Cuntz U, Frank G, Lehnert P, Fichter M
Klinik Roseneck, Center for Behavioral Medicine, Prien am Chiemsee, Germany.
Int J Eat Disord. 2000 Apr;27(3):297-303. doi: 10.1002/(sici)1098-108x(200004)27:3<297::aid-eat6>3.0.co;2-6.
Starvation severely affects normal pancreatic function in children suffering from Kwashiorkor and in animals undergoing food deprivation. This study examines whether pancreatic size, as determined by ultrasound, is dependent on starvation or on eating patterns in patients with eating disorders.
In 109 inpatients with eating disorders, 86 with anorexia nervosa and 23 with bulimia nervosa, we determined the pancreatic size by means of abdominal ultrasonography before increase in weight. Twenty-four inpatients with other psychiatric disorders served as controls. Pancreatic size was defined by the maximal diameter and the length of the head, the diameter of the head at the confluence of the splenic and mesenteric veins, and the diameters of the body and tail. In 41 eating disorder patients, pancreatic size was also measured during the course of therapy and increase in weight.
Pancreatic size correlates highly with body mass index (BMI). Counteracting actions such as purging do not seem to influence this pathophysiologic finding. Dystrophy of the pancreas is reversible in a short period of time. The increase in pancreatic size after maintenance of a normal eating pattern, however, exceeded the size expected by regression equation with an increase in the BMI. Pancreatic size seems to correlate with the actual amount of digested food. The increase in BMI is only an indicator of food intake.
Pancreatic size might therefore be useful for the assessment of normalization of the eating pattern. Future research is necessary to investigate the impairment of pancreatic function resulting from dystrophy, the impact of possible pancreatic malfunction on the course of eating disorders, and the regulatory mechanisms responsible for the change of pancreatic size.
饥饿会严重影响夸希奥科病患儿以及经历食物剥夺的动物的正常胰腺功能。本研究探讨了超声测定的胰腺大小是否取决于饥饿或饮食失调患者的进食模式。
在109例饮食失调住院患者中，86例神经性厌食症患者和23例神经性贪食症患者，在体重增加前通过腹部超声检查确定胰腺大小。24例患有其他精神疾病的住院患者作为对照。胰腺大小由最大直径、头部长度、脾静脉和肠系膜静脉汇合处的头部直径以及体部和尾部直径定义。在41例饮食失调患者中，还在治疗过程中和体重增加期间测量了胰腺大小。
胰腺大小与体重指数（BMI）高度相关。诸如催吐等抵消行为似乎不会影响这一病理生理发现。胰腺萎缩在短时间内是可逆的。然而，维持正常进食模式后胰腺大小的增加超过了根据BMI增加通过回归方程预期的大小。胰腺大小似乎与实际消化食物量相关。BMI的增加只是食物摄入量的一个指标。
因此，胰腺大小可能有助于评估进食模式的正常化。未来有必要研究萎缩导致的胰腺功能损害、可能的胰腺功能障碍对饮食失调病程的影响以及负责胰腺大小变化的调节机制。
