Metabolic and neuroendocrine adaptations to undernutrition in anorexia nervosa: from a clinical to a basic research point of view

Author(s):  
Odile Viltart ◽  
Philibert Duriez ◽  
Virginie Tolle

Abstract The exact mechanisms linking metabolic and neuroendocrine adaptations to undernutrition and the pathophysiology of anorexia nervosa (AN) are not fully understood. AN is a psychiatric disorder of complex etiology characterized by extreme starvation while the disease is progressing into a chronic state. Metabolic and endocrine alterations associated to this disorder are part of a powerful response to maintain whole body energy homeostasis. But these modifications may also contribute to associated neuropsychiatric symptoms (reward abnormalities, anxiety, depression) and thus participate to sustain the disease. The current review presents data with both a clinical and basic research point of view on the role of nutritional and energy sensors with neuroendocrine actions in the pathophysiology of the disease, as they modulate metabolic responses, reproductive functions, stress responses as well as physical activity. While clinical data present a full description of changes occurring in AN, animal models that integrate either spontaneous genetic mutations or experimentally-induced food restriction with hyperactivity and/or social stress recapitulate the main metabolic and endocrine alterations of AN and provide mechanistic information between undernutrition state and symptoms of the disease. Further progress on the central and peripheral mechanism involved in the pathophysiology of eating disorders partly relies on the development and/or refinement of existing animal models to include recently identified genetic traits and better mimic the complex and multifactorial dimensions of the disease.

2021 ◽  
Vol 12 ◽  
Author(s):  
Jie Zhang ◽  
Stephanie C. Dulawa

Anorexia nervosa (AN) is a severe eating disorder that primarily affects young women and girls, and is characterized by abnormal restrictive feeding and a dangerously low body-mass index. AN has one of the highest mortality rates of any psychiatric disorder, and no approved pharmacological treatments exist. Current psychological and behavioral treatments are largely ineffective, and relapse is common. Relatively little basic research has examined biological mechanisms that underlie AN compared to other major neuropsychiatric disorders. A recent large-scale genome-wide association study (GWAS) revealed that the genetic architecture of AN has strong metabolic as well as psychiatric origins, suggesting that AN should be reconceptualized as a metabo-psychiatric disorder. Therefore, identifying the metabo-psychiatric mechanisms that contribute to AN may be essential for developing effective treatments. This review focuses on animal models for studying the metabo-psychiatric mechanisms that may contribute to AN, with a focus on the activity-based anorexia (ABA) paradigm. We also highlight recent work using modern circuit-dissecting neuroscience techniques to uncover metabolic mechanisms that regulate ABA, and encourage further work to ultimately identify novel treatment strategies for AN.


1976 ◽  
Vol 15 (05) ◽  
pp. 246-247
Author(s):  
S. C. Jain ◽  
G. C. Bhola ◽  
A. Nagaratnam ◽  
M. M. Gupta

SummaryIn the Marinelli chair, a geometry widely used in whole body counting, the lower part of the leg is seen quite inefficiently by the detector. The present paper describes an attempt to modify the standard chair geometry to minimise this limitation. The subject sits crossed-legged in the “Buddha Posture” in the standard chair. Studies with humanoid phantoms and a volunteer sitting in the Buddha posture show that this modification brings marked improvement over the Marinelli chair both from the point of view of sensitivity and uniformity of spatial response.


Author(s):  
B. A. Katsnelson ◽  
M. P. Sutunkova ◽  
N. A. Tsepilov ◽  
V. G. Panov ◽  
A. N. Varaksin ◽  
...  

Sodium fluoride solution was injected i.p. to three groups of rats at a dose equivalent to 0.1 LD50 three times a week up to 18 injections. Two out of these groups and two out of three groups were sham-injected with normal saline and were exposed to the whole body impact of a 25 mT static magnetic field (SMF) for 2 or 4 hr a day, 5 times a week. Following the exposure, various functional and biochemical indices were evaluated along with histological examination and morphometric measurements of the femur in the differently exposed and control rats. The mathematical analysis of the combined effects of the SMF and fluoride based on the a response surface model demonstrated that, in full correspondence with what we had previously found for the combined toxicity of different chemicals, the combined adverse action of a chemical plus a physical agent was characterized by a tipological diversity depending not only on particular effects these types were assessed for but on the dose and effect levels as well. From this point of view, the indices for which at least one statistically significant effect was observed could be classified as identifying (I) mainly single-factor action; (II) additive unidirectional action; (III) synergism (superadditive unidirectional action); (IV) antagonism, including both subadditive unidirectional action and all variants of contradirectional action.


2021 ◽  
Vol 10 (12) ◽  
pp. 2656
Author(s):  
Alberto Fogagnolo ◽  
Federica Montanaro ◽  
Lou’i Al-Husinat ◽  
Cecilia Turrini ◽  
Michela Rauseo ◽  
...  

Mechanical ventilation (MV) is still necessary in many surgical procedures; nonetheless, intraoperative MV is not free from harmful effects. Protective ventilation strategies, which include the combination of low tidal volume and adequate positive end expiratory pressure (PEEP) levels, are usually adopted to minimize the ventilation-induced lung injury and to avoid post-operative pulmonary complications (PPCs). Even so, volutrauma and atelectrauma may co-exist at different levels of tidal volume and PEEP, and therefore, the physiological response to the MV settings should be monitored in each patient. A personalized perioperative approach is gaining relevance in the field of intraoperative MV; in particular, many efforts have been made to individualize PEEP, giving more emphasis on physiological and functional status to the whole body. In this review, we summarized the latest findings about the optimization of PEEP and intraoperative MV in different surgical settings. Starting from a physiological point of view, we described how to approach the individualized MV and monitor the effects of MV on lung function.


Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1412
Author(s):  
Katarzyna Piotrowska ◽  
Maciej Tarnowski

In recent years, adipose tissue has attracted a lot of attention. It is not only an energy reservoir but also plays important immune, paracrine and endocrine roles. BMAT (bone marrow adipose tissue) is a heterogeneous tissue, found mostly in the medullary canal of the long bones (tibia, femur and humerus), in the vertebrae and iliac crest. Adipogenesis in bone marrow cavities is a consequence of ageing or may accompany pathologies like diabetes mellitus type 1 (T1DM), T2DM, anorexia nervosa, oestrogen and growth hormone deficiencies or impaired haematopoiesis and osteoporosis. This paper focuses on studies concerning BMAT and its physiology in dietary interventions, like obesity in humans and high fat diet in rodent studies; and opposite: anorexia nervosa and calorie restriction in animal models.


1981 ◽  
Vol 26 (4) ◽  
pp. 224-227 ◽  
Author(s):  
David M. Garner

Despite much recent interest in the objective measurement of body image in anorexia nervosa, many questions remain regarding basic mechanisms responsible for the findings as well as their meaning in the disorder. It is unclear if “whole body” measures assess the same underlying phenomena as the “body part” method, and it is unclear if body image disturbances are etiologic or a byproduct of anorexia nervosa. The possible association between self-esteem and body satisfaction and the relationship of the latter variable to actual size estimation supports the hypothesis that size perception may be closely tied to satisfaction with non-physical aspects of self. Finally it must be determined if over estimation is a function of a general psychological disturbance or of a deficit of specific interest in this disorder. Despite these questions, the way in which anorexic patients see themselves as well as the cognitive and affective responses to this perception remains an interesting and potentially fruitful area of study with this disorder.


2008 ◽  
Vol 68 (4) ◽  
pp. 572-578 ◽  
Author(s):  
R H Straub ◽  
G Pongratz ◽  
H Hirvonen ◽  
T Pohjolainen ◽  
M Mikkelsson ◽  
...  

Objective:Acute stress in patients with rheumatoid arthritis (RA) should stimulate a strong stress response. After cryotherapy, we expected to observe an increase of hormones of the adrenal gland and the sympathetic nervous system.Methods:A total of 55 patients with RA were recruited for whole-body cryotherapy at −110°C and −60°C, and local cold therapy between −20°C and −30°C for 7 days. We measured plasma levels of steroid hormones, neuropeptide Y (sympathetic marker), and interleukin (IL)6 daily before and after cryotherapy.Results:In both therapy groups with/without glucocorticoids (GC), hormone and IL6 levels at baseline and 5 h after cold stress did not change over 7 days of cryotherapy. In patients without GC, plasma levels of cortisol and androstenedione were highest after −110°C cold stress followed by −60°C or local cold stress. The opposite was found in patients under GC therapy, in whom, unexpectedly, −110°C cold stress elicited the smallest responses. In patients without GC, adrenal cortisol production increased relative to other adrenal steroids, and again the opposite was seen under GC therapy with a loss of cortisol and an increase of dehydroepiandrosterone. Importantly, there was no sympathetic stress response in both groups. Patients without GC and −110°C cold stress demonstrated higher plasma IL6 compared to the other treatment groups (not observed under GC), but they showed the best clinical response.Conclusions:We detected an inadequate stress response in patients with GC. It is further shown that the sympathetic stress response was inadequate in patients with/without GC. Paradoxically, plasma levels of IL6 increased under strong cold stress in patients without GC. These findings confirm dysfunctional stress axes in RA.


PEDIATRICS ◽  
1990 ◽  
Vol 86 (3) ◽  
pp. 440-447 ◽  
Author(s):  
Laura K. Bachrach ◽  
David Guido ◽  
Debra Katzman ◽  
Iris F. Litt ◽  
Robert Marcus

Osteoporosis develops in women with chronic anorexia nervosa. To determine whether bone mass is reduced in younger patients as well, bone density was studied in a group of adolescent patients with anorexia nervosa. With single- and dual-photon absorptiometry, a comparison was made of bone mineral density of midradius, lumbar spine, and whole body in 18 girls (12 to 20 years of age) with anorexia nervosa and 25 healthy control subjects of comparable age. Patients had significantly lower lumbar vertebral bone density than did control subjects (0.830 ± 0.140 vs 1.054 ± 0.139 g/cm2) and significantly lower whole body bone mass (0.700 ± 0.130 vs 0.955 ± 0.130 g/cm2). Midradius bone density was not significantly reduced. Of 18 patients, 12 had bone density greater than 2 standard deviations less than normal values for age. The diagnosis of anorexia nervosa had been made less than 1 year earlier for half of these girls. Body mass index correlated significantly with bone mass in girls who were not anorexic (P < .05, .005, and .0001 for lumbar, radius, and whole body, respectively). Bone mineral correlated significantly with body mass index in patients with anorexia nervosa as well. In addition, age at onset and duration of anorexia nervosa, but not calcium intake, activity level, or duration of amenorrhea correlated significantly with bone mineral density. It was concluded that important deficits of bone mass occur as a frequent and often early complication of anorexia nervosa in adolescence. Whole body is considerably more sensitive than midradius bone density as a measure of cortical bone loss in this illness. Low body mass index is an important predictor of this reduction in bone mass.


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