[Anorexia nervosa: a follow-up of nutritional, hormonal and psychiatric parameters]. / Anoressia nervosa: follow-up di parametri nutrizionali, ormonali e psichiatrici.

ABSTRACT

Well known is the need to treat "acute onset" Anorexia Nervosa in care units. Nevertheless even the "successfully treated" patients show a very high percentage of relapse. The aim of our study has been to revalue different clinical, nutritional (hemoglobin, transferrin, IGF1), hormonal (thyroid function, gonadotropins) and psychiatric (EDI Eating Disorder Inventory Test) parameters in a group of nineteen women aged 20-34 years (median 27 years) admitted to our department 1-11 years (median 6 years) before for anorexia nervosa treatment. On admission their weight loss was -33% +/- 10% according to Ideal Body Weight (IBW); a "low T3 syndrome" was present and all the patients not treated with estro-progestins were amenorrhoic. After a long hospitalization (median 51 days) the patients showed a significant decrease in weight loss (25% +/- 6%; p < 0.01). At follow-up seventeen patients had a weight better than at discharge (13% +/- 12%; p < 0.01) and 9/17 patients non treated with estro-progestins had spontaneous menses. Nutritional (hemoglobin* 13 +/- 0.2 g%, transferrin* 313 +/- 57 mg%, IGF-1 187 +/- 15 ng/ml) and hormonal (LH* 9.4 +/- 1 mUI/ml, FSH* 15 +/- 1.3 mUI/ml, T3 1 +/- 1 ng/ml) parameters were significantly improved (*p < 0.01, p < 0.05) compared to those at admission (hemoglobin 12 +/- 0.2 g%, transferrin 218 +/- 58 mg%, IGF-1 154 +/- 21 ng/ml, LH 5.6 +/- 0.8 mUI/ml, FSH 9.5 +/- 1 mUI/ml, T3 0.8 +/- 1 ng/ml). The EDI test has shown a persistence of anorexic condition ("overt" or latent) in 2/3 of patients. This study confirms the endocrine and nutritional modifications of anorexia nervosa and underlines the persistence of psychiatric ones in a great number of patients including the "clinically cured", justifying long-term follow-up and the high percentage of disease relapse.