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Erschienen in: Journal für Gynäkologische Endokrinologie/Schweiz 1/2023

17.03.2023 | Essstörungen | Gynäkologische Endokrinologie

Endokrine Veränderungen bei Essstörungen

verfasst von: Prof. Dr. med. Sabine Elisabeth Segerer

Erschienen in: Journal für Gynäkologische Endokrinologie/Schweiz | Ausgabe 1/2023

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Zusammenfassung

Essstörungen führen zu multiplen Adaptationsmechanismen des endokrinen Systems. Bei Esssucht und resultierender Adipositas kommt es zu einer gesteigerten Leptinbildung in den Adipozyten, welche die Gonadotropinsekretion stört. Bei restriktivem Essverhalten infolge einer Anorexia nervosa (AN) kommt es zu einer verminderten Leptinbildung, welche wiederum eine Störung der Gonadotropinsekretion und in der Folge Zyklusstörungen/Amenorrhö hervorrufen kann. Neben diesen Effekten sind zahlreiche andere Adaptationsmechanismen des endokrinen Systems bekannt, welche als Ziel haben, dem Körper eine Euglykämie zu erhalten. Bei AN kann es zu akuten Störungen im Elektrolythaushalt kommen, welche z. T. lebensbedrohliche Folgen (Syndrom der inadäquaten Sekretion des antidiuretischen Hormons, SIADH) haben. Als Langzeitfolge kann es zu einer Verminderung der Knochendichte und einer Steigerung der Frakturrate kommen.
Literatur
1.
Zurück zum Zitat Smink FR, van Hoeken D, Hoek HW (2013) Epidemiology, course, and outcome of eating disorders. Curr Opin Psychiatry 26(6):543–548CrossRefPubMed Smink FR, van Hoeken D, Hoek HW (2013) Epidemiology, course, and outcome of eating disorders. Curr Opin Psychiatry 26(6):543–548CrossRefPubMed
2.
Zurück zum Zitat Leehr EJ, Krohmer K, Schag K, Dresler T, Zipfel S, Giel KE (2015) Emotion regulation model in binge eating disorder and obesity—a systematic review. Neurosci Biobehav Rev 49:125–134CrossRefPubMed Leehr EJ, Krohmer K, Schag K, Dresler T, Zipfel S, Giel KE (2015) Emotion regulation model in binge eating disorder and obesity—a systematic review. Neurosci Biobehav Rev 49:125–134CrossRefPubMed
3.
Zurück zum Zitat Golden NH, Jacobson MS, Schebendach J, Solanto MV, Hertz SM, Shenker IR (1997) Resumption of menses in anorexia nervosa. Arch Pediatr Adolesc Med 151(1):16–21CrossRefPubMed Golden NH, Jacobson MS, Schebendach J, Solanto MV, Hertz SM, Shenker IR (1997) Resumption of menses in anorexia nervosa. Arch Pediatr Adolesc Med 151(1):16–21CrossRefPubMed
4.
Zurück zum Zitat Misra M, Prabhakaran R, Miller KK, Tsai P, Lin A, Lee N, Herzog DB, Klibanski A (2006) Role of cortisol in menstrual recovery in adolescent girls with anorexia nervosa. Pediatr Res 59(4 Pt 1):598–603CrossRefPubMed Misra M, Prabhakaran R, Miller KK, Tsai P, Lin A, Lee N, Herzog DB, Klibanski A (2006) Role of cortisol in menstrual recovery in adolescent girls with anorexia nervosa. Pediatr Res 59(4 Pt 1):598–603CrossRefPubMed
5.
Zurück zum Zitat Jacoangeli F, Masala S, Staar Mezzasalma F, Fiori R, Martinetti A, Ficoneri C, Novi B, Pierangeli S, Marchetti G, Simonetti G, Bollea MR (2006) Amenorrhea after weight recover in anorexia nervosa: role of body composition and endocrine abnormalities. Eat Weight Disord 11(1):e20–e26CrossRefPubMed Jacoangeli F, Masala S, Staar Mezzasalma F, Fiori R, Martinetti A, Ficoneri C, Novi B, Pierangeli S, Marchetti G, Simonetti G, Bollea MR (2006) Amenorrhea after weight recover in anorexia nervosa: role of body composition and endocrine abnormalities. Eat Weight Disord 11(1):e20–e26CrossRefPubMed
6.
Zurück zum Zitat Bulik CM, Sullivan PF, Fear JL, Pickering A, Dawn A, McCullin M (1999) Fertility and reproduction in women with anorexia nervosa: a controlled study. J Clin Psychiatry 60(2):130–135 (quiz 135–137)CrossRefPubMed Bulik CM, Sullivan PF, Fear JL, Pickering A, Dawn A, McCullin M (1999) Fertility and reproduction in women with anorexia nervosa: a controlled study. J Clin Psychiatry 60(2):130–135 (quiz 135–137)CrossRefPubMed
7.
Zurück zum Zitat Balsells M, Garcia-Patterson A, Corcoy R (2016) Systematic review and meta-analysis on the association of prepregnancy underweight and miscarriage. Eur J Obstet Gynecol Reprod Biol 207:73–79CrossRefPubMed Balsells M, Garcia-Patterson A, Corcoy R (2016) Systematic review and meta-analysis on the association of prepregnancy underweight and miscarriage. Eur J Obstet Gynecol Reprod Biol 207:73–79CrossRefPubMed
8.
Zurück zum Zitat Lawson EA, Klibanski A (2008) Endocrine abnormalities in anorexia nervosa. Nat Clin Pract Endocrinol Metab 4(7):407–414CrossRefPubMed Lawson EA, Klibanski A (2008) Endocrine abnormalities in anorexia nervosa. Nat Clin Pract Endocrinol Metab 4(7):407–414CrossRefPubMed
9.
Zurück zum Zitat Lawson EA, Donoho D, Miller KK, Misra M, Meenaghan E, Lydecker J, Wexler T, Herzog DB, Klibanski A (2009) Hypercortisolemia is associated with severity of bone loss and depression in hypothalamic amenorrhea and anorexia nervosa. J Clin Endocrinol Metab 94(12):4710–4716CrossRefPubMedPubMedCentral Lawson EA, Donoho D, Miller KK, Misra M, Meenaghan E, Lydecker J, Wexler T, Herzog DB, Klibanski A (2009) Hypercortisolemia is associated with severity of bone loss and depression in hypothalamic amenorrhea and anorexia nervosa. J Clin Endocrinol Metab 94(12):4710–4716CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Gorwood P, Blanchet-Collet C, Chartrel N, Duclos J, Dechelotte P, Hanachi M, Fetissov S, Godart N, Melchior J‑C, Ramoz N, Rovere-Jovene C, Tolle V, Viltart O, Epelbaum J (2016) New insights in anorexia nervosa. Front Neurosci 10:256CrossRefPubMedPubMedCentral Gorwood P, Blanchet-Collet C, Chartrel N, Duclos J, Dechelotte P, Hanachi M, Fetissov S, Godart N, Melchior J‑C, Ramoz N, Rovere-Jovene C, Tolle V, Viltart O, Epelbaum J (2016) New insights in anorexia nervosa. Front Neurosci 10:256CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Arvat E, Maccario M, Di Vito L, Broglio F, Benso A, Gottero C, Papotti M, Muccioli G, Dieguez C, Casanueva FF, Deghenghi R, Camanni F, Ghigo E (2001) Endocrine activities of ghrelin, a natural growth hormone secretagogue (GHS), in humans: comparison and interactions with hexarelin, a nonnatural peptidyl GHS, and GH-releasing hormone. J Clin Endocrinol Metab 86(3):1169–1174PubMed Arvat E, Maccario M, Di Vito L, Broglio F, Benso A, Gottero C, Papotti M, Muccioli G, Dieguez C, Casanueva FF, Deghenghi R, Camanni F, Ghigo E (2001) Endocrine activities of ghrelin, a natural growth hormone secretagogue (GHS), in humans: comparison and interactions with hexarelin, a nonnatural peptidyl GHS, and GH-releasing hormone. J Clin Endocrinol Metab 86(3):1169–1174PubMed
12.
Zurück zum Zitat Connan F, Lightman SL, Landau S, Wheeler M, Treasure J, Campbell IC (2007) An investigation of hypothalamic-pituitary-adrenal axis hyperactivity in anorexia nervosa: the role of CRH and AVP. J Psychiatr Res 41(1–2):131–143CrossRefPubMed Connan F, Lightman SL, Landau S, Wheeler M, Treasure J, Campbell IC (2007) An investigation of hypothalamic-pituitary-adrenal axis hyperactivity in anorexia nervosa: the role of CRH and AVP. J Psychiatr Res 41(1–2):131–143CrossRefPubMed
13.
Zurück zum Zitat Miller KK, Grinspoon SK, Ciampa J, Hier J, Herzog D, Klibanski A (2005) Medical findings in outpatients with anorexia nervosa. Arch Intern Med 165(5):561–566CrossRefPubMed Miller KK, Grinspoon SK, Ciampa J, Hier J, Herzog D, Klibanski A (2005) Medical findings in outpatients with anorexia nervosa. Arch Intern Med 165(5):561–566CrossRefPubMed
14.
Zurück zum Zitat Stoving RK, Veldhuis JD, Flyvbjerg A, Vinten J, Hangaard J, Koldkjaer OG, Kristiansen J, Hagen C (1999) Jointly amplified basal and pulsatile growth hormone (GH) secretion and increased process irregularity in women with anorexia nervosa: indirect evidence for disruption of feedback regulation within the GH-insulin-like growth factor I axis. J Clin Endocrinol Metab 84(6):2056–2063PubMed Stoving RK, Veldhuis JD, Flyvbjerg A, Vinten J, Hangaard J, Koldkjaer OG, Kristiansen J, Hagen C (1999) Jointly amplified basal and pulsatile growth hormone (GH) secretion and increased process irregularity in women with anorexia nervosa: indirect evidence for disruption of feedback regulation within the GH-insulin-like growth factor I axis. J Clin Endocrinol Metab 84(6):2056–2063PubMed
15.
Zurück zum Zitat Modan-Moses D, Yaroslavsky A, Novikov I, Segev S, Toledano A, Miterany E, Stein D (2003) Stunting of growth as a major feature of anorexia nervosa in male adolescents. Pediatrics 111(2):270–276CrossRefPubMed Modan-Moses D, Yaroslavsky A, Novikov I, Segev S, Toledano A, Miterany E, Stein D (2003) Stunting of growth as a major feature of anorexia nervosa in male adolescents. Pediatrics 111(2):270–276CrossRefPubMed
16.
Zurück zum Zitat Modan-Moses D, Yaroslavsky A, Kochavi B, Toledano A, Segev S, Balawi F, Mitrany E, Stein D (2012) Linear growth and final height characteristics in adolescent females with anorexia nervosa. Plos One 7(9):e45504CrossRefPubMedPubMedCentral Modan-Moses D, Yaroslavsky A, Kochavi B, Toledano A, Segev S, Balawi F, Mitrany E, Stein D (2012) Linear growth and final height characteristics in adolescent females with anorexia nervosa. Plos One 7(9):e45504CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Christo K, Cord J, Mendes N, Miller KK, Goldstein MA, Klibanski A, Misra M (2008) Acylated ghrelin and leptin in adolescent athletes with amenorrhea, eumenorrheic athletes and controls: a cross-sectional study. Clin Endocrinol 69(4):628–633CrossRef Christo K, Cord J, Mendes N, Miller KK, Goldstein MA, Klibanski A, Misra M (2008) Acylated ghrelin and leptin in adolescent athletes with amenorrhea, eumenorrheic athletes and controls: a cross-sectional study. Clin Endocrinol 69(4):628–633CrossRef
18.
Zurück zum Zitat Germain N, Galusca B, Grouselle D, Frere D, Billard S, Epelbaum J, Estour B (2010) Ghrelin and obestatin circadian levels differentiate bingeing-purging from restrictive anorexia nervosa. J Clin Endocrinol Metab 95(6):3057–3062CrossRefPubMed Germain N, Galusca B, Grouselle D, Frere D, Billard S, Epelbaum J, Estour B (2010) Ghrelin and obestatin circadian levels differentiate bingeing-purging from restrictive anorexia nervosa. J Clin Endocrinol Metab 95(6):3057–3062CrossRefPubMed
20.
Zurück zum Zitat Misra M, Miller KK, Tsai P, Gallagher K, Lin A, Lee N, Herzog DB, Klibanski A (2006) Elevated peptide YY levels in adolescent girls with anorexia nervosa. J Clin Endocrinol Metab 91(3):1027–1033CrossRefPubMed Misra M, Miller KK, Tsai P, Gallagher K, Lin A, Lee N, Herzog DB, Klibanski A (2006) Elevated peptide YY levels in adolescent girls with anorexia nervosa. J Clin Endocrinol Metab 91(3):1027–1033CrossRefPubMed
21.
Zurück zum Zitat Lucas AR, Melton LJ 3rd, Crowson CS, O’Fallon WM (1999) Long-term fracture risk among women with anorexia nervosa: a population-based cohort study. Mayo Clin Proc 74(10):972–977CrossRefPubMed Lucas AR, Melton LJ 3rd, Crowson CS, O’Fallon WM (1999) Long-term fracture risk among women with anorexia nervosa: a population-based cohort study. Mayo Clin Proc 74(10):972–977CrossRefPubMed
22.
Zurück zum Zitat Vestergaard P, Emborg C, Stoving RK, Hagen C, Mosekilde L, Brixen K (2003) Patients with eating disorders. A high-risk group for fractures. Orthop Nurs 22(5):325–331CrossRefPubMed Vestergaard P, Emborg C, Stoving RK, Hagen C, Mosekilde L, Brixen K (2003) Patients with eating disorders. A high-risk group for fractures. Orthop Nurs 22(5):325–331CrossRefPubMed
23.
Zurück zum Zitat Schorr M, Miller KK (2017) The endocrine manifestations of anorexia nervosa: mechanisms and management. Nat Rev Endocrinol 13(3):174–186CrossRefPubMed Schorr M, Miller KK (2017) The endocrine manifestations of anorexia nervosa: mechanisms and management. Nat Rev Endocrinol 13(3):174–186CrossRefPubMed
24.
Zurück zum Zitat Faje AT, Fazeli PK, Miller KK, Katzman DK, Ebrahimi S, Lee H, Mendes N, Snelgrove D, Meenaghan E, Misra M, Klibanski A (2014) Fracture risk and areal bone mineral density in adolescent females with anorexia nervosa. Int J Eat Disord 47(5):458–466CrossRefPubMedPubMedCentral Faje AT, Fazeli PK, Miller KK, Katzman DK, Ebrahimi S, Lee H, Mendes N, Snelgrove D, Meenaghan E, Misra M, Klibanski A (2014) Fracture risk and areal bone mineral density in adolescent females with anorexia nervosa. Int J Eat Disord 47(5):458–466CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Misra M (2008) Long-term skeletal effects of eating disorders with onset in adolescence. Ann N Y Acad Sci 1135:212–218CrossRefPubMed Misra M (2008) Long-term skeletal effects of eating disorders with onset in adolescence. Ann N Y Acad Sci 1135:212–218CrossRefPubMed
26.
Zurück zum Zitat Golden NH, Lanzkowsky L, Schebendach J, Palestro CJ, Jacobson MS, Shenker IR (2002) The effect of estrogen-progestin treatment on bone mineral density in anorexia nervosa. J Pediatr Adolesc Gynecol 15(3):135–143CrossRefPubMed Golden NH, Lanzkowsky L, Schebendach J, Palestro CJ, Jacobson MS, Shenker IR (2002) The effect of estrogen-progestin treatment on bone mineral density in anorexia nervosa. J Pediatr Adolesc Gynecol 15(3):135–143CrossRefPubMed
27.
Zurück zum Zitat Strokosch GR, Friedman AJ, Wu SC, Kamin M (2006) Effects of an oral contraceptive (norgestimate/ethinyl estradiol) on bone mineral density in adolescent females with anorexia nervosa: a double-blind, placebo-controlled study. J Adolesc Health 39(6):819–827CrossRefPubMed Strokosch GR, Friedman AJ, Wu SC, Kamin M (2006) Effects of an oral contraceptive (norgestimate/ethinyl estradiol) on bone mineral density in adolescent females with anorexia nervosa: a double-blind, placebo-controlled study. J Adolesc Health 39(6):819–827CrossRefPubMed
28.
Zurück zum Zitat Klibanski A, Biller BM, Schoenfeld DA, Herzog DB, Saxe VC (1995) The effects of estrogen administration on trabecular bone loss in young women with anorexia nervosa. J Clin Endocrinol Metab 80(3):898–904PubMed Klibanski A, Biller BM, Schoenfeld DA, Herzog DB, Saxe VC (1995) The effects of estrogen administration on trabecular bone loss in young women with anorexia nervosa. J Clin Endocrinol Metab 80(3):898–904PubMed
29.
Zurück zum Zitat Weissberger AJ, Ho KK, Lazarus L (1991) Contrasting effects of oral and transdermal routes of estrogen replacement therapy on 24-hour growth hormone (GH) secretion, insulin-like growth factor I, and GH-binding protein in postmenopausal women. J Clin Endocrinol Metab 72(2):374–381CrossRefPubMed Weissberger AJ, Ho KK, Lazarus L (1991) Contrasting effects of oral and transdermal routes of estrogen replacement therapy on 24-hour growth hormone (GH) secretion, insulin-like growth factor I, and GH-binding protein in postmenopausal women. J Clin Endocrinol Metab 72(2):374–381CrossRefPubMed
30.
Zurück zum Zitat Misra M, Katzman D, Miller KK, Mendes N, Snelgrove D, Russell M, Goldstein MA, Ebrahimi S, Clauss L, Weigel T, Mickley D, Schoenfeld DA, Herzog DB, Klibanski A (2011) Physiologic estrogen replacement increases bone density in adolescent girls with anorexia nervosa. J Bone Miner Res 26(10):2430–2438CrossRefPubMed Misra M, Katzman D, Miller KK, Mendes N, Snelgrove D, Russell M, Goldstein MA, Ebrahimi S, Clauss L, Weigel T, Mickley D, Schoenfeld DA, Herzog DB, Klibanski A (2011) Physiologic estrogen replacement increases bone density in adolescent girls with anorexia nervosa. J Bone Miner Res 26(10):2430–2438CrossRefPubMed
31.
Zurück zum Zitat Grinspoon S, Thomas L, Miller K, Herzog D, Klibanski A (2002) Effects of recombinant human IGF‑I and oral contraceptive administration on bone density in anorexia nervosa. J Clin Endocrinol Metab 87(6):2883–2891CrossRefPubMed Grinspoon S, Thomas L, Miller K, Herzog D, Klibanski A (2002) Effects of recombinant human IGF‑I and oral contraceptive administration on bone density in anorexia nervosa. J Clin Endocrinol Metab 87(6):2883–2891CrossRefPubMed
Metadaten
Titel
Endokrine Veränderungen bei Essstörungen
verfasst von
Prof. Dr. med. Sabine Elisabeth Segerer
Publikationsdatum
17.03.2023
Verlag
Springer Vienna
Erschienen in
Journal für Gynäkologische Endokrinologie/Schweiz / Ausgabe 1/2023
Print ISSN: 1995-6924
Elektronische ISSN: 2520-8500
DOI
https://doi.org/10.1007/s41975-023-00285-z

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