Brauman H, Gregoire F
Eur J Clin Invest. 1975 Jun 12;5(3):289-95. doi: 10.1111/j.1365-2362.1975.tb00457.x.
Hypoglycaemic stimulation of growth hormone (GH) secretion has been measured in 12 anorexia nervosa patients, 11 adolescents approximately matched for weight and age, 14 underweight adults with no history of anorexia nervosa and 27 normal patients. The results showed a high proportion of blunted growth hormone responses among the anorexia nervosa patients as compared to normal subjects, underweight adolescents or adults. In the group of underweight adults, diminshed growth hormone responses were most frequently seen in patients with depressive illness. The complex pathogenesis of the diminshed growth hormone response in anorexia nervosa involves many factors; undernutrition itself, possible hypothalamic insufficiency related to the psychopathological background and other endocrine abnormalities like hypogonadism, relative hypercorticism and hypothyroidism. The interference of the nutritional, psychological and endocrine factors could not be dissociated in our investigation or from the review of the literature on this subject. It is suggested that hypothalamic insufficiency plays a prominent role in the growth hormone hyporesponsiveness in anorexia nervosa. Although diminished, the stimulated growth hormone response remains higher in anorexia nervosa than in true hypopituitarism. This phenomenon coupled to a preserved or even increased suprarenal function enables one to differentiate cachexia resulting from anorexia nervosa and hypopituitarism leading eventually to cachexia.
在12名神经性厌食症患者、11名年龄和体重大致匹配的青少年、14名无神经性厌食症病史的体重过轻的成年人以及27名正常患者中，测量了低血糖对生长激素（GH）分泌的刺激作用。结果显示，与正常受试者、体重过轻的青少年或成年人相比，神经性厌食症患者中生长激素反应迟钝的比例很高。在体重过轻的成年人组中，生长激素反应减弱最常见于患有抑郁症的患者。神经性厌食症中生长激素反应减弱的复杂发病机制涉及许多因素；营养不良本身、可能与心理病理背景相关的下丘脑功能不全以及其他内分泌异常，如性腺功能减退、相对皮质醇增多症和甲状腺功能减退。在我们的研究中以及对该主题的文献综述中，营养、心理和内分泌因素的相互干扰无法区分。有人认为，下丘脑功能不全在神经性厌食症的生长激素低反应性中起主要作用。尽管有所减弱，但神经性厌食症患者中受刺激的生长激素反应仍高于真正的垂体功能减退症患者。这种现象加上肾上腺功能的保留甚至增加，使得人们能够区分神经性厌食症导致的恶病质和最终导致恶病质的垂体功能减退症。
