Effects of neuroendocrine changes on results of ambulatory blood pressure monitoring (ABPM) in adolescent girls with anorexia nervosa.
OBJECTIVE
Anorexia nervosa (AN) is characterized by marked neuroendocrine and autonomic dysfunctions. In the recent studies using automatic blood pressure monitoring (ABPM), lower BP values and lack of circardian variation of BP in anorectic patients were demonstrated. Unfortunately effects of hormonal changes, that may explain BP abnormalities were not analysed together.


METHODS
The aim of our study was the assessment of ABPM and hormonal status in anorectic girls.


METHODS
The study was performed on hospitalized 25 female anorectic adolescents aged 12-18 years. Control group was 17 age and height matched girls with normal weight and negative history for hypertension. ABPM was performed between 5 and 7 day of hospitalization, every 30 minutes during active period and every 60 minutes during sleep. Hormones (FSH, LH, estradiol, cortisol and fT4) serum concentrations were also evaluated.


RESULTS
Mean systolic BP values were significantly lower in patients with AN in comparison to controls. Maximal diastolic and mean arterial pressure values for the whole day and active period but not for sleep were lower in AN than in controls. Anorectic girls showed tendency to night-time bradycardia. Moreover, there were no physiological circadian variations of BP in AN.


CONCLUSIONS
We conclude that hormonal regulation of blood pressure and heart rate in anorectic patients is at least partially preserved. Lower blood pressure values, bradycardia and lack of physiological night fall of BP in anorectic patients may result from altered autonomic system function resulting from hormonal disturbances and other centrally mediated mechanisms.
Oświecimska
Joanna
J
Department of Paediatrics, Silesian University of Medicine, ul. 3 Maja 13/15, 41-800 Zabrze, Poland. smina@poczta.onet.pl
Ziora
Katarzyna
K
Adamczyk
Piotr
P
Roczniak
Wojciech
W
Pikiewicz-Koch
Anna
A
Stojewska
Małgorzata
M
Dyduch
Antoni
A
D000293:Adolescent; D041923:Adolescent Development / Q000502:physiology*; D000856:Anorexia Nervosa / Q000150:complications / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D001919:Bradycardia / Q000209:etiology / Q000503:physiopathology; D016022:Case-Control Studies; D002648:Child; D002940:Circadian Rhythm / Q000502:physiology; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007986:Luteinizing Hormone / Q000097:blood; D009490:Neurosecretory Systems / Q000502:physiology*
D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D006854:Hydrocortisone