Appetite regulatory hormones in women with anorexia nervosa: binge-eating/purging versus restricting type.
Appetite regulatory hormones in women with anorexia nervosa: binge-eating/purging versus restricting type.
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DOI：
10.4088/jcp.13m08753
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发表时间：
2015-01
期刊：
影响因子：
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通讯作者：
Miller KK
中科院分区：
文献类型：
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作者：
Eddy KT;Lawson EA;Meade C;Meenaghan E;Horton SE;Misra M;Klibanski A;Miller KK
神经性厌食症是一种以体重过轻、饮食失调和神经内分泌功能紊乱为特征的精神疾病。行为表型由显性限制或暴食/净化来定义；暴饮暴食型神经性厌食症的预后较差。厌食症神经类型的病理生理机制尚不清楚，但已知与饮食行为有关的激素改变可能起作用。为了研究厌食症激素在神经性厌食症亚型中的作用，我们检测了血清肽YY （PYY；总和活性[3-36]形式）、脑源性神经营养因子（BDNF）和瘦素水平，作为OSM-5限制型神经性厌食症（n=50）、暴食/泻型神经性厌食症（n= 22）和健康对照（n= 22）的主要结局。此外，女性还完成了饮食失调精神病理学（饮食失调检查问卷）和抑郁和焦虑症状（汉密尔顿抑郁量表[HDRS]和焦虑量表[HARS]）的次要结果测量。研究样本采集时间为2004年5月22日至2012年2月7日。暴食/泻食型神经性厌食症患者的平均PYY 3-36和瘦素水平低于限制性神经性厌食症患者，BDNF水平高于限制性神经性厌食症患者（p值均< 0.05）。在控制体重指数后，不同神经性厌食症患者PYY和PYY 3-36的差异有统计学意义（P< 0.05）， BDNF的差异处于趋势水平（P< 0.10）。PYY 3-36与饮食限制呈正相关（r=0.27， P= 0.02），瘦素呈负相关（r= - 0.51， P< 0.0001）；BDNF与清肠频率呈正相关（r=0.21， P= 0.04）；瘦素与暴食频率（r= - 0.29， P=.007）和排便频率（r= - 0.31， P=.004）呈负相关。在患有神经性厌食症的女性中，在限制型和暴食型之间，厌食性激素PYY、BDNF和瘦素的调节是不同的。这些激素通路是否在神经性厌食症的行为类型中起病因学作用或具有代偿性，值得进一步研究。
Anorexia nervosa is a psychiatric illness characterized by low weight, disordered eating, and hallmark neuroendocrine dysfunction. Behavioral phenotypes are defined by predominant restriction or bingeing/purging; binge-eating/purging type anorexia nervosa is associated with poorer outcome. The pathophysiology underlying anorexia nervosa types is unknown, but altered hormones, known to be involved in eating behaviors, may play a role. To examine the role of anorexigenic hormones in anorexia nervosa subtypes, we examined serum levels of peptide YY (PYY; total and active [3-36] forms), brain-derived neurotrophic factor (BDNF), and leptin as primary outcomes in women with OSM-5 restricting type anorexia nervosa (n=50), binge-eating/purging type anorexia nervosa (n = 22), and healthy controls (n = 22).1n addition, women completed validated secondary outcome measures of eating disorder psychopathology (Eating Disorder Examination-Questionnaire) and depression and anxiety symptoms (Hamilton Rating Scales for Depression [HDRS] and Anxiety [HARS]). The study samples were collected from May 22, 2004, to February 7, 2012. Mean PYY 3-36 and leptin levels were lower and BDNF levels higher in binge-eating/purging type anorexia nervosa than in restricting type anorexia nervosa (all Pvalues <.05). After controlling for body mass index, differences in PYY and PYY 3-36 between anorexia nervosa types were significant (P<.05) and differences in BDNF were at the trend level (P < .10). PYY 3-36 was positively (r=0.27, P=.02) and leptin was negatively (r=−0.51, P< .0001) associated with dietary restraint; BDNF was positively associated with frequency of purging (r=0.21, P=.04); and leptin was negatively associated with frequency of bingeing (r=−0.29, P=.007) and purging (r=−0.31, P=.004). Among women with anorexia nervosa, the anorexigenic hormones PYY, BDNF, and leptin are differentially regulated between the restricting and binge/purge types. Whether these hormone pathways play etiologic roles with regard to anorexia nervosa behavioral types or are compensatory merits further study.