Herpertz S, Albers N, Wagner R, Pelz B, Köpp W, Mann K, Blum W F, Senf W, Hebebrand J
Clinic of Psychotherapy and Psychosomatics, University of Essen, Postfach 103043, D-45030 Essen, Germany.
Eur J Endocrinol. 2000 Apr;142(4):373-9. doi: 10.1530/eje.0.1420373.
To study the longitudinal changes in plasma levels of leptin, insulin and cortisol during the transition from the state of starvation to the state of refeeding focussing on diurnal secretion characteristics and their temporal relationships.
Leptin, insulin and cortisol were measured every 2h for 24h during acute starvation (T1). Sampling was repeated after reaching half the target-body mass index (BMI) (T2) and again at target-BMI (17. 5kg/m(2); T3). The temporal relationships between the diurnal secretion patterns were assessed by cross-correlation analysis.
Although BMIs at T1 were uniformly low, leptin levels varied widely within a range clearly below normal levels (0.03-1. 7microg/l). With increasing body fat during the course of refeeding, mean leptin levels increased from 0.64microg/l (range: 0.27-1. 73microg/l) (T1) to 1.61microg/l (range: 0.36-4.2microg/l) (T2) and to 3.67microg/l (range: 0.7-9.8microg/l) (T3). Circadian leptin secretion patterns showed maximal values uniformly around 0200h and minimal values around 0800h at all stages of the study. At all three weight levels, plasma leptin levels were highest between midnight and the early morning hours and lowest around the late morning hours. Refeeding neither profoundly changed secretion patterns of leptin nor did it change the positive, time-delayed relationship between leptin and insulin with increments in insulin secretion preceding those of leptin by 6h. A temporal relationship between leptin and cortisol could not be demonstrated in the state of semistarvation but emerged after a substantial weight gain; at that time, leptin increases preceded cortisol increases by 8h.
Absolute leptin, insulin and cortisol levels are profoundly changed during starvation in anorectic patients, while refeeding, paralleled by a BMI gain, reverses these changes. During refeeding the relationship between leptin and cortisol changed profoundly, showing no significant correlation in the state of starvation, whereas at T3 after refeeding a strong inverse relationship could be observed. Leptin and insulin did not correlate significantly at any of the three stages studied.
研究从饥饿状态过渡到再喂养状态期间，瘦素、胰岛素和皮质醇血浆水平的纵向变化，重点关注昼夜分泌特征及其时间关系。
在急性饥饿期间（T1），每2小时测量一次瘦素、胰岛素和皮质醇，共测量24小时。在达到目标体重指数（BMI）的一半时（T2）重复采样，并在目标BMI（17.5kg/m²；T3）时再次采样。通过互相关分析评估昼夜分泌模式之间的时间关系。
尽管T1时的BMI均较低，但瘦素水平在明显低于正常水平的范围内（0.03 - 1.7μg/l）变化很大。随着再喂养过程中体脂增加，平均瘦素水平从0.64μg/l（范围：0.27 - 1.73μg/l）（T1）增加到1.61μg/l（范围：0.36 - 4.2μg/l）（T2），并增加到3.67μg/l（范围：0.7 - 9.8μg/l）（T3）。在研究的所有阶段，昼夜瘦素分泌模式均在0200h左右出现最大值，在0800h左右出现最小值。在所有三个体重水平下，血浆瘦素水平在午夜至清晨时段最高，在上午晚些时候左右最低。再喂养既没有深刻改变瘦素的分泌模式，也没有改变瘦素与胰岛素之间的正向、时间延迟关系，胰岛素分泌增加比瘦素提前6小时。在半饥饿状态下，瘦素与皮质醇之间未显示出时间关系，但在体重显著增加后出现了这种关系；此时，瘦素增加比皮质醇增加提前8小时。
厌食症患者在饥饿期间，瘦素、胰岛素和皮质醇的绝对水平发生了深刻变化，而再喂养伴随着BMI增加，逆转了这些变化。再喂养期间，瘦素与皮质醇之间的关系发生了深刻变化，在饥饿状态下无显著相关性，而在再喂养后的T3时可观察到强烈的负相关关系。在所研究的三个阶段中的任何一个阶段，瘦素与胰岛素均无显著相关性。
