RESUMO
Women in whom anorexia nervosa develops during adolescence have failure of linear growth associated with low levels of insulin-like growth factor I (IGF-1). To investigate the pathophysiology of growth retardation in adolescents with anorexia nervosa, we measured basal growth hormone (GH), growth hormone-binding protein (GHBP), IGF-1, and insulin-like growth factor binding protein-3 (IGFBP-3) in three groups of patients: (1) 28 recently hospitalized female adolescents with anorexia nervosa, (2) 23 of the same patients after partial weight restoration, and (3) 28 healthy control subjects matched for age, sex, and pubertal stage. Fasting GH levels in group 1 did not differ significantly from those in group 3. In contrast, serum GHBP (p < 0.001), IGF-1 (p < 0.001), and IGFBP-3 (p < 0.01) were significantly lower in group 1 than in group 3. Serum GHBP and IGFBP-3 levels were positively correlated with body mass index. Serum GHBP levels were low in patients in all five pubertal stages and even in those shown to have adequate GH secretion. In group 2 (after refeeding) the serum IGF-1 concentration increased significantly and GHBP and IGFBP-3 returned to normal. We conclude that patients with anorexia nervosa have diminished GH action resulting in decreased secretion of IGF-1. The positive correlation with body mass index and the reversibility with refeeding suggest that these changes are secondary to malnutrition. Altered GH function that occurs during the years of active growth can explain the growth retardation seen in anorexia nervosa.
Assuntos
Anorexia Nervosa/fisiopatologia , Hormônio do Crescimento/metabolismo , Somatomedinas/análise , Adolescente , Adulto , Anorexia Nervosa/tratamento farmacológico , Anorexia Nervosa/metabolismo , Metabolismo Basal , Índice de Massa Corporal , Proteínas de Transporte/sangue , Estudos de Casos e Controles , Criança , Feminino , Hormônio do Crescimento/sangue , Inibidores do Crescimento/sangue , Humanos , Proteínas de Ligação a Fator de Crescimento Semelhante a Insulina , Fator de Crescimento Insulin-Like I/análiseRESUMO
We compared the frequency of ovarian microcysts in girls with premature thelarche (n = 27) to that in age-matched control subjects (n = 24). There was an increased prevalence of detectable ovarian microcysts in girls with premature thelarche. The presence or absence of cysts did not correlate with basal gonadotropin or estradiol levels.
Assuntos
Mama/crescimento & desenvolvimento , Cistos Ovarianos/diagnóstico por imagem , Puberdade Precoce/complicações , Pré-Escolar , Estradiol/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Incidência , Lactente , Hormônio Luteinizante/sangue , Cistos Ovarianos/complicações , Puberdade Precoce/sangue , UltrassonografiaRESUMO
The clinical and pathologic features of 18 patients with gastric carcinoma younger than age 36 years were studied. Of these patients, 36.8% were Hispanics of Mexican origin. Eighteen percent of the Mexican population with gastric carcinoma were younger than 36 years as compared to 2.8% of the overall population (P less than 0.05). Fifty percent of the gastric ulcers in the Mexican population were malignant as compared to 6% in the non-Mexican population (P less than 0.05). In addition, a subset of aggressive carcinomas were found. Patients presenting with symptoms of less than 6 months' duration had a survival of less than 6 months, compared to the less aggressive subset, in which patients had symptoms for greater than 6 months and survived longer than 6 months. Racial, environmental influences, or selection bias may account for the differences in gastric carcinoma in the Mexican and non-Mexican population. Factors contributing to a more aggressive form of carcinoma are unclear and require further study.