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

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Abstract
Plasma levels of cortisol, dehydroepiandrosterone (DHA), dehydroepiandrosterone sulfate (DHAS), .DELTA.5-androstenediol (.DELTA.5-DIOL), .DELTA.5-androstenediol sulfate (.DELTA.5-DIOL-S) and testosterone were determined every 2 h from 1000 to 2200 h in 8 normal women and 10 with anorexia nervosa. Plasma levels of cortisol, DHA and .DELTA.5-DIOL were significantly (P < 0.001) higher, while DHAS levels were significantly (P < 0.001) lower in the anorexic women. The levels of .DELTA.5-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 .DELTA.5-DIOL, .DELTA.5-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 .DELTA.5-DIOL-S; the diurnal variations of .DELTA.5-DIOL and testosterone levels in the anorexic women were similar to those in the normal women. 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.