Monteleone P, Luisi M, Colurcio B, Casarosa E, Monteleone P, Ioime R, Genazzani A R, Maj M
Institute of Psychiatry, University of Naples SUN, Italy.
Psychosom Med. 2001 Jan-Feb;63(1):62-8. doi: 10.1097/00006842-200101000-00008.
Animal data suggest that neuroactive steroids, such as 3alpha,5alpha-tetrahydroprogesterone (3a,5a-THP), dehydroepiandrosterone (DHEA), and its sulfated metabolite (DHEA-S), are involved in the modulation of eating behavior, aggressiveness, mood, and anxiety. Anorexia nervosa (AN) and bulimia nervosa (BN) are eating disorders characterized by abnormal eating patterns, depressive and anxious symptoms, enhanced aggressiveness, and endocrine alterations. Previous studies reported decreased blood levels of DHEA and DHEA-S in small samples of anorexic patients, whereas no study has been performed to evaluate the secretion of these neuroactive steroids in BN as well as the production of 3alpha,5alpha-THP in both AN and BN. Therefore, we measured plasma levels of DHEA, DHEA-S, 3alpha,5alpha-THP and other hormones in patients with AN or BN and explored possible relationships between neuroactive steroids and psychopathology.
Ninety-two women participated in the study. There were 30 drug-free AN patients, 32 drug-free BN patients, and 30 age-matched, healthy control subjects. Blood samples were collected in the morning for determination of hormone levels. Eating-related psychopathology, depressive symptoms, and aggressiveness were rated by using specific psychopathological scales.
Compared with healthy women, both AN and BN patients exhibited increased plasma levels of 3alpha,5alpha-THP, DHEA, DHEA-S, and cortisol but reduced concentrations of 17beta-estradiol. Plasma testosterone levels were decreased in anorexic women but not in bulimic women. Plasma levels of neuroactive steroids were not correlated with any clinical or demographic variable.
These findings demonstrate increased morning plasma levels of peripheral neuroactive steroids in anorexic and bulimic patients. The relevance of such hormonal alterations to the pathophysiology of eating disorders remains to be elucidated.
动物数据表明，神经活性甾体，如3α,5α - 四氢孕酮（3a,5a - THP）、脱氢表雄酮（DHEA）及其硫酸化代谢物（DHEA - S），参与饮食行为、攻击性、情绪和焦虑的调节。神经性厌食症（AN）和神经性贪食症（BN）是饮食失调症，其特征为异常的饮食模式、抑郁和焦虑症状、攻击性增强以及内分泌改变。先前的研究报道，在少量厌食症患者样本中，DHEA和DHEA - S的血液水平降低，然而尚未有研究评估这些神经活性甾体在BN中的分泌情况以及在AN和BN中3α,5α - THP的产生情况。因此，我们测量了AN或BN患者血浆中DHEA、DHEA - S、3α,5α - THP及其他激素的水平，并探讨了神经活性甾体与精神病理学之间可能的关系。
92名女性参与了该研究。其中有30名未服用药物的AN患者、32名未服用药物的BN患者以及30名年龄匹配的健康对照者。于早晨采集血样以测定激素水平。使用特定的精神病理量表对饮食相关的精神病理学、抑郁症状和攻击性进行评分。
与健康女性相比，AN和BN患者的血浆3α,5α - THP、DHEA、DHEA - S和皮质醇水平均升高，但17β - 雌二醇浓度降低。厌食症女性的血浆睾酮水平降低，而贪食症女性则未降低。神经活性甾体的血浆水平与任何临床或人口统计学变量均无相关性。
这些发现表明，厌食症和贪食症患者早晨外周神经活性甾体的血浆水平升高。此类激素改变与饮食失调症病理生理学的相关性仍有待阐明。
