Monteleone Palmiero, Luisi Michele, De Filippis Gennaro, Colurcio Barbara, Monteleone Patrizia, Genazzani Andrea R, Maj Mario
Department of Psychiatry, University of Naples SUN, Naples, Italy.
Int J Eat Disord. 2003 Dec;34(4):432-40. doi: 10.1002/eat.10199.
Increased plasma levels of allopregnenolone (3alpha,5alpha-tetrahydroprogesterone [3alpha,5alpha-THP]), dehydroepiandrosterone (DHEA), and DHEA sulphate (DHEA-S) have been reported in patients with anorexia nervosa or bulimia nervosa. To assess whether those changes are related to malnutrition, we investigated plasma levels of neuroactive steroids in women with binge eating disorder (BED) who compulsively binge as bulimic patients, but do not incur malnutrition.
Sixty-eight women participated in the study (31 nonobese healthy controls, 9 nonobese patients with BED, 16 obese patients with BED, and 12 obese non-binge eating women). Blood samples were collected in the morning for determination of plasma levels of 3alpha,5alpha-THP, DHEA, DHEA-S, and cortisol.
Nonobese BED women had significantly higher plasma levels of DHEA, DHEA-S, and 3alpha,5alpha-THP than nonobese healthy women. Similarly, obese individuals with BED exhibited significantly higher neurosteroid plasma levels than non-binge eating obese subjects. No significant differences in plasma cortisol levels were observed among the groups.
This study shows increased plasma levels of neuroactive steroids in BED patients. These findings could have been influenced by methodologic limitations (e.g., the absence of diurnal sampling). However, they suggest that if malnutrition is involved in the determination of increased plasma levels of neuroactive steroids in people with anorexia or bulimia nervosa, then different factors may induce similar effects in people with BED. Alternatively, common unknown factors could be responsible for neurosteroid changes in anorexia nervosa, bulimia nervosa, and BED.
据报道，神经性厌食症或神经性贪食症患者的血浆中孕烯醇酮（3α,5α-四氢孕酮[3α,5α-THP]）、脱氢表雄酮（DHEA）和硫酸脱氢表雄酮（DHEA-S）水平升高。为了评估这些变化是否与营养不良有关，我们调查了患有暴饮暴食症（BED）的女性的神经活性甾体血浆水平，这些女性像神经性贪食症患者一样强迫性暴饮暴食，但不会出现营养不良。
68名女性参与了该研究（31名非肥胖健康对照者、9名非肥胖BED患者、16名肥胖BED患者和12名肥胖非暴饮暴食女性）。于早晨采集血样，以测定血浆中3α,5α-THP、DHEA、DHEA-S和皮质醇的水平。
非肥胖BED女性的DHEA、DHEA-S和3α,5α-THP血浆水平显著高于非肥胖健康女性。同样，患有BED的肥胖个体的神经甾体血浆水平显著高于非暴饮暴食的肥胖受试者。各组间血浆皮质醇水平未观察到显著差异。
本研究显示BED患者的神经活性甾体血浆水平升高。这些发现可能受到方法学局限性的影响（例如，缺乏昼夜采样）。然而，它们表明，如果营养不良参与了神经性厌食症或神经性贪食症患者神经活性甾体血浆水平升高的测定，那么不同的因素可能在BED患者中诱导出类似的效应。或者，共同的未知因素可能是神经性厌食症、神经性贪食症和BED中神经甾体变化的原因。
