Concentration patterns of plasma dehydroepiandrosterone, Δ5-androstenediol and their sulphates, testosterone and cortisol in normal healthy women and in women with anorexia nervosa

Abstract

Abstract. Plasma levels of cortisol, dehydroepiandrosterone (DHA), dehydroepiandrosterone sulphate (DHAS), Δ5-androstenediol (Δ5-DIOL), Δ5-androstenediol sulphate (Δ5-DIOL-S) and testosterone were determined every 2 h from 10.00 to 22.00 h in 8 normal women and 10 with anorexia nervosa. Plasma levels of cortisol, DHA and Δ5-DIOL were significantly (P < 0.001) higher while DHAS levels were significantly (P < 0.001) lower in the anorexic women. The levels of Δ5-DIOL-S and testosterone were similar in both groups of women. In the normal women there were significant (P < 0.001) diurnal fluctuations in the levels of cortisol, DHA and DHAS with high levels in the morning and a nadir in the evening; however, there were significant P < 0.001) 'reverse' diurnal fluctuations in the levels of Δ5-DIOL, Δ5-DIOL-S and testosterone with low levels in the morning and elevated levels in the evening. In the anorexia nervosa women there was a loss of the diurnal variation in the levels of cortisol, DHA and DHAS and Δ5-DIOL-S; the diurnal variations of Δ5-DIOL and testosterone levels in the anorexic women were similar to those in the normal women. In general, these findings support the suggestion of a disturbance in the mechanisms regulating hypothalamic-pituitary-adrenal function resulting from a primary hypothalamic defect and/or abnormal alterations in steroid metabolism associated with the malnutrition in anorexia nervosa.