Regulation of corticosteroid receptors in patients with anorexia nervosa and Cushing’s syndrome

We have studied 16 patients with anorexia nervosa (11 with a stabilised weight loss and 5 in the weight-losing phase), 11 healthy controls, and 10 patients with Cushing’s syndrome, by measuring plasma cortisol (by enzyme-immunoassay), ACTH (by RIA), corticosteroid (Type I-mineralocorticoid and Type II-glucocorticoid) receptors in mononuclear leukocytes (by radio-receptor assay), and lymphocyte subpopulations (by cytofluorimetry). In anorexic patients with a stabilised weight loss and in Cushing’s syndrome the mean value of both Type I and Type II corticosteroid receptors in mononuclear leuko-cytes was significantly lower than in controls. The corre-lation between Type II receptors and plasma cortisol was inverse in stabilised anorexia nervosa and in Cushing’s syndrome, and direct in healthy controls. Anorexic patients in the weight-losing phase showed a significant increase in plasma cortisol levels and a normal number of Type II receptors. From these results we hypothesise that in anorexia nervosa there is a progression from an increase in plasma cortisol in the weight-losing phase, to a concomitant decrease in Type II receptors when the disease is stabilised. Journal of Endocrinology (1998) 158, 435–43