Endocrine abnormalities associated with deprivational dwarfism and anorexia nervosa

Height and body proportions in child abuse

Abused children are said to retain 'infantile body proportions'. The presenting height, sitting height, and leg length standard deviation scores of 91 victims have been calculated from data derived from a study of local inner city schoolchildren. In the study population 31/91 (34%) were significantly short and all but two of these had relatively shorter legs than backs, this limb disproportion being significant in 17. In 25 patients of the original group followed up after various social interventions there was a significant recovery of leg length. Measurement of height and proportionality, especially when compared with appropriate modern or local standards, is an important means of detecting and following up victims of child abuse.

Short stature in anorexia nervosa patients

In the treatment of many anorexia nervosa (AN) patients, we observed clinically that these girls were short in stature. In order to test this hypothesis, we reviewed the height records of all patients seen with a previous diagnosis of AN in an eight-year period. Of 104 patients, 85 were suitable for study and were compared to a control group of 85 age-matched subjects. Seventy-six percent of the AN patients (mean age 15.8 years) were below the 50th height percentile for age; 14.1% were below the 5th percentile; and 25.8% were between the 25th and 49th percentile. Parental height was available for 35 subjects. The AN patients were significantly shorter than their parents, and comparison suggests an impairment of growth rather than a familial etiology. As 80% of subjects developed AN after menarche, malnutrition does not appear to be responsible for the observed height deficits.

Anorexia nervosa presenting as growth retardation in adolescents

Two adolescent males and one adolescent female were referred for evaluation of short stature. Extensive laboratory studies, often performed over several years, were unremarkable. After several years of observation, the diagnosis of anorexia nervosa was established. We emphasize the necessity to consider anorexia nervosa in the differential diagnosis of growth retardation in young adolescents.

Action of anorexigenic peptide injected into the brain: dissociation of effect on body weight and feeding in the rat

Previous reports on the effect of anorexigenic peptide (AXP) administered systemically in the rodent are inconsistent in terms of the effect of the tri-peptide on food intake and body weight. The purpose of this study was to examine the effect of AXP infused into the brain on these measures. In post-pubescent female rats of the Sprague-Dawley strain, guide cannulae were permanently implanted in the lateral cerebral ventricle for repeated intracerebroventricular (ICV) infusion. Postoperatively, measures of food and water intake and body weight were obtained every day at the same time. After a 7-day base-line period, AXP was infused bilaterally in a total volume of 15 microliter and in a dose of either 0.25 microgram (n=7) or 1.25 micrograms (n=5), with artificial CSF vehicle serving as the control solution (n=6). ICV infusions were given once daily for 20 consecutive days, after which the same intake and body weight measures were recorded for another 7-day period. The rats given 0.25 micrograms AXP showed a significant suppression in weight gain with the overall slope of the growth curve being 0.358. In contrast, the growth slope of the rats given the 1.25 micrograms dose of AXP was 0.621, whereas those given the CSF was 0.823. Although the trends of intake of food tended to follow the curves of the rats body weight, the difference between g/kg food intake of rats during ICV infusions of either dose of AXP was not significantly different from that of the CSF controls. Water intake also was unaffected by either dose of AXP. These results demonstrate that this tri-peptide derived from urine of patients afflicted with anorexia nervosa exerts a direct effect on the brain. Since the 0.25 micrograms dose of AXP infused acutely ICV caused a sustained hyperthermia, its mechanism of action is apparently a metabolic one; that is, the interruption in the gain in body weight of the rat is independent of the amount of food it ingests.