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Master's Dissertation
DOI
10.11606/D.5.2011.tde-11012012-142602
Document
Author
Full name
Louise Cominato
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2011
Supervisor
Committee
Damiani, Durval (President)
Bilyk, Bacy Fleitlich
Ceccon, Maria Esther Jurfest Rivero
Title in Portuguese
Disfunções endócrinas associadas à anorexia nervosa: importância do IGF-1 e da leptina
Keywords in Portuguese
Anorexia nervosa
Ciclo menstrual
Fator de crescimento insulin-like I
Leptina
Abstract in Portuguese
Anorexia nervosa e transtorno alimentar não especificado (TANE) são os transtornos alimentares mais frequentes na adolescência. Cursam com alterações hormonais e amenorreia. Este projeto tem como objetivo a maior compreensão das alterações laboratoriais e hormonais que ocorrem concomitantemente com esses transtornos alimentares na adolescência, em especial a relação com o retorno dos ciclos menstruais, a recuperação nutricional e a secreção de leptina e IGF-1. Vinte e oito adolescentes do sexo feminino, portadoras de anorexia nervosa ou TANE foram submetidas a coletas de amostras de sangue para dosagem de leptina, LH, FSH, PRL, estradiol, GH, IGF-1, TSH, T4L, T4, T3, proteínas totais e frações, função renal, hemograma, ferro, ferritina e eletrólitos no início do estudo e a cada cinco semanas num total de cinco coletas. Densitometria óssea foi realizada no início do acompanhamento e após seis meses para avaliar comprometimento ósseo. As principais complicações clínicas observadas foram amenorreia (78%) e osteoporose (14,8%). No início do estudo, 12 pacientes encontravam-se desnutridas com z score de IMC -2. As alterações hormonais presentes foram: diminuição do T3, estradiol, leptina, LH e IGF-1. As pacientes evoluíram com boa recuperação nutricional (variação da média de IMC ao longo do estudo IMC p < 0,01) e melhora dos parâmetros clínicos e hormonais. O IGF-1 apresentou-se como o melhor marcador de recuperação nutricional (p = 0,0001) e teve boa correlação com o retorno menstrual. À época do retorno menstrual as pacientes apresentaram IGF-1 > 340ng/mL (p = 0,04)
Title in English
Endocrine dysfunction associated with anorexia nervosa: importance of IGF-1 and leptin
Keywords in English
Anorexia nervosa
Insulin like growth factor I
Leptin
Menstrual cycle
Abstract in English
Anorexia Nervosa (AN) and eating disorder not otherwise specified (EDNOS) are the most frequent eating disorders in adolescence. The patients show hormonal alterations as well as amenorrhea. The aim of this study was to improve the knowledge of hormonal disturbances that occur together with AN and EDNOS, especially with regard to menstrual cycles, nutritional recovery as well as leptin and IGF-1 secretion. Twenty eight female adolescents with AN or EDNOS had blood collected for the following dosages: leptin, LH, FSH, PRL, estradiol, GH, IGF-1, TSH, FT4, T4, T3, total proteins and fractions, renal function, CBC, iron , ferritin, electrolytes in the beginning of the study and at every 5 weeks totalizing 5 samples per patient. Bone densitometry was performed at the start and after 6 months. The main clinical complications were amenorrhea (78%) and osteoporosis (14.8%). Twelve patients were undernourished at the start of the study (BMI z score = -2). Hormonal alterations were low T3, estradiol, leptina, LH, and IGF-1. The patients had good nutritional recovery, evaluated as a variation of BMI (p < 0.001) and improved clinical and hormonal parameters. IGF-I was the best marker of nutritional recovery (p = 0.0001) and correlated very well with menstrual cycles recovery. At the time when the patients resumed menstrual cycles, IGF-1 was above 340ng/mL (p = 0.04)
 
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LouiseCominato.pdf (372.77 Kbytes)
Publishing Date
2012-01-16
 
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