Tagami Tetsuya, Satoh Noriko, Usui Takeshi, Yamada Kazunori, Shimatsu Akira, Kuzuya Hideshi
Clinical Research Institute, Center for Endocrine and Metabolic Diseases, Kyoto National Hospital, Kyoto 612-8555, Japan.
J Clin Endocrinol Metab. 2004 Apr;89(4):1833-7. doi: 10.1210/jc.2003-031260.
To study the role of adiponectin, a novel adipocyte-specific secreted protein, on the pathophysiology of eating disorders, circulating levels of fasting adiponectin, leptin, insulin, and glucose were measured in 31 female patients with anorexia nervosa (AN) and in 11 with bulimia nervosa. Hormone levels were compared with 16 age-matched, normal body weight controls, six healthy constitutionally thin subjects, and nine obese subjects. Moreover, changes in levels were reevaluated after nutritional treatment and weight gain in 13 patients with AN. Serum adiponectin concentrations in AN and bulimia nervosa were significantly lower than those in normal-weight controls. These results were unexpected because the levels were high in constitutionally thin subjects and low in obese subjects, which provide a negative correlation with body mass index (BMI) and body fat mass. In contrast, serum leptin levels correlated very well with BMI and fat mass among all the patients and controls. The insulin resistance was significantly low in AN and high in obese subjects. The concentrations of adiponectin after weight recovery increased to the normal level despite a relatively small increase in BMI. These findings suggest that abnormal feeding behavior in the patients with eating disorders may reduce circulating adiponectin level, and weight recovery can restore it.
为研究一种新型脂肪细胞特异性分泌蛋白脂联素在饮食失调病理生理学中的作用，我们测定了31例神经性厌食症（AN）女性患者和11例神经性贪食症女性患者空腹时循环中的脂联素、瘦素、胰岛素及葡萄糖水平。将这些激素水平与16名年龄匹配的正常体重对照者、6名健康的体质消瘦者及9名肥胖者进行了比较。此外，还对13例AN患者营养治疗及体重增加后的激素水平变化进行了重新评估。AN和神经性贪食症患者的血清脂联素浓度显著低于正常体重对照者。这些结果出人意料，因为体质消瘦者脂联素水平高，肥胖者脂联素水平低，且脂联素水平与体重指数（BMI）和体脂量呈负相关。相比之下，在所有患者及对照者中，血清瘦素水平与BMI和脂肪量密切相关。AN患者的胰岛素抵抗显著降低，肥胖者的胰岛素抵抗则较高。尽管BMI仅有相对较小的增加，但体重恢复后脂联素浓度升至正常水平。这些发现提示，饮食失调患者的异常进食行为可能会降低循环脂联素水平，而体重恢复可使其恢复正常。
