Abstract
The purpose of the study was to identify diagnostic criteria that can distinguish
between subjects with functional hypothalamic amenorrhea largely related to minimal
energy deficiency and those in whom failure of adaptive response to stress prevails.
We studied 59 young women with secondary amenorrhea related to modest eating disorders
and 58 who complained of stressful events in their history. We assessed anthropometric
measurements, body composition using dual energy X-ray absorptiometry (DEXA) and bioelectrical
impedance analysis (BIA), and basal endocrine profile. Subjects with disordered eating
had lower body mass index (BMI), fat mass (FM) measured with both techniques, lumbar
mineral density and direct and indirect measures of lean mass. Leptin and free tri-iodothyronine(FT3) concentrations also proved lower in the group of subjects with eating disorders,
although there was no significant difference in cortisol between the two groups. Leptin
levels were positively associated not only with fat mass, but also with body cell
mass indexed to height and phase angle, parameters studied with BIA as expression
of active lean compartment. A multivariate model confirmed the utility of integrating
endocrine data with the study of body composition. The use of bioelectrical impedance
analysis proved to be, in clinical use, a valid diagnostic alternative to DEXA, especially
considering body cell mass and phase angle.
Key Words
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Article info
Publication history
Published online: September 12, 2011
Footnotes
The authors report no conflicts of interest.
Identification
Copyright
© 2011 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
