Nine women, aged 17 to 23 years, with anorexia nervosa participated in this study of plasma luteinizing hormone (LH) concentrations measured at 20 minute intervals for 24 hours. Of these nine patients, eight demonstrated secretory patterns that resembled those of either normal prepubertal or pubertal, premenarchal girls. These LH secretory patterns were inappropriate for the patient's chronologic age, and suggested that a regression in the patients with secondary amenorrhea or an arrest in the patients with primary amenorrhea of the normal LH secretory program had occurred. Following treatment there was a maturation process from an early pubertal LH secretory pattern to one characteristic of adult women in one case which followed a return of body weight to normal and a clinical remission. This result indicated the importance of body weight as a determinant of the functional integrity of the hypothalamic pituitary gonadal axis. Data from other studies suggested that the gonadotropin abnormality probably originated in the central nervous system. A secondary finding was that changes in body weight may affect the spontaneous 24 hour LH secretory pattern and relate to the sequential changes that occur in the LH secretory pattern during normal sexual maturation.
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