Elsevier

Biological Psychiatry

Volume 30, Issue 1, 1 July 1991, Pages 37-48
Biological Psychiatry

Circadian patterns of cortisol, prolactin, and growth hormonal secretion during bingeing and vomiting in normal weight bulimic patients

https://doi.org/10.1016/0006-3223(91)90068-WGet rights and content

Abstract

Women who are of normal weight and have bulimia nervosa exhibit multiple neuroendocrine disturbances. We hypothesized that bingeing and vomiting behavior could be contributory because food consumption in healthy volunteers increases plasma cortisol and prolactin secretion and suppresses growth hormone secretion. Thus, we investigated the effects of bingeing and vomiting on the circadian pattern (measurements every 20 min for 24 hr) of these hormones in comparison to healthy control women eating normally. Bingeing and vomiting were associated with modest increases in cortisol and prolactin and reductions in growth hormone secretion. However, this bingeing or purging did not alter mean 24-hr pattern of cortisol and growth hormone secretion as values for bulimics were similar to controls. While mean daytime patterns of prolactin secretion were similar in bulimics and controls, bulimic patients had a significant reduction of nocturnal prolactin levels. In summary, bingeing and vomiting does not appear to have a substantial influence on hormonal secretion. However, bulimic women have blunted nocturnal prolactin patterns.

References (40)

  • G.W. Arana et al.

    The dexamthasone suppression test for diagnosis and prognosis in psychiatry

    Arch Gen Psychiatry

    (1985)
  • R.D. Bell et al.

    Effect of dopamine agonist (lergotril mesylate) therapy on twenty-four hour secretion of prolactin in treated Parkinson's Disease

    J Clin Endocrinol Metab

    (1978)
  • T.D. Brewerton et al.

    Serotonin and eating disorders

  • H.E. Carlson et al.

    Prolactin stimulation by meals is related to protein content

    J Clin Endocrinol Metab

    (1983)
  • B.J. Carroll et al.

    A specific laboratory test for the diagnosis of melancholia: Standardization, validation, and clinical utility

    Arch Gen Psychiatry

    (1981)
  • K. Chihara et al.

    Suppressive effects of L-Dopa on human prolactin release during sleep

    Acta Endocrinol

    (1976)
  • C.G. Fairburn et al.

    The clinical features of bulimia nervosa

    Br J Psychiatry

    (1984)
  • M.M. Fichter et al.

    Hypothalamic pituitary function in starving healthy subject

  • M. Follenius et al.

    Diurnal cortisol peaks and their relationships to meals

    J Clin Endocrinol Metab

    (1982)
  • P.W. Gold et al.

    Abnormal hypothalamic-pituitary-adrenal function in anorexia nervosa: Pathophysiologic mechanisms in underweight and weight-corrected patients

    N Engl J Med

    (1986)
  • Cited by (20)

    • Chapter 1: The human hypothalamus in metabolic and episodic disorders

      2006, Progress in Brain Research
      Citation Excerpt :

      The HPA axis is generally found to be hyperactive in bulimia (Licinio et al., 1996; Monteleone et al., 1999; Cotrufo et al., 2000; Neudeck et al., 2001). Bingeing and vomiting in bulimic patients was associated with modest increases in cortisol secretion (Weltzin et al., 1991; Galderisi et al., 2003) and increased dehydroxyepiandrosterone (sulfate) (DHEA(S)) levels (Galderisi et al., 2003), whereas normal-weight bulimic women showed normal circadian ACTH and cortisol variations and levels (Vescovi et al., 1996). A more recent study showed elevated cortisol secretion following exacerbation of bulimic symptoms (Lester et al., 2003).

    View all citing articles on Scopus
    ∗∗

    We would like to thank Anna Marie Schollaert, Stacy Stull, Beverly Nelson, Diane Deep, and the Child and Adolescent Neuroendocrine Sleep Lab and Outpatient Eating Disorder Clinic at WPIC for their invaluable help in the preparation of this manuscript.

    View full text