Insulin, glucose, and pancreatic polypeptide responses to a test meal in restricting type anorexia nervosa before and after weight restoration
Insulin, glucose, and pancreatic polypeptide responses to a test meal in restricting type anorexia nervosa before and after weight restoration
复制标题
DOI：
10.1152/ajpendo.00347.2006
复制
发表时间：
2007-05-01
影响因子：
5.1
通讯作者：
Guarda, Angela S.
中科院分区：
文献类型：
--
作者：
Kinzig, Kimberly P.;Coughlin, Janelle W.;Guarda, Angela S.
神经性厌食症 (AN) 患者的长期营养不良与内分泌功能的改变有关，而内分泌功能的改变可能在该疾病中发挥持续作用。我们假设 AN 中进食引起的内分泌反应异常是可逆的，并且取决于体重恢复。我们在住院期间的三个时间点测量了 AN 受试者的膳食引起的内分泌反应：重新喂养前（n = 13，平均 BMI 16.7 kg/m(2)）、重新喂养 2 周后（平均 BMI 18.0 kg/m(2)）和体重恢复状态（平均 BMI 20.3 kg/m(2)）。对照受试者（n = 13，BMI 19-24.9 kg/m(2)）接受一次测试。测试持续 2.5 小时，在类似于 650 kcal 测试早餐之前、期间和之后每 15 分钟抽血一次。相对于对照组，血糖峰值水平降低，对测试餐摄入的胰岛素峰值水平延迟，第三次试验中的反应模式与对照组最相似。无论体重状况如何，AN 中的胰多肽 (PP) 水平相对于对照组均有所增加。胰岛素释放延迟和 PP 水平升高并不能通过短期重新喂养来纠正，并且可能导致 AN 的高复发率和维持。
Prolonged malnutrition in individuals with anorexia nervosa ( AN) has been associated with alterations in endocrine function that may play a sustaining role in the disorder. We hypothesized that abnormalities in endocrine responses to ingestion of a meal in AN are reversible and depend on weight restoration. We measured meal-induced endocrine responses in AN subjects at three time points during hospitalization: before refeeding (n = 13, mean BMI 16.7 kg/m(2)), after 2 wk of refeeding (mean BMI 18.0 kg/m(2)), and in the weight-restored state (mean BMI 20.3 kg/m(2)). Control subjects (n = 13, BMI 19-24.9 kg/m(2)) were tested once. Tests were 2.5-h sessions in which blood was drawn every 15 min before, during, and after a similar to 650-kcal test breakfast. Relative to controls, peak levels of glucose were depressed and peak levels of insulin in response to ingestion of the test meal were delayed, with response patterns in the third trial most similar to controls. Pancreatic polypeptide ( PP) levels were increased in AN relative to controls regardless of weight status. The delay in insulin release and elevated PP levels did not correct with short-term refeeding and may contribute to the high relapse rates and maintenance of AN.