Relationship between impulsivity and lipid metabolism, and immune function among the young patients with eating disorders, depression and social anxiety disorder

我们以往的研究表明，可能是心理因素而不是异常的饮食行为影响了免疫功能。另外，其他因素如脂肪细胞因子（脂联素、瘦素、抵抗素）或脑源性神经营养因子（BDNF）也可能导致饮食失调患者的焦虑或抑郁情绪。本研究旨在探讨神经性贪食症患者异常饮食行为、心理状态（一般焦虑和抑郁情绪）、免疫功能、脂肪细胞因子和BDNF之间的横断面和纵向关系。研究对象为16例女性神经性贪食症患者和9例对照组。对8例神经性贪食症患者进行了纵向研究。所有人都得到了书面通知。神经性贪食症患者淋巴细胞CD4/CD8比值、淋巴细胞增殖反应刺激指数、肿瘤坏死因子、脂联素、瘦素可溶性受体、抵抗素等指标与对照组无显著差异。然而，神经性贪食症患者的瘦素和BDNF明显低于对照组。此外，BDNF与暴食和呕吐的频率呈显著（负）相关。在纵向研究中，低BDNF是根据异常饮食行为和心理状态的改善而恢复的。与假设相反，本研究认为BDNF可能受到消极心理状态和异常饮食行为的影响。或者，BDNF而不是脂肪细胞因子或细胞因子对心理状态产生负面影响。为了解决这些机制，需要更大样本的纵向研究。

Previous our studies suggested the possibilities that psychological factors rather than the abnormal eating behaviors contribute immunological functions. Alternatively, other factors such adipocytokines (adiponectin, leptin, resistin) or brain-derived neurotrophic factor (BDNF) might contribute anxiety or depressive mood in eating disorder patients. In this current study, we investigates the relationship between abnormal eating behaviors, psychological states (general anxiety and depressive mood), immunological functions, adipocytokines and BDNF in the patients with bulimia nervosa cross-sectionally as well longitudinally.Subjects consisted of 16 female patients with bulimia nervosa and 9 controls. Eight patients with bulimia nervosa were longitudinally studied. All were given written informed.There were no significant differences in CD4/CD8 ratio of lymphocyte, stimulation index of lymphocyte proliferative responses, tumor necrosis factor, adiponectin, leptin soluble receptor, and resistin between bulimia nervosa and controls. However, patients with bulimia nervosa showed significantly lower leptin and BDNF than controls. In addition, BDNF was significantly (inversely) related with frequencies of binge and vomiting. In longitudinal study, low BDNF recovered according to improvement of abnormal eating behaviors and psychological states.Contrast with hypotheses, this study suggested that BDNF might be influenced by negative psychological states and abnormal eating behaviors. Alternatively, BDNF rather than the adipocytokines or cytokines negatively influenced psychological states. To resolve these mechanisms, longitudinal study in larger sample is needed.