Journal of Clinical Endocrinology & Metabolism, Vol 64, 203-208, Copyright © 1987 by Endocrine Society

ARTICLES

Elevated cerebrospinal fluid levels of immunoreactive corticotropin- releasing hormone in anorexia nervosa: relation to state of nutrition, adrenal function, and intensity of depression

WH Kaye, HE Gwirtsman, DT George, MH Ebert, DC Jimerson, TP Tomai, GP Chrousos and PW Gold

To study the pathophysiology of hypercortisolism in anorexia nervosa, we measured the cerebrospinal fluid (CSF) levels of corticotropin- releasing hormone (CRH) in patients when they were underweight and at intervals after weight restoration. CSF CRH levels were significantly elevated in hypercortisolemic underweight patients. Both CSF CRH levels and pituitary-adrenal function normalized after weight recovery. A significant positive correlation was found between CSF CRH levels and depression ratings in weight-corrected patients. We conclude that the hypercortisolism of anorexia nervosa reflects a defect at or above the hypothalamus which results in the hypersecretion of endogenous CRH. The positive correlation between CSF CRH and depression in the weight- restored patients is compatible with previous data indicating increased CRH secretion in the depressed phase of primary affective disorder and supports the notion of a relationship between CRH and depressive symptomatology. Moreover, these data are compatible with observations that depression is part of the anorexia nervosa syndrome.

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				References PsychiatryOnline CME, May 1, 2007; 2007(1): 2 - 2. [Full Text]

				F. Lanfranco, L. Gianotti, A. Picu, R. Giordano, G. A. Daga, V. Mondelli, G. Malfi, S. Fassino, E. Ghigo, and E. Arvat Effects of free fatty acids on ACTH and cortisol secretion in anorexia nervosa. Eur. J. Endocrinol., May 1, 2006; 154(5): 731 - 738. [Abstract] [Full Text] [PDF]

				B. Brundu, T. L. Loucks, L. J. Adler, J. L. Cameron, and S. L. Berga Increased Cortisol in the Cerebrospinal Fluid of Women with Functional Hypothalamic Amenorrhea J. Clin. Endocrinol. Metab., April 1, 2006; 91(4): 1561 - 1565. [Abstract] [Full Text] [PDF]

				J. J. Puder, P. U. Freda, R. S. Goland, M. Ferin, and S. L. Wardlaw Stimulatory Effects of Stress on Gonadotropin Secretion in Estrogen-Treated Women J. Clin. Endocrinol. Metab., June 1, 2000; 85(6): 2184 - 2188. [Abstract] [Full Text]

				T.M. O'CONNOR, D.J. O'HALLORAN, and F. SHANAHAN The stress response and the hypothalamic-pituitary-adrenal axis: from molecule to melancholia QJM, June 1, 2000; 93(6): 323 - 333. [Abstract] [Full Text] [PDF]

				M. Ferin Stress and the Reproductive Cycle J. Clin. Endocrinol. Metab., June 1, 1999; 84(6): 1768 - 1774. [Full Text]

				E. Xiao, L. Xia-Zhang, and M. Ferin Stress and the Menstrual Cycle: Short- and Long-Term Response to a Five-Day Endotoxin Challenge during the Luteal Phase in the Rhesus Monkey J. Clin. Endocrinol. Metab., February 1, 1999; 84(2): 623 - 626. [Abstract] [Full Text]