Neuroendocrinological response to standardized mixed meal in female anorectic patients during active and refeeding phases

To evaluate the neuroendocrinological dysfunction in anorexia nervosa, plas ma somatostatin, glucose, insulin, and growth hormone were monitored in ten patients with anorexia nervosa in the active and refeeding (remission) pha ses of the disorder and in nine age-matched healthy control subjects. Somat ostatin levels were significantly higher in the anorectic patients in both the active and refeeding phases than in the controls at baseline (mean +/-S D 27.4 +/-5,5 and 31.1 +/- 2.6 vs 21.3 +/- 1.9 pg/ml; p < 0,001), and signi ficantly higher in the anorectic patients in the active phase compared to t he refeeding phase and to the controls in response to a mixed meal (p<0,05) , Insulin levels were significantly lower in the anorectic patients in both the active and refeeding phases compared to the controls at baseline (9,3 +/- 1,1, 7.6 +/- 1,0 vs 14.7+/-3.5 mu U/ml; p < 0,0001) and after a mixed m eal (p < 0,05), An attenuated glucose response discriminated the anorectic patients in the active state from the same patients in the refeeding state and the controls (p < 0.0001). There was no significant difference in growt h hormone response between the anorectic patients and the controls. These f indings suggest that there is an augmented response of somatostatin and an attenuated response of insulin to mixed meal stimulation in active anorexia , The diminished insulin response persists during the refeeding phase. It s eems that central and peripheral alterations in endocrine function occur in anorexia nervosa.