title: Absence of circadian salivary cortisol rhythm in women with anorexia nervosa.
abstract: OBJECTIVE
  To compare the cortisol levels and 24 hour salivary cortisol rhythm in patients with anorexia nervosa (AN) and normal controls.
  
  
  METHODS
  Prospective transversal controlled study.
  
  
  METHODS
  Tertiary-referral University Hospital.
  
  
  METHODS
  Twenty-five patients aged 15 to 35 years, 13 of them with regular ovulatory cycles, and 12 with diagnosis of AN.
  
  
  METHODS
  Salivary and blood collection for cortisol 24-hour rhythm determination.
  
  
  RESULTS
  Salivary cortisol was determined at 9 am, 5 pm, and 11 pm. Seric follicle-stimulating hormone, luteinizing hormone (LH), prolactin, estradiol (E2), progesterone, dehydroepiandrosterone-S (DHEA-S), and cortisol were sampled together with the 9 am salivary sample.
  
  
  RESULTS
  LH, E2, and DHEA-S levels were reduced in patients with AN. A correlation between salivary and serum cortisol levels was observed in the 9 am sample only in controls (r = 0.67, P = 0.01; AN: r = 0.48, P = 0.12). Cortisol rhythm was present in all control subjects, whereas it was absent in one third of AN patients. The area under the curve for the AN group with preserved rhythm was significantly higher than for the control group (Me = 6811 ng/dl/24h vs 3708 ng/dl/24 h; P = 0.034).
  
  
  CONCLUSIONS
  Patients with AN have higher salivary cortisol levels when compared to normal women and some of them do not present circadian rhythm.
authors.affiliation: Department of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Evaldo
authors.initials: E
authors.lastname: dos Santos
authors.forename: José E
authors.initials: JE
authors.lastname: dos Santos
authors.forename: Rosane P
authors.initials: RP
authors.lastname: Ribeiro
authors.forename: Ana C J S
authors.initials: AC
authors.lastname: Rosa E Silva
authors.forename: Ayrton C
authors.initials: AC
authors.lastname: Moreira
authors.forename: Marcos F
authors.initials: MF
authors.lastname: Silva de Sá
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000097:blood / Q000378:metabolism*; D016022:Case-Control Studies; D002940:Circadian Rhythm; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000378:metabolism*; D007986:Luteinizing Hormone / Q000097:blood; D011374:Progesterone / Q000097:blood; D011388:Prolactin / Q000097:blood; D011446:Prospective Studies; D012463:Saliva / Q000378:metabolism
chemical_list: D011374:Progesterone; D004958:Estradiol; D019314:Dehydroepiandrosterone Sulfate; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D006854:Hydrocortisone