title: Endocrine dysregulation in anorexia nervosa update.
abstract: BACKGROUND
  Anorexia nervosa is a primary psychiatric disorder with serious endocrine consequences, including dysregulation of the gonadal, adrenal, and GH axes, and severe bone loss. This Update reviews recent advances in the understanding of the endocrine dysregulation observed in this state of chronic starvation, as well as the mechanisms underlying the disease itself.
  
  
  METHODS
  Findings of this update are based on a PubMed search and the author's knowledge of this field.
  
  
  RESULTS
  Recent studies have provided insights into the mechanisms underlying endocrine dysregulation in states of chronic starvation as well as the etiology of anorexia nervosa itself. This includes a more complex understanding of the pathophysiologic bases of hypogonadism, hypercortisolemia, GH resistance, appetite regulation, and bone loss. Nevertheless, the etiology of the disease remains largely unknown, and effective therapies for the endocrine complications and for the disease itself are lacking.
  
  
  CONCLUSIONS
  Despite significant progress in the field, further research is needed to elucidate the mechanisms underlying the development of anorexia nervosa and its endocrine complications. Such investigations promise to yield important advances in the therapeutic approach to this disease as well as to the understanding of the regulation of endocrine function, skeletal biology, and appetite regulation.
authors: Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA. KKMiller@partners.org
authors: K K
authors: KK
authors: Miller
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000150:complications* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D001066:Appetite / Q000502:physiology; D001069:Appetite Regulation; D001847:Bone Diseases / Q000209:etiology; D004700:Endocrine System Diseases / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006058:Gonadal Disorders / Q000209:etiology / Q000503:physiopathology; D019382:Human Growth Hormone / Q000502:physiology; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D008875:Middle Aged; D018377:Neurotransmitter Agents / Q000502:physiology; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D020127:Recovery of Function; D012201:Reward; D015430:Weight Gain / Q000502:physiology
chemical_list: D018377:Neurotransmitter Agents; D019382:Human Growth Hormone