight gain have not been elucidated. Objective: We characterized urinary steroid excretion and metabolism in AN patients and investigated the effects of refeeding. Design: In an intervention study, we recruited 7 women with life-threatening weight loss upon admission and after a median [interquartile range (IQR)] of 95 d (88–125 d) of intensive refeeding; 15 age-matched women were recruited as control subjects. The major urinary metabolites were quantified in 24-h collections by capillary gas chromatography. A single examiner measured weights, heights, and skinfold thicknesses. Results: The median (IQR) age of patients was 24 y (21–26 y), and the duration of AN was 4.0 y (3.3–8.0 y). Body mass index (BMI; in kg/m2) increased from 12.8 (12.7–13.1) to 18.6 (18.0–19.6) after refeeding (P < 0.0001). Steroid values [median pre-, post-refeeding (P value)] were as follows: androgen metabolites [472, 1017 µg/24 h (0.93)], cortisol metabolites [1960, 3912 µg/24 h (0.60)], and ratios of androsterone (5a)/etiocholanolone (5ß) [0.28, 0.63 (<0.001)], 5a-/5ß-tetrahydrocortisol [0.20, 0.48 (0.02)], tetrahydrocortisols/tetrahydrocortisone [0.87, 0.61 (0.09)], 20-hydroxy-/20-oxocortisol metabolites [0.29, 0.47 (0.01)], and 20a-/20ß-reduced cortisol metabolites [1.18, 1.89 (=1.00)]. BMI change was positively correlated with 5a-/5ß-tetrahydrocortisol (r = 0.95, P < 0.001). Before refeeding, the following metabolites were lower in patients than in control subjects: androsterone, 5a-tetrahydrocortisol, a-cortolone and a-cortol, 5a-/5ß-tetrahydrocortisol, androsterone/etiocholanolone, and 20-hydroxy/20-oxocortisol (all P < 0.05). After refeeding, all steroid metabolites in patients were at concentrations that were comparable with those in control subjects. Conclusions: Significant changes in urine steroid-metabolite excretion occurred upon starvation, which were reversed upon refeeding. For cortisol, there were decreases in 5a-/5ß-tetrahydrocortisol and 20-hydroxy-/20-oxometabolites; for androgen, there was a decrease in androsterone/etiocholanolone.

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