Stein D, Maayan R, Ram A, Loewenthal R, Achiron A, Modan-Moses D, Feigin M, Weizman A, Valevski A
Pediatric Psychosomatic Department, Chaim Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Eur Neuropsychopharmacol. 2005 Dec;15(6):647-53. doi: 10.1016/j.euroneuro.2005.05.001. Epub 2005 Jul 14.
Nineteen female adolescent inpatients diagnosed with anorexia nervosa, restricting type (AN-R) and 16 non-eating disordered (ED) controls were assessed for plasma dehydroepiandrosterone (DHEA), dehydroepiandrosterone-sulphate (DHEA-S), and cortisol levels, and for eating-related and non-eating-related psychopathology. AN-R patients were assessed at admission, 1 month and 4 months following hospitalization. The non-ED controls were assessed once. No baseline between-group differences were found in plasma cortisol, DHEA, and DHEA-S levels, whereas the patient group had a significantly lower Cortisol/DHEA-S ratio and elevated scores on most psychopathological parameters. A significant increase was found in the body mass index of the AN-R patients at 4 months post-hospitalization, accompanied by a decrease in plasma cortisol levels and a trend towards decreased Cortisol/DHEA and Cortisol/DHEA-S ratios, whereas no change occurred in psychopathology. The difference in Cortisol/DHEA-S ratio between AN-R patients and non-ED controls, and the different patterns of change in cortisol vs. DHEA(-S) levels following weight restoration, may in part account for the feeding difficulties in AN, particularly during refeeding.
对19名被诊断为神经性厌食症限制型（AN-R）的女性青少年住院患者和16名非饮食失调（ED）对照者进行了血浆脱氢表雄酮（DHEA）、硫酸脱氢表雄酮（DHEA-S）和皮质醇水平以及饮食相关和非饮食相关精神病理学评估。对AN-R患者在入院时、住院后1个月和4个月进行评估。对非ED对照者进行了一次评估。血浆皮质醇、DHEA和DHEA-S水平在组间未发现基线差异，而患者组的皮质醇/DHEA-S比值显著较低，且大多数精神病理学参数得分升高。在住院后4个月时，AN-R患者的体重指数显著增加，同时血浆皮质醇水平降低，皮质醇/DHEA和皮质醇/DHEA-S比值有下降趋势，而精神病理学方面没有变化。AN-R患者与非ED对照者之间皮质醇/DHEA-S比值的差异，以及体重恢复后皮质醇与DHEA（-S）水平的不同变化模式，可能部分解释了神经性厌食症患者的进食困难，尤其是在重新进食期间。
