Evidence of diffuse atrophy of the thyroid gland in patients with anorexianervosa

Objective: The altered function of the hypothalamic-pituitary-thyroid axis (HPT) in anorexia nervosa (ANI patients has not been clearly elucidated so far. Low triiodothyronine (T3) syndrome and a blunted and delayed thyrotrop in (TSH) response to exogenously administrated thyrotropin-releasing hormon e (TRH) are common findings. However,er, no attention has been paid to thyr oid morphology in AN patients, Method: We performed an utrasonographic (US) evaluation of the thyroid gland in 22 AN patients and in 44 age and sex-ma tched control subjects. Lean body mass (LBM) was determined by dual-energy X-ray absorptiometry. Results: US-determined thyroid volume was significant ly reduced in AN patients (9.2 +/- 0.4 vs. 17.8 +/- 1.2 mi in the controls; M +/- SEM; p < 10(-4)). In healthy subjects, it has previously been establ ished that thyroid volume can be estimated from age and body weight. In the present study, the measured thyroid volume in patients with AN was signifi cantly lower than the predicted thyroid volume (measured: 9.2 +/- 0.4 vs, e stimated: 12.2 +/- 0.2 mi; p < 10(-4)). Furthermore, in the AN patients, th e thyroid size was not correlated to body mass index (BMI) or LBM. Discussi on: Thyroid volume in AN patients was markedly reduced compared with the co ntrol group and with the volume expected from age and body weight or LBM. T his indicates thyroid atrophy, which, hypothetically could be involved in a vicious circle maintaining anorectic or depressive symptomatology. (C) 200 1 by John Wiley & Sons, Inc.