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Query: UMLS:C0038187 (starvation)
 24,951 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Computed tomographic (CT) brain scans were performed in 50 inpatients with bulimia nervosa, 50 anorectic inpatients, and 50 age-matched control subjects. A number of patients with bulimia nervosa had enlarged ventricles and/or sulcal widening, but the degree and frequency of ventricular dilatation and sulcal widening were not so pronounced as in patients with anorexia nervosa. As the bulimic patients were of normal body weight, the CT abnormalities cannot be attributed to emaciation, which has often been suggested as the cause of abnormalities found in anorectic patients. Since many bulimic patients repeatedly attempt to lose weight by going on restrictive diets, the morphological brain alterations may reflect the endocrine and metabolic reactions to starvation--regardless of whether starvation has led to emaciation, as in the case of anorexia nervosa, or only counterbalanced the binges of high-caloric food. This assumption is supported by the finding that in both bulimic and anorectic patients ventricular size is inversely correlated with the plasma levels of triiodothyronine, a low concentration of which is an indicator for starvation.
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PMID:Structural brain abnormalities in patients with bulimia nervosa. 292 42

To examine the effects of chronic dehydration and starvation on plasma levels of human atrial natriuretic polypeptide (hANP) in human subjects, the basal level and saline-induced rise of plasma hANP in 7 patients with anorexia nervosa were compared with those in age-matched healthy subjects. The unstimulated level of plasma hANP was markedly high in the patients with anorexia nervosa (patients vs. control; 55.4 +/- 9.0 pg/ml vs. 11.4 +/- 6.1 pg/ml, P less than 0.01). However, no significant increase of plasma hANP in the anorectic patients was observed in response to saline-infusion, while a 3-fold increase over the basal level of plasma hANP was noted in the saline-infused normal young subjects. These results show that hANP may be secreted to an inadequate extent, hence the release would be resistant to volume-loading. The pathophysiological meaning of such a high plasma concentrations of hANP in anorexia nervosa is the subject of ongoing studies.
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PMID:Human atrial natriuretic polypeptide in plasma of patients with anorexia nervosa. 297 65

Platelets alpha 2-adrenoceptors were studied in 24 patients with anorexia nervosa shortly after admission to the hospital and after 10% weight gain. Twenty patients with bulimia and 24 healthy age- and sex-matched normal subjects also were studied. Receptor number was significantly increased in patients with bulimia and anorexia nervosa. After 10% weight gain, the receptor number almost normalized in anorexia nervosa patients. Kd values were increased in all patients groups at all times of study. In patients with bulimia or anorexia nervosa, both initially and after weight gain, the maximal effect of prostaglandin E1 (PGE1) on platelet cAMP production was greatly increased, while the half-maximally effective dose was unchanged. Also, the maximal inhibitory effects of epinephrine and clonidine on PGE1-stimulated platelet cAMP production were greater, while the half-maximal dose of both alpha 2-agonists was unchanged. Metabolic and endocrine indicators of starvation were present in both bulimic and anorexia nervosa patients initially. Blood beta-hydroxybutyric acid was elevated, and plasma T3 values and the orthostatic response of plasma norepinephrine (delta NA) were reduced, while cortisol was elevated (only in anorexia nervosa patients). Among these parameters, only delta NA significantly correlated with the actions of PGE1 and epinephrine on cAMP production. In conclusion, the activity of the sympathetic nervous system was reduced in patients with anorexia nervosa and bulimia. This reduction was accompanied by an increased capacity and a decreased affinity of platelet alpha 2-receptors and an increased PGE1 stimulatory and epinephrine inhibitory effects on cAMP production.
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PMID:Platelet alpha 2-adrenoceptor and adenylate cyclase in patients with anorexia nervosa and bulimia. 299 57

Ovarian volume and the diameter of the intra-ovarian follicles correlated with the percentage of premorbid weight in 36 patients with anorexia nervosa who had repeated pelvic ultrasound scans during weight gain. Oestradiol levels increased when the follicles became dominant and were greater than 1 cm in diameter; and uterine growth increased linearly with plasma oestradiol. Pelvic ultrasonography can thus be used as a simple, rapid, bioassay to determine hypothalamic-pituitary-ovarian function in patients with anorexia nervosa and provides a useful guide to the degree of weight restoration required to enable menstrual function to recover. The outcome of anorexia nervosa may be related to the degree to which the biological consequences of starvation which perpetuate the disorder are overcome. The menstrual abnormalities in bulimia nervosa are associated with pelvic ultrasound findings such as small multifollicular ovaries and small uterine areas which also occur in anorexia nervosa and simple weight loss amenorrhoea. This suggests that weight loss or the nutritional disturbance in bulimia nervosa may underlie the menstrual irregularities which commonly occur in this condition.
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PMID:The ultrasonographic features in anorexia nervosa and bulimia nervosa: a simplified method of monitoring hormonal states during weight gain. 306 87

Anorexia nervosa is a disease of prepuberty and puberty occurring predominantly in females. There is growing evidence that it is increasing in frequency. The essential features are an intense fear of becoming obese, a disturbance of body image, amenorrhea, and significant weight loss followed by secondary physical changes. The disorder seems to be a product of the reciprocal interplay of biological, familial and sociocultural factors leading to starvation which, in turn, provide feedback perpetuating the anorexia nervosa syndrome. Patients often need therapeutic help to break through the denial. Our management therapy concept includes weight restoration and stabilization, as well as individual and family therapy. At follow-up, 50% of the anorectic patients reveal a good outcome, 25% fall in an intermediate category, and the rest show a poor prognosis.
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PMID:[Anorexia nervosa in adolescence]. 306 34

This article summarizes a variety of physiological abnormalities found in anorexia nervosa. Metabolic aberrations, endocrine dysfunctions and other physical complications including those of weight-restoring treatments are discussed. Most of them are due to weight loss and the starvation process itself and revert to normal with nutritional rehabilitation.
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PMID:[Somatic disturbances in anorexia nervosa]. 306 36

The patient described in this case report had anorexia nervosa, which ultimately was fatal. She presented with complete serous atrophy of the bone marrow associated with pancytopenia. After 2 weeks of intensive nutritional support, her peripheral blood counts had returned to normal. At autopsy on day 24, the serous atrophy had resolved and the bone marrow was populated by normal numbers of hematopoietic precursors. This case is unique in demonstrating that starvation-induced severe serous atrophy of the bone marrow is reversible with nutritional intervention.
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PMID:Reversal of severe serous atrophy of the bone marrow in anorexia nervosa. 311 34

There are clinical similarities between anorexia nervosa and hypothyroidism. Circulating levels of T4 and particularly T3 have been reported to be low in this eating disorder. Previous reports have, however, shown normal basal levels of serum TSH with normal or delayed responses to TRH. To assess thyroid function and the hypothalamic-pituitary axis in 21 women with anorexia nervosa, serum levels of free and total thyroid hormones, binding proteins, and TSH employing an extremely sensitive assay (detection limit = 0.02 microU/ml) were measured. Serum T4, free T4, T3, free T3, TSH, TBG and TBPA concentrations were significantly lower and rT3 levels were significantly higher in anorexia nervosa patients than in normal controls. A delayed TSH response to TRH was noted in 66% of patients, hyporesponsiveness was seen in another 24%, and a normal response in only 10%. In 10 anorexia nervosa patients studied after weight gain, T4, T3, free T3, TSH, TBG and TBPA were significantly increased, and rT3 was significantly decreased. No change in mean free T4 levels with weight gain was noted. Other parameters of hypothalamic dysfunction in anorexia nervosa have been reported and the present data suggest that apparent hypothalamic hypothyroidism occurs perhaps as an adaptation to prolonged starvation.
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PMID:Hypothalamic-pituitary-thyroidal dysfunctions in anorexia nervosa. 311 19

Plasma and erythrocyte amino acid concentrations in seven female patients in the acute stage of anorexia nervosa were compared with values in the same subjects after refeeding, and with normal controls. We also compared these values with literature values from patients with protein-calorie malnutrition and prolonged starvation in an attempt to identify a biological indicator of severity and prognosis. Our data indicate: (1) Routine laboratory analyses that reflect protein status do not differentiate normal subjects from patients with anorexia nervosa. (2) The plasma aminogram in the acute stage of anorexia nervosa differs from normal, and differs from values reported for both protein malnutrition and prolonged starvation. (3) The Whitehead ratio clearly separates the acutely ill anorectic state from the treated state and from normal controls. (4) Both erythrocyte and plasma amino acid concentrations differ from normal in anorexia nervosa, but changes in erythrocyte concentrations are more obvious. (5) Erythrocyte glycine concentrations are unique, in that values were persistently elevated at all stages of illness in anorexia nervosa. (6) Erythrocyte-to-plasma amino acid ratios do not provide a biological index of severity and prognosis for patients with anorexia nervosa, in contrast to data reported for individuals with protein malnutrition.
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PMID:Plasma and erythrocyte amino acid concentrations in anorexia nervosa. 311 92

It has been observed that basal and/or TRH-stimulated serum TSH levels occasionally conflict with the actual values of circulating thyroid hormones in patients with anorexia nervosa. In the present study sixteen female patients with anorexia nervosa during self-induced starvation displayed clinical findings suggesting hypothyroidism, e.g., cold intolerance, constipation, bradycardia, hypothermia and hypercholesterolemia in association with decreased serum total T3 (62.8 +/- 5.2 ng/dl) and T4 (6.6 +/- 0.3 micrograms/dl). Markedly decreased T3 correlated positively with average heart rate (r = 0.5655, P less than 0.025) and negatively with total cholesterol (r = -0.7413, P less than 0.005). This result may suggest that peripheral metabolic state of the underweight anorexics depends considerably upon the serum T3 concentration. Despite decreased total thyroid hormones, free T4 assayed by radioimmunoassay was normal in all five cases examined (1.4 +/- 0.2 ng/dl) and the free T4 index in fifteen cases was normal except in one case. Basal TSH was not increased and TSH response to exogenous TRH was not exaggerated in any. These results may be compatible with a theory that free T4 has a dominant influence on pituitary TSH secretion. Furthermore, glucocorticoids may also have some influence on depressed TSH response, because an inverse correlation between increased plasma cortisol and the sum of net TSH increase after TRH was observed in twelve cases examined. In conclusion, it is suggested that normal sensitivity of peripheral tissues and pituitary thyrotroph to different circulating thyroid hormones is maintained in anorexia nervosa patients even during severe self-induced starvation, and that the metabolic state in these patients is considerably under the influence of circulating T3.
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PMID:Assessment of the relationship between serum thyroid hormone levels and peripheral metabolism in patients with anorexia nervosa. 319 56


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