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

Multiple endocrine determinations were carried out on 101 patients with anorexia nervosa. Ninety-five percent of the patients studied were female, and in 94% of patients the anorexia nervosa began before 30 years of age. Evidence of gonadal dysfunction was the predominant manifestation, both clinically and by laboratory studies. Amenorrhea occurred before or concurrent with onset of weight loss in 65% of the women. The average weight loss was 28% of the weight before illness began. In an additional 11%, the disease began before menarche. The mean age of menarche in patients with secondary amenorrhea was 13 years. Urinary excretion of pituitary gonadotropin was undetectable in 44 of 65 patients and was below 19 rat units per 24 hours in the remaining patients. Serum luteinizing hormone level was below 8 microgram/dl in 15 of 27 patients studied and serum follicle-stimulating hormone was below 10 microgram/dl in 7 of 27 patients studied. Mean serum or urinary estrogens, or both, were low in more than 50% of the patients. Elevation of serum corticosteroids or loss or reversal of diurnal variation, or both, was noted in 50% of patients. Fasting serum growth hormone levels were elevated in 45% of the patients. Mean total and free serum thyroxine, thyroid-stimulating hormone, and triiodothyronine levels were low. These hormonal alterations in the hypothalamic-pituitary axis in patients with anorexia nervosa probably represent adaptive and protective mechanisms for chronic starvation and weight loss.
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PMID:Hypothalamic-endocrine dysfunction in anorexia nervosa. 92 47

Adequate nutrition is essential for normal reproductive function in man. Menarche occurs at a critical level of 'fatness' and it appears that the hypothalamic events leading to pubertal development and the achievement of reproductive competence may be triggered by metabolic/endocrinological changes due to an increase in fat. The attainment and maintenance of ovulatory cycles demands a minimum degree of body fat (about 22%). Undernutrition results in weight loss and a reduction in fat tissue. This alteration in body composition in turn precipitates the hypothalamic changes that cause impaired gonadotrophin secretion, inappropriate ovarian stimulation and menstrual abnormalities--usually primary or secondary amenorrhoea. Refeeding with restoration of fat tissue will usually result in recovery of reproductive function. There are many causes of undernutrition and the main ones have been discussed. In developed countries the dietary restriction is usually self-imposed--either by rigid control of intake or by the high energy demands of intensive exercise. In contrast to this 'starvation amidst affluence', in developing countries malnutrition is usually the result of inadequate food supplies and poverty. While infertility is often the consequence of undernutrition, many women with suboptimal nutritional states do succeed in becoming pregnant. Malnutrition prejudices pregnancy outcome and results in increased maternal and fetal morbidity and mortality as well as long-term developmental sequelae in the infant. Dietary supplementation is helpful but cannot always overcome the insult caused by the periconceptional undernutrition. The cessation of reproductive function in the undernourished woman represents an adaptive phenomenon, since pregnancy would be prejudicial both to her and the fetus. In view of this, treatment should always aim at refeeding and not at induction of ovulation. Malnourished communities require dietary support and they present the problem of provision of adequate resources. So-called ethnic and culture differences in pubertal development and reproductive performances are in fact often the result of discrepancies in resources and nutrition. Given equal nutritional opportunities these variations may well disappear within a few decades.
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PMID:Nutrition and reproduction. 390 60

One of the symptoms of anorexia nervosa (a.n.) is cessation of pubescence or secondary amenorrhea. Their origin in anorexia nervosa is multifactorial, partly resulting from starvation-induced hipogonadism. Amenorrhea in a.n. may persist despite weight recovery and is often related to osteoporosis. The authors' present causes of amenorrhea and its persisting in a.n., pointing to the factors influencing prognosis according to resumption of menses. They also review reports of hormonal replacement therapy in this group of patients.
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PMID:[Menstrual dysfunction in anorexia nervosa]. 2067 46

The present study analyzes body fat distribution, a well-known and important indicator of reproductive capability, in young women between 18 and 28 years of age (mean=23.3 years) suffering from secondary amenorrhea and therefore temporary infertility resulting from self-starvation. Body composition parameters estimated by means of dual energy x-ray absorptiometry and the fat distribution index, indicating body shape, were compared with those of healthy controls. Although members of the infertile, amenorrheic group exhibited dramatically low body weight and total amount of body fat, and therefore a marked negative energy balance in comparison with the healthy controls, the sex-specific fat distribution patterns did not differ between infertile and fertile young women. In contrast, the lower the weight and total fat amount, the more gynoid the fat distribution, even in infertile women. This observation may be interpreted in an evolutionary sense: Our ancestors had to cope with frequent food shortages, even starvation, and therefore lengthy periods of negative energy balance. In addition to pregnancy and lactation, temporary infertility as a result of long-term negative energy balance was not an uncommon phenomenon in female life histories. Nevertheless, after a time of plenty, reproductive function recovered, and therefore the gynoid fat distribution patterns in temporarily infertile young women may be interpreted as signal of reproductive capability, which resumes after a time of surplus.
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PMID:Fat distribution patterns in young amenorrheic females. 2619 66