Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Особенности метаболического и пищевого статуса пациенток с функциональной гипоталамической аменореей
Особенности метаболического и пищевого статуса пациенток с функциональной гипоталамической аменореей
Чернуха Г.Е., Гусев Д.В., Москвичева Ю.Б., Табеева Г.И. Особенности метаболического и пищевого статуса пациенток с функциональной гипоталамической аменореей. Гинекология. 2017; 19 (2): 15–18.
________________________________________________
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
Цель исследования – анализ пищевого статуса, содержания жировой ткани и лептина у пациенток с функциональной гипоталамической аменореей.
Материалы и методы. Проведено клинико-лабораторное обследование 48 больных с функциональной гипоталамической аменореей – ФГА (возраст 25,8±5,43 года, индекс массы тела – ИМТ 19,7±2,01 кг/м2), включающее оценку характера питания, пищевого поведения, содержание жировой ткани методом двухэнергетической рентгеновской абсорбциометрии, определение липидного спектра крови и уровня лептина.
Результаты. Дефицит массы тела наблюдался у 29,2% пациенток, дефицит жировой ткани – у 100% пациенток с низким значением и у 58,8% с нормальным ИМТ. Гиполептинемия выявлена у 77,1% пациенток, гиперхолестеринемия без повышения коэффициента атерогенности – у 68,8% больных. Анализ опросников EDI-2 показал, что желание похудеть высказали 54,2% пациенток, неудовлетворенность своим телом – 22,9%. По дневникам питания снижение калорийности наблюдалось у 50% пациенток, нехватка суточного потребления углеводов – 91,7%, превышение потребления белка – 70,8%, жиров – 62,5%. Соотношение потребления белков, жиров, углеводов составило 1:1:0,3.
Заключение. Выявленные особенности метаболического и пищевого статуса у пациенток с ФГА указывают на необходимость мультидисциплинарного взаимодействия гинеколога, диетолога и психотерапевта для нормализации пищевого поведения, энергетического баланса, содержания жировой ткани и восстановления ритма менструаций.
Ключевые слова: энергетический баланс, менструальный цикл, аменорея, питание, лептин, жировая ткань.
Subjects and methods. Clinical and laboratory methods were performed to examine 48 patients with FHA (age 25.8±5.43 years, BMI 19.7±2.01 kg/m2), including an assessment of the nutrient intake, eating behavior, lipid profile, leptin level and body composition by using dual-energy X-ray absorptiometry.
Results. Body weight loss was observed in 29.2% of patients, body fat deficiency – in 100% of patients with low and in 58.8% with normal BMI respectively. Hypoleptinemia was detected in 77.1% of patients, hypercholesterolemia without increasin go fatherogenic index in 68.8% of patients. The analysis of the EDI-2 questionnaires showed that 54.2% of patients had drive for thinness, 22.9% of patients had body dissatisfaction. Nutritional examination showed a decrease of caloric intake in 50% of patients, daily carbohydrate intake – in 91.7%, increase protein intake in 70.8%, fats in 62.5% of patients. The ratio of nutrient consumption (proteins, fats, carbohydrates) was 1:1:0.3.
Conclusion. The revealed features of the metabolic and nutritional status of patients with FHA point to the need for multidisciplinary interaction of the gynecologist, nutritionist and psychotherapist to normalize eating behavior, energy balance, total body fat percentage and menstrual status.
Key words: energy balance, menstrual cycle, amenorrhea, nutrition, leptin, body fat.
Материалы и методы. Проведено клинико-лабораторное обследование 48 больных с функциональной гипоталамической аменореей – ФГА (возраст 25,8±5,43 года, индекс массы тела – ИМТ 19,7±2,01 кг/м2), включающее оценку характера питания, пищевого поведения, содержание жировой ткани методом двухэнергетической рентгеновской абсорбциометрии, определение липидного спектра крови и уровня лептина.
Результаты. Дефицит массы тела наблюдался у 29,2% пациенток, дефицит жировой ткани – у 100% пациенток с низким значением и у 58,8% с нормальным ИМТ. Гиполептинемия выявлена у 77,1% пациенток, гиперхолестеринемия без повышения коэффициента атерогенности – у 68,8% больных. Анализ опросников EDI-2 показал, что желание похудеть высказали 54,2% пациенток, неудовлетворенность своим телом – 22,9%. По дневникам питания снижение калорийности наблюдалось у 50% пациенток, нехватка суточного потребления углеводов – 91,7%, превышение потребления белка – 70,8%, жиров – 62,5%. Соотношение потребления белков, жиров, углеводов составило 1:1:0,3.
Заключение. Выявленные особенности метаболического и пищевого статуса у пациенток с ФГА указывают на необходимость мультидисциплинарного взаимодействия гинеколога, диетолога и психотерапевта для нормализации пищевого поведения, энергетического баланса, содержания жировой ткани и восстановления ритма менструаций.
Ключевые слова: энергетический баланс, менструальный цикл, аменорея, питание, лептин, жировая ткань.
________________________________________________
Subjects and methods. Clinical and laboratory methods were performed to examine 48 patients with FHA (age 25.8±5.43 years, BMI 19.7±2.01 kg/m2), including an assessment of the nutrient intake, eating behavior, lipid profile, leptin level and body composition by using dual-energy X-ray absorptiometry.
Results. Body weight loss was observed in 29.2% of patients, body fat deficiency – in 100% of patients with low and in 58.8% with normal BMI respectively. Hypoleptinemia was detected in 77.1% of patients, hypercholesterolemia without increasin go fatherogenic index in 68.8% of patients. The analysis of the EDI-2 questionnaires showed that 54.2% of patients had drive for thinness, 22.9% of patients had body dissatisfaction. Nutritional examination showed a decrease of caloric intake in 50% of patients, daily carbohydrate intake – in 91.7%, increase protein intake in 70.8%, fats in 62.5% of patients. The ratio of nutrient consumption (proteins, fats, carbohydrates) was 1:1:0.3.
Conclusion. The revealed features of the metabolic and nutritional status of patients with FHA point to the need for multidisciplinary interaction of the gynecologist, nutritionist and psychotherapist to normalize eating behavior, energy balance, total body fat percentage and menstrual status.
Key words: energy balance, menstrual cycle, amenorrhea, nutrition, leptin, body fat.
Полный текст
Список литературы
1. Starka L, Duskova M. Functional hypothalamic amenorrhea. Vnitr Lek 2015; 61 (10): 882–5.
2. Meczekalski B, Podfigurna-Stopa A, Warenik-Szymankiewicz A, Genazzani AR. Functional hypothalamic amenorrhea: current view on neuroendocrine aberrations. Gynecol Endocrinol 2008; 24: 4–11.
3. Bronson FH, Manning JM. The energetic regulation of ovulation: arealistic role for body fat. Biol Reprod 1991; 44: 945–50.
4. Al-Dakhiel Winkler L, Stampe Frоlich J, Schulpen M, Stоving RK. Body Composition and Menstrual Status in Adults With a History of Anorexia Nervosa–At What Fat Percentage is the Menstrual Cycle Restored? Int J Eat Disord 2017; 50 (4): 370–7.
5. Tinahones FJ, Martinez-Alfaro B, Gonzalo-Marin M et al. Recovery of menstrual cycle after therapy for anorexia nervosa. Eating Weight Disord 2005; 10: 52–5.
6. Williams NI, Leidy HJ, Hill BR et al. Magnitude of daily energy deficit predicts frequency but not severity of menstrual disturbances associated with exercise and caloric restriction. Am J Physiol Endocrinol Metab 2015; 308 (1): 29–39.
7. Dardeno Ta, Chou SH, Moon HS et al. Leptin in human physiology and therapeutics. Front Neuroendocrinol 2010; 31: 377–93.
8. Koehler K, Williams NI, Mallinson RJ et al. Low resting metabolic rate in exercise-associated amenorrhea is not due to a reduced proportion of highly active metabolic tissue compartments. Am J Physiol Endocrinol Metab 2016; 311 (2): 480–7.
9. De Souza MJ, Lee DK, VanHeest JL et al. Severity of energy-related menstrual disturbances increases in proportion to indices of energy conservation in exercising women. Fertil Steril 2007; 88: 971–5.
10. De Souza MJ, Williams NI. Physiological aspects and clinical sequelae of energy deficiency and hypoestrogenism in exercising women. Hum Reprod Update 2004; 10: 433–48.
11. De Souza MJ, Hontscharuk R, Olmsted M et al. Drive for thinness score is a proxy indicator of energy deficiency in exercising women. Appetite 2007; 48: 359–67.
12. Maimoun L, Paris F, Coste O, Sultan C. Intensive training and menstrual disorders in young female: Impact on bone mass. Gynecol Obstet Fertil 2016; 44 (11): 659–63.
13. Gordon CM. Functional hypothalamic amenorrhea. N Engl J Med 2010; 363: 365–71.
14. Berz K, McCambridge T. Amenorrhea in the Female Athlete: What to Do and When to Worry. Pediatr Ann 2016; 45 (3): 97–102.
15. Michopoulos V, Mancini F, Loucks TL, Berga SL. Neuroendocrine recovery initiated by cognitive behavioral therapy in women with functional hypothalamic amenorrhea: a randomized, controlled trial. Fertil Steril 2013; 99 (7): 2084–91.
16. Allaway HC, Southmayd EA, De Souza MJ. The physiology of functional hypothalamic amenorrhea associated with energy deficiency in exercising women and in women with anorexia nervosa. Horm Mol Biol Clin Investig 2016; 25 (2): 91–119.
17. Bomba M, Corbetta F, Bonini L et al. Psychopathological traits of adolescents with functional hypothalamic amenorrhea: a comparison with anorexia nervosa. Eat Weight Disord 2014; 19 (1): 41–8.
18. Genazzani AD, Chierchia E, Santagni S et al. Hypothalamic amenorrhea: From diagnosis to therapeutical approach. Annales d’Endocrinologie 2010; 71: 163–9.
19. Rigaud D, Tallonneau I, Verges B. Hypercholesterolaemia in anorexia nervosa: frequency and changes during refeeding. Diabetes Metab 2009; 35 (1): 57–63.
20. Ohwada R, Hotta M, Oikawa S, Takano K. Etiology of Hypercholesterolemia in patients with anorexia nervosa. J Eat Disord 2006; 39: 598–601.
21. Monteleonea P, Santonastasob P, Pannutoa M et al. Enhanced serum cholesterol and triglyceride levels in bulimia nervosa: Relationships to psychiatric comorbidity, psychopathology and hormonal variables. Psychiatry Res 2005; 134: 267–73.
22. Weinbrenner T, Zuger M, Jacoby GE et al. Lipoprotein metabolism in patients with anorexia nervosa: a case-control study investigating the mechanisms leading to hypercholesterolaemia. Br J Nutr 2004; 91 (6): 959–69.
23. Matzkin V, Slobodianik N, Pallaro A et al. Risk factors for cardiovascular disease in patients with anorexia nervosa. Int J Psychiatr Nurs Res 2007; 13: 1531–45.
24. Bruni V et al. Body Composition Variables and Leptin Levels in Functional Hypothalamic Amenorrhea and Amenorrhea Related to Eating Disorders, J Pediatr Adolesc Gynecol 2011; 24: 347–52.
25. Uzum AK, Yucel B, Omer B et al. Leptin concentration indexed to fat mass is increased in untreated anorexia nervosa (AN) patients. Clin Endocrinol (Oxf) 2009; 71: 33–40.
26. Sikvia Adrico et al. Leptin in functional hypothalamic amenorrhoea. Hum Reproduct 2002; 17 (8): 2043–8.
27. Choua SH, Chamberlanda JP et al. Leptin is an effective treatment for hypothalamic amenorrhea. PNAS 2011; 108 (16): 6585–90.
28. Welt CK et al. Recombinant human leptin in women with hypothalamicamenorrhea. N Engl J Med 2004; 351: 987–97.
29. Jauregui Lobera I, Bolanos Rios P. Choice of diet in patients with anorexia nervosa. Nutr Hosp 2009; 24 (6): 682–7.
30. Hadigan C, Anderson E, Miller K et al. Assessment of macronutrient and micronutrient intake in women with anorexia nervosa. Int J Eat Disord 2000; 28: 284–92.
31. Marugan de Miguelsanz JM, Torres Hinojal Mdel C et al. Nutritional approach of inpatients with anorexia nervosa. Nutr Hosp 2016; 33 (3): 258.
32. Laughlin GA, Dominguez CE, Yen SSC. Nutritional and Endocrine-Metabolic Aberrations in Women with Functional Hypothalamic Amenorrhea. J Clin Endocrinol Metab 1998; 83 (1): 25–32.
33. Melin et al. Low-energy density and high fiber intake are dietary concerns in female endurance athletes. Scand J Med Sci Sports 2015; 1–12.
2. Meczekalski B, Podfigurna-Stopa A, Warenik-Szymankiewicz A, Genazzani AR. Functional hypothalamic amenorrhea: current view on neuroendocrine aberrations. Gynecol Endocrinol 2008; 24: 4–11.
3. Bronson FH, Manning JM. The energetic regulation of ovulation: arealistic role for body fat. Biol Reprod 1991; 44: 945–50.
4. Al-Dakhiel Winkler L, Stampe Frоlich J, Schulpen M, Stоving RK. Body Composition and Menstrual Status in Adults With a History of Anorexia Nervosa–At What Fat Percentage is the Menstrual Cycle Restored? Int J Eat Disord 2017; 50 (4): 370–7.
5. Tinahones FJ, Martinez-Alfaro B, Gonzalo-Marin M et al. Recovery of menstrual cycle after therapy for anorexia nervosa. Eating Weight Disord 2005; 10: 52–5.
6. Williams NI, Leidy HJ, Hill BR et al. Magnitude of daily energy deficit predicts frequency but not severity of menstrual disturbances associated with exercise and caloric restriction. Am J Physiol Endocrinol Metab 2015; 308 (1): 29–39.
7. Dardeno Ta, Chou SH, Moon HS et al. Leptin in human physiology and therapeutics. Front Neuroendocrinol 2010; 31: 377–93.
8. Koehler K, Williams NI, Mallinson RJ et al. Low resting metabolic rate in exercise-associated amenorrhea is not due to a reduced proportion of highly active metabolic tissue compartments. Am J Physiol Endocrinol Metab 2016; 311 (2): 480–7.
9. De Souza MJ, Lee DK, VanHeest JL et al. Severity of energy-related menstrual disturbances increases in proportion to indices of energy conservation in exercising women. Fertil Steril 2007; 88: 971–5.
10. De Souza MJ, Williams NI. Physiological aspects and clinical sequelae of energy deficiency and hypoestrogenism in exercising women. Hum Reprod Update 2004; 10: 433–48.
11. De Souza MJ, Hontscharuk R, Olmsted M et al. Drive for thinness score is a proxy indicator of energy deficiency in exercising women. Appetite 2007; 48: 359–67.
12. Maimoun L, Paris F, Coste O, Sultan C. Intensive training and menstrual disorders in young female: Impact on bone mass. Gynecol Obstet Fertil 2016; 44 (11): 659–63.
13. Gordon CM. Functional hypothalamic amenorrhea. N Engl J Med 2010; 363: 365–71.
14. Berz K, McCambridge T. Amenorrhea in the Female Athlete: What to Do and When to Worry. Pediatr Ann 2016; 45 (3): 97–102.
15. Michopoulos V, Mancini F, Loucks TL, Berga SL. Neuroendocrine recovery initiated by cognitive behavioral therapy in women with functional hypothalamic amenorrhea: a randomized, controlled trial. Fertil Steril 2013; 99 (7): 2084–91.
16. Allaway HC, Southmayd EA, De Souza MJ. The physiology of functional hypothalamic amenorrhea associated with energy deficiency in exercising women and in women with anorexia nervosa. Horm Mol Biol Clin Investig 2016; 25 (2): 91–119.
17. Bomba M, Corbetta F, Bonini L et al. Psychopathological traits of adolescents with functional hypothalamic amenorrhea: a comparison with anorexia nervosa. Eat Weight Disord 2014; 19 (1): 41–8.
18. Genazzani AD, Chierchia E, Santagni S et al. Hypothalamic amenorrhea: From diagnosis to therapeutical approach. Annales d’Endocrinologie 2010; 71: 163–9.
19. Rigaud D, Tallonneau I, Verges B. Hypercholesterolaemia in anorexia nervosa: frequency and changes during refeeding. Diabetes Metab 2009; 35 (1): 57–63.
20. Ohwada R, Hotta M, Oikawa S, Takano K. Etiology of Hypercholesterolemia in patients with anorexia nervosa. J Eat Disord 2006; 39: 598–601.
21. Monteleonea P, Santonastasob P, Pannutoa M et al. Enhanced serum cholesterol and triglyceride levels in bulimia nervosa: Relationships to psychiatric comorbidity, psychopathology and hormonal variables. Psychiatry Res 2005; 134: 267–73.
22. Weinbrenner T, Zuger M, Jacoby GE et al. Lipoprotein metabolism in patients with anorexia nervosa: a case-control study investigating the mechanisms leading to hypercholesterolaemia. Br J Nutr 2004; 91 (6): 959–69.
23. Matzkin V, Slobodianik N, Pallaro A et al. Risk factors for cardiovascular disease in patients with anorexia nervosa. Int J Psychiatr Nurs Res 2007; 13: 1531–45.
24. Bruni V et al. Body Composition Variables and Leptin Levels in Functional Hypothalamic Amenorrhea and Amenorrhea Related to Eating Disorders, J Pediatr Adolesc Gynecol 2011; 24: 347–52.
25. Uzum AK, Yucel B, Omer B et al. Leptin concentration indexed to fat mass is increased in untreated anorexia nervosa (AN) patients. Clin Endocrinol (Oxf) 2009; 71: 33–40.
26. Sikvia Adrico et al. Leptin in functional hypothalamic amenorrhoea. Hum Reproduct 2002; 17 (8): 2043–8.
27. Choua SH, Chamberlanda JP et al. Leptin is an effective treatment for hypothalamic amenorrhea. PNAS 2011; 108 (16): 6585–90.
28. Welt CK et al. Recombinant human leptin in women with hypothalamicamenorrhea. N Engl J Med 2004; 351: 987–97.
29. Jauregui Lobera I, Bolanos Rios P. Choice of diet in patients with anorexia nervosa. Nutr Hosp 2009; 24 (6): 682–7.
30. Hadigan C, Anderson E, Miller K et al. Assessment of macronutrient and micronutrient intake in women with anorexia nervosa. Int J Eat Disord 2000; 28: 284–92.
31. Marugan de Miguelsanz JM, Torres Hinojal Mdel C et al. Nutritional approach of inpatients with anorexia nervosa. Nutr Hosp 2016; 33 (3): 258.
32. Laughlin GA, Dominguez CE, Yen SSC. Nutritional and Endocrine-Metabolic Aberrations in Women with Functional Hypothalamic Amenorrhea. J Clin Endocrinol Metab 1998; 83 (1): 25–32.
33. Melin et al. Low-energy density and high fiber intake are dietary concerns in female endurance athletes. Scand J Med Sci Sports 2015; 1–12.
2. Meczekalski B, Podfigurna-Stopa A, Warenik-Szymankiewicz A, Genazzani AR. Functional hypothalamic amenorrhea: current view on neuroendocrine aberrations. Gynecol Endocrinol 2008; 24: 4–11.
3. Bronson FH, Manning JM. The energetic regulation of ovulation: arealistic role for body fat. Biol Reprod 1991; 44: 945–50.
4. Al-Dakhiel Winkler L, Stampe Frоlich J, Schulpen M, Stоving RK. Body Composition and Menstrual Status in Adults With a History of Anorexia Nervosa–At What Fat Percentage is the Menstrual Cycle Restored? Int J Eat Disord 2017; 50 (4): 370–7.
5. Tinahones FJ, Martinez-Alfaro B, Gonzalo-Marin M et al. Recovery of menstrual cycle after therapy for anorexia nervosa. Eating Weight Disord 2005; 10: 52–5.
6. Williams NI, Leidy HJ, Hill BR et al. Magnitude of daily energy deficit predicts frequency but not severity of menstrual disturbances associated with exercise and caloric restriction. Am J Physiol Endocrinol Metab 2015; 308 (1): 29–39.
7. Dardeno Ta, Chou SH, Moon HS et al. Leptin in human physiology and therapeutics. Front Neuroendocrinol 2010; 31: 377–93.
8. Koehler K, Williams NI, Mallinson RJ et al. Low resting metabolic rate in exercise-associated amenorrhea is not due to a reduced proportion of highly active metabolic tissue compartments. Am J Physiol Endocrinol Metab 2016; 311 (2): 480–7.
9. De Souza MJ, Lee DK, VanHeest JL et al. Severity of energy-related menstrual disturbances increases in proportion to indices of energy conservation in exercising women. Fertil Steril 2007; 88: 971–5.
10. De Souza MJ, Williams NI. Physiological aspects and clinical sequelae of energy deficiency and hypoestrogenism in exercising women. Hum Reprod Update 2004; 10: 433–48.
11. De Souza MJ, Hontscharuk R, Olmsted M et al. Drive for thinness score is a proxy indicator of energy deficiency in exercising women. Appetite 2007; 48: 359–67.
12. Maimoun L, Paris F, Coste O, Sultan C. Intensive training and menstrual disorders in young female: Impact on bone mass. Gynecol Obstet Fertil 2016; 44 (11): 659–63.
13. Gordon CM. Functional hypothalamic amenorrhea. N Engl J Med 2010; 363: 365–71.
14. Berz K, McCambridge T. Amenorrhea in the Female Athlete: What to Do and When to Worry. Pediatr Ann 2016; 45 (3): 97–102.
15. Michopoulos V, Mancini F, Loucks TL, Berga SL. Neuroendocrine recovery initiated by cognitive behavioral therapy in women with functional hypothalamic amenorrhea: a randomized, controlled trial. Fertil Steril 2013; 99 (7): 2084–91.
16. Allaway HC, Southmayd EA, De Souza MJ. The physiology of functional hypothalamic amenorrhea associated with energy deficiency in exercising women and in women with anorexia nervosa. Horm Mol Biol Clin Investig 2016; 25 (2): 91–119.
17. Bomba M, Corbetta F, Bonini L et al. Psychopathological traits of adolescents with functional hypothalamic amenorrhea: a comparison with anorexia nervosa. Eat Weight Disord 2014; 19 (1): 41–8.
18. Genazzani AD, Chierchia E, Santagni S et al. Hypothalamic amenorrhea: From diagnosis to therapeutical approach. Annales d’Endocrinologie 2010; 71: 163–9.
19. Rigaud D, Tallonneau I, Verges B. Hypercholesterolaemia in anorexia nervosa: frequency and changes during refeeding. Diabetes Metab 2009; 35 (1): 57–63.
20. Ohwada R, Hotta M, Oikawa S, Takano K. Etiology of Hypercholesterolemia in patients with anorexia nervosa. J Eat Disord 2006; 39: 598–601.
21. Monteleonea P, Santonastasob P, Pannutoa M et al. Enhanced serum cholesterol and triglyceride levels in bulimia nervosa: Relationships to psychiatric comorbidity, psychopathology and hormonal variables. Psychiatry Res 2005; 134: 267–73.
22. Weinbrenner T, Zuger M, Jacoby GE et al. Lipoprotein metabolism in patients with anorexia nervosa: a case-control study investigating the mechanisms leading to hypercholesterolaemia. Br J Nutr 2004; 91 (6): 959–69.
23. Matzkin V, Slobodianik N, Pallaro A et al. Risk factors for cardiovascular disease in patients with anorexia nervosa. Int J Psychiatr Nurs Res 2007; 13: 1531–45.
24. Bruni V et al. Body Composition Variables and Leptin Levels in Functional Hypothalamic Amenorrhea and Amenorrhea Related to Eating Disorders, J Pediatr Adolesc Gynecol 2011; 24: 347–52.
25. Uzum AK, Yucel B, Omer B et al. Leptin concentration indexed to fat mass is increased in untreated anorexia nervosa (AN) patients. Clin Endocrinol (Oxf) 2009; 71: 33–40.
26. Sikvia Adrico et al. Leptin in functional hypothalamic amenorrhoea. Hum Reproduct 2002; 17 (8): 2043–8.
27. Choua SH, Chamberlanda JP et al. Leptin is an effective treatment for hypothalamic amenorrhea. PNAS 2011; 108 (16): 6585–90.
28. Welt CK et al. Recombinant human leptin in women with hypothalamicamenorrhea. N Engl J Med 2004; 351: 987–97.
29. Jauregui Lobera I, Bolanos Rios P. Choice of diet in patients with anorexia nervosa. Nutr Hosp 2009; 24 (6): 682–7.
30. Hadigan C, Anderson E, Miller K et al. Assessment of macronutrient and micronutrient intake in women with anorexia nervosa. Int J Eat Disord 2000; 28: 284–92.
31. Marugan de Miguelsanz JM, Torres Hinojal Mdel C et al. Nutritional approach of inpatients with anorexia nervosa. Nutr Hosp 2016; 33 (3): 258.
32. Laughlin GA, Dominguez CE, Yen SSC. Nutritional and Endocrine-Metabolic Aberrations in Women with Functional Hypothalamic Amenorrhea. J Clin Endocrinol Metab 1998; 83 (1): 25–32.
33. Melin et al. Low-energy density and high fiber intake are dietary concerns in female endurance athletes. Scand J Med Sci Sports 2015; 1–12.
________________________________________________
2. Meczekalski B, Podfigurna-Stopa A, Warenik-Szymankiewicz A, Genazzani AR. Functional hypothalamic amenorrhea: current view on neuroendocrine aberrations. Gynecol Endocrinol 2008; 24: 4–11.
3. Bronson FH, Manning JM. The energetic regulation of ovulation: arealistic role for body fat. Biol Reprod 1991; 44: 945–50.
4. Al-Dakhiel Winkler L, Stampe Frоlich J, Schulpen M, Stоving RK. Body Composition and Menstrual Status in Adults With a History of Anorexia Nervosa–At What Fat Percentage is the Menstrual Cycle Restored? Int J Eat Disord 2017; 50 (4): 370–7.
5. Tinahones FJ, Martinez-Alfaro B, Gonzalo-Marin M et al. Recovery of menstrual cycle after therapy for anorexia nervosa. Eating Weight Disord 2005; 10: 52–5.
6. Williams NI, Leidy HJ, Hill BR et al. Magnitude of daily energy deficit predicts frequency but not severity of menstrual disturbances associated with exercise and caloric restriction. Am J Physiol Endocrinol Metab 2015; 308 (1): 29–39.
7. Dardeno Ta, Chou SH, Moon HS et al. Leptin in human physiology and therapeutics. Front Neuroendocrinol 2010; 31: 377–93.
8. Koehler K, Williams NI, Mallinson RJ et al. Low resting metabolic rate in exercise-associated amenorrhea is not due to a reduced proportion of highly active metabolic tissue compartments. Am J Physiol Endocrinol Metab 2016; 311 (2): 480–7.
9. De Souza MJ, Lee DK, VanHeest JL et al. Severity of energy-related menstrual disturbances increases in proportion to indices of energy conservation in exercising women. Fertil Steril 2007; 88: 971–5.
10. De Souza MJ, Williams NI. Physiological aspects and clinical sequelae of energy deficiency and hypoestrogenism in exercising women. Hum Reprod Update 2004; 10: 433–48.
11. De Souza MJ, Hontscharuk R, Olmsted M et al. Drive for thinness score is a proxy indicator of energy deficiency in exercising women. Appetite 2007; 48: 359–67.
12. Maimoun L, Paris F, Coste O, Sultan C. Intensive training and menstrual disorders in young female: Impact on bone mass. Gynecol Obstet Fertil 2016; 44 (11): 659–63.
13. Gordon CM. Functional hypothalamic amenorrhea. N Engl J Med 2010; 363: 365–71.
14. Berz K, McCambridge T. Amenorrhea in the Female Athlete: What to Do and When to Worry. Pediatr Ann 2016; 45 (3): 97–102.
15. Michopoulos V, Mancini F, Loucks TL, Berga SL. Neuroendocrine recovery initiated by cognitive behavioral therapy in women with functional hypothalamic amenorrhea: a randomized, controlled trial. Fertil Steril 2013; 99 (7): 2084–91.
16. Allaway HC, Southmayd EA, De Souza MJ. The physiology of functional hypothalamic amenorrhea associated with energy deficiency in exercising women and in women with anorexia nervosa. Horm Mol Biol Clin Investig 2016; 25 (2): 91–119.
17. Bomba M, Corbetta F, Bonini L et al. Psychopathological traits of adolescents with functional hypothalamic amenorrhea: a comparison with anorexia nervosa. Eat Weight Disord 2014; 19 (1): 41–8.
18. Genazzani AD, Chierchia E, Santagni S et al. Hypothalamic amenorrhea: From diagnosis to therapeutical approach. Annales d’Endocrinologie 2010; 71: 163–9.
19. Rigaud D, Tallonneau I, Verges B. Hypercholesterolaemia in anorexia nervosa: frequency and changes during refeeding. Diabetes Metab 2009; 35 (1): 57–63.
20. Ohwada R, Hotta M, Oikawa S, Takano K. Etiology of Hypercholesterolemia in patients with anorexia nervosa. J Eat Disord 2006; 39: 598–601.
21. Monteleonea P, Santonastasob P, Pannutoa M et al. Enhanced serum cholesterol and triglyceride levels in bulimia nervosa: Relationships to psychiatric comorbidity, psychopathology and hormonal variables. Psychiatry Res 2005; 134: 267–73.
22. Weinbrenner T, Zuger M, Jacoby GE et al. Lipoprotein metabolism in patients with anorexia nervosa: a case-control study investigating the mechanisms leading to hypercholesterolaemia. Br J Nutr 2004; 91 (6): 959–69.
23. Matzkin V, Slobodianik N, Pallaro A et al. Risk factors for cardiovascular disease in patients with anorexia nervosa. Int J Psychiatr Nurs Res 2007; 13: 1531–45.
24. Bruni V et al. Body Composition Variables and Leptin Levels in Functional Hypothalamic Amenorrhea and Amenorrhea Related to Eating Disorders, J Pediatr Adolesc Gynecol 2011; 24: 347–52.
25. Uzum AK, Yucel B, Omer B et al. Leptin concentration indexed to fat mass is increased in untreated anorexia nervosa (AN) patients. Clin Endocrinol (Oxf) 2009; 71: 33–40.
26. Sikvia Adrico et al. Leptin in functional hypothalamic amenorrhoea. Hum Reproduct 2002; 17 (8): 2043–8.
27. Choua SH, Chamberlanda JP et al. Leptin is an effective treatment for hypothalamic amenorrhea. PNAS 2011; 108 (16): 6585–90.
28. Welt CK et al. Recombinant human leptin in women with hypothalamicamenorrhea. N Engl J Med 2004; 351: 987–97.
29. Jauregui Lobera I, Bolanos Rios P. Choice of diet in patients with anorexia nervosa. Nutr Hosp 2009; 24 (6): 682–7.
30. Hadigan C, Anderson E, Miller K et al. Assessment of macronutrient and micronutrient intake in women with anorexia nervosa. Int J Eat Disord 2000; 28: 284–92.
31. Marugan de Miguelsanz JM, Torres Hinojal Mdel C et al. Nutritional approach of inpatients with anorexia nervosa. Nutr Hosp 2016; 33 (3): 258.
32. Laughlin GA, Dominguez CE, Yen SSC. Nutritional and Endocrine-Metabolic Aberrations in Women with Functional Hypothalamic Amenorrhea. J Clin Endocrinol Metab 1998; 83 (1): 25–32.
33. Melin et al. Low-energy density and high fiber intake are dietary concerns in female endurance athletes. Scand J Med Sci Sports 2015; 1–12.
Авторы
Г.Е.Чернуха*, Д.В.Гусев, Ю.Б.Москвичева, Г.И.Табеева
ФГБУ «Научный центр акушерства, гинекологии и перинатологии им. В.И.Кулакова» Минздрава России. 117997, Россия, Москва, ул. Академика Опарина, д. 4
*c-galina1@yandex.ru
V.I.Kulakov Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Akademika Oparina, d. 4
*c-galina1@yandex.ru
ФГБУ «Научный центр акушерства, гинекологии и перинатологии им. В.И.Кулакова» Минздрава России. 117997, Россия, Москва, ул. Академика Опарина, д. 4
*c-galina1@yandex.ru
________________________________________________
V.I.Kulakov Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Akademika Oparina, d. 4
*c-galina1@yandex.ru
Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.