Morrow Jarret D, McManus Karen, Tait Glendon R, Bellavance Francois, Chrapko Wendy, Lara Nathalie, Le Mellédo Jean-Michel
Department of Psychiatry, University of Alberta, Edmonton, Alta.
J Psychiatry Neurosci. 2003 Mar;28(2):127-33.
The primary objective of this study was to assess whether pentagastrin-induced panic symptoms are associated with release of free fatty acids (FFAs) in a manner that could explain the mechanism of correlations observed between serum cholesterol levels and frequency and severity of panic attacks in patients with panic disorder (PD). A secondary objective was to assess whether pretreatment with ethinyl estradiol (EE) attenuates pentagastrin-induced release of FFAs.
A double-blind, crossover, placebo-controlled study was conducted in which patients with PD and healthy volunteers received 2 injections of pentagastrin, 7-10 days apart, with randomization of the order of pretreatment with placebo and EE.
We found a statistically significant, time-dependent release of FFAs in response to pentagastrin challenge. However, this release of FFAs was not attenuated by pretreatment with EE.
These results support the hypothesis that release of FFAs in association with panic attacks occurs in a manner similar to the stress-induced lipolysis model. This suggests a possible mechanism for the elevated serum cholesterol levels observed in patients with PD. However, the occurrence of a delayed increase in low-density lipoprotein (LDL) cholesterol following induction of a panic attack remains to be tested in studiesincorporating a placebo injection visit and timed measurements of LDL cholesterol.
本研究的主要目的是评估五肽胃泌素诱导的惊恐症状是否与游离脂肪酸（FFA）释放相关，其方式能否解释惊恐障碍（PD）患者血清胆固醇水平与惊恐发作频率和严重程度之间观察到的相关性机制。次要目的是评估乙炔雌二醇（EE）预处理是否能减弱五肽胃泌素诱导的FFA释放。
进行了一项双盲、交叉、安慰剂对照研究，PD患者和健康志愿者接受两次五肽胃泌素注射，间隔7 - 10天，随机安排安慰剂和EE预处理的顺序。
我们发现，对五肽胃泌素激发有统计学显著的、时间依赖性的FFA释放。然而，EE预处理并未减弱这种FFA释放。
这些结果支持以下假设，即与惊恐发作相关的FFA释放以类似于应激诱导的脂肪分解模型的方式发生。这提示了PD患者中观察到的血清胆固醇水平升高的一种可能机制。然而，在纳入安慰剂注射访视和低密度脂蛋白（LDL）胆固醇定时测量的研究中，惊恐发作诱导后LDL胆固醇延迟升高的情况仍有待检验。
