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Investigation of Salivary Cortisol Response to Awakening in Underweight and Weight-Restored Patients with Anorexia Nervosa

Published online by Cambridge University Press:  23 March 2020

F. Pellegrino ,
A.M. Monteleone ,
M. Nigro ,
V. Ruzzi ,
M. Cimino ,
U. Volpe  and
P. Monteleone
F. Pellegrino
Affiliation:
Second University of Naples, Department of Psychiatry, Naples, Italy
A.M. Monteleone
Affiliation:
Second University of Naples, Department of Psychiatry, Naples, Italy
M. Nigro
Affiliation:
Second University of Naples, Department of Psychiatry, Naples, Italy
V. Ruzzi
Affiliation:
Second University of Naples, Department of Psychiatry, Naples, Italy
M. Cimino
Affiliation:
Second University of Naples, Department of Psychiatry, Naples, Italy
U. Volpe
Affiliation:
Second University of Naples, Department of Psychiatry, Naples, Italy
P. Monteleone
Affiliation:
University of Salerno, Department of Medicine and Surgery, Salerno, Italy

Abstract

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Introduction

Anorexia nervosa (AN) is characterized by dysregulated eating that leads to chronic malnutrition, which may be responsible for several physical complications, including endocrine alterations, such as hyperactivity of the hypothalamus-pituitary-adrenal (HPA) axis.

Objectives

Several studies have shown a dysregulation of the cortisol awakening response (CAR) in symptomatic AN patients. However, it has not been established if the deranged CAR of underweight AN patients is a primary phenomenon or an alteration secondary to malnutrition.

Aims

The aim of this study was to explore the salivary CAR in both underweight and weight-restored patients with AN.

Methods

We recruited 59 women: 18 undernourished AN patients, 15 weight-restored AN women and 26 normal-weight healthy controls. Saliva samples were collected in the morning, immediately after awakening and after 15, 30 and 60 minutes, in order to measure saliva levels of cortisol. Participants filled in the state-trait anxiety inventory (STAI) to test their anxiety levels in the morning of the test.

Results

Compared to healthy controls, underweight AN patients showed an enhanced CAR whereas the weight recovered patients had a normal CAR. These results were not correlated with levels of anxiety.

Conclusions

For the first time, our results demonstrate that the deranged CAR found in acute AN patients is not present in weight-restored ones, suggesting that altered activity of the HPA axis of symptomatic AN patients is a state-dependent phenomenon.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster Walk: Sexual medicine and mental health/sleep disorders and stress/eating disorders
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S283
Copyright
Copyright © European Psychiatric Association 2017
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