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Gitsi E, Livadas S, Argyrakopoulou G. Nutritional and exercise interventions to improve conception in women suffering from obesity and distinct nosological entities. Front Endocrinol (Lausanne) 2024; 15:1426542. [PMID: 39006367 PMCID: PMC11239444 DOI: 10.3389/fendo.2024.1426542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 06/17/2024] [Indexed: 07/16/2024] Open
Abstract
Infertility among women, particularly those living with obesity, presents a multifaceted challenge with implications for reproductive health worldwide. Lifestyle interventions, mainly focusing on weight loss, have emerged as promising strategies to improve fertility outcomes in this population. This review aims to explore the effectiveness of various lifestyle interventions, encompassing dietary modifications and exercise regimens, in enhancing fertility outcomes among women with obesity and associated conditions such as polycystic ovary syndrome, congenital adrenal hyperplasia, type 2 diabetes mellitus, premenopause, hypothyroidism and eating disorders. Methodology of study search encompass a broad spectrum, ranging from interventions targeting weight management through slow or rapid weight loss to dietary approaches emphasizing whole food groups, specific nutrients, and dietary patterns like low-carbohydrate or ketogenic diets, as well as the Mediterranean diet. By synthesizing existing findings and recommendations, this review contributes to the understanding of lifestyle interventions in addressing infertility, with an emphasis on the population of women of reproductive age with excess weight and known or unknown infertility issues, while promoting their integration into clinical practice to optimize reproductive health and overall well-being.
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Affiliation(s)
- Evdoxia Gitsi
- Diabetes and Obesity Unit, Athens Medical Center, Athens, Greece
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2
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Liang J, Ali F, Ramaiyer M, Borahay MA. Determinants and Assessment of Menstrual Blood Flow. CURR EPIDEMIOL REP 2023; 10:210-220. [PMID: 38275001 PMCID: PMC10810143 DOI: 10.1007/s40471-023-00332-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 01/27/2024]
Abstract
Purpose of review a)The modifiable and non-modifiable determinants and the currently available methods of assessment of menstrual blood flow will be discussed, with the goal of helping healthcare providers, researchers, and those interested in public health. Recent findings b)Several factors can impact menstruation. The determinants include modifiable factors such as smoking, nutrition, exercise, stress, weight fluctuation, and benign gynecologic diseases, and non-modifiable factors such as age, race, and the individual's genes. The intertwined dynamic among these determinants needs more critical attention. Currently, the methods for the assessment of menstruation all have advantages and disadvantages, often with a tradeoff between practicality and accuracy. Summary c)Considered by many as the fifth vital, menstruation provides a window to an individual's general health. The discussion of its determinants and assessment can be more appropriate for individual contexts, especially from a public health perspective as it can improve the reproductive health of the population.
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Affiliation(s)
- Jinxiao Liang
- Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Gynecologic Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Fiza Ali
- Johns Hopkins University, Krieger School of Arts and Sciences, Baltimore, Maryland, USA
| | - Malini Ramaiyer
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mostafa A. Borahay
- Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, Maryland, USA
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3
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Abstract
An important component in the treatment of anorexia nervosa (AN) is the evaluation and management of its endocrine complications, including functional hypogonadotropic hypogonadism and increased fracture risk. The body's adaptive response to chronic starvation results in many endocrine abnormalities, most of which are reversible upon weight restoration. A multidisciplinary team with experience in treating patients with AN is critical to improving endocrine outcomes in patients with this disorder, including in women with AN who are interested in fertility. Much less is understood about endocrine abnormalities in men, as well as sexual and gender minorities, with AN. In this article, we review the pathophysiology and evidence-based recommendations for the treatment of endocrine complications in AN, as well as discuss the status of clinical research in this area.
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Affiliation(s)
- Melanie S Haines
- Neuroendocrine Unit, Massachusetts General Hospital, 50 Staniford Street, Suite 750B, Boston, MA, 02114, USA. .,Harvard Medical School, Boston, MA, USA.
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4
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Huckins LM, Signer R, Johnson J, Wu YK, Mitchell KS, Bulik CM. What next for eating disorder genetics? Replacing myths with facts to sharpen our understanding. Mol Psychiatry 2022; 27:3929-3938. [PMID: 35595976 PMCID: PMC9718676 DOI: 10.1038/s41380-022-01601-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 04/20/2022] [Accepted: 04/26/2022] [Indexed: 02/07/2023]
Abstract
Substantial progress has been made in the understanding of anorexia nervosa (AN) and eating disorder (ED) genetics through the efforts of large-scale collaborative consortia, yielding the first genome-wide significant loci, AN-associated genes, and insights into metabo-psychiatric underpinnings of the disorders. However, the translatability, generalizability, and reach of these insights are hampered by an overly narrow focus in our research. In particular, stereotypes, myths, assumptions and misconceptions have resulted in incomplete or incorrect understandings of ED presentations and trajectories, and exclusion of certain patient groups from our studies. In this review, we aim to counteract these historical imbalances. Taking as our starting point the Academy for Eating Disorders (AED) Truth #5 "Eating disorders affect people of all genders, ages, races, ethnicities, body shapes and weights, sexual orientations, and socioeconomic statuses", we discuss what we do and do not know about the genetic underpinnings of EDs among people in each of these groups, and suggest strategies to design more inclusive studies. In the second half of our review, we outline broad strategic goals whereby ED researchers can expand the diversity, insights, and clinical translatability of their studies.
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Affiliation(s)
- Laura M Huckins
- Pamela Sklar Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Mental Illness Research, Education and Clinical Centers, James J. Peters Department of Veterans Affairs Medical Center, Bronx, NY, 14068, USA
| | - Rebecca Signer
- Pamela Sklar Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Jessica Johnson
- Pamela Sklar Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Ya-Ke Wu
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Karen S Mitchell
- National Center for PTSD at VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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5
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Behary P, Comninos AN. Bone Perspectives in Functional Hypothalamic Amenorrhoea: An Update and Future Avenues. Front Endocrinol (Lausanne) 2022; 13:923791. [PMID: 35795153 PMCID: PMC9251506 DOI: 10.3389/fendo.2022.923791] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 05/11/2022] [Indexed: 01/22/2023] Open
Abstract
One of the most important and potentially long-lasting detrimental consequences of Functional Hypothalamic Amenorrhoea (FHA) is on skeletal homeostasis. Beyond oestrogen deficiency, FHA is associated with a cascade of additional neuro-endocrine and metabolic alterations, some adaptive, but which combine to disrupt skeletal homeostasis. Ultimately, this leads to a two-fold increased risk of fractures in women with FHA compared to healthy eumenorrhoeic women. Although the cornerstone of management of FHA-related bone loss remains recovery of menses via restoration of metabolic/psychological balance, there is rapidly developing evidence for hormonal manipulations (with a particular emphasis on route of administration) and other pharmacological treatments that can protect or improve skeletal homeostasis in FHA. In this mini-review, we provide an update on the pathophysiology, clinical management and future avenues in the field from a bone perspective.
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Affiliation(s)
- Preeshila Behary
- Endocrine Bone Unit, Imperial College Healthcare NHS Trust, London, United Kingdom
- Section of Endocrinology and Investigative Medicine, Imperial College London, London, United Kingdom
- Department of Endocrinology, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Alexander N. Comninos
- Endocrine Bone Unit, Imperial College Healthcare NHS Trust, London, United Kingdom
- Section of Endocrinology and Investigative Medicine, Imperial College London, London, United Kingdom
- Department of Endocrinology, Imperial College Healthcare NHS Trust, London, United Kingdom
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6
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Curran KA, Pitt PD. The Reproductive Impact of Eating Disorders in Adolescents. Semin Reprod Med 2022; 40:79-86. [PMID: 35073591 DOI: 10.1055/s-0042-1742326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Eating disorders are common, chronic illnesses that frequently arise during adolescence. Because of the impact on nutrition, individuals with eating disorders have significant health consequences, including effects on reproductive health. Adolescent women with eating disorders frequently have menstrual irregularities, though the causes of these abnormalities are complex and vary depending on the type of eating disorder. Teens with eating disorders may have changes in current and future fertility, and eating disorders during pregnancy can have medical and psychologic impacts for both mother and child. Though not well researched, eating disorders in men can affect reproductive health and potentially impact fertility. Lastly, eating disorders in adolescents can have significantly deleterious, irreversible effects on bone health.
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Affiliation(s)
- Kelly A Curran
- Section of Adolescent Medicine, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Paulette D Pitt
- Department of Education and Psychology, East Central University, Ada, Oklahoma
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Minabe S, Iwata K, Tsuchida H, Tsukamura H, Ozawa H. Effect of diet-induced obesity on kisspeptin-neurokinin B-dynorphin A neurons in the arcuate nucleus and luteinizing hormone secretion in sex hormone-primed male and female rats. Peptides 2021; 142:170546. [PMID: 33794282 DOI: 10.1016/j.peptides.2021.170546] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 03/13/2021] [Accepted: 03/24/2021] [Indexed: 12/16/2022]
Abstract
Metabolic stress resulting from either lack or excess of nutrients often causes infertility in both sexes. Kisspeptin-neurokinin B-dynorphin A (KNDy) neurons in the arcuate nucleus (ARC) has been suggested to be a key players in reproduction via direct stimulation of the pulsatile gonadotropin-releasing hormone (GnRH) and subsequent gonadotropin release in mammalian species. In this study, we investigated the effect of high-fat diet (HFD) on hypothalamic KNDy gene expression to examine the pathogenic mechanism underlying obesity-induced infertility in male and female rats. Male and female rats at 7 weeks of age were fed with either a standard or HFD for 4 months. In the male rats, the HFD caused a significant suppression of ARC Kiss1 and Pdyn gene expressions, but did not affect the plasma luteinizing hormone (LH) levels and sizes of the morphology of the testis and epididymis. In the female rats, 58% of the HFD-fed female rats exhibited irregular estrous cycles, whereas the remaining rats showed regular cycles. Two of the 10 rats that showed HFD-induced irregular estrous cycles showed profound suppression of LH pulse frequency and the number of ARC Kiss1-expressing cells, whereas the other females showed normal LH pulses and ARC Kiss1 expression. Our finding shows that suppression of ARC Kiss1 expression might be the initial pathological change of hypogonadotropic hypogonadism in HFD-fed male rats, while the obese-related infertility in the female rats may be mainly induced by KNDy-independent pathways. Taken together, ARC kisspeptin neurons in male rats may be susceptible to HFD-induced obesity compared with those in female rats.
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Affiliation(s)
- Shiori Minabe
- Department of Anatomy and Neurobiology, Graduate School of Medicine, Nippon Medical School, Tokyo, 113- 8602, Japan.
| | - Kinuyo Iwata
- Department of Anatomy and Neurobiology, Graduate School of Medicine, Nippon Medical School, Tokyo, 113- 8602, Japan
| | - Hitomi Tsuchida
- Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya, Aichi, 464-8601, Japan
| | - Hiroko Tsukamura
- Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya, Aichi, 464-8601, Japan
| | - Hitoshi Ozawa
- Department of Anatomy and Neurobiology, Graduate School of Medicine, Nippon Medical School, Tokyo, 113- 8602, Japan
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Milano W, Ambrosio P, Carizzone F, De Biasio V, Foia MG, Saetta B, Milano MF, Capasso A. Menstrual Disorders Related to Eating Disorders. Endocr Metab Immune Disord Drug Targets 2021; 22:471-480. [PMID: 34182917 DOI: 10.2174/1871530321666210625145345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 03/27/2021] [Accepted: 04/06/2021] [Indexed: 11/22/2022]
Abstract
Eating disorders (ED) are associated with multiple physical complications that strongly affect the physical health of these young and fragile patients and can also cause significant mortality, the highest among psychiatric pathologies. Among the various organic complications, albeit still little known, the gynecological implications, up to infertility, are very widespread. Among adolescent and adult patients, gynecological symptoms can be very widespread and range from menstrual irregularities to amenorrhea, from vaginitis to ovarian polycystosis, up to complications during the gestational phase and postpartum, in addition to the possible consequences on the unborn child. Among the most frequent and significant gynecological disorders in women with ED, there are menstrual irregularities that may occur with oligomenorrhea or even amenorrhea. , Although no longer part of the DSM-5 diagnostic criteria for defining anorexia nervosa (AN), this symptom must be considered a very relevant event in the overall evaluation of young women and adolescents with eating disorders. Functional hypothalamic amenorrhea in ED patients is related to psychological distress, excessive exercise, disordered eating, or a combination of these factors, which results in suppression of the hypothalamic-pituitary-ovarian axis, and consequently, hypoestrogenism. This paper has the objective to summarize the causes and the mechanism underlying menstrual disorders and provide a better understanding of the correlation between the reproductive system and the mechanisms that regulate food intake and eating habits. In addition, early recognition of risk factors for eating disorders for gynecological implications can help put more accurate assessments of patients to prevent potentially fatal complications. The importance of the involvement of specialist gynecologists in the multidisciplinary team that has to follow patients with eating disorders is also discussed.
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Affiliation(s)
- Walter Milano
- UOSD Eating Disorder Unit, Mental Health Department ASL Napoli 2 Nord, 80027 Napoli, Italy
| | - Paola Ambrosio
- UOSD Eating Disorder Unit, Mental Health Department ASL Napoli 2 Nord, 80027 Napoli, Italy
| | - Francesca Carizzone
- UOSD Eating Disorder Unit, Mental Health Department ASL Napoli 2 Nord, 80027 Napoli, Italy
| | - Valeria De Biasio
- UOSD Eating Disorder Unit, Mental Health Department ASL Napoli 2 Nord, 80027 Napoli, Italy
| | - Maria Gabriella Foia
- UOSD Eating Disorder Unit, Mental Health Department ASL Napoli 2 Nord, 80027 Napoli, Italy
| | - Biancamaria Saetta
- UOSD Eating Disorder Unit, Mental Health Department ASL Napoli 2 Nord, 80027 Napoli, Italy
| | | | - Anna Capasso
- Department of Pharmacy , University of Salerno, Fisciano, 84084 Salerno, Italy
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9
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Lantzouni E, Grady R. Eating Disorders in Children and Adolescents: A Practical Review and Update for Pediatric Gynecologists. J Pediatr Adolesc Gynecol 2021; 34:281-287. [PMID: 33486085 DOI: 10.1016/j.jpag.2021.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/14/2021] [Indexed: 01/14/2023]
Abstract
Eating disorders (EDs) are common among female adolescents and young adults and can have serious and diverse health consequences. Pediatric gynecology providers have the opportunity to play a vital role in the recognition of EDs in this population. Early medical detection and referral for appropriate evidence-based treatment can lead to better health outcomes for youth. In this article we aim to increase the awareness of the pediatric gynecologist of typical and subtle presentations of EDs, provide guidance for screening, discuss common and serious medical complications, and review treatment considerations for gynecologic issues in patients with EDs.
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Affiliation(s)
- Eleni Lantzouni
- The Craig Dalsimer Division of Adolescent Medicine, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Rosheen Grady
- Division of Adolescent Medicine, Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Ontario, Canada
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Szkodziak F, Krzyżanowski J, Szkodziak P. Psychological aspects of infertility. A systematic review. J Int Med Res 2021; 48:300060520932403. [PMID: 32600086 PMCID: PMC7328491 DOI: 10.1177/0300060520932403] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Objective Fertility may be defined as a capacity to conceive and produce offspring. Infertility is characterized by failure to establish a clinical pregnancy after 12 months of regular and unprotected sexual intercourse. Infertility concerns an estimated 8–12% of the global population, and is associated with factors including time of unwanted non-conception, age of female partner and number of diseases impacting fertility. Unexplained infertility is described as idiopathic. This study aimed to analyse and evaluate the influence of mental disorders, often considered as reasons for idiopathic infertility, on female and male fertility, including stress, depression, sleep and eating disorders, and addictions. Methods This systematic review comprised a search of MEDLINE, Cochrane and PubMed databases for relevant articles that were analysed by two independent reviewers. Results A total of 106 articles published between 1955–2019 were included. Mental disorders modify endocrine gland and immune system functioning at both the tissue and cellular level, and are negatively associated with female and male fertility. Conclusion Mental disorders may negatively impact female and male fertility. Further studies are required to explain the exact role and contribution of mental disorders to fertility.
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Affiliation(s)
- Filip Szkodziak
- 3rd Chair and Department of Gynaecology, Medical University of Lublin, Lublin, Poland
| | - Jarosław Krzyżanowski
- 3rd Chair and Department of Gynaecology, Medical University of Lublin, Lublin, Poland
| | - Piotr Szkodziak
- 3rd Chair and Department of Gynaecology, Medical University of Lublin, Lublin, Poland
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11
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Estienne A, Bongrani A, Ramé C, Kurowska P, Błaszczyk K, Rak A, Ducluzeau PH, Froment P, Dupont J. Energy sensors and reproductive hypothalamo-pituitary ovarian axis (HPO) in female mammals: Role of mTOR (mammalian target of rapamycin), AMPK (AMP-activated protein kinase) and SIRT1 (Sirtuin 1). Mol Cell Endocrinol 2021; 521:111113. [PMID: 33301839 DOI: 10.1016/j.mce.2020.111113] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/02/2020] [Accepted: 12/03/2020] [Indexed: 12/11/2022]
Abstract
In female, energy metabolism influences reproductive function by modulating the Hypothalamic Pituitary Ovarian axis including the hypothalamic GnRH neuronal network, the pituitary gonadotropin secretion and the ovarian follicle growth and steroidogenesis. Several hormones and neuropeptides or metabolites are important signals between energy balance and reproduction. These energy sensors mediate their action on reproductive cells through specific kinases or signaling pathways. This review focuses on the role of three main enzymes-specifically, mTOR, AMPK, and SIRT1 at the hypothalamic pituitary and ovarian axis in normal female fertility and then we discuss their possible involvement in some women reproductive disorders known to be associated with metabolic complications, such as polycystic ovary syndrome (PCOS) and premature ovarian failure (POF).
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Affiliation(s)
- Anthony Estienne
- INRAE UMR85 Physiologie de la Reproduction et des Comportements, F-37380, Nouzilly, France; CNRS UMR7247 Physiologie de la Reproduction et des Comportements, F-37380, Nouzilly, France; Université François Rabelais de Tours, F-37041, Tours, France; IFCE, F-37380, Nouzilly, France
| | - Alice Bongrani
- INRAE UMR85 Physiologie de la Reproduction et des Comportements, F-37380, Nouzilly, France; CNRS UMR7247 Physiologie de la Reproduction et des Comportements, F-37380, Nouzilly, France; Université François Rabelais de Tours, F-37041, Tours, France; IFCE, F-37380, Nouzilly, France
| | - Christelle Ramé
- INRAE UMR85 Physiologie de la Reproduction et des Comportements, F-37380, Nouzilly, France; CNRS UMR7247 Physiologie de la Reproduction et des Comportements, F-37380, Nouzilly, France; Université François Rabelais de Tours, F-37041, Tours, France; IFCE, F-37380, Nouzilly, France
| | - Patrycja Kurowska
- Department of Physiology and Toxicology of Reproduction, Institute of Zoology and Biomedical Research, Jagiellonian University in Krakow, 30-387, Krakow, Poland
| | - Klaudia Błaszczyk
- Department of Physiology and Toxicology of Reproduction, Institute of Zoology and Biomedical Research, Jagiellonian University in Krakow, 30-387, Krakow, Poland
| | - Agnieszka Rak
- Department of Physiology and Toxicology of Reproduction, Institute of Zoology and Biomedical Research, Jagiellonian University in Krakow, 30-387, Krakow, Poland
| | - Pierre-Henri Ducluzeau
- INRAE UMR85 Physiologie de la Reproduction et des Comportements, F-37380, Nouzilly, France; CNRS UMR7247 Physiologie de la Reproduction et des Comportements, F-37380, Nouzilly, France; Université François Rabelais de Tours, F-37041, Tours, France; IFCE, F-37380, Nouzilly, France
| | - Pascal Froment
- INRAE UMR85 Physiologie de la Reproduction et des Comportements, F-37380, Nouzilly, France; CNRS UMR7247 Physiologie de la Reproduction et des Comportements, F-37380, Nouzilly, France; Université François Rabelais de Tours, F-37041, Tours, France; IFCE, F-37380, Nouzilly, France
| | - Joëlle Dupont
- INRAE UMR85 Physiologie de la Reproduction et des Comportements, F-37380, Nouzilly, France; CNRS UMR7247 Physiologie de la Reproduction et des Comportements, F-37380, Nouzilly, France; Université François Rabelais de Tours, F-37041, Tours, France; IFCE, F-37380, Nouzilly, France.
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12
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Hauck C, Schipfer M, Ellrott T, Cook B. The relationship between food addiction and patterns of disordered eating with exercise dependence: in amateur endurance athletes. Eat Weight Disord 2020; 25:1573-1582. [PMID: 31654288 PMCID: PMC7581610 DOI: 10.1007/s40519-019-00794-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 10/03/2019] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Examine the prevalence and potential relationships among food addiction (FA)-as measured by Yale Food Addiction Scale 2.0 (YFAS 2.0), eating disorders (ED)-as measured by Eating Disorder Diagnostic Scale (EDDS)-and exercise dependence (EXD)-as measured by Questionnaire to Diagnose Exercise Dependence in Endurance Sports (FESA), for the first time worldwide, in amateur endurance athletes. METHODS A total of 1022 German-speaking endurance athletes (44% male, Ø 36 years, Ø BMI 23 kg/m2) replied to an online questionnaire consisting of demographics, related parameters, and the German versions of YFAS 2.0, EDDS, and FESA. RESULTS Prevalence of FA, ED, and EXD was 6.2, 6.5, and 30.5%. The probability for FA increases with BMI, thoughts about food and EXD score, and decreases with age and when an ED is present. People with FA and people with ED vs. people with both, FA&ED, differed significantly in this cohort. Strong significant relationships were found between FA and EXD (X2 (1) = 15.117, p < 0.001, n = 1022). CONCLUSIONS A considerable number of amateur endurance athletes may suffer from FA. The association between FA and EXD is stronger than between ED and EXD, indicating FA as a potentially more relevant subject-than ED-for prevention or therapy in people with EXD. Further studies are needed to investigate parameters and relationships between the possibly involved types of ED, FA, and EXD. LEVEL OF EVIDENCE Level III, well-designed cohort analytic study.
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Affiliation(s)
- Carolin Hauck
- Institute for Nutrition and Psychology at the University of Goettingen, Humboldtallee 32, 37073, Göttingen, Germany.
| | - Melanie Schipfer
- Martin-Luther-University Halle-Wittenberg, Universitaetsplatz 10, 06108, Halle (Saale), Germany.,Profusa Inc., 345 Allerton Avenue, South San Francisco, CA, 94080, USA
| | - Thomas Ellrott
- Institute for Nutrition and Psychology at the University of Goettingen, Humboldtallee 32, 37073, Göttingen, Germany
| | - Brian Cook
- Alsana: An Eating Disorder Recovery Community, 2545 W Hillcrest Dr, Suite 205, Thousand Oaks, CA, 91320, USA
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13
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Goldberg HR, Katzman DK, Allen L, Martin S, Sheehan C, Kaiserman J, Macdonald G, Kives S. The Prevalence of Children and Adolescents at Risk for Avoidant Restrictive Food Intake Disorder in a Pediatric and Adolescent Gynecology Clinic. J Pediatr Adolesc Gynecol 2020; 33:466-469. [PMID: 32553711 DOI: 10.1016/j.jpag.2020.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 04/30/2020] [Accepted: 06/08/2020] [Indexed: 11/30/2022]
Abstract
STUDY OBJECTIVE The purpose of this study was to determine the prevalence of child and adolescent females at risk for Avoidant Restrictive Food Intake Disorder (ARFID) in a tertiary care pediatric and adolescent gynecology (PAG) clinic. DESIGN Cross-sectional study design. SETTING Tertiary care PAG clinic at the Hospital for Sick Children in Toronto, Ontario, Canada. PARTICIPANTS Females between 8 and 18 years of age presenting to the tertiary care PAG clinic. INTERVENTION Between October 2017 and April 2019, eligible patients completed a 3-part, self-administered questionnaire that included demographic and anthropometric information, reason(s) for referral, medical history, menstrual history and function, and the Eating Disorders in Youth-Questionnaire (EDY-Q). MAIN OUTCOME MEASURES The main outcome measure was the prevalence of child and adolescent females who were identified to be at risk for ARFID in a tertiary care PAG clinic. RESULTS Seven (3.7%) of 190 patients were identified to be at risk for ARFID based on the EDY-Q. All patients at risk for ARFID had a significantly lower body mass index (17.4 ± 1.6 vs 24.4 ± 6.7, P < .001) than patients not at risk for ARFID. CONCLUSIONS This study demonstrated that 3.7% of patients seeking treatment in a tertiary care PAG clinic were identified to be at risk for ARFID. Clinicians in tertiary care PAG clinics can play a pivotal role in the identification and referral of children and adolescents at risk for ARFID. Referral to the patients' primary care physician or to an eating disorder program is important so as not to delay the diagnosis and treatment.
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Affiliation(s)
- Hanna R Goldberg
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada; Division of Gynecology, Department of Endocrinology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Debra K Katzman
- Division of Adolescent Medicine, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Lisa Allen
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada; Division of Gynecology, Department of Endocrinology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Samantha Martin
- Division of Adolescent Medicine, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Carolyn Sheehan
- Division of Gynecology, Department of Endocrinology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Jenna Kaiserman
- Division of Gynecology, Department of Endocrinology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Gina Macdonald
- Division of Gynecology, Department of Endocrinology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Sari Kives
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada; Division of Gynecology, Department of Endocrinology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
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14
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Rastogi R, Sieke EH, Nahra A, Sabik J, Rome ES. Return of Menses in Previously Overweight Patients with Eating Disorders. J Pediatr Adolesc Gynecol 2020; 33:133-138. [PMID: 31715368 DOI: 10.1016/j.jpag.2019.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 10/02/2019] [Accepted: 11/04/2019] [Indexed: 10/25/2022]
Abstract
STUDY OBJECTIVE Adolescents with eating disorders and a history of overweight present with higher weights, longer duration of disease, but equally severe symptomatology compared with previously normal weight patients. To better delineate treatment goals for this understudied population, we compared weight at menses resumption with premorbid maximum weight among previously overweight and normal weight patients. DESIGN Retrospective cohort study. SETTING Outpatient adolescent medicine clinic at an eating disorder referral center. PARTICIPANTS Postmenarchal patients meeting criteria for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition eating disorders. History of overweight was defined as a body mass index (BMI) greater than or equal to the 85th percentile or 25 or more. INTERVENTIONS AND MAIN OUTCOME MEASURES Weight characteristics at presentation and menses resumption (BMI, BMI z-score, change from maximum weight to presentation weight) RESULTS: Previously overweight patients presented with greater mean weight, longer duration of disease, and higher BMI than previously normal weight patients. No difference was found in rates of amenorrhea at presentation or menses resumption. Previously overweight patients resumed menses at a younger age and higher BMI z-scores. The difference between weight at menses resumption and premorbid maximum weight was greater for previously overweight patients. CONCLUSION Previously overweight patients with eating disorders present differently than their normal-weight peers, so reliance on weight status as a screening criterion might result in underdiagnosis. Although BMI z-scores associated with menses resumption are higher for previously overweight patients, there is no difference in weight gain between presentation and menses resumption and time to menses resumption compared with previously normal-weight patients. Moreover, menses resumption occurred at weights significantly lower than premorbid maximum weight for previously overweight patients, so restoration to highest premorbid weight is not necessary.
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Affiliation(s)
- Radhika Rastogi
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
| | - Erin H Sieke
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Alexa Nahra
- Department of General Pediatrics and Adolescent Medicine, Cleveland Clinic Children's Hospital, Cleveland, Ohio
| | - Julia Sabik
- Department of General Pediatrics and Adolescent Medicine, Cleveland Clinic Children's Hospital, Cleveland, Ohio
| | - Ellen S Rome
- Department of General Pediatrics and Adolescent Medicine, Cleveland Clinic Children's Hospital, Cleveland, Ohio
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15
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Castellini G, Lelli L, Cassioli E, Ricca V. Relationships between eating disorder psychopathology, sexual hormones and sexual behaviours. Mol Cell Endocrinol 2019; 497:110429. [PMID: 31026479 DOI: 10.1016/j.mce.2019.04.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 04/09/2019] [Accepted: 04/12/2019] [Indexed: 11/17/2022]
Abstract
A growing body of evidences demonstrated that sexuality is an important topic in the clinical research of eating disorders (EDs), due to its association with specific psychopathological features, and etiological factors. The present review took into consideration the complex relationship between sexual behaviours, hormonal alterations and EDs psychopathology. Studies pertaining sexual behaviours in EDs were divided into those focusing on sexual dysfunctions, and those related to risky sexual behaviours. The limited number of studies on sexual dysfunctions, reported a controversial association with weight status and hormonal alterations, and a clear relationship with severity of specific psychopathology (e.g. body image disturbance). Risky sexual behaviours have been associated with impulsivity and dissociation, as well as with abnormal stress response. Finally, both restriction and uncontrolled eating have been found to be responsible for several complex metabolic alterations, determining varied sexual and gynecologic problems, such as amenorrhea, hypogonadism, genital vascular problems, infertility, and miscarriage, although it is also possible that alterations in feeding and stress hormones contribute to altered eating behaviour.
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Affiliation(s)
- Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences. University of Florence, Italy
| | - Lorenzo Lelli
- Psychiatry Unit, Department of Health Sciences. University of Florence, Italy
| | - Emanuele Cassioli
- Psychiatry Unit, Department of Health Sciences. University of Florence, Italy
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences. University of Florence, Italy.
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16
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Abstract
Eating disorders affect a significant number of individuals across the life span and are found among all demographic groups (including all genders, socioeconomic statuses, and ethnicities). They can cause malnutrition, which can have significant effects on every organ system in the body. Cardiovascular complications are particularly dangerous and cause eating disorders to have the highest mortality rate of all mental illnesses. This article outlines the medical assessment and treatment of malnutrition due to disordered eating.
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Affiliation(s)
- Rebecka Peebles
- Eating Disorder Assessment and Treatment Program, The Children's Hospital of Philadelphia, Perelman School of Medicine at The University of Pennsylvania, Roberts Center for Pediatric Research, 2716 South Street, Room 14360, Philadelphia, PA 19146, USA.
| | - Erin Hayley Sieke
- The Children's Hospital of Philadelphia, 3401 Civic Center Boulevard 9NW55, Philadelphia, PA 19104, USA
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17
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Abstract
Fertility awareness, or general knowledge about one's fertility, is low in adolescents and in adult women as well. Misconceptions about reproduction contribute to high rates of unplanned pregnancy in the United States, as well as delayed childbearing and infertility. Alhough primary care providers caring for adolescents have historically focused on contraception and reduction of sexually transmitted infections during their sexual and reproductive health conversations with adolescents and young adult women, fertility awareness counseling would help these women optimize their future fertility and make informed reproductive choices throughout their life. This is particularly true for adolescents with chronic medical conditions, certain gynecologic conditions, or a history of therapies that could potentially affect fertility, for whom preemptive conversations about fertility are needed, but often overlooked. [Pediatr Ann. 2019;48(2):e86-e91.].
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18
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Huckins LM, Hatzikotoulas K, Southam L, Thornton LM, Steinberg J, Aguilera-McKay F, Treasure J, Schmidt U, Gunasinghe C, Romero A, Curtis C, Rhodes D, Moens J, Kalsi G, Dempster D, Leung R, Keohane A, Burghardt R, Ehrlich S, Hebebrand J, Hinney A, Ludolph A, Walton E, Deloukas P, Hofman A, Palotie A, Palta P, van Rooij FJA, Stirrups K, Adan R, Boni C, Cone R, Dedoussis G, van Furth E, Gonidakis F, Gorwood P, Hudson J, Kaprio J, Kas M, Keski-Rahonen A, Kiezebrink K, Knudsen GP, Slof-Op 't Landt MCT, Maj M, Monteleone AM, Monteleone P, Raevuori AH, Reichborn-Kjennerud T, Tozzi F, Tsitsika A, van Elburg A, Collier DA, Sullivan PF, Breen G, Bulik CM, Zeggini E. Investigation of common, low-frequency and rare genome-wide variation in anorexia nervosa. Mol Psychiatry 2018; 23:1169-1180. [PMID: 29155802 PMCID: PMC5828108 DOI: 10.1038/mp.2017.88] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 02/16/2017] [Accepted: 02/17/2017] [Indexed: 12/12/2022]
Abstract
Anorexia nervosa (AN) is a complex neuropsychiatric disorder presenting with dangerously low body weight, and a deep and persistent fear of gaining weight. To date, only one genome-wide significant locus associated with AN has been identified. We performed an exome-chip based genome-wide association studies (GWAS) in 2158 cases from nine populations of European origin and 15 485 ancestrally matched controls. Unlike previous studies, this GWAS also probed association in low-frequency and rare variants. Sixteen independent variants were taken forward for in silico and de novo replication (11 common and 5 rare). No findings reached genome-wide significance. Two notable common variants were identified: rs10791286, an intronic variant in OPCML (P=9.89 × 10-6), and rs7700147, an intergenic variant (P=2.93 × 10-5). No low-frequency variant associations were identified at genome-wide significance, although the study was well-powered to detect low-frequency variants with large effect sizes, suggesting that there may be no AN loci in this genomic search space with large effect sizes.
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Affiliation(s)
- L M Huckins
- Department of Human Genetics, Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
- Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - K Hatzikotoulas
- Department of Human Genetics, Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - L Southam
- Department of Human Genetics, Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - L M Thornton
- Department of Psychiatry and Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - J Steinberg
- Department of Human Genetics, Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - F Aguilera-McKay
- Department of Human Genetics, Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - J Treasure
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - U Schmidt
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - C Gunasinghe
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR BRC SLaM BioResource for Mental Health, SGDP Centre & Centre for Neuroimaging Sciences, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - A Romero
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR BRC SLaM BioResource for Mental Health, SGDP Centre & Centre for Neuroimaging Sciences, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - C Curtis
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR BRC SLaM BioResource for Mental Health, SGDP Centre & Centre for Neuroimaging Sciences, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - D Rhodes
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR BRC SLaM BioResource for Mental Health, SGDP Centre & Centre for Neuroimaging Sciences, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - J Moens
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR BRC SLaM BioResource for Mental Health, SGDP Centre & Centre for Neuroimaging Sciences, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - G Kalsi
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR BRC SLaM BioResource for Mental Health, SGDP Centre & Centre for Neuroimaging Sciences, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - D Dempster
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR BRC SLaM BioResource for Mental Health, SGDP Centre & Centre for Neuroimaging Sciences, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - R Leung
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR BRC SLaM BioResource for Mental Health, SGDP Centre & Centre for Neuroimaging Sciences, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - A Keohane
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR BRC SLaM BioResource for Mental Health, SGDP Centre & Centre for Neuroimaging Sciences, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - R Burghardt
- Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik Klinikum Frankfurt, Frankfurt, Germany
| | - S Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
- Eating Disorders Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - J Hebebrand
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - A Hinney
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - A Ludolph
- Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt, Neuherberg, Germany
| | - E Walton
- Division of Psychological & Social Medicine and Developmental Neurosciences, Technische Universität Dresden, Faculty of Medicine, University Hospital C.G. Carus, Dresden, Germany
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - P Deloukas
- Department of Human Genetics, Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - A Hofman
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - A Palotie
- Center for Human Genome Research at the Massachusetts General Hospital, Boston, MA, USA
- Department of Public Health & Institute for Molecular Medicine FIMM, University of Helsinki, Helsinki, Finland
| | - P Palta
- Department of Public Health & Institute for Molecular Medicine FIMM, University of Helsinki, Helsinki, Finland
| | - F J A van Rooij
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - K Stirrups
- Department of Human Genetics, Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - R Adan
- Brain Center Rudolf Magnus, Department of Neuroscience and Pharmacology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - C Boni
- INSERM U984, Centre of Psychiatry and Neuroscience, Paris, France
| | - R Cone
- Mary Sue Coleman Director, Life Sciences Institute, Professor of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
| | - G Dedoussis
- Department of Dietetics-Nutrition, Harokopio University, Athens, Greece
| | - E van Furth
- Rivierduinen Eating Disorders Ursula, Leiden, Zuid-Holland, The Netherlands
| | - F Gonidakis
- Eating Disorders Unit, 1st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - P Gorwood
- INSERM U984, Centre of Psychiatry and Neuroscience, Paris, France
| | - J Hudson
- Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - J Kaprio
- Department of Public Health & Institute for Molecular Medicine FIMM, University of Helsinki, Helsinki, Finland
| | - M Kas
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, The Netherlands
| | - A Keski-Rahonen
- Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland
| | - K Kiezebrink
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - G-P Knudsen
- Health Data and Digitalisation, Norwegian Institute of Public Health, Oslo, Norway
| | | | - M Maj
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | - A M Monteleone
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | - P Monteleone
- Department of Medicine and Surgery, Section of Neurosciences, University of Salerno, Salerno, Italy
| | - A H Raevuori
- Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland
| | - T Reichborn-Kjennerud
- Department of Genetics, Environment and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - F Tozzi
- eHealth Lab-Computer Science Department, University of Cyprus, Nicosia, Cyprus
| | - A Tsitsika
- Adolescent Health Unit (A.H.U.), 2nd Department of Pediatrics – Medical School, University of Athens "P. & A. Kyriakou" Children's Hospital, Athens, Greece
| | - A van Elburg
- Center for Eating Disorders Rintveld, University of Utrecht, Utrecht, The Netherlands
| | - D A Collier
- Eli Lilly and Company, Erl Wood Manor, Windlesham, UK
| | - P F Sullivan
- Departments of Genetics and Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinksa Institutet, Stockholm, Sweden
| | - G Breen
- Social Genetic and Developmental Psychiatry, King's College London, London, UK
| | - C M Bulik
- Department of Psychiatry and Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinksa Institutet, Stockholm, Sweden
| | - E Zeggini
- Department of Human Genetics, Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
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19
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Rivera HM, Stincic TL. Estradiol and the control of feeding behavior. Steroids 2018; 133:44-52. [PMID: 29180290 PMCID: PMC5864536 DOI: 10.1016/j.steroids.2017.11.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 11/20/2017] [Accepted: 11/21/2017] [Indexed: 12/21/2022]
Abstract
This review lays out the evidence for the role of E2 in homeostatic and hedonic feeding across several species. While significant effort has been expended on homeostatic feeding research, more studies for hedonic feeding need to be conducted (i.e. are there increases in meal size and enhanced motivation to natural food rewards). By identifying the underlying neural circuitry involved, one can better delineate the mechanisms by which E2 influences feeding behavior. By utilizing more selective neural targeting techniques, such as optogenetics, significant progress can be made toward this goal. Together, behavioral and physiological techniques will help us to better understand neural deficits that can increase the risk for obesity in the absence of E2 (menopause) and aid in developing therapeutic strategies.
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Affiliation(s)
- H M Rivera
- Department of Physiology and Pharmacology, Oregon Health and Science University, Portland, OR 97239, USA
| | - T L Stincic
- Department of Physiology and Pharmacology, Oregon Health and Science University, Portland, OR 97239, USA.
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20
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Frank GKW, Favaro A, Marsh R, Ehrlich S, Lawson EA. Toward valid and reliable brain imaging results in eating disorders. Int J Eat Disord 2018; 51:250-261. [PMID: 29405338 PMCID: PMC7449370 DOI: 10.1002/eat.22829] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 01/13/2018] [Accepted: 01/14/2018] [Indexed: 12/14/2022]
Abstract
Human brain imaging can help improve our understanding of mechanisms underlying brain function and how they drive behavior in health and disease. Such knowledge may eventually help us to devise better treatments for psychiatric disorders. However, the brain imaging literature in psychiatry and especially eating disorders has been inconsistent, and studies are often difficult to replicate. The extent or severity of extremes of eating and state of illness, which are often associated with differences in, for instance hormonal status, comorbidity, and medication use, commonly differ between studies and likely add to variation across study results. Those effects are in addition to the well-described problems arising from differences in task designs, data quality control procedures, image data preprocessing and analysis or statistical thresholds applied across studies. Which of those factors are most relevant to improve reproducibility is still a question for debate and further research. Here we propose guidelines for brain imaging research in eating disorders to acquire valid results that are more reliable and clinically useful.
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Affiliation(s)
- Guido K. W. Frank
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora, Colorado,Neuroscience Program, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Angela Favaro
- Department of General Psychology, University of Padova, Padova, Italy
| | - Rachel Marsh
- Department of Psychiatry, The New York State Psychiatric Institute and the College of Physicians and Surgeons at Columbia University, New York, New York
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neuroscience, Technische Universität Dresden, Dresden, Germany,Department of Child and Adolescent Psychiatry, Eating Disorder Treatment and Research Center, Technische Universität Dresden, Dresden, Germany
| | - Elizabeth A. Lawson
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts,Harvard Medical School, Boston, Massachusetts
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21
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Aurigemma NC, Koltun KJ, VanEvery H, Rogers CJ, De Souza MJ. Linking the Gut Microbiota to Bone Health in Anorexia Nervosa. Curr Osteoporos Rep 2018; 16:65-75. [PMID: 29417446 DOI: 10.1007/s11914-018-0420-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to examine the anorexia nervosa-microbiota-bone relationship, offering a compilation of the relevant human and animal studies that may contribute to a more comprehensive understanding of potential mechanisms involved. RECENT FINDINGS Recent studies have implicated fermentation by-products of the gut microbiota in bone metabolism. Compromised bone health often accompanies anorexia nervosa due to energy deficiency and hypoestrogenism. The gut microbiome has been implicated as a link between these conditions and impaired bone growth phenotypes. Current research supports decrements in Firmicutes and short-chain fatty acids with increases in Methanobrevibacter smithii and Proteobacteria in anorexia nervosa. A potential mechanism for microbiome-regulated bone growth is through modulation of insulin-like growth factor-1. Future research should aim to examine short-chain fatty acids, probiotics, and prebiotics as alternative therapies to treat low bone density in anorexia nervosa.
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Affiliation(s)
- Nicole C Aurigemma
- Women's Health and Exercise Lab, Department of Kinesiology, The Pennsylvania State University, University Park, PA, 16802, USA.
| | - Kristen J Koltun
- Women's Health and Exercise Lab, Department of Kinesiology, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Hannah VanEvery
- Departments of Nutritional Sciences and Clinical and Translational Sciences, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Connie J Rogers
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Mary Jane De Souza
- Women's Health and Exercise Lab, Department of Kinesiology and Physiology, The Pennsylvania State University, University Park, PA, 16802, USA
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22
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Tabler J, Utz RL, Smith KR, Hanson HA, Geist C. Variation in reproductive outcomes of women with histories of bulimia nervosa, anorexia nervosa, or eating disorder not otherwise specified relative to the general population and closest-aged sisters. Int J Eat Disord 2018; 51:102-111. [PMID: 29331083 PMCID: PMC6599590 DOI: 10.1002/eat.22827] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 12/19/2017] [Accepted: 12/22/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study seeks to examine the long-term reproductive consequences of eating disorders (ED), to assess variation in reproductive outcomes by ED type, and to examine reproductive differences between women with previous ED diagnosis and their discordant sisters. METHOD Using a sample of women with previous ED diagnosis generated by the Utah Population Database, this study compares the fecundity (parity) and age at first birth of women by ED subtype (bulimia nervosa [BN], anorexia nervosa [AN], and ED not otherwise specified [EDNOS]) (n = 1,579). We also employed general population match case-control, and discordant sibling pair analyses, to estimate the magnitude of association between EDs and reproductive outcomes. RESULTS Women previously diagnosed with AN or EDNOS experienced delayed first birth (HRR = 0.33, HRR = 0.34, respectively) and lower parity (IRR = 0.19, IRR = 0.22, respectively) relative to BN (p < .05), the general population (p < .05), and closest-aged sisters (p < .05). Women previously diagnosed with BN experienced more moderate reductions and delays to their reproduction, and had similar reproductive outcomes as their discordant sisters. DISCUSSION Clinicians should consider ED type and family fertility histories when addressing the long-term reproductive health needs of women with prior AN, BN, or EDNOS diagnosis. Women previously diagnosed with AN or EDNOS likely experience the greatest reductions and delays in reproduction across their lifespan. Reproductive health screenings may be especially critical for the wellbeing of women with a history of AN or EDNOS.
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Affiliation(s)
- Jennifer Tabler
- Department of Sociology and Anthropology, The University of Texas Rio Grande Valley, Edinburg, Texas
| | - Rebecca L. Utz
- Department of Sociology, University of Utah, Salt Lake City, Utah
| | - Ken R. Smith
- Department of Family and Consumer Studies, Pedigree and Population Resource, University of Utah, Salt Lake City, Utah,Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Heidi A. Hanson
- Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah,Department of Surgery, University of Utah, Salt Lake City, Utah
| | - Claudia Geist
- Department of Sociology, University of Utah, Salt Lake City, Utah,Division of Gender Studies, University of Utah, Salt Lake City, Utah
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Sominsky L, Hodgson DM, McLaughlin EA, Smith R, Wall HM, Spencer SJ. Linking Stress and Infertility: A Novel Role for Ghrelin. Endocr Rev 2017; 38:432-467. [PMID: 28938425 DOI: 10.1210/er.2016-1133] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 07/24/2017] [Indexed: 12/23/2022]
Abstract
Infertility affects a remarkable one in four couples in developing countries. Psychological stress is a ubiquitous facet of life, and although stress affects us all at some point, prolonged or unmanageable stress may become harmful for some individuals, negatively impacting on their health, including fertility. For instance, women who struggle to conceive are twice as likely to suffer from emotional distress than fertile women. Assisted reproductive technology treatments place an additional physical, emotional, and financial burden of stress, particularly on women, who are often exposed to invasive techniques associated with treatment. Stress-reduction interventions can reduce negative affect and in some cases to improve in vitro fertilization outcomes. Although it has been well-established that stress negatively affects fertility in animal models, human research remains inconsistent due to individual differences and methodological flaws. Attempts to isolate single causal links between stress and infertility have not yet been successful due to their multifaceted etiologies. In this review, we will discuss the current literature in the field of stress-induced reproductive dysfunction based on animal and human models, and introduce a recently unexplored link between stress and infertility, the gut-derived hormone, ghrelin. We also present evidence from recent seminal studies demonstrating that ghrelin has a principal role in the stress response and reward processing, as well as in regulating reproductive function, and that these roles are tightly interlinked. Collectively, these data support the hypothesis that stress may negatively impact upon fertility at least in part by stimulating a dysregulation in ghrelin signaling.
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Affiliation(s)
- Luba Sominsky
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria 3083, Australia
| | - Deborah M Hodgson
- School of Psychology, Faculty of Science and IT, The University of Newcastle, New South Wales 2308, Australia
| | - Eileen A McLaughlin
- School of Biological Sciences, Faculty of Science, The University of Auckland, Auckland 1010, New Zealand.,School of Environmental & Life Sciences, Faculty of Science and IT, The University of Newcastle, New South Wales 2308, Australia
| | - Roger Smith
- Mothers and Babies Research Centre, Hunter Medical Research Institute, Lookout Road, New Lambton Heights, New South Wales 2305, Australia.,Priority Research Centre in Reproductive Science, The University of Newcastle, New South Wales 2308, Australia
| | - Hannah M Wall
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria 3083, Australia
| | - Sarah J Spencer
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria 3083, Australia
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24
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Duncan L, Yilmaz Z, Gaspar H, Walters R, Goldstein J, Anttila V, Bulik-Sullivan B, Ripke S, Thornton L, Hinney A, Daly M, Sullivan PF, Zeggini E, Breen G, Bulik CM, Duncan L, Yilmaz Z, Gaspar H, Walters R, Goldstein J, Anttila V, Bulik-Sullivan B, Ripke S, Adan R, Alfredsson L, Ando T, Andreassen O, Aschauer H, Baker J, Barrett J, Bencko V, Bergen A, Berrettini W, Birgegård A, Boni C, Perica VB, Brandt H, Burghardt R, Carlberg L, Cassina M, Cesta C, Cichon S, Clementi M, Cohen-Woods S, Coleman J, Cone R, Courtet P, Crawford S, Crow S, Crowley J, Danner U, Davis O, de Zwaan M, Dedoussis G, Degortes D, DeSocio J, Dick D, Dikeos D, Dina C, Ding B, Dmitrzak-Weglarz M, Docampo E, Egberts K, Ehrlich S, Escaramís G, Esko T, Espeseth T, Estivill X, Favaro A, Fernández-Aranda F, Fichter M, Finan C, Fischer K, Floyd J, Föcker M, Foretova L, Forzan M, Fox C, Franklin C, Gaborieau V, Gallinger S, Gambaro G, Giegling I, Gonidakis F, Gorwood P, Gratacos M, Guillaume S, Guo Y, Hakonarson H, Halmi K, Harrison R, Hatzikotoulas K, Hauser J, Hebebrand J, Helder S, Hendriks J, Herms S, Herpertz-Dahlmann B, Herzog W, Hilliard C, Huckins L, Hudson J, Huemer J, Imgart H, Inoko H, Jall S, Jamain S, Janout V, Jiménez-Murcia S, Johnson C, Jordan J, Julià A, Juréus A, Kalsi G, Kaplan A, Kaprio J, Karhunen L, Karwautz A, Kas M, Kaye W, Kennedy M, Kennedy J, Keski-Rahkonen A, Kiezebrink K, Kim YR, Klareskog L, Klump K, Knudsen GP, Koeleman B, Koubek D, La Via M, Landén M, Le Hellard S, Leboyer M, Levitan R, Li D, Lichtenstein P, Lilenfeld L, Lissowska J, Lundervold A, Magistretti P, Maj M, Mannik K, Marsal S, Kaminska D, Martin N, Mattingsdal M, McDevitt S, McGuffin P, Merl E, Metspalu A, Meulenbelt I, Micali N, Mitchell J, Mitchell K, Monteleone P, Monteleone AM, Montgomery G, Mortensen P, Munn-Chernoff M, Müller T, Nacmias B, Navratilova M, Nilsson I, Norring C, Ntalla I, Ophoff R, O’Toole J, Palotie A, Pantel J, Papezova H, Parker R, Pinto D, Rabionet R, Raevuori A, Rajewski A, Ramoz N, Rayner NW, Reichborn-Kjennerud T, Ricca V, Ripatti S, Ritschel F, Roberts M, Rotondo A, Rujescu D, Rybakowski F, Santonastaso P, Scherag A, Scherer S, Schmidt U, Schork N, Schosser A, Scott L, Seitz J, Slachtova L, Sladek R, Slagboom PE, ’t Landt MSO, Slopien A, Smith T, Soranzo N, Sorbi S, Southam L, Steen V, Strengman E, Strober M, Szatkiewicz J, Szeszenia-Dabrowska N, Tachmazidou I, Tenconi E, Tortorella A, Tozzi F, Treasure J, Tschöp M, Tsitsika A, Tziouvas K, van Elburg A, van Furth E, Wade T, Wagner G, Walton E, Watson H, Wichmann HE, Widen E, Woodside DB, Yanovski J, Yao S, Zerwas S, Zipfel S, Thornton L, Hinney A, Daly M, Sullivan PF, Zeggini E, Breen G, Bulik CM. Significant Locus and Metabolic Genetic Correlations Revealed in Genome-Wide Association Study of Anorexia Nervosa. Am J Psychiatry 2017; 174:850-858. [PMID: 28494655 PMCID: PMC5581217 DOI: 10.1176/appi.ajp.2017.16121402] [Citation(s) in RCA: 308] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The authors conducted a genome-wide association study of anorexia nervosa and calculated genetic correlations with a series of psychiatric, educational, and metabolic phenotypes. METHOD Following uniform quality control and imputation procedures using the 1000 Genomes Project (phase 3) in 12 case-control cohorts comprising 3,495 anorexia nervosa cases and 10,982 controls, the authors performed standard association analysis followed by a meta-analysis across cohorts. Linkage disequilibrium score regression was used to calculate genome-wide common variant heritability (single-nucleotide polymorphism [SNP]-based heritability [h2SNP]), partitioned heritability, and genetic correlations (rg) between anorexia nervosa and 159 other phenotypes. RESULTS Results were obtained for 10,641,224 SNPs and insertion-deletion variants with minor allele frequencies >1% and imputation quality scores >0.6. The h2SNP of anorexia nervosa was 0.20 (SE=0.02), suggesting that a substantial fraction of the twin-based heritability arises from common genetic variation. The authors identified one genome-wide significant locus on chromosome 12 (rs4622308) in a region harboring a previously reported type 1 diabetes and autoimmune disorder locus. Significant positive genetic correlations were observed between anorexia nervosa and schizophrenia, neuroticism, educational attainment, and high-density lipoprotein cholesterol, and significant negative genetic correlations were observed between anorexia nervosa and body mass index, insulin, glucose, and lipid phenotypes. CONCLUSIONS Anorexia nervosa is a complex heritable phenotype for which this study has uncovered the first genome-wide significant locus. Anorexia nervosa also has large and significant genetic correlations with both psychiatric phenotypes and metabolic traits. The study results encourage a reconceptualization of this frequently lethal disorder as one with both psychiatric and metabolic etiology.
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Affiliation(s)
- Laramie Duncan
- From the UNC Center of Excellence for Eating Disorders, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, N.C.; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; the Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston; the Social, Genetic, and Developmental Psychiatry Research Centre and Biomedical Research Centre for Mental Health at King's College London and South London
| | - Zeynep Yilmaz
- From the UNC Center of Excellence for Eating Disorders, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, N.C.; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; the Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston; the Social, Genetic, and Developmental Psychiatry Research Centre and Biomedical Research Centre for Mental Health at King's College London and South London
| | - Helena Gaspar
- From the UNC Center of Excellence for Eating Disorders, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, N.C.; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; the Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston; the Social, Genetic, and Developmental Psychiatry Research Centre and Biomedical Research Centre for Mental Health at King's College London and South London
| | - Raymond Walters
- From the UNC Center of Excellence for Eating Disorders, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, N.C.; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; the Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston; the Social, Genetic, and Developmental Psychiatry Research Centre and Biomedical Research Centre for Mental Health at King's College London and South London
| | - Jackie Goldstein
- From the UNC Center of Excellence for Eating Disorders, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, N.C.; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; the Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston; the Social, Genetic, and Developmental Psychiatry Research Centre and Biomedical Research Centre for Mental Health at King's College London and South London
| | - Verneri Anttila
- From the UNC Center of Excellence for Eating Disorders, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, N.C.; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; the Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston; the Social, Genetic, and Developmental Psychiatry Research Centre and Biomedical Research Centre for Mental Health at King's College London and South London
| | - Brendan Bulik-Sullivan
- From the UNC Center of Excellence for Eating Disorders, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, N.C.; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; the Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston; the Social, Genetic, and Developmental Psychiatry Research Centre and Biomedical Research Centre for Mental Health at King's College London and South London
| | - Stephan Ripke
- From the UNC Center of Excellence for Eating Disorders, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, N.C.; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; the Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston; the Social, Genetic, and Developmental Psychiatry Research Centre and Biomedical Research Centre for Mental Health at King's College London and South London
| | - Laura Thornton
- From the UNC Center of Excellence for Eating Disorders, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, N.C.; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; the Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston; the Social, Genetic, and Developmental Psychiatry Research Centre and Biomedical Research Centre for Mental Health at King's College London and South London
| | - Anke Hinney
- From the UNC Center of Excellence for Eating Disorders, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, N.C.; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; the Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston; the Social, Genetic, and Developmental Psychiatry Research Centre and Biomedical Research Centre for Mental Health at King's College London and South London
| | - Mark Daly
- From the UNC Center of Excellence for Eating Disorders, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, N.C.; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; the Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston; the Social, Genetic, and Developmental Psychiatry Research Centre and Biomedical Research Centre for Mental Health at King's College London and South London
| | - Patrick F. Sullivan
- From the UNC Center of Excellence for Eating Disorders, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, N.C.; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; the Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston; the Social, Genetic, and Developmental Psychiatry Research Centre and Biomedical Research Centre for Mental Health at King's College London and South London
| | - Eleftheria Zeggini
- From the UNC Center of Excellence for Eating Disorders, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, N.C.; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; the Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston; the Social, Genetic, and Developmental Psychiatry Research Centre and Biomedical Research Centre for Mental Health at King's College London and South London
| | - Gerome Breen
- From the UNC Center of Excellence for Eating Disorders, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, N.C.; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; the Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston; the Social, Genetic, and Developmental Psychiatry Research Centre and Biomedical Research Centre for Mental Health at King's College London and South London
| | - Cynthia M. Bulik
- From the UNC Center of Excellence for Eating Disorders, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, N.C.; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; the Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston; the Social, Genetic, and Developmental Psychiatry Research Centre and Biomedical Research Centre for Mental Health at King's College London and South London
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Predictors and long-term health outcomes of eating disorders. PLoS One 2017; 12:e0181104. [PMID: 28700663 PMCID: PMC5507321 DOI: 10.1371/journal.pone.0181104] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 06/25/2017] [Indexed: 12/12/2022] Open
Abstract
Anorexia and bulimia nervosa may have long-term effects on overall and reproductive health. We studied predictors of self-reported eating disorders and associations with later health events. We estimated odds ratios (ORs) for these associations in 47,759 participants from the Sister Study. Two percent (n = 967) of participants reported a history of an eating disorder. Risk factors included being non-Hispanic white, having well-educated parents, recent birth cohort (OR = 2.16, 95% confidence interval [CI]: 2.01–2.32 per decade), and having a sister with an eating disorder (OR = 3.68, CI: 1.92–7.02). As adults, women who had experienced eating disorders were more likely to smoke, to be underweight, to have had depression, to have had a later first birth, to have experienced bleeding or nausea during pregnancy, or to have had a miscarriage or induced abortion. In this descriptive analysis, we identified predictors of and possible long-term health consequences of eating disorders. Eating disorders may have become more common over time. Interventions should focus on prevention and mitigation of long-term adverse health effects.
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Insulin signalling and glucose transport in the ovary and ovarian function during the ovarian cycle. Biochem J 2017; 473:1483-501. [PMID: 27234585 PMCID: PMC4888492 DOI: 10.1042/bcj20160124] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 03/03/2016] [Indexed: 12/16/2022]
Abstract
Data derived principally from peripheral tissues (fat, muscle and liver) show that insulin signals via diverse interconnecting intracellular pathways and that some of the major intersecting points (known as critical nodes) are the IRSs (insulin receptor substrates), PI3K (phosphoinositide kinase)/Akt and MAPK (mitogen-activated protein kinase). Most of these insulin pathways are probably also active in the ovary and their ability to interact with each other and also with follicle-stimulating hormone (FSH) and luteinizing hormone (LH) signalling pathways enables insulin to exert direct modulating influences on ovarian function. The present paper reviews the intracellular actions of insulin and the uptake of glucose by ovarian tissues (granulosa, theca and oocyte) during the oestrous/menstrual cycle of some rodent, primate and ruminant species. Insulin signals through diverse pathways and these are discussed with specific reference to follicular cell types (granulosa, theca and oocyte). The signalling pathways for FSH in granulosa cells and LH in granulosa and theca cells are summarized. The roles of glucose and of insulin-mediated uptake of glucose in folliculogenesis are discussed. It is suggested that glucose in addition to its well-established role of providing energy for cellular function may also have insulin-mediated signalling functions in ovarian cells, involving AMPK (AMP-dependent protein kinase) and/or hexosamine. Potential interactions of insulin signalling with FSH or LH signalling at critical nodes are identified and the available evidence for such interactions in ovarian cells is discussed. Finally the action of the insulin-sensitizing drugs metformin and the thiazolidinedione rosiglitazone on follicular cells is reviewed.
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Drosdzol-Cop A, Bąk-Sosnowska M, Sajdak D, Białka A, Kobiołka A, Franik G, Skrzypulec-Plinta V. Assessment of the menstrual cycle, eating disorders and self-esteem of Polish adolescents. J Psychosom Obstet Gynaecol 2017; 38:30-36. [PMID: 27584558 DOI: 10.1080/0167482x.2016.1216959] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION Eating disorders are an important factor in menstrual cycle disorders in girls. Moreover, low self-esteem among adolescent girls may be a risk factor for eating disorders. The aim of the study was to assess the menstrual cycle, eating habits and self-esteem of Polish adolescents. METHODS The study was conducted from January 2014 to March 2015 and included 623 girls, aged 15-19, from randomly selected junior high schools in Silesia, Poland, in which their menstrual cycle, risk of eating disorders and self-esteem were evaluated. A five-part questionnaire was used to assess basic demographic data, lifestyle and physical activity, gynecological history, as well as Rosenberg Self-Esteem Scale (SES) and Eating Attitude Test (EAT-26). RESULTS Irregular menstrual cycles were observed in 236 (37.88%) girls; 5.20% presented secondary amenorrhea. Based on the EAT-26 test, 101 (16.21%) girls were indicated being at risk for an eating disorder. Low self-esteem was observed in 340 (54.57%) study girls on the base of SES. DISCUSSION Girls with irregular menses had higher scores on the EAT-26 test in subscales: EAT-overall score, EAT-diet and EAT-bulimia, while lower scores on the SES. In our study, we did not observe a significant relationship between exercise intensity, body mass, BMI and menstrual cycle regularity. Low self-esteem among adolescent girls may be a risk factor for eating disorders which could interrupt the menstrual cycle.
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Affiliation(s)
- Agnieszka Drosdzol-Cop
- a School of Health Sciences in Katowice, Medical University of Silesia , Katowice , Poland
| | - Monika Bąk-Sosnowska
- b School of Health Sciences in Katowice, Medical University of Silesia , Katowice , Poland
| | - Dominika Sajdak
- a School of Health Sciences in Katowice, Medical University of Silesia , Katowice , Poland
| | - Agnieszka Białka
- a School of Health Sciences in Katowice, Medical University of Silesia , Katowice , Poland
| | - Agnieszka Kobiołka
- a School of Health Sciences in Katowice, Medical University of Silesia , Katowice , Poland
| | - Grzegorz Franik
- c Department of Endocrinological Gynecology , Medical University of Silesia , Katowice , Poland
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Kudesia R, Talib HJ, Pollack SE. Fertility Awareness Counseling for Adolescent Girls; Guiding Conception: The Right Time, Right Weight, and Right Way. J Pediatr Adolesc Gynecol 2017; 30:9-17. [PMID: 27486027 DOI: 10.1016/j.jpag.2016.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 07/25/2016] [Accepted: 07/25/2016] [Indexed: 11/28/2022]
Abstract
STUDY OBJECTIVE To provide a detailed summary of fertility awareness counseling pearls for healthy teens and those with fertility-relevant comorbidities, and to assist providers in offering such counseling to adolescents and young adult women. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Comprehensive literature review of English-language studies relating to fertility in pediatric and adolescent female patients (ages 13-21 years), and evidence-based dialogue guide. RESULTS The literature indicates that although adolescents are interested in discussing sexuality and reproduction, this is commonly overlooked during the standard office medical visit. As a result, adolescents often turn to less reliable sources and hold a variety of reproductive misconceptions and a sense of lack of control over future fertility. We found no studies that examined the routine provision of fertility awareness counseling with healthy adolescents. There are a multitude of specific gynecologic and medical conditions that have ramifications for fertility. We detail these comprehensively, and provide a dialogue guide to assist with fertility awareness counseling for the female adolescent, containing specific information and indications for referral. CONCLUSION Providers caring for adolescent girls have the opportunity to enhance fertility awareness as part of a larger reproductive health conversation that adolescents desire, and from which they might benefit. Identifying potential future fertility issues, understanding age-related fertility decline, and aiding in health optimization before future conception might empower the adolescent to make informed reproductive decisions. We provide an algorithm to use with adolescents to discuss the "right time, right weight, right way" to pursue childbearing.
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Affiliation(s)
- Rashmi Kudesia
- Division of Reproductive Endocrinology and Infertility, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Hina J Talib
- Division of Adolescent Medicine, Department of Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York
| | - Staci E Pollack
- Division of Reproductive Endocrinology and Infertility, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
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Boisseau CL. Identification and management of eating disorders in gynecology: menstrual health as an underutilized screening tool. Am J Obstet Gynecol 2016; 215:572-578. [PMID: 27422054 DOI: 10.1016/j.ajog.2016.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 06/18/2016] [Accepted: 07/05/2016] [Indexed: 02/01/2023]
Abstract
Eating disorders are life-threatening conditions that disproportionately affect females, often during child-bearing years. Although the endocrinological and reproductive sequelae of these conditions often fall within the treatment purview of obstetrician-gynecologists, the assessment of eating pathology is challenging and often not part of routine clinical care. This commentary focuses on one of the common presenting symptoms of eating disorders in women, menstrual dysfunction, and discusses considerations for its clinical management in gynecology. Assessment of menstrual status provides a natural starting point for provider-patient discussion of disordered eating and weight behavior. Routine screening for eating disorders is critical and must be universal given the serious long-term consequences of these disorders.
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O'Brien KM, Whelan DR, Sandler DP, Weinberg CR. Eating Disorders and Breast Cancer. Cancer Epidemiol Biomarkers Prev 2016; 26:206-211. [PMID: 27756775 DOI: 10.1158/1055-9965.epi-16-0587] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 09/21/2016] [Accepted: 09/23/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Eating disorders such as anorexia nervosa and bulimia nervosa affect overall and reproductive health and may also affect breast cancer risk. We studied the association between self-reported eating disorders and breast cancer risk in a prospective cohort study. METHODS In 2003-2009, the Sister Study enrolled women ages 35-74 years who had a sister with breast cancer but had never had it themselves. Using data from 47,813 women, we estimated adjusted HRs and 95% confidence intervals (CI) for the association between eating disorders and invasive breast cancer over a median of 5.4 years of follow-up. RESULTS Three percent (n = 1,569) of participants reported a history of an eating disorder. Compared with women who never had an eating disorder, women who reported eating disorders in the past had reduced breast cancer risk (HR = 0.62; 95% CI, 0.42-0.92). CONCLUSIONS In this large prospective, observational cohort study, we observed an inverse association between having a history of an eating disorder and invasive breast cancer. IMPACT Historical eating disorders may be associated with a long-term reduction in breast cancer risk. Cancer Epidemiol Biomarkers Prev; 26(2); 206-11. ©2016 AACR.
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Affiliation(s)
- Katie M O'Brien
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
| | - Denis R Whelan
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina.,Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
| | - Clarice R Weinberg
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina.
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Martini MG, Solmi F, Krug I, Karwautz A, Wagner G, Fernandez-Aranda F, Treasure J, Micali N. Associations between eating disorder diagnoses, behaviors, and menstrual dysfunction in a clinical sample. Arch Womens Ment Health 2016; 19:553-7. [PMID: 26399871 DOI: 10.1007/s00737-015-0576-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 09/14/2015] [Indexed: 11/25/2022]
Abstract
We explored associations between lifetime eating disorder (ED) diagnoses and behaviors and menstrual dysfunction using logistic regression models. Body mass index (BMI) fully explained differences in the odds of secondary amenorrhea (SA) across diagnoses. Women with dieting behaviors had borderline significantly higher odds of SA than those without after accounting for BMI. We suggest the presence of a strong association between BMI and SA and that dieting might represent a risk factor for SA regardless of BMI and ED diagnosis.
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Affiliation(s)
- Maria Giulia Martini
- Institute of Child Health, Behavioral and Brain Sciences Unit, University College London, 30 Guilford Street, WC1N 1EH, London, UK.
- Psychiatric Unit, United Hospitals of Ancona and Academic Department of Experimental and Clinical Medicine, Polytechnic University of Marche, via Conca 71, Ancona, Italy.
| | - Francesca Solmi
- Department of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Isabel Krug
- School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Andreas Karwautz
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Gudrun Wagner
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Fernando Fernandez-Aranda
- Department of Psychiatry, University Hospital Bellvitge-IDIBELL and CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Barcelona, Spain
| | - Janet Treasure
- Eating Disorders Research Unit, Psychological Medicine, Institute of Psychiatry, King's College London, London, UK
| | - Nadia Micali
- Institute of Child Health, Behavioral and Brain Sciences Unit, University College London, 30 Guilford Street, WC1N 1EH, London, UK
- Dept. of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
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Nezi M, Christopoulos P, Paltoglou G, Gryparis A, Bakoulas V, Deligeoroglou E, Creatsas G, Mastorakos G. Focus on BMI and subclinical hypothyroidism in adolescent girls first examined for amenorrhea or oligomenorrhea. The emerging role of polycystic ovary syndrome. J Pediatr Endocrinol Metab 2016; 29:693-702. [PMID: 27089404 DOI: 10.1515/jpem-2015-0312] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 02/09/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Primary amenorrhea, oligomenorrhea and secondary amenorrhea are diagnosed commonly during adolescence. Weight aberrations are associated with menstrual disorders. Autoimmune thyroiditis is frequent during adolescence. In this study, the commonest clinical and hormonal characteristics of amenorrhea or oligomenorrhea during adolescence were investigated. METHODS In this cross-sectional study, one hundred and thirty-eight consecutive young patients presenting with amenorrhea or oligomenorrhea referred to an adolescent endocrinology and gynecology university clinic were studied. Clinical examination and an abdominal ultrasound were performed. Testosterone, free-testosterone, estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), dehydroepiandrosterone sulfate (DHEA-S), 17-OH progesterone, sex hormone binding globulin (SHBG), Δ4-androstenedione (Δ4A), free androgen index (FAI), insulin, glucose, thyroid stimulating hormone (TSH), total thyroxine (T4) (TT4), free T4 (FT4), total triiodothyronine (T3) (TT3) and free T3 (FT3). Concentrations were measured in blood samples. RESULTS Patients with primary and secondary amenorrhea presented more often with body mass index (BMI) <18.5 and BMI >25 kg/m2, respectively. BMI values correlated positively with insulin (r=0.742) and glucose (r=0.552) concentrations and negatively with glucose/insulin ratio values (r=-0.54); BMI values and insulin concentrations correlated positively with FAI values (r=0.629 and r=0.399, respectively). In all patients, BMI values correlated positively and negatively with free testosterone (r=0.249) and SHBG (r=-0.24) concentrations, respectively. In patients with secondary amenorrhea insulin concentrations correlated negatively with SHBG concentrations (r=-0.75). In patients with oligomenorrhea BMI values correlated positively with insulin (r=0.490) and TSH (r=0.325) concentrations, and negatively with SHBG (r=-0.33) concentrations. Seventy-two percent, 21% and 7% of patients presented with TSH concentrations <2.5 μIU/mL, between 2.5 μIU/mL, 4.5 μIU/mL and >4.5 μIU/mL (subclinical hypothyroidism), respectively. Following the definition of polycystic ovary syndrome (PCOS) according to either the National Institutes of Health (NIH) criteria or those proposed in the literature by Carmina and his team, patients presented mainly with oligomenorrhea or secondary amenorrhea. There was good agreement between patients with amenorrhea or oligomenorrhea fulfilling both of the PCOS definition criteria employed. CONCLUSIONS Among adolescent patients presenting with amenorrhea or oligomenorrhea for the first time those with low and high BMI present more often with primary and secondary amenorrhea, respectively. Obesity is involved in the development of hyperandrogenemia and hyperinsulinemia, particularly in PCOS patients. In these patients, subclinical hypothyroidism may be concealed and it should be investigated. These patients should be treated for abnormally increased or decreased BMI and be investigated for autoimmune thyroiditis.
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Wolfe BE, Dunne JP, Kells MR. Nursing Care Considerations for the Hospitalized Patient with an Eating Disorder. Nurs Clin North Am 2016; 51:213-35. [PMID: 27229277 DOI: 10.1016/j.cnur.2016.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Eating disorders are chronic psychiatric illnesses with significant medical complications, psychological distress, and psychiatric comorbidity. Although many patients are treated on an outpatient basis, inpatient care for the more severely ill hospitalized patient can be challenging given the severity of illness and concurrent issues requiring intervention. This article provides an overview of the clinical characteristics of eating disorders typically seen for inpatient care, focusing primarily on anorexia nervosa and bulimia nervosa, and the associated key areas for nursing assessment, diagnoses, and plan of care during hospitalization.
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Affiliation(s)
- Barbara E Wolfe
- Boston College Wm. F. Connell School of Nursing, Maloney Hall, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA.
| | - Julie P Dunne
- Boston College Wm. F. Connell School of Nursing, Maloney Hall, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA
| | - Meredith R Kells
- Boston College Wm. F. Connell School of Nursing, Maloney Hall, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA
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Kimmel M, Ferguson E, Zerwas S, Bulik C, Meltzer-Brody S. Obstetric and gynecologic problems associated with eating disorders. Int J Eat Disord 2016; 49:260-75. [PMID: 26711005 PMCID: PMC5683401 DOI: 10.1002/eat.22483] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/10/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This article summarizes the literature on obstetric and gynecologic complications associated with eating disorders. METHOD We performed a comprehensive search of the current literature on obstetric and gynecologic complications associated with eating disorders using PubMed. More recent randomized-controlled trials and larger data sets received priority. We also chose those that we felt would be the most relevant to providers. RESULTS Common obstetric and gynecologic complications for women with eating disorders include infertility, unplanned pregnancy, miscarriage, poor nutrition during pregnancy, having a baby with small head circumference, postpartum depression and anxiety, sexual dysfunction and complications in the treatment for gynecologic cancers. There are also unique associations by eating disorder diagnosis, such as earlier cessation of breastfeeding in anorexia nervosa; increased polycystic ovarian syndrome in bulimia nervosa; and complications of obesity as a result of binge eating disorder. DISCUSSION We focus on possible biological and psychosocial factors underpinning risk for poor obstetric and gynecological outcomes in eating disorders. Understanding these factors may improve both our understanding of the reproductive needs of women with eating disorders and their medical outcomes. We also highlight the importance of building multidisciplinary teams to provide comprehensive care to women with eating disorders during the reproductive years.
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Affiliation(s)
- M.C. Kimmel
- Department of Psychiatry, University of North Carolina-Chapel Hill Chapel Hill, North Carolina,Correspondence to: M.C. Kimmel, Department of Psychiatry, University of North Carolina-Chapel Hill Chapel Hill, North Carolina.
| | - E.H. Ferguson
- Department of Psychiatry, University of North Carolina-Chapel Hill Chapel Hill, North Carolina
| | - S. Zerwas
- Department of Psychiatry, University of North Carolina-Chapel Hill Chapel Hill, North Carolina
| | - C.M. Bulik
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - S. Meltzer-Brody
- Department of Psychiatry, University of North Carolina-Chapel Hill Chapel Hill, North Carolina
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Javier SJ, Moore MP, Belgrave FZ. Racial comparisons in perceptions of maternal and peer attitudes, body dissatisfaction, and eating disorders among African American and White women. Women Health 2015; 56:615-33. [DOI: 10.1080/03630242.2015.1118721] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Minabe S, Deura C, Ikegami K, Goto T, Sanbo M, Hirabayashi M, Inoue N, Uenoyama Y, Maeda KI, Tsukamura H. Pharmacological and Morphological Evidence of AMPK-Mediated Energy Sensing in the Lower Brain Stem Ependymocytes to Control Reproduction in Female Rodents. Endocrinology 2015; 156:2278-87. [PMID: 25822714 PMCID: PMC4430616 DOI: 10.1210/en.2014-2018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Ependymocytes are one of the energy-sensing cells that regulate animal reproduction through their responsiveness to changes in extracellular glucose levels and the expression of pancreatic-type glucokinase and glucose transporter 2, which play a critical role in sensing blood glucose levels in pancreatic β-cells. Molecular mechanisms underlying glucose sensing in the ependymocytes remain poorly understood. The AMP-activated protein kinase (AMPK), a serine/threonine kinase highly conserved in all eukaryotic cells, has been suggested to be an intracellular fuel gauge that detects cellular energy status. The present study aims to clarify the role AMPK of the lower brainstem ependymocytes has in sensing glucose levels to regulate reproductive functions. First, we will show that administration of 5-aminoimidazole-4-carboxamide-1-β-D-ribofuranoside, an AMPK activator, into the 4th ventricle suppressed pulsatile LH release in female rats. Second, we will demonstrate the presence of AMPK catalytic subunit immunoreactivities in the rat lower brainstem ependymocytes. Third, transgenic mice were generated to visualize the ependymocytes with Venus, a green fluorescent protein, expressed under the control of the mouse vimentin promoter for further in vitro study. The Venus-labeled ependymocytes taken from the lower brainstem of transgenic mice revealed that AMPK activation by 5-aminoimidazole-4-carboxamide-1-β-D-ribofuranoside, an AMPK activator, increased in vitro intracellular calcium concentrations. Taken together, malnutrition-induced AMPK activation of ependymocytes of the lower brainstem might be involved in suppression of GnRH/LH release and then gonadal activities.
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Affiliation(s)
- Shiori Minabe
- Graduate School of Bioagricultural Sciences (S.M., C.D., K.I., T.G., N.I., Y.U., H.T.), Nagoya University, Nagoya, Aichi 464-8601, Japan; Center for Genetic Analysis of Behavior (M.S., M.H.), National Institute for Physiological Sciences, Okazaki, Aichi 444-8585, Japan; and Veterinary Medical Sciences (K.-i.M.), University of Tokyo, Tokyo 113-8657, Japan
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Knoll S, Föcker M, Hebebrand J. [Changes to the classification of Eating Disorders in DSM-5]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2014; 42:361-6; quiz 367-8. [PMID: 25163998 DOI: 10.1024/1422-4917/a000311] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) resulted in substantial changes with regard to the classification of Eating Disorders. In DSM-5, Feeding and Eating Disorders are for the first time subsumed in a single category. The Binge Eating Disorder (BED) was established as the third classical eating disorder in addition to Anorexia Nervosa (AN) and Bulimia Nervosa (BN). The criteria for AN changed remarkably, whereas there were only minor changes to the BN criteria. The criteria for BED differ only marginally from the DSM-IV research criteria. There are now subtypes of AN, BN, and BED in the new category "Other Specific Feeding and Eating Disorders." The rest category "Eating Disorders Not Otherwise Specified" has been renamed to "Unspecified Feeding or Eating Disorders." The practicability of the DSM-5 criteria for Eating Disorders, and for AN in particular, for both clinical practice and research remains to be seen.
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Affiliation(s)
- Susanne Knoll
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Essen
| | - Manuel Föcker
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Essen
| | - Johannes Hebebrand
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Essen
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38
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Boraska V, Franklin CS, Floyd JAB, Thornton LM, Huckins LM, Southam L, Rayner NW, Tachmazidou I, Klump KL, Treasure J, Lewis CM, Schmidt U, Tozzi F, Kiezebrink K, Hebebrand J, Gorwood P, Adan RAH, Kas MJH, Favaro A, Santonastaso P, Fernández-Aranda F, Gratacos M, Rybakowski F, Dmitrzak-Weglarz M, Kaprio J, Keski-Rahkonen A, Raevuori A, Van Furth EF, Slof-Op 't Landt MCT, Hudson JI, Reichborn-Kjennerud T, Knudsen GPS, Monteleone P, Kaplan AS, Karwautz A, Hakonarson H, Berrettini WH, Guo Y, Li D, Schork NJ, Komaki G, Ando T, Inoko H, Esko T, Fischer K, Männik K, Metspalu A, Baker JH, Cone RD, Dackor J, DeSocio JE, Hilliard CE, O'Toole JK, Pantel J, Szatkiewicz JP, Taico C, Zerwas S, Trace SE, Davis OSP, Helder S, Bühren K, Burghardt R, de Zwaan M, Egberts K, Ehrlich S, Herpertz-Dahlmann B, Herzog W, Imgart H, Scherag A, Scherag S, Zipfel S, Boni C, Ramoz N, Versini A, Brandys MK, Danner UN, de Kovel C, Hendriks J, Koeleman BPC, Ophoff RA, Strengman E, van Elburg AA, Bruson A, Clementi M, Degortes D, Forzan M, Tenconi E, Docampo E, Escaramís G, Jiménez-Murcia S, Lissowska J, Rajewski A, Szeszenia-Dabrowska N, Slopien A, Hauser J, Karhunen L, Meulenbelt I, Slagboom PE, Tortorella A, Maj M, Dedoussis G, Dikeos D, Gonidakis F, Tziouvas K, Tsitsika A, Papezova H, Slachtova L, Martaskova D, Kennedy JL, Levitan RD, Yilmaz Z, Huemer J, Koubek D, Merl E, Wagner G, Lichtenstein P, Breen G, Cohen-Woods S, Farmer A, McGuffin P, Cichon S, Giegling I, Herms S, Rujescu D, Schreiber S, Wichmann HE, Dina C, Sladek R, Gambaro G, Soranzo N, Julia A, Marsal S, Rabionet R, Gaborieau V, Dick DM, Palotie A, Ripatti S, Widén E, Andreassen OA, Espeseth T, Lundervold A, Reinvang I, Steen VM, Le Hellard S, Mattingsdal M, Ntalla I, Bencko V, Foretova L, Janout V, Navratilova M, Gallinger S, Pinto D, Scherer SW, Aschauer H, Carlberg L, Schosser A, Alfredsson L, Ding B, Klareskog L, Padyukov L, Courtet P, Guillaume S, Jaussent I, Finan C, Kalsi G, Roberts M, Logan DW, Peltonen L, Ritchie GRS, Barrett JC, Estivill X, Hinney A, Sullivan PF, Collier DA, Zeggini E, Bulik CM. A genome-wide association study of anorexia nervosa. Mol Psychiatry 2014; 19:1085-94. [PMID: 24514567 PMCID: PMC4325090 DOI: 10.1038/mp.2013.187] [Citation(s) in RCA: 241] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 11/21/2013] [Accepted: 11/25/2013] [Indexed: 02/06/2023]
Abstract
Anorexia nervosa (AN) is a complex and heritable eating disorder characterized by dangerously low body weight. Neither candidate gene studies nor an initial genome-wide association study (GWAS) have yielded significant and replicated results. We performed a GWAS in 2907 cases with AN from 14 countries (15 sites) and 14 860 ancestrally matched controls as part of the Genetic Consortium for AN (GCAN) and the Wellcome Trust Case Control Consortium 3 (WTCCC3). Individual association analyses were conducted in each stratum and meta-analyzed across all 15 discovery data sets. Seventy-six (72 independent) single nucleotide polymorphisms were taken forward for in silico (two data sets) or de novo (13 data sets) replication genotyping in 2677 independent AN cases and 8629 European ancestry controls along with 458 AN cases and 421 controls from Japan. The final global meta-analysis across discovery and replication data sets comprised 5551 AN cases and 21 080 controls. AN subtype analyses (1606 AN restricting; 1445 AN binge-purge) were performed. No findings reached genome-wide significance. Two intronic variants were suggestively associated: rs9839776 (P=3.01 × 10(-7)) in SOX2OT and rs17030795 (P=5.84 × 10(-6)) in PPP3CA. Two additional signals were specific to Europeans: rs1523921 (P=5.76 × 10(-)(6)) between CUL3 and FAM124B and rs1886797 (P=8.05 × 10(-)(6)) near SPATA13. Comparing discovery with replication results, 76% of the effects were in the same direction, an observation highly unlikely to be due to chance (P=4 × 10(-6)), strongly suggesting that true findings exist but our sample, the largest yet reported, was underpowered for their detection. The accrual of large genotyped AN case-control samples should be an immediate priority for the field.
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Affiliation(s)
- V Boraska
- 1] Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK [2] University of Split School of Medicine, Split, Croatia
| | - C S Franklin
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - J A B Floyd
- 1] Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK [2] William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, John Vane Science Centre, Charterhouse Square, London, UK
| | - L M Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - L M Huckins
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - L Southam
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - N W Rayner
- 1] Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK [2] Wellcome Trust Centre for Human Genetics (WTCHG), University of Oxford, Oxford, UK [3] Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM), Oxford, UK
| | - I Tachmazidou
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - K L Klump
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - J Treasure
- Section of Eating Disorders, Institute of Psychiatry, King's College London, London, UK
| | - C M Lewis
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
| | - U Schmidt
- Section of Eating Disorders, Institute of Psychiatry, King's College London, London, UK
| | - F Tozzi
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - K Kiezebrink
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - J Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Universitätsklinikum Essen, University of Duisburg-Essen, Essen, Germany
| | - P Gorwood
- 1] INSERM U894, Centre of Psychiatry and Neuroscience, Paris, France [2] Sainte-Anne Hospital (CMME), University of Paris-Descartes, Paris, France
| | - R A H Adan
- 1] Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands [2] Altrecht Eating Disorders Rintveld, Zeist, The Netherlands
| | - M J H Kas
- Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands
| | - A Favaro
- Department of Neurosciences, University of Padova, Padova, Italy
| | - P Santonastaso
- Department of Neurosciences, University of Padova, Padova, Italy
| | - F Fernández-Aranda
- 1] Department of Psychiatry and CIBERON, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain [2] Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - M Gratacos
- 1] Genomics and Disease Group, Centre for Genomic Regulation (CRG), Barcelona, Spain [2] Universitat Pompeu Fabra (UPF), Barcelona, Spain [3] Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain [4] Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - F Rybakowski
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - M Dmitrzak-Weglarz
- Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - J Kaprio
- 1] Hjelt Institute, University of Helsinki, Helsinki, Finland [2] Institute of Molecular Medicine, University of Helsinki, Helsinki, Finland [3] Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
| | | | - A Raevuori
- 1] Hjelt Institute, University of Helsinki, Helsinki, Finland [2] Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
| | - E F Van Furth
- 1] Center for Eating Disorders Ursula, Leidschendam, The Netherlands [2] Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
| | - M C T Slof-Op 't Landt
- 1] Center for Eating Disorders Ursula, Leidschendam, The Netherlands [2] Molecular Epidemiology Section, Department of Medical Statistics, Leiden University Medical Centre, Leiden, The Netherlands
| | - J I Hudson
- Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - T Reichborn-Kjennerud
- 1] Department of Genetics, Environment and Mental Health, Norwegian Institute of Public Health, Oslo, Norway [2] Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - G P S Knudsen
- Department of Genetics, Environment and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - P Monteleone
- 1] Department of Psychiatry, University of Naples SUN, Naples, Italy [2] Chair of Psychiatry, University of Salerno, Salerno, Italy
| | - A S Kaplan
- 1] Centre for Addiction and Mental Health, Toronto, ON, Canada [2] Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - A Karwautz
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - H Hakonarson
- 1] The Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA [2] The Division of Human Genetics, Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - W H Berrettini
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Y Guo
- The Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - D Li
- The Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - N J Schork
- Department of Molecular and Experimental Medicine and The Scripps Translational Science Institute, The Scripps Research Institute, La Jolla, CA, USA
| | - G Komaki
- 1] Department of Psychosomatic Research, National Institute of Mental Health, NCNP, Tokyo, Japan [2] School of Health Sciences at Fukuoka, International University of Health and Welfare, Fukuoka, Japan
| | - T Ando
- Department of Psychosomatic Research, National Institute of Mental Health, NCNP, Tokyo, Japan
| | - H Inoko
- Department of Molecular Life Sciences, Tokai University School of Medicine, Kanagawa, Japan
| | - T Esko
- Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - K Fischer
- Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - K Männik
- 1] Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia [2] Center for Integrative Genomics, University of Lausanne, Lausanne, Switzerland
| | - A Metspalu
- 1] Estonian Genome Center, University of Tartu, Tartu, Estonia [2] Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
| | - J H Baker
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - R D Cone
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - J Dackor
- Department of Genetics, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - J E DeSocio
- Seattle University College of Nursing, Seattle, WA, USA
| | - C E Hilliard
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - J Pantel
- Centre de Psychiatrie et Neurosciences - Inserm U894, Paris, France
| | - J P Szatkiewicz
- Department of Genetics, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - C Taico
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - S Zerwas
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - S E Trace
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - O S P Davis
- 1] Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK [2] Department of Genetics, Evolution and Environment, University College London, UCL Genetics Institute, London, UK
| | - S Helder
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
| | - K Bühren
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Clinics RWTH Aachen, Aachen, Germany
| | - R Burghardt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité, Berlin, Germany
| | - M de Zwaan
- 1] Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany [2] Department of Psychosomatic Medicine and Psychotherapy, University of Erlangen-Nuremberg, Erlangen, Germany
| | - K Egberts
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Würzburg, Würzburg, Germany
| | - S Ehrlich
- 1] Department of Child and Adolescent Psychiatry, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany [2] Athinoula A. Martinos Center for Biomedical Imaging, Psychiatric Neuroimaging Research Program, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA
| | - B Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Clinics RWTH Aachen, Aachen, Germany
| | - W Herzog
- Departments of Psychosocial and Internal Medicine, Heidelberg University, Heidelberg, Germany
| | - H Imgart
- Parklandklinik, Bad Wildungen, Germany
| | - A Scherag
- Institute for Medical Informatics, Biometry and Epidemiology, Universitätsklinikum Essen, University of Duisburg-Essen, Essen, Germany
| | - S Scherag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Universitätsklinikum Essen, University of Duisburg-Essen, Essen, Germany
| | - S Zipfel
- Department of Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tübingen, Tübingen, Germany
| | - C Boni
- INSERM U894, Centre of Psychiatry and Neuroscience, Paris, France
| | - N Ramoz
- INSERM U894, Centre of Psychiatry and Neuroscience, Paris, France
| | - A Versini
- INSERM U894, Centre of Psychiatry and Neuroscience, Paris, France
| | - M K Brandys
- 1] Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands [2] Altrecht Eating Disorders Rintveld, Zeist, The Netherlands
| | - U N Danner
- Altrecht Eating Disorders Rintveld, Zeist, The Netherlands
| | - C de Kovel
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J Hendriks
- Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands
| | - B P C Koeleman
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R A Ophoff
- 1] Center for Neurobehavioral Genetics, University of California, Los Angeles, Los Angeles, CA, USA [2] Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - E Strengman
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - A A van Elburg
- 1] Altrecht Eating Disorders Rintveld, Zeist, The Netherlands [2] Department of Child and Adolescent Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - A Bruson
- Clinical Genetics Unit, Department of Woman and Child Health, University of Padova, Padova, Italy
| | - M Clementi
- Clinical Genetics Unit, Department of Woman and Child Health, University of Padova, Padova, Italy
| | - D Degortes
- Department of Neurosciences, University of Padova, Padova, Italy
| | - M Forzan
- Clinical Genetics Unit, Department of Woman and Child Health, University of Padova, Padova, Italy
| | - E Tenconi
- Department of Neurosciences, University of Padova, Padova, Italy
| | - E Docampo
- 1] Genomics and Disease Group, Centre for Genomic Regulation (CRG), Barcelona, Spain [2] Universitat Pompeu Fabra (UPF), Barcelona, Spain [3] Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain [4] Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - G Escaramís
- 1] Genomics and Disease Group, Centre for Genomic Regulation (CRG), Barcelona, Spain [2] Universitat Pompeu Fabra (UPF), Barcelona, Spain [3] Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain [4] Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - S Jiménez-Murcia
- 1] Department of Psychiatry and CIBERON, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain [2] Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - J Lissowska
- M. Sklodowska-Curie Cancer Center and Institute of Oncology, Warsaw, Poland
| | - A Rajewski
- Department of Epidemiology, Institute of Occupational Medicine, Department of Epidemiology, Lodz, Poland
| | - N Szeszenia-Dabrowska
- Department of Epidemiology, Institute of Occupational Medicine, Department of Epidemiology, Lodz, Poland
| | - A Slopien
- Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - J Hauser
- Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - L Karhunen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - I Meulenbelt
- Molecular Epidemiology Section, Department of Medical Statistics, Leiden University Medical Centre, Leiden, The Netherlands
| | - P E Slagboom
- 1] Molecular Epidemiology Section, Department of Medical Statistics, Leiden University Medical Centre, Leiden, The Netherlands [2] Netherlands Consortium for Healthy Ageing, Leiden University Medical Center, Leiden, The Netherlands
| | - A Tortorella
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | - M Maj
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | - G Dedoussis
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - D Dikeos
- 1st Department of Psychiatry, Athens University Medical School, Athens, Greece
| | - F Gonidakis
- Eating Disorders Unit, 1st Department of Psychiatry, Athens University Medical School, Athens, Greece
| | - K Tziouvas
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - A Tsitsika
- Adolescent Health Unit (A.H.U.), 2nd Department of Pediatrics - Medical School, University of Athens 'P. & A. Kyriakou' Children's Hospital, Athens, Greece
| | - H Papezova
- Department of Psychiatry, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - L Slachtova
- Department of Pediatrics, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - D Martaskova
- Department of Psychiatry, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - J L Kennedy
- 1] Centre for Addiction and Mental Health, Toronto, ON, Canada [2] Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - R D Levitan
- 1] Centre for Addiction and Mental Health, Toronto, ON, Canada [2] Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Z Yilmaz
- 1] Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA [2] Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - J Huemer
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - D Koubek
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - E Merl
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - G Wagner
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - P Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - G Breen
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
| | - S Cohen-Woods
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
| | - A Farmer
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
| | - P McGuffin
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
| | - S Cichon
- 1] Department of Genomics, Life & Brain Center, Institute of Human Genetics, University of Bonn, Bonn, Germany [2] Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany [3] Division of Medical Genetics, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - I Giegling
- Klinikum der Medizinischen Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale, Germany
| | - S Herms
- 1] Department of Genomics, Life & Brain Center, Institute of Human Genetics, University of Bonn, Bonn, Germany [2] Division of Medical Genetics, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - D Rujescu
- Klinikum der Medizinischen Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale, Germany
| | - S Schreiber
- Institute of Clinical Molecular Biology, University of Kiel, Kiel, Germany
| | - H-E Wichmann
- 1] Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany [2] Institute of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-University, Munich, Germany
| | - C Dina
- CNRS 8090-Institute of Biology, Pasteur Institute, Lille, France
| | - R Sladek
- McGill University and Genome Quebec Innovation Centre, Montreal, QC, Canada
| | - G Gambaro
- Division of Nephrology, Department of Internal Medicine and Medical Specialties, Columbus-Gemelly Hospitals, Catholic University, Rome, Italy
| | - N Soranzo
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - A Julia
- Unitat de Recerca de Reumatologia (URR), Institut de Recerca Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - S Marsal
- Unitat de Recerca de Reumatologia (URR), Institut de Recerca Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - R Rabionet
- 1] Genomics and Disease Group, Centre for Genomic Regulation (CRG), Barcelona, Spain [2] Universitat Pompeu Fabra (UPF), Barcelona, Spain [3] Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain [4] Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - V Gaborieau
- Genetic Epidemiology Group, International Agency for Research on Cancer (IARC), Lyon, France
| | - D M Dick
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - A Palotie
- 1] Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK [2] The Finnish Institute of Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland [3] The Program for Human and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - S Ripatti
- 1] The Finnish Institute of Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland [2] Finnish Institute of Occupational Health, Helsinki, Finland
| | - E Widén
- 1] The Finnish Institute of Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland [2] Finnish Institute of Occupational Health, Helsinki, Finland
| | - O A Andreassen
- NORMENT, K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - T Espeseth
- 1] NORMENT, K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway [2] Department of Psychology, University of Oslo, Oslo, Norway
| | - A Lundervold
- 1] Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway [2] Kavli Research Centre for Aging and Dementia, Haraldsplass Deaconess Hospital, Bergen, Norway [3] K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Bergen, Norway
| | - I Reinvang
- Department of Psychology, University of Oslo, Oslo, Norway
| | - V M Steen
- 1] Department of Clinical Science, K.G. Jebsen Centre for Psychosis Research, Norwegian Centre For Mental Disorders Research (NORMENT), University of Bergen, Bergen, Norway [2] Dr Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
| | - S Le Hellard
- 1] Department of Clinical Science, K.G. Jebsen Centre for Psychosis Research, Norwegian Centre For Mental Disorders Research (NORMENT), University of Bergen, Bergen, Norway [2] Dr Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
| | - M Mattingsdal
- NORMENT, K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - I Ntalla
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - V Bencko
- Institute of Hygiene and Epidemiology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - L Foretova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - V Janout
- Palacky University, Olomouc, Czech Republic
| | - M Navratilova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - S Gallinger
- 1] University Health Network, Toronto General Hospital, Toronto, ON, Canada [2] Mount Sinai Hospital, Samuel Lunenfeld Research Institute, Toronto, ON, Canada
| | - D Pinto
- Departments of Psychiatry, and Genetics and Genomic Sciences, Seaver Autism Center, and the Mindich Child Health and Development Institute, Mount Sinai School of Medicine, New York, NY, USA
| | - S W Scherer
- The Centre for Applied Genomics and Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - H Aschauer
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - L Carlberg
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - A Schosser
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - L Alfredsson
- The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - B Ding
- The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - L Klareskog
- Rheumatology Unit, Department of Medicine at the Karolinska University Hospital, Solna, Sweden
| | - L Padyukov
- Rheumatology Unit, Department of Medicine at the Karolinska University Hospital, Solna, Sweden
| | - P Courtet
- 1] Inserm, U1061, Université Montpellier 1, Montpellier, France [2] Department of Emergency Psychiatry, CHU Montpellier, Montpellier, France
| | - S Guillaume
- 1] Inserm, U1061, Université Montpellier 1, Montpellier, France [2] Department of Emergency Psychiatry, CHU Montpellier, Montpellier, France
| | - I Jaussent
- 1] Inserm, U1061, Université Montpellier 1, Montpellier, France [2] Department of Emergency Psychiatry, CHU Montpellier, Montpellier, France
| | - C Finan
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - G Kalsi
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
| | - M Roberts
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
| | - D W Logan
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - L Peltonen
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - G R S Ritchie
- 1] Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK [2] European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge
| | - J C Barrett
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - X Estivill
- 1] Genomics and Disease Group, Centre for Genomic Regulation (CRG), Barcelona, Spain [2] Universitat Pompeu Fabra (UPF), Barcelona, Spain [3] Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain [4] Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - A Hinney
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Universitätsklinikum Essen, University of Duisburg-Essen, Essen, Germany
| | - P F Sullivan
- 1] Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA [2] Department of Genetics, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - D A Collier
- 1] Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK [2] Eli Lilly and Company, Erl Wood Manor, Windlesham, UK
| | - E Zeggini
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - C M Bulik
- 1] Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA [2] Department of Nutrition, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Cao X, Xu P, Oyola MG, Xia Y, Yan X, Saito K, Zou F, Wang C, Yang Y, Hinton A, Yan C, Ding H, Zhu L, Yu L, Yang B, Feng Y, Clegg DJ, Khan S, DiMarchi R, Mani SK, Tong Q, Xu Y. Estrogens stimulate serotonin neurons to inhibit binge-like eating in mice. J Clin Invest 2014; 124:4351-62. [PMID: 25157819 DOI: 10.1172/jci74726] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Accepted: 07/10/2014] [Indexed: 12/19/2022] Open
Abstract
Binge eating afflicts approximately 5% of US adults, though effective treatments are limited. Here, we showed that estrogen replacement substantially suppresses binge-like eating behavior in ovariectomized female mice. Estrogen-dependent inhibition of binge-like eating was blocked in female mice specifically lacking estrogen receptor-α (ERα) in serotonin (5-HT) neurons in the dorsal raphe nuclei (DRN). Administration of a recently developed glucagon-like peptide-1-estrogen (GLP-1-estrogen) conjugate designed to deliver estrogen to GLP1 receptor-enhanced regions effectively targeted bioactive estrogens to the DRN and substantially suppressed binge-like eating in ovariectomized female mice. Administration of GLP-1 alone reduced binge-like eating, but not to the same extent as the GLP-1-estrogen conjugate. Administration of ERα-selective agonist propylpyrazole triol (PPT) to murine DRN 5-HT neurons activated these neurons in an ERα-dependent manner. PPT also inhibited a small conductance Ca2+-activated K+ (SK) current; blockade of the SK current prevented PPT-induced activation of DRN 5-HT neurons. Furthermore, local inhibition of the SK current in the DRN markedly suppressed binge-like eating in female mice. Together, our data indicate that estrogens act upon ERα to inhibit the SK current in DRN 5-HT neurons, thereby activating these neurons to suppress binge-like eating behavior and suggest ERα and/or SK current in DRN 5-HT neurons as potential targets for anti-binge therapies.
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Jappe LM, Cao L, Crosby RD, Crow SJ, Peterson CB, Le Grange D, Engel SG, Wonderlich SA. Stress and eating disorder behavior in anorexia nervosa as a function of menstrual cycle status. Int J Eat Disord 2014; 47:181-8. [PMID: 24222529 PMCID: PMC3946633 DOI: 10.1002/eat.22211] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 08/12/2013] [Accepted: 09/06/2013] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Fluctuations in ovarian hormones during the menstrual cycle and psychosocial stress contribute to eating disorder (ED) behavior. METHOD Using ecological momentary assessment techniques, this study examined relationships between stress and binge eating, self-induced vomiting, and dietary restriction based on menstrual cycle status in anorexia nervosa (AN). One hundred nine females with full and subthreshold AN (17-45 years old) recorded ED behavior and stress ratings over 2 weeks. Using hierarchical linear modeling, individuals with eumenorrhea and those with amenorrhea or oligomenorrhea were compared. RESULTS Following episodes of meal skipping, momentary stress decreased in individuals with normal menstrual cycles and increased in those with irregular menstrual cycles. DISCUSSION Results suggest that changes in stress severity in response to food restriction may differ based on ovarian hormonal status and may be a mechanism by which AN is maintained in individuals without menstrual disturbance.
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Affiliation(s)
| | - Li Cao
- Neuropsychiatric Research Institute, Department of Psychiatry, University of North Dakota
| | - Ross D. Crosby
- Neuropsychiatric Research Institute, Department of Psychiatry, University of North Dakota
| | | | | | - Daniel Le Grange
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago
| | - Scott G. Engel
- Neuropsychiatric Research Institute Department of Psychiatry, University of North Dakota
| | - Stephen A. Wonderlich
- Neuropsychiatric Research Institute Department of Psychiatry, University of North Dakota
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Hoffman ER, Zerwas SC, Bulik CM. Reproductive issues in anorexia nervosa. ACTA ACUST UNITED AC 2014; 6:403-414. [PMID: 22003362 DOI: 10.1586/eog.11.31] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Despite a high prevalence of menstrual irregularities, women with anorexia nervosa are becoming pregnant. The physical and psychological demands of pregnancy and motherhood can represent an immense challenge for women already struggling with the medical and psychological stress of an eating disorder. This article summarizes key issues related to reproduction in women with anorexia nervosa, highlighting the importance of preconception counseling, adequate gestational weight gain, and sufficient pre- and post-natal nutrition. Postpartum issues including eating disorder symptom relapse, weight loss, breastfeeding, and risk of perinatal depression and anxiety are also discussed.
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Affiliation(s)
- Elizabeth R Hoffman
- Department of Psychiatry, University of North Carolina at Chapel Hill, CB #7160, 101 Manning Drive, Chapel Hill, NC 27599-7160, USA
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42
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Baker JH, Girdler SS, Bulik CM. The role of reproductive hormones in the development and maintenance of eating disorders. ACTA ACUST UNITED AC 2014; 7:573-583. [PMID: 23585773 DOI: 10.1586/eog.12.54] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Much remains to be understood about the etiology of eating disorders. There is substantial evidence that reproductive hormones, specifically estrogens, play a direct role in normal food intake. Evidence is increasing that the reproductive hormones play a role in the abnormal food intake associated with eating disorders. For example, there is an inverse association between estradiol and eating disorder symptoms. Preliminary studies also suggest that hormone augmentation may be a beneficial adjunct to the standard treatment of choice for eating disorders. However, research is limited, so definitive conclusions about the benefit of hormone augmentation in treatment cannot be drawn. Future research, with a focus on translational studies, should continue to explore the role of reproductive hormones in the vulnerability to and maintenance of eating disorders.
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Affiliation(s)
- Jessica H Baker
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive, CB #7160, Chapel Hill, NC 27599, USA
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Ålgars M, Huang L, Von Holle AF, Peat CM, Thornton L, Lichtenstein P, Bulik CM. Binge eating and menstrual dysfunction. J Psychosom Res 2014; 76:19-22. [PMID: 24360136 PMCID: PMC3909535 DOI: 10.1016/j.jpsychores.2013.11.011] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 11/21/2013] [Accepted: 11/22/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The relation between eating disorders and menstrual function has been widely studied, but it is unknown whether the behavior of binge eating itself is related to menstrual dysfunction. METHODS The 11,503 women included in this study were from the Swedish Twin study of Adults: Genes and Environment. The associations between menstrual dysfunction and binge eating were analyzed using logistic regression or multiple linear regression models with generalized estimation equations. RESULTS Women who reported lifetime binge eating were more likely to report either amenorrhea or oligomenorrhea than women who reported no binge eating. These results persisted when controlling for compensatory behaviors including self-induced vomiting, laxative use, and diuretic use. No differences between women with and without a history of binge eating were observed for age at menarche. CONCLUSION Even when controlling for the effect of compensatory behaviors, the behavior of binge eating is associated with menstrual dysfunction. Metabolic and endocrinological factors could underlie this association. Careful evaluation of menstrual status is warranted for women with all eating disorders, not just anorexia nervosa.
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Affiliation(s)
- Monica Ålgars
- Department of Psychology and Logopedics, Abo Akademi University, Turku, Finland
| | - Lu Huang
- Department of Psychiatry, University of North Carolina at Chapel Hill
| | - Ann F. Von Holle
- Department of Psychiatry, University of North Carolina at Chapel Hill
| | - Christine M. Peat
- Department of Psychiatry, University of North Carolina at Chapel Hill
| | - Laura Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill,Department of Nutrition, University of North Carolina at Chapel Hill
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Baker JH, Sisk CL, Thornton LM, Brandt H, Crawford S, Fichter MM, Halmi KA, Johnson C, Jones I, Kaplan AS, Mitchell JE, Strober M, Treasure J, Woodside DB, Berrettini WH, Kaye WH, Bulik CM, Klump KL. Primary amenorrhea in anorexia nervosa: impact on characteristic masculine and feminine traits. EUROPEAN EATING DISORDERS REVIEW 2014; 22:32-8. [PMID: 24123541 PMCID: PMC4266542 DOI: 10.1002/erv.2263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 07/10/2013] [Accepted: 09/10/2013] [Indexed: 11/09/2022]
Abstract
Animal studies indicate that gonadal hormones at puberty have an effect on the development of masculine and feminine traits. However, it is unknown whether similar processes occur in humans. We examined whether women with anorexia nervosa (AN), who often experience primary amenorrhea, exhibit attenuated feminization in their psychological characteristics in adulthood due to the decrease/absence of gonadal hormones at puberty. Women with AN were compared on a number of psychological characteristics using general linear models on the basis of the presence/absence of primary amenorrhea. Although women with primary amenorrhea exhibited lower anxiety scores than those without primary amenorrhea, in general, results did not provide evidence of attenuated feminization in women with AN with primary amenorrhea. Future research should utilize novel techniques and direct hormone measurement to explore the effects of pubertal gonadal hormones on masculine and feminine traits.
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Micali N, dos-Santos-Silva I, De Stavola B, Steenweg-de Graaff J, Steenweg-de Graaf J, Jaddoe V, Hofman A, Verhulst FC, Steegers E, Tiemeier H. Fertility treatment, twin births, and unplanned pregnancies in women with eating disorders: findings from a population-based birth cohort. BJOG 2013; 121:408-16. [PMID: 24206173 PMCID: PMC4155863 DOI: 10.1111/1471-0528.12503] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2013] [Indexed: 11/27/2022]
Abstract
Objective To investigate fertility treatment, twin births, and unplanned pregnancies in pregnant women with eating disorders in a population-based sample. Design A longitudinal population-based birth cohort (Generation R). Setting Rotterdam, the Netherlands. Sample Women from the Generation R study who reported a history of (recent or past) anorexia nervosa (n = 160), bulimia nervosa (n = 265), or both (n = 130), and a history of psychiatric disorders other than eating disorders (n = 1396) were compared with women without psychiatric disorders (n = 4367). Methods Women were compared on the studied outcomes using logistic regression. We performed crude and adjusted analyses (adjusting for relevant confounding factors). Main outcome measures Fertility treatment, twin births, unplanned pregnancies, and women's feelings towards unplanned pregnancies. Results Relative to women without psychiatric disorders, women with bulimia nervosa had increased odds (odds ratio, OR, 2.3; 95% confidence interval, 95% CI, 1.1–5.2) of having undergone fertility treatment. Women with all eating disorders had increased odds of twin births (anorexia nervosa, OR 2.7, 95% CI 1.0–7.7; bulimia nervosa, OR 2.7, 95% CI 1.1–6.6; anorexia and bulimia nervosa, OR 3.795% CI 1.3–10.7). Anorexia nervosa was associated with increased odds of unplanned pregnancies (OR 1.8, 95% CI 1.2–2.6) and mixed feelings about these pregnancies (adjusted OR 5.0, 95% CI 1.7–14.4). Pre-pregnancy body mass index did not explain the observed associations. Conclusions Eating disorders are associated with increased odds of receiving fertility treatment and twin births. Women with anorexia nervosa were more likely to have an unplanned pregnancy and have mixed feelings about the unplanned pregnancy. Fertility treatment specialists should be aware that both active and past eating disorders (both anorexia nervosa and bulimia nervosa) might underlie fertility problems.
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Affiliation(s)
- N Micali
- Behavioural and Brain Sciences Unit, UCL Institute of Child Health, London, UK
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The relationship between Internet addiction and bulimia in a sample of Chinese college students: depression as partial mediator between Internet addiction and bulimia. Eat Weight Disord 2013; 18:233-43. [PMID: 23760906 DOI: 10.1007/s40519-013-0025-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2011] [Accepted: 06/28/2012] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND It has been reported that Internet addiction is associated with substance dependence. Eating disorders have high rates of co-morbidity with substance use disorders. The relationship between Internet addiction and eating disorders was reported in a previous study. AIMS To examine the hypothesis that Internet addiction is closely associated with bulimia. The hypothesis that depression mediates the relationship between Internet addiction and bulimia symptoms was also tested. METHODS 2,036 Chinese college students were assessed on Internet addiction, eating behaviors and depression. Binge eating, compensatory behaviors, weight concern, menarche and weight change were also reported. Multiple regression analysis was used to test the mediating effect of depression. RESULTS Internet addicts showed significantly higher scores on most subscales on EDI-1 than the controls. They reported significantly more binge eating, weight concern and weight change than the controls. Among all of the participants, depression was found to be a partial mediator in the relationship between Internet addiction and bulimia. CONCLUSION This survey provides evidence of the co-morbidity of Internet addiction and bulimia.
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Asarian L, Geary N. Sex differences in the physiology of eating. Am J Physiol Regul Integr Comp Physiol 2013; 305:R1215-67. [PMID: 23904103 DOI: 10.1152/ajpregu.00446.2012] [Citation(s) in RCA: 350] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Hypothalamic-pituitary-gonadal (HPG) axis function fundamentally affects the physiology of eating. We review sex differences in the physiological and pathophysiological controls of amounts eaten in rats, mice, monkeys, and humans. These controls result from interactions among genetic effects, organizational effects of reproductive hormones (i.e., permanent early developmental effects), and activational effects of these hormones (i.e., effects dependent on hormone levels). Male-female sex differences in the physiology of eating involve both organizational and activational effects of androgens and estrogens. An activational effect of estrogens decreases eating 1) during the periovulatory period of the ovarian cycle in rats, mice, monkeys, and women and 2) tonically between puberty and reproductive senescence or ovariectomy in rats and monkeys, sometimes in mice, and possibly in women. Estrogens acting on estrogen receptor-α (ERα) in the caudal medial nucleus of the solitary tract appear to mediate these effects in rats. Androgens, prolactin, and other reproductive hormones also affect eating in rats. Sex differences in eating are mediated by alterations in orosensory capacity and hedonics, gastric mechanoreception, ghrelin, CCK, glucagon-like peptide-1 (GLP-1), glucagon, insulin, amylin, apolipoprotein A-IV, fatty-acid oxidation, and leptin. The control of eating by central neurochemical signaling via serotonin, MSH, neuropeptide Y, Agouti-related peptide (AgRP), melanin-concentrating hormone, and dopamine is modulated by HPG function. Finally, sex differences in the physiology of eating may contribute to human obesity, anorexia nervosa, and binge eating. The variety and physiological importance of what has been learned so far warrant intensifying basic, translational, and clinical research on sex differences in eating.
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Affiliation(s)
- Lori Asarian
- Institute of Veterinary Physiology and Center for Integrated Human Physiology, University of Zurich, Zurich, Switzerland; and
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Abstract
We first discuss current diagnostic issues concerning the classification of anorexia nervosa (AN) by reference to the proposed criteria of the fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). We strongly welcome the changes in the latest revision of DSM-5 (update April 2012), which in our opinion partially solve the previously delineated classification problems. Nevertheless, we still miss a standard or reference(s) for the weight criterion including the delineation between a healthy and unhealthy underweight, a better operationalization of observable behaviors including symptoms of disordered eating, readily accessible cognitions and a better allowance for cross-cultural aspects in the proposed DSM-5 classification of AN. In the second part, we review the treatment recommendations of the NICE guidelines for AN, which overall are characterized by a lack of evidence. Nevertheless, NICE recommended an outpatient treatment setting based on one randomized controlled trial with many methodological limitations. A review of the current literature shows that (a) the optimal treatment setting (inpatient vs. outpatient treatment) still is a subject of debate, and (b) the evaluation of treatment costs in AN plays an important role within this discussion. In contrast to the German Guidelines for the Treatment of Eating Disorders, NICE does not offer any specific criteria for the clinician with regard to determining the adequate treatment setting.
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Schweiger U, Wischmann T, Strowitzki T. Psychische Störungen und weibliche Infertilität. DER NERVENARZT 2012; 83:1442-7. [PMID: 23052895 DOI: 10.1007/s00115-012-3662-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Foo JP, Hamnvik OPR, Mantzoros CS. Optimizing bone health in anorexia nervosa and hypothalamic amenorrhea: new trials and tribulations. Metabolism 2012; 61:899-905. [PMID: 22300837 PMCID: PMC5501329 DOI: 10.1016/j.metabol.2012.01.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Accepted: 01/03/2012] [Indexed: 01/25/2023]
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