Pannacciulli Nicola, Vettor Roberto, Milan Gabriella, Granzotto Marnie, Catucci Alessandro, Federspil Giovanni, De Giacomo Piero, Giorgino Riccardo, De Pergola Giovanni
Internal Medicine, Endocrinology, and Metabolic Diseases, Department of Neurological and Psychiatric Sciences, University of Bari, Italy.
J Clin Endocrinol Metab. 2003 Apr;88(4):1748-52. doi: 10.1210/jc.2002-021215.
The aim of the present study was to examine the effects of anorexia nervosa (AN) on adipocytokines (leptin and adiponectin) plasma concentrations and insulin-stimulated glucose disposal in adolescent and young adult women. Adiponectin and leptin plasma levels, along with insulin-stimulated glucose disposal (as measured by the euglycemic-hyperinsulinemic glucose clamp) and oxidative and nonoxidative glucose metabolism (as measured by indirect calorimetry during the last 60 min of the insulin clamp), were measured in 11 anorectic patients and 26 normal-weight healthy female controls. Leptin levels were significantly lower in AN patients, according to the reduced body mass index and their respective fat mass. On the contrary, adiponectin plasma levels were significantly higher in AN patients than in control women. Likewise, insulin-stimulated glucose disposal and nonoxidative glucose metabolism were significantly lower in AN patients. In conclusion, our study shows that young women affected by AN have higher adiponectin plasma levels than healthy female controls of similar age, despite the presence of an impairment of insulin-stimulated glucose disposal, with a prevalent failure of nonoxidative glucose metabolism. Taken together, these data suggest that the reduction of fat mass may play the major role in the control of adiponectin release, with respect to changes in insulin sensitivity.
本研究的目的是检测神经性厌食症(AN)对青春期及年轻成年女性脂肪细胞因子(瘦素和脂联素)血浆浓度以及胰岛素刺激的葡萄糖代谢的影响。在11名厌食症患者和26名体重正常的健康女性对照中,测量了脂联素和瘦素的血浆水平,以及胰岛素刺激的葡萄糖代谢(通过正常血糖 - 高胰岛素血糖钳夹法测量)和氧化及非氧化葡萄糖代谢(在胰岛素钳夹的最后60分钟通过间接量热法测量)。根据体重指数降低及其各自的脂肪量,AN患者的瘦素水平显著降低。相反,AN患者的脂联素血浆水平显著高于对照女性。同样,AN患者中胰岛素刺激的葡萄糖代谢和非氧化葡萄糖代谢显著降低。总之,我们的研究表明,尽管存在胰岛素刺激的葡萄糖代谢受损,且非氧化葡萄糖代谢普遍失败,但受AN影响的年轻女性的脂联素血浆水平高于年龄相仿的健康女性对照。综上所述,这些数据表明,相对于胰岛素敏感性的变化,脂肪量的减少可能在脂联素释放的控制中起主要作用。