Tanaka Muneki, Tatebe Yoshiki, Nakahara Toshihiro, Yasuhara Daisuke, Sagiyama Ken-ichiro, Muranaga Tetsuro, Ueno Hiroaki, Nakazato Masamitsu, Nozoe Shin-ichi, Naruo Tetsuro
Department of Psychosomatic Medicine, Kagoshima University Hospital, Faculty of Medicine, Kagoshima University, Sakuragaoka, Kagoshima, Japan.
Clin Endocrinol (Oxf). 2003 Nov;59(5):574-9. doi: 10.1046/j.1365-2265.2003.01886.x.
Ghrelin is thought to be involved in the regulation of eating behaviour and energy metabolism in acute and chronic feeding states. Circulating plasma ghrelin levels in healthy humans have been found to decrease significantly after oral glucose administration. Because it is suggested that eating behaviour may influence the secretion of ghrelin and insulin in anorexia nervosa (AN), we examined the effect of oral glucose on ghrelin and insulin secretion in subtypes of AN patients.
Twenty female AN patients and 10 age-matched female controls were subjects. The patients were subdivided into two subtypes based on eating behaviour as follows: 11 restricting type (AN-R), nine binge-eating and purging type (AN-BP). Subjects underwent an oral glucose tolerance test at 08.00 h. Blood was collected 0, 30, 60, 120 and 180 min after the glucose load.
Both AN-R and AN-BP had a significant increased basal ghrelin level (P < 0.01) and a significantly decreased basal insulin level (P < 0.05) as compared to controls. The time of the nadir of mean ghrelin in AN-BP (120 min, 58.1% of basal level, 204.9 +/- 34.3 pmol/l, mean +/- SEM) was delayed compared to controls (60 min, 60.2%, 74.3 +/- 7.9 pmol/l), and in the AN-R group it kept decreasing for 180 min (80.0%, 182.4 +/- 31.5 pmol/l). The peaks insulin levels in AN-BP (120 min, 319.3 +/- 88.8 pmol/l) and AN-R (180 min, 418.9 +/- 68.4 pmol/l) were also delayed as compared to controls (60 min, 509.2 +/- 88.8 pmol/l). The glucose level at 180 min in AN-R was significantly (P < 0.05) higher than in controls.
These findings suggest that differences in eating behaviour in AN may induce alterations in both ghrelin and insulin metabolism in the acute feeding state. Furthermore, metabolic changes in the restrictive eating pattern may be related to the pathophysiology of small quantitative meal intake in AN-R patients.
胃饥饿素被认为参与急性和慢性进食状态下的饮食行为和能量代谢调节。研究发现，健康人口服葡萄糖后，循环血浆胃饥饿素水平显著下降。由于有研究表明饮食行为可能会影响神经性厌食症（AN）患者体内胃饥饿素和胰岛素的分泌，因此我们研究了口服葡萄糖对AN患者不同亚型体内胃饥饿素和胰岛素分泌的影响。
20名女性AN患者和10名年龄匹配的女性对照者作为研究对象。根据饮食行为将患者分为两个亚型：11名限制型（AN-R），9名暴饮暴食清除型（AN-BP）。研究对象于上午8点接受口服葡萄糖耐量试验。在葡萄糖负荷后0、30、60、120和180分钟采集血液。
与对照组相比，AN-R和AN-BP的基础胃饥饿素水平均显著升高（P<0.01），基础胰岛素水平均显著降低（P<0.05）。AN-BP组平均胃饥饿素水平最低点出现的时间（120分钟，基础水平的58.1%，204.9±34.3 pmol/l，平均值±标准误）比对照组（60分钟，60.2%，74.3±7.9 pmol/l）延迟，而AN-R组在180分钟内持续下降（80.0%，182.4±31.5 pmol/l）。AN-BP组（120分钟，319.3±88.8 pmol/l）和AN-R组（180分钟，418.9±68.4 pmol/l）的胰岛素峰值水平也比对照组（60分钟，509.
