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483 PITUITARY FUNCTION IN PRIMARY MALNUTRITION DUE TO ANOREXIA NERVOSA AND OTHER EATING DISORDERS

The effects of nutritional state on pituitary function were studied using a combined pituitary stimulation test in 3 groups of 10 patients each. 1-Classical Anorexia Nervosa (AN) with a weight deficit for height (WDH) of 26.0±8.1%, aged 12–19 years. 2-Non-AN eating disorders with a WDH of 12.5±8.6%, aged 12–17 years. 3-Familial or constitutional short stature without pathological WDH and no nutritionally based growth disorder, aged 10–16 years. Each patient received seqentially IV TRH, LRH, regular insulin and PO L-Dopa. Serum TSH, glucose, cortisol, GH, LH and FSH, and prolactin were sampled periodically over 2 hrs. Basal T3, T4, Somatomedin-C and other chemistries were obtained. The peak TSH response was blunted and delayed in direct relation to the WDH. The ratio of the integrated TSH response from 0 min. to 45 min. divided by the 45 min. to 120 min. response was correlated to the WDH (p<0.001) and to recovery from hypoglycemia (p<0.001). Also, the recovery from hypoglycemia (p<0.001), the basal cortisol (p<0.05), and transferrin (p<0.05), all correlated to the WDH. The transferrin correlated to the T3 (p<0.01). The most underweight patients had the lowest T3, basal glucose and Somatomedin-C levels. This study shows the newly described integrated TSH ratio to correlate well to the WDH and the ability to recover from stress. Also demonstrated was that the responses noted were independant of the etiology of the eating disorder which resulted in the malnourished state.