Amenorrhoea is the constant feature of Anorexia Nervosa (AN), caused by sharp metabolism reduction of gonadotropines as compared with prepubertal level, but its exact mechanism is unknown. Biochemical mediators, involved in this process, include cortisol, leptin, growth hormone (GH), insulin-like growth factor (IGF-1) and cytokines. Experimental investigation that leptin, produced by fat cells, plays a role of the metabolic signal, which regulates hypothalamic – pituitary – ovarian function. Functional activity of a reproductive axis depends on the adequacy of energy stocks. Leptin plays one of the most important role in the maintenance of energy homeostasis.

Objective: To investigate immuno-endocrine disorders in adolescent girls with AN to optimize the treatment tactics of this category of patients.

The investigation was carried out in 3 groups of adolescent girls: I - 59 AN diagnosed patients with BMI =15,34+1,04; II - 53 patients with amenorrhea and BMI=15.7+0,6, without AN; III - control - 20 healthy girls with BMI=20.3+1,4.

Measure of serum concentration of Insulin, Leptin, Neuropeptide Y (NPY), Tumor necrosis factor-α (TNF-α), GH, IGF-1, Gonadotropins, Estradiol (E2), Cortisol, Thyroxin (T3), Triiodothyronine (T4) and Thyrotropin (TSH) by ELISA was carried out.

The highest TNF-α, GH, Cortisol levels, together with the minimum values of Insulin, Leptin, NPY, IGF1, gonadotropins, E2, T3, T4, TSH were revealed in the anorectic patients (I group) compared to the comparison (II group) and control (III) groups.

Absolute hypoleptinaemia and low NPY levels in AN patients testifies to formation of résistance to a low leptin level. The highest GH levels together with the minimum values of IGF-1 compared to comparison and control groups, denoted the formation of GH-resistance.

The presented results permit to characterize the neuro-endocrine-metabolic disorders of the reproductive function regulation at AN: absolute hypoleptinemia, resistance to the low leptin level, GH- resistance, hypoinsulinism as a consequence of starvation and sharp contrinsular effects of GH and TNF-α, hypogonadotropic hypogonadism and thyroid status disorder in the form of the secondary hypothyreosis, caused by dysfunction of hypothalamic- pituitary axis. Neuro-endocrine-metabolic disorders are associated with impaired production of cytokines and are damaging factors for the functional state of the hypothalamic-pituitary-ovarian axis.