神经性厌食症患者血清中酸不稳定亚基水平降低。

Decreased serum levels of acid-labile subunit in patients with anorexia nervosa.

作者信息

Fukuda I, Hotta M, Hizuka N, Takano K, Ishikawa Y, Asakawa-Yasumoto K, Tagami E, Demura H

机构信息

Department of Medicine II, Tokyo Women's Medical University, Japan.

出版信息

J Clin Endocrinol Metab. 1999 Jun;84(6):2034-6. doi: 10.1210/jcem.84.6.5737.

DOI:10.1210/jcem.84.6.5737

PMID:10372706

Abstract

One of the observations in malnutrition is that serum insulin-like growth factor (IGF)-I levels are decreased, and this decrease is associated with an altered profile of IGF binding proteins (IGFBPs). In human circulation, IGFs are mostly present as an approximately 150-kDa ternary protein complex consisting of IGFs, IGFBP-3, and acid-labile subunit (ALS). In the present study, to clarify the effect of nutrition on serum ALS levels, we investigated 33 patients with anorexia nervosa. Serum levels of ALS were measured by RIA. Furthermore, we measured serum IGF-I, IGF-II, IGFBP-2, and IGFBP-3 levels in the patients. From these data, we investigated which was the best predictor of body mass index (BMI) as a nutritional status marker. In the patients with anorexia nervosa, the serum ALS levels ranged from 0.7-16.9, with a mean of 10.6 +/- 0.7 mg/L, and the levels were significantly lower than those of normal subjects (13.8 +/- 0.8 mg/L, P < 0.05). Serum ALS levels positively correlated with BMI (r = 0.41, P < 0.05), and the levels increased during treatment. The serum IGFBP-2 levels in the patients were increased (871 +/- 91 microg/L), and the levels inversely correlated with BMI (r = -0.52, P < 0.01). The serum IGF-I and IGFBP-3 levels were low (152 +/- 14 microg/L and 2.56 +/- 0.12 mg/L, respectively), and the levels positively correlated with BMI (r = 0.46, P < 0.01; and r = 0.39, P < 0.05, respectively). The serum IGFBP-2, IGF-I, and IGFBP-3 levels returned toward normal ranges as BMI in the patients improved during treatment. Serum IGF-II levels did not correlate with BMI (r = 0.24, P = 0.17). Stepwise regression analysis revealed that serum IGFBP-2 was the best marker of BMI among these variables. The present study suggested that ALS was regulated by nutritional status, the same as IGF-I, IGFBP-2 and IGFBP-3; but the serum IGFBP-2 was the best predictor of BMI as nutritional status marker among the parameters in patients with anorexia nervosa.

摘要

营养不良的一个观察结果是血清胰岛素样生长因子（IGF）-I水平降低，且这种降低与IGF结合蛋白（IGFBP）的分布改变有关。在人体循环中，IGF大多以一种由IGF、IGFBP-3和酸不稳定亚基（ALS）组成的约150 kDa的三元蛋白复合物形式存在。在本研究中，为阐明营养对血清ALS水平的影响，我们调查了33例神经性厌食症患者。采用放射免疫分析法测定血清ALS水平。此外，我们还测定了患者的血清IGF-I、IGF-II、IGFBP-2和IGFBP-3水平。根据这些数据，我们研究了作为营养状况标志物的体重指数（BMI）的最佳预测指标是什么。在神经性厌食症患者中，血清ALS水平在0.7 - 16.9之间，平均为10.6±0.7 mg/L，显著低于正常受试者（13.8±0.8 mg/L，P < 0.05）。血清ALS水平与BMI呈正相关（r = 0.41，P < 0.05），且在治疗过程中水平升高。患者的血清IGFBP-2水平升高（871±91 μg/L），且与BMI呈负相关（r = -0.52，P < 0.01）。血清IGF-I和IGFBP-3水平较低（分别为152±14 μg/L和2.56±0.12 mg/L），且与BMI呈正相关（分别为r = 0.46，P < 0.01；r = 0.39，P < 0.05）。随着治疗过程中患者BMI的改善，血清IGFBP-2、IGF-I和IGFBP-3水平恢复至正常范围。血清IGF-II水平与BMI无相关性（r = 0.24，P = 0.17）。逐步回归分析显示，血清IGFBP-2是这些变量中BMI的最佳标志物。本研究表明，ALS与IGF-I、IGFBP-2和IGFBP-3一样受营养状况调节；但在神经性厌食症患者的各项参数中，血清IGFBP-2是作为营养状况标志物的BMI的最佳预测指标。