{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T02:46:13Z","timestamp":1771641973790,"version":"3.50.1"},"reference-count":61,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T00:00:00Z","timestamp":1671667200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"DFG","award":["EH 367\/5-1"],"award-info":[{"award-number":["EH 367\/5-1"]}]},{"name":"\u201cMarga and Walter Boll-Stiftung\u201d","award":["EH 367\/5-1"],"award-info":[{"award-number":["EH 367\/5-1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Metabolites"],"abstract":"<jats:p>Anorexia nervosa (AN) is a complex psychiatric disorder accompanied by a variety of endocrine effects. Altered levels of the sex steroid hormones progesterone and dehydroepiandrosterone (DHEA) have been shown to occur in patients with AN using short-term hormonal measurement methods based on blood, saliva, and urine samples. However, since sex steroid hormone levels fluctuate during the menstrual cycle, these measurement methods require a great deal of effort due to the need to collect multiple samples in order to correctly determine the basal level of sex hormones. In contrast, hair-based assessments provide a marker of accumulated longer-term hormone exposure using a single, non-invasive sample. The aim of this study was to investigate sex steroid hormone levels via hair-based assessments in acutely underweight AN in comparison with healthy, age-matched, female control participants. Additionally, we compared progesterone and DHEA hair levels longitudinally during inpatient treatment in AN. Collected hair samples were analyzed using liquid chromatography-mass spectrometry (LC-MS\/MS) to determine a monthly hormone level of progesterone and DHEA. Our results indicate that DHEA hair hormone levels were similar across groups but progesterone was suppressed in underweight AN compared with healthy controls. In the longitudinal design, no significant change in hair hormone levels during partial weight restoration in patients with AN was observed. Our findings suggest that hair analysis can be used to detect suppressed progesterone levels in severe AN, and that progesterone does not increase during short-term weight restoration.<\/jats:p>","DOI":"10.3390\/metabo13010021","type":"journal-article","created":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T02:09:03Z","timestamp":1671761343000},"page":"21","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Hair-Based Assessment of Sex Steroid Hormones in Patients with Anorexia Nervosa"],"prefix":"10.3390","volume":"13","author":[{"given":"Victoria-Luise","family":"Batury","sequence":"first","affiliation":[{"name":"Division of Psychological and Social Medicine and Developmental Neurosciences, Translational Developmental Neuroscience Section, University Hospital C.G. Carus, Technische Universit\u00e4t Dresden, 01307 Dresden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8333-867X","authenticated-orcid":false,"given":"Friederike I.","family":"Tam","sequence":"additional","affiliation":[{"name":"Division of Psychological and Social Medicine and Developmental Neurosciences, Translational Developmental Neuroscience Section, University Hospital C.G. Carus, Technische Universit\u00e4t Dresden, 01307 Dresden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inger","family":"Hellerhoff","sequence":"additional","affiliation":[{"name":"Division of Psychological and Social Medicine and Developmental Neurosciences, Translational Developmental Neuroscience Section, University Hospital C.G. Carus, Technische Universit\u00e4t Dresden, 01307 Dresden, Germany"},{"name":"Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C.G. Carus, Technische Universit\u00e4t Dresden, 01307 Dresden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3907-6630","authenticated-orcid":false,"given":"Marie-Louis","family":"Wronski","sequence":"additional","affiliation":[{"name":"Division of Psychological and Social Medicine and Developmental Neurosciences, Translational Developmental Neuroscience Section, University Hospital C.G. Carus, Technische Universit\u00e4t Dresden, 01307 Dresden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katrin","family":"Borucki","sequence":"additional","affiliation":[{"name":"Institute of Clinical Chemistry and Pathobiochemistry, Otto-von-Guericke-University Magdeburg, 39120 Magdeburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerstin","family":"Weidner","sequence":"additional","affiliation":[{"name":"Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, University Hospital C.G. Carus, Technische Universit\u00e4t Dresden, 01307 Dresden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1873-7081","authenticated-orcid":false,"given":"Veit","family":"Roessner","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital C.G. Carus, Technische Universit\u00e4t Dresden, 01307 Dresden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Psychology, Technische Universit\u00e4t Dresden, 01062 Dresden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Ehrlich","sequence":"additional","affiliation":[{"name":"Division of Psychological and Social Medicine and Developmental Neurosciences, Translational Developmental Neuroscience Section, University Hospital C.G. Carus, Technische Universit\u00e4t Dresden, 01307 Dresden, Germany"},{"name":"Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C.G. Carus, Technische Universit\u00e4t Dresden, 01307 Dresden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1038\/nrendo.2016.175","article-title":"The Endocrine Manifestations of Anorexia Nervosa: Mechanisms and Management","volume":"13","author":"Schorr","year":"2017","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_2","first-page":"899","article-title":"Endocrine Consequences of Anorexia Nervosa","volume":"108","author":"Milos","year":"2019","journal-title":"Acta Acad. Med. Sin."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Berner, L.A., Brown, T.A., Lavender, J.M., Lopez, E., Wierenga, C.E., and Kaye, W.H. (2019). Neuroendocrinology of Reward in Anorexia Nervosa and Bulimia Nervosa: Beyond Leptin and Ghrelin. Mol. Cell. Endocrinol., 497.","DOI":"10.1016\/j.mce.2018.10.018"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1210\/jc.2009-2304","article-title":"Endocrine Manifestations of Eating Disorders","volume":"96","author":"Warren","year":"2011","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/j.ecl.2013.05.007","article-title":"Endocrine Effects of Anorexia Nervosa","volume":"42","author":"Miller","year":"2013","journal-title":"Endocrinol. Metab. Clin. N. Am."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1586\/eog.12.54","article-title":"The Role of Reproductive Hormones in the Development and Maintenance of Eating Disorders","volume":"7","author":"Baker","year":"2012","journal-title":"Expert Rev. Obstet. Gynecol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1515\/hmbci-2015-0053","article-title":"The Physiology of Functional Hypothalamic Amenorrhea Associated with Energy Deficiency in Exercising Women and in Women with Anorexia Nervosa","volume":"25","author":"Allaway","year":"2016","journal-title":"Horm. Mol. Biol. Clin. Investig."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"R139","DOI":"10.1530\/JME-16-0013","article-title":"Novel Mechanisms for DHEA Action","volume":"56","author":"Prough","year":"2016","journal-title":"J. Mol. Endocrinol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1210\/jcem-56-4-668","article-title":"Subnormal Plasma Dehydroisoandrosterone to Cortisol Ratio in Anorexia Nervosa: A Second Hormonal Parameter of Ontogenic Regression*","volume":"56","author":"Zumoff","year":"1983","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1210\/jcem-61-4-693","article-title":"Adrenocorticotropin-Stimulated Adrenal Androgen Secretion in Anorexia Nervosa: Impaired Secretion at Low Weight with Normalization after Long-Term Weight Recovery","volume":"61","author":"WINTERER","year":"1985","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1097\/00006842-200101000-00008","article-title":"Plasma Levels of Neuroactive Steroids Are Increased in Untreated Women With Anorexia Nervosa or Bulimia Nervosa","volume":"63","author":"Monteleone","year":"2001","journal-title":"Psychosom. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1016\/j.psyneuen.2005.08.015","article-title":"Impaired Reduction of Enhanced Levels of Dehydroepiandrosterone by Oral Dexamethasone in Anorexia Nervosa","volume":"31","author":"Monteleone","year":"2006","journal-title":"Psychoneuroendocrinology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1210\/jc.2008-2558","article-title":"Adrenal Glucocorticoid and Androgen Precursor Dissociation in Anorexia Nervosa","volume":"94","author":"Lawson","year":"2009","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/j.euroneuro.2005.05.001","article-title":"Circulatory Neurosteroid Levels in Underweight Female Adolescent Anorexia Nervosa Inpatients and Following Weight Restoration","volume":"15","author":"Stein","year":"2005","journal-title":"Eur. Neuropsychopharmacol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1002\/eat.23714","article-title":"Dehydroepiandrosterone Status and Efficacy of Dehydroepiandrosterone Supplementation for Bone Health in Anorexia Nervosa: A Systematic Review and Meta-analysis","volume":"55","author":"Lin","year":"2022","journal-title":"Int. J. Eat. Disord."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"3600","DOI":"10.1210\/jc.2004-2386","article-title":"No Evidence for Hepatic Conversion of Dehydroepiandrosterone (DHEA) Sulfate to DHEA: In Vivo and in Vitro Studies","volume":"90","author":"Hammer","year":"2005","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Stern, J., Arslan, R.C., and Penke, L. (2022). Stability and Validity of Steroid Hormones in Hair and Saliva across Two Ovulatory Cycles. Compr. Psychoneuroendocrinology, 9.","DOI":"10.1016\/j.cpnec.2022.100114"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1017\/S0033291718002088","article-title":"Treatment Outcomes for Anorexia Nervosa: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"49","author":"Murray","year":"2019","journal-title":"Psychol. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1203\/01.pdr.0000203097.64918.63","article-title":"Role of Cortisol in Menstrual Recovery in Adolescent Girls with Anorexia Nervosa","volume":"59","author":"Misra","year":"2006","journal-title":"Pediatr. Res."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Dempfle, A., Herpertz-Dahlmann, B., Timmesfeld, N., Schwarte, R., Egberts, K.M., Pfeiffer, E., Fleischhaker, C., Wewetzer, C., and B\u00fchren, K. (2013). Predictors of the Resumption of Menses in Adolescent Anorexia Nervosa. BMC Psychiatry, 13.","DOI":"10.1186\/1471-244X-13-308"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e25","DOI":"10.15586\/jptcp.v26i2.601","article-title":"IS BODY FAT PERCENTAGE A GOOD PREDICTOR OF MENSTRUAL RECOVERY IN FEMALES WITH ANOREXIA NERVOSA AFTER WEIGHT RESTORATION? A SYSTEMATIC REVIEW AND EXPLORATORY AND SELECTIVE META-ANALYSIS","volume":"26","author":"Traboulsi","year":"2019","journal-title":"J. Popul. Ther. Clin. Pharmacol."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Roberts, R.E., Farahani, L., Webber, L., and Jayasena, C. (2020). Current Understanding of Hypothalamic Amenorrhoea. Ther. Adv. Endocrinol. Metab., 11.","DOI":"10.1177\/2042018820945854"},{"key":"ref_23","first-page":"445","article-title":"Impact of Anorexia, Bulimia and Obesity on the Gynecologic Health of Adolescents","volume":"64","author":"Seidenfeld","year":"2001","journal-title":"Am. Fam. Physician"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.psyneuen.2018.02.005","article-title":"Genetic and Environmental Influences on Pubertal Hormones in Human Hair across Development","volume":"90","author":"Grotzinger","year":"2018","journal-title":"Psychoneuroendocrinology"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Walther, A., Tsao, C., Pande, R., Kirschbaum, C., Field, E., and Berkman, L. (2019). Do Dehydroepiandrosterone, Progesterone, and Testosterone Influence Women\u2019s Depression and Anxiety Levels? Evidence from Hair-Based Hormonal Measures of 2105 Rural Indian Women. Psychoneuroendocrinology, 109.","DOI":"10.1016\/j.psyneuen.2019.104382"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1198\/106186006X137047","article-title":"Optimal Full Matching and Related Designs via Network Flows","volume":"15","author":"Hansen","year":"2006","journal-title":"J. Comput. Graph. Stat."},{"key":"ref_27","unstructured":"Fichter, M., and Quadflieg, N. (1999). Strukturiertes Inventar F\u00fcr Anorektische Und Bulimische Essst\u00f6rungen (SIAB); Fragebogen (SIAB-S) Und Interview (SIAB-EX) Nach DSM-IV Und ICD-10; Handanweisung, Hogrefe."},{"key":"ref_28","first-page":"365","article-title":"A German Version of the Eating Disorder Inventory EDI-2","volume":"47","author":"Thiel","year":"1997","journal-title":"Psychother. Psychosom. Med. Psychol."},{"key":"ref_29","unstructured":"Hautzinger, M., Keller, F., and K\u00fchner, C. (2009). BDI-II. Beck-Depressions-Inventar, Pearson Assessment. 2. Auflage."},{"key":"ref_30","unstructured":"Franke, G., and Derogatis, L. (2002). Symptom-Checkliste von LR Derogatis: SCL-90-R, Beltz Test. Deutsche Version."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1055\/s-0030-1253666","article-title":"Perzentilen Des Body-Mass-Index Auch F\u00fcr 18- Bis 80-J\u00e4hrige? Daten Der Nationalen Verzehrsstudie II","volume":"135","author":"Hemmelmann","year":"2010","journal-title":"Dtsch. Med. Wochenschr. (DMW)"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1007\/s001120170107","article-title":"Perzentile F\u00fcr Den Body-Mass-Index F\u00fcr Das Kindes-Und Jugendalter Unter Heranziehung Verschiedener Deutscher Stichproben","volume":"149","author":"Wabitsch","year":"2001","journal-title":"Mon. Kinderheilkd."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research Electronic Data Capture (REDCap)\u2014A Metadata-Driven Methodology and Workflow Process for Providing Translational Research Informatics Support","volume":"42","author":"Harris","year":"2009","journal-title":"J. Biomed. Inform."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/S0379-0738(99)00146-2","article-title":"Potential Problems with the Interpretation of Hair Analysis Results","volume":"107","author":"Wennig","year":"2000","journal-title":"Forensic Sci. Int."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/0379-0738(93)90255-9","article-title":"Anatomy and Physiology of Hair","volume":"63","author":"Harkey","year":"1993","journal-title":"Forensic Sci. Int."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jchromb.2013.03.008","article-title":"Quantitative Analysis of Steroid Hormones in Human Hair Using a Column-Switching LC\u2013APCI\u2013MS\/MS Assay","volume":"928","author":"Gao","year":"2013","journal-title":"J. Chromatogr. B"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.jsbmb.2015.12.022","article-title":"LC\u2013MS Based Analysis of Endogenous Steroid Hormones in Human Hair","volume":"162","author":"Gao","year":"2016","journal-title":"J. Steroid Biochem. Mol. Biol."},{"key":"ref_38","unstructured":"Croghan, C.W., and Egeghy, P.P. (2003). Methods of Dealing with Values Below the Limit of Detection Using SAS, US-EPA."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/j.2517-6161.1995.tb02031.x","article-title":"Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing","volume":"57","author":"Benjamini","year":"1995","journal-title":"J. R. Stat. Soc. Ser. B"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1210\/er.2016-1133","article-title":"Linking Stress and Infertility: A Novel Role for Ghrelin","volume":"38","author":"Sominsky","year":"2017","journal-title":"Endocr. Rev."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.yhbeh.2013.02.019","article-title":"Puberty as a Critical Risk Period for Eating Disorders: A Review of Human and Animal Studies","volume":"64","author":"Klump","year":"2013","journal-title":"Horm. Behav."},{"key":"ref_42","first-page":"E474","article-title":"Food Intake, Body Weight, and Adiposity in Female Rats: Actions and Interactions of Progestins and Antiestrogens","volume":"240","author":"Gray","year":"1981","journal-title":"Am. J. Physiol. Metab."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/0018-506X(89)90064-0","article-title":"Effects of Ovarian Hormones on Eating Behaviors, Body Weight, and Glucoregulation in Rhesus Monkeys","volume":"23","author":"Kemnitz","year":"1989","journal-title":"Horm. Behav."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/S0031-9384(99)00152-3","article-title":"Effect of Estradiol and Progesterone on Daily Rhythm in Food Intake and Feeding Patterns in Fischer Rats","volume":"68","author":"VARMA","year":"1999","journal-title":"Physiol. Behav."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"King, S.R. (2013). Neurosteroids and the Nervous System, Springer.","DOI":"10.1007\/978-1-4614-5559-2"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1038\/npp.2017.269","article-title":"Neuroactive Steroids and Affective Symptoms in Women Across the Weight Spectrum","volume":"43","author":"Dichtel","year":"2018","journal-title":"Neuropsychopharmacology"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.yfrne.2016.03.002","article-title":"Sex Hormones and Adult Hippocampal Neurogenesis: Regulation, Implications, and Potential Mechanisms","volume":"41","author":"Mahmoud","year":"2016","journal-title":"Front. Neuroendocrinol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"R9","DOI":"10.1530\/EJE-18-0596","article-title":"MECHANISMS IN ENDOCRINOLOGY: Anorexia Nervosa and Endocrinology: A Clinical Update","volume":"180","year":"2019","journal-title":"Eur. J. Endocrinol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/S0165-1781(03)00074-X","article-title":"Persistent Amenorrhoea in Weight-Recovered Anorexics: Psychological and Biological Aspects","volume":"118","author":"Brambilla","year":"2003","journal-title":"Psychiatry Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1210\/jcem-71-3-705","article-title":"A Comparative and Longitudinal Study on Endocrine Changes Related to Ovarian Function in Patients with Anorexia Nervosa","volume":"71","author":"Bennink","year":"1990","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1001\/archpedi.1997.02170380020003","article-title":"Resumption of Menses in Anorexia Nervosa","volume":"151","author":"Golden","year":"1997","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1002\/eat.20503","article-title":"Treatment Goal Weight in Adolescents with Anorexia Nervosa: Use of BMI Percentiles","volume":"41","author":"Golden","year":"2008","journal-title":"Int. J. Eat. Disord."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5826\/dpc.0701a01","article-title":"Diet and Hair Loss: Effects of Nutrient Deficiency and Supplement Use","volume":"7","author":"Guo","year":"2017","journal-title":"Dermatol. Pract. Concept."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Grymowicz, M., Rudnicka, E., Podfigurna, A., Napierala, P., Smolarczyk, R., Smolarczyk, K., and Meczekalski, B. (2020). Hormonal Effects on Hair Follicles. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21155342"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1159\/000455867","article-title":"Hair Cortisol Concentrations Are Associated with Hair Growth Rate","volume":"23","author":"Xiang","year":"2016","journal-title":"Neuroimmunomodulation"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1177\/120347540200600407","article-title":"Cutaneous Manifestations of Eating Disorders","volume":"6","author":"Tyler","year":"2002","journal-title":"J. Cutan. Med. Surg."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"165","DOI":"10.2165\/00128071-200506030-00003","article-title":"Dermatologic Signs in Patients with Eating Disorders","volume":"6","author":"Strumia","year":"2005","journal-title":"Am. J. Clin. Dermatol."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Herpertz-Dahlmann, B. (2021). Intensive Treatments in Adolescent Anorexia Nervosa. Nutrients, 13.","DOI":"10.3390\/nu13041265"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Schury, K., Koenig, A.M., Isele, D., Hulbert, A.L., Krause, S., Umlauft, M., Kolassa, S., Ziegenhain, U., Karabatsiakis, A., and Reister, F. (2017). Alterations of Hair Cortisol and Dehydroepiandrosterone in Mother-Infant-Dyads with Maternal Childhood Maltreatment. BMC Psychiatry, 17.","DOI":"10.1186\/s12888-017-1367-2"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1177\/1077559520988786","article-title":"Childhood Maltreatment and Eating Disorders: A Prospective Investigation","volume":"27","author":"Talmon","year":"2022","journal-title":"Child Maltreat."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1111\/jne.12179","article-title":"Stress and the Reproductive Axis","volume":"26","author":"Toufexis","year":"2014","journal-title":"J. Neuroendocrinol."}],"container-title":["Metabolites"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2218-1989\/13\/1\/21\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:48:39Z","timestamp":1760147319000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2218-1989\/13\/1\/21"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,22]]},"references-count":61,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["metabo13010021"],"URL":"https:\/\/doi.org\/10.3390\/metabo13010021","relation":{},"ISSN":["2218-1989"],"issn-type":[{"value":"2218-1989","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,22]]}}}