The role of Bulimia Nervosa in hormonal and metabolic profile, as well as in menstrual pattern, of overweight and obese adolescents

Vasileios Karountzos (GR), PANDELIS TSIMARIS (GR), KONSTANTINOS DIMOPOULOS (GR), EVGENIA STERGIOTI (GR), FLORA BACOPOULOU (GR), GEORGE PANOTOPOULOS (GR), EFTICHIA PAPACHATZOPOULOU (GR), NIKOLAOS ATHANASOPOULOS (GR), AIKATERINI GIANNOULI (GR), ANASTASIA VATOPOULOU (GR), DESPINA APOSTOLAKI (GR), IRENE IORDANIDOU (GR), KONSTANTINOS PANOULIS (GR), EFTHIMIOS DELIGEOROGLOU (GR)

[Karountzos] Division of Pediatric-Adolescent Gynecology & Reconstructive Surgery, 2nd Department of Ob/Gyn, Medical School, University of Athens, , [TSIMARIS] Division of Pediatric-Adolescent Gynecology & Reconstructive Surgery, 2nd Department of Ob/Gyn, Medical School, University of Athens, "Aretaieion" Hospital, [DIMOPOULOS] Division of Pediatric-Adolescent Gynecology & Reconstructive Surgery, 2nd Department of Ob/Gyn, Medical School, University of Athens, "Aretaieion" Hospital, [STERGIOTI] Division of Pediatric-Adolescent Gynecology & Reconstructive Surgery, 2nd Department of Ob/Gyn, Medical School, University of Athens, "Aretaieion" Hospital, [BACOPOULOU] Division of Pediatric-Adolescent Gynecology & Reconstructive Surgery, 2nd Department of Ob/Gyn, Medical School, University of Athens, "Aretaieion" Hospital, [PANOTOPOULOS] Division of Pediatric-Adolescent Gynecology & Reconstructive Surgery, 2nd Department of Ob/Gyn, Medical School, University of Athens, "Aretaieion" Hospital, [PAPACHATZOPOULOU] Divisio

Context - Objective: The aim of this study is to assess the differences between overweight (OW) and obese (OB) adolescents with (BN+) or without (BN-) Bulimia Nervosa regarding menstrual patterns, Sex Hormone-Binding Globulin (SHBG), Testosterone (T), Free Androgen Index (FAI), Insulin and ovarian ultrasonographic (U/S) characteristics. Methods - Patient(s) - Intervention(s): Prospective study of 32 BN+ compared to 67 BN- OW & OB adolescents matched for age, BMI, WHR and Waist Circumference. Menstrual patterns were recorded, SHBG, T, FAI, glucose and Insulin were measured, while ovarian U/S characteristics were assessed in all girls. Main Outcome Measure(s) - Result(s): 21/32 BN+ and 26/67 BN- girls reported oligomenorrhea, amenorrhoea or polymenorrhea (65,6% vs 38,8%, p=0.012). Mean fasting Insulin levels (27.32 vs 22.74 mIU/L), mean fasting Glucose levels (107.7 vs 96.16 mg/dl) mean serum T levels (1.46 vs 1.12 ng/ml), mean FAI (7.6 vs 4.6) and mean SHBG (66.65 vs 84.34 nmol/l) where significantly different in BN+ compared to BN- OW and OB adolescents (all p < 0.05). There was no significant difference in U/S ovarian characteristics between the two Groups. Conclusions: BN+ OW and OB adolescents, independently of body weight or fat distribution, are in greater risk to present menstrual disorders, fasting glucose and Insulin disorders, as well as hyperandrogenemia compared to controls. A multidisciplinary approach is always indicated for these patients with a seriously unhealthy hormonal and metabolic profile, while further studies, with greater sample are needed to confirm these results.