Monteleone P, Carratù R, Cartenì M, Generoso M, Lamberti M, Magistris L De, Brambilla F, Colurcio B, Secondulfo M, Maj M
Department of Psychiatry, University of Naples S.U.N., Naples, Italy.
Mol Psychiatry. 2004 Jan;9(1):76-80. doi: 10.1038/sj.mp.4001374.
Malnutrition and absence of exogenous luminal nutrients in the gastrointestinal tract affect intestinal permeability (IP) leading to an increased penetration of substances that passively cross intestinal epithelium via intercellular pathways. We hypothesised that an increase in IP could occur in patients with anorexia nervosa because of their prolonged fasting and chronic malnutrition. Therefore, we assessed IP in 14 drug-free anorexic women and 19 drug-free age-matched healthy women by means of the lactulose/mannitol (LA/MA) test. To this purpose, after an overnight fast, subjects ingested an oral solution containing 5 g lactulose and 2 g mannitol in 100 ml water. Urine specimens were collected immediately before and 30, 60, 120, 180, 240 and 300 min after the ingestion of the sugar solution. Urinary lactulose and mannitol were determined by high-performance anion exchange chromatography coupled with pulsed amperometric detection. We found that IP, as expressed by the 5-h LA/MA excretion ratio, was significantly decreased in anorexic women because of a lower urinary recovery of lactulose. Moreover, in patients, the time course of lactulose excretion significantly differs from healthy controls. These results do not confirm our hypothesis of increased IP in anorexia nervosa. Since IP reflects the anatomo-functional status of intestinal mucosa, the present findings support the idea that changes in the anatomo-physiology of intestinal mucosa occur in anorexia nervosa.
营养不良以及胃肠道缺乏外源性肠腔营养物质会影响肠道通透性（IP），导致物质通过细胞间途径被动穿过肠上皮的渗透增加。我们推测神经性厌食症患者可能会出现IP增加，因为他们长期禁食和慢性营养不良。因此，我们通过乳果糖/甘露醇（LA/MA）试验评估了14名未服用药物的神经性厌食症女性和19名年龄匹配的未服用药物的健康女性的IP。为此，在禁食过夜后，受试者摄入了一种口服溶液，该溶液在100毫升水中含有5克乳果糖和2克甘露醇。在摄入糖溶液之前以及之后30、60、120、180、240和300分钟立即收集尿液样本。通过高效阴离子交换色谱结合脉冲安培检测法测定尿中乳果糖和甘露醇。我们发现，由于乳果糖的尿回收率较低，用5小时LA/MA排泄率表示的IP在神经性厌食症女性中显著降低。此外，在患者中，乳果糖排泄的时间进程与健康对照有显著差异。这些结果并未证实我们关于神经性厌食症患者IP增加的假设。由于IP反映了肠黏膜的解剖功能状态，目前的研究结果支持了神经性厌食症患者肠黏膜解剖生理学发生变化的观点。
