Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-05T05:35:46.616Z Has data issue: false hasContentIssue false

Continuous infusion of luteinizing hormone releasing hormone (LHRH) in patients with anorexia nervosa

Published online by Cambridge University Press:  09 July 2009

P. J. V. Beumont*
Affiliation:
Department of Psychiatry, University of Sydney, Australia
Suzanne F. Abraham
Affiliation:
Department of Psychiatry, University of Sydney, Australia
*
1Address for correspondence: Professor P. J. V. Beumont, Department of Psychiatry, University of Sydney, Broadway 2006, Australia.

Synopsis

LHRH was administered by continuous 4-hour intravenous infusion to 14 anorexia nervosa patients on a refeeding programme. Infusions were repeated in 7 patients following weight gain and in 4 after a course of bromocriptine. Five healthy female volunteers in the early or midfollicular phase of the menstrual cycle served as controls.

The LH response was diminished in patients at 65% standard weight, but was of progressively increasing magnitude in patients at 80% and 95% standard weight. The pattern of LH response to the 4-hour infusion was suggestive of a deficient stimulation by endogenous LHRH in patients at extremely low weights, and of an impaired oestrogen feedback mechanism in patients at intermediate weights. Bromocriptine enhanced the LH response on one occasion in a patient with moderately elevated plasma HPR values, but failed to produce a similar effect when given to 3 patients with normal HPR levels. The mean FSH response did not differ significantly between patients in different weight categories, although those at 65% standard weight had a markedly greater variance of response. Plasma oestradiol values were lower in patients at 65% standard weight than in those at higher weights.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1981

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abraham, G. E. (1969). Solid phase radioimmunoassay of plasma oestradiol-17 beta. Journal of Clinical Endocrinology and Metabolism 29, 866871.CrossRefGoogle Scholar
Beumont, P. J. V. (1979). The endocrinology of anorexia nervosa. Medical Journal of Australia i, 611613.CrossRefGoogle Scholar
Beumont, P. J. V., Beardwood, C. J. & Russell, G. F. M. (1971). The occurrence of the syndrome of anorexia nervosa in male subjects. Psychological Medicine 2, 216231.CrossRefGoogle Scholar
Beumont, P. J. V., Carr, P. J. & Gelder, M. G. (1973). Plasma levels of luteinizing hormone and of immunoreactive oestrogens (oestradiol) in anorexia nervosa: response to clomiphene citrate. Psychological Medicine 3, 495501.CrossRefGoogle ScholarPubMed
Beumont, P. J. V., Friesen, H. G., Gelder, M. C. & Kolakowska, T. (1974). Plasma prolactin and luteinizing hormone levels in anorexia nervosa. Psychological Medicine 4, 219221.CrossRefGoogle ScholarPubMed
Beumont, P. J. V., George, G. C. W., Pimstone, B. L. & Vinik, A. I. (1976). The pituitary response to hypothalamic releasing hormones in patients with anorexia nervosa. Journal of Clinical Endocrinology 43, 487496.CrossRefGoogle ScholarPubMed
Beumont, P. J. V., Abraham, S. F., Argall, W. & Turtle, J. R. (1978 a). Plasma gonadotrophins and LHRH infusions in anorexia nervosa. Australian and New Zealand Journal of Medicine 8, 509514.CrossRefGoogle ScholarPubMed
Beumont, P. J. V., Abraham, S. F., Argall, W., George, G. C. W. & Glaun, D. E. (1978 b). The onset of anorexia nervosa. Australian and New Zealand Journal of Psychiatry 12, 145149.CrossRefGoogle ScholarPubMed
Bremner, W. J. & Paulson, C. A. (1974). Two pools of luteinizing hormone in the human pituitary: evidence from constant administration of luteinizing hormone releasing hormone. Journal of Clinical Endocrinology and Metabolism 39, 811815.CrossRefGoogle ScholarPubMed
Fishman, J., Boyar, R. & Hellman, L. (1975). The influence of body weight on estradiol metabolism in young women. Journal of Clinical Endocrinology and Metabolism 41, 989991.CrossRefGoogle ScholarPubMed
Halmi, K. A. (1976). Selective pituitary deficiency in anorexia nervosa. In Hormones, Behavior and Psychopaihology (ed. Sachar, E.), pp. 285290. Raven Press: New York.Google Scholar
Hwang, P., Guyda, H. A. & Friesen, H. G. (1971). A radioimmunoassay for human prolactin. Proceedings of the National Academy of Sciences 68, 19021906.CrossRefGoogle ScholarPubMed
Morgan, H. G. & Russell, G. F. M. (1975). Value of family background and clinical features as predictors of long term outcome in anorexia nervosa: four-year follow-up study of 41 patients. Psychological Medicine 5, 355371.CrossRefGoogle ScholarPubMed
Naftolin, F. (1970). Unpublished PhD thesis, University of Oxford.Google Scholar
Nimrod, A. & Ryan, K. J. (1975). Aromatization of androgens by human abdominal and breast fat tissue. Journal of Clinical Endocrinology and Metabolism 40, 367372.CrossRefGoogle ScholarPubMed
O'Dell, W. D., Ross, G. T. & Rayford, P. L. (1967). Radioimmunoassay for luteinizing hormone in human plasma or serum: physiological studies. Journal of Clinical Investigation 46, 248.CrossRefGoogle Scholar
O'Dell, W. D., Parcow, A. F., Cargille, C. M. & Ross, G. T. (1968). Radioimmunoassay for human follicle-stimulating hormone: physiological studies. Journal of Clinical Investigation 47, 2551.CrossRefGoogle Scholar
Russell, G. F. M. (1965). Metabolic aspects of anorexia nervosa. Proceedings of the Royal Society of Medicine 58, 811814.CrossRefGoogle ScholarPubMed
Russell, G. F. M. (1970). Anorexia nervosa: its identity as an illness and its treatment. In Modern Trends in Psychological Medicine (ed. Price, J. H.), pp. 131164. Butterworths: London.Google Scholar
Sheldon, J. H. (1939). Anorexia nervosa. Proceedings of the Royal Society of Medicine 32, 738740.Google Scholar
Society of Actuaries (1959). Build and Blood Pressure Study Vol. 1. Society of Actuaries: Chicago.Google Scholar
Wakeling, A., de Souza, V. A. & Beardwood, C. J. (1977). Assessment of the negative and positive feedback effects of administered oestrogen on gondatrophin release in patients with anorexia nervosa. Psychological Medicine 7, 397405.CrossRefGoogle Scholar
Williams, P. (1977). Anorexia nervosa and the secretion of prolactin. British Journal of Psychiatry 13, 6972.CrossRefGoogle Scholar
Yen, S. S. C. (1977). Neuroendocrine aspects of the regulation of cyclic gonadotrophin release in women. In Clinical Endocrinology (ed. Martini, L. and Besser, G. M.), pp. 175196. Academic Press: New York.Google Scholar
Yoshimoto, Y., Moridera, K. & Imura, H. (1975). Restoration of normal pituitary gonadotrophin reserve by administration of luteinizing hormone releasing hormone in patients with hypogonadotropic hypogonadism. New England Journal of Medicine 292, 242245.CrossRefGoogle ScholarPubMed