Dykens Elisabeth M, Maxwell Melissa A, Pantino Elizabeth, Kossler Rebecca, Roof Elizabeth
Vanderbilt Kennedy Center for Research on Human Development, 230 Appleton Place, Peabody Box 40, Vanderbilt University, Nashville, TN 37203, USA.
Obesity (Silver Spring). 2007 Jul;15(7):1816-26. doi: 10.1038/oby.2007.216.
Prader-Willi syndrome (PWS), the leading known genetic cause of obesity, is characterized by intellectual disabilities, maladaptive and compulsive behaviors, and hyperphagia. Although complications of obesity resulting from hyperphagia are the leading cause of death in PWS, quantifying this drive for food has long been an unmet research need. This study provides factor-analytic and within-syndrome analyses of a new measure of hyperphagia in PWS.
A 13-item informant measure, the Hyperphagia Questionnaire, was developed and administered to the parents of 153 persons with PWS, 4 to 51 years of age. The intelligence quotients, genetic subtypes of PWS, and BMIs of offspring were obtained, as were measures of their non-food problem behaviors.
Factor analyses with varimax rotation produced three statistically and conceptually robust factors that accounted for 59% of the variance: Hyperphagic Behaviors, Drive, and Severity. Hyperphagic Behavior increased with age, whereas Drive remained stable, and Severity dipped in older adults. Hyperphagic Drive and Severity were positively correlated with non-food behavior problems, and Hyperphagic Drive differentiated the 36% of participants with extreme obesity from those who had overweight/obese (48%) or healthy (16%) BMI classifications.
The Hyperphagia Questionnaire is a robust tool for relating breakthroughs in the neurobiology of hyperphagia to in vivo food-seeking behavior and for examining the psychological and developmental correlates of hyperphagia in PWS. The Hyperphagia Questionnaire also offers a nuanced, real-life outcome measure for future clinical trials aimed at curbing the life-threatening drive for food in PWS.
普拉德-威利综合征（PWS）是已知导致肥胖的主要遗传原因，其特征为智力障碍、适应不良和强迫行为以及食欲亢进。尽管食欲亢进导致的肥胖并发症是PWS患者的主要死因，但长期以来，量化这种对食物的驱动力一直是未得到满足的研究需求。本研究对一种新的PWS食欲亢进测量方法进行了因素分析和综合征内分析。
编制了一份包含13个条目的知情人调查问卷——《食欲亢进问卷》，并对153名年龄在4至51岁的PWS患者的父母进行了调查。获取了后代的智商、PWS的遗传亚型和体重指数，以及他们非食物问题行为的测量结果。
采用方差最大化旋转的因素分析产生了三个在统计学和概念上都很稳健的因素，它们解释了59%的方差：食欲亢进行为、驱动力和严重程度。食欲亢进行为随年龄增长而增加，而驱动力保持稳定，严重程度在老年人中有所下降。食欲亢进驱动力和严重程度与非食物行为问题呈正相关，食欲亢进驱动力将36%的极端肥胖参与者与超重/肥胖（48%）或健康（16%）体重指数分类的参与者区分开来。
《食欲亢进问卷》是一个强有力的工具，可用于将食欲亢进神经生物学的突破与体内觅食行为联系起来，并用于研究PWS患者食欲亢进的心理和发育相关性。《食欲亢进问卷》还为未来旨在抑制PWS患者危及生命的食物驱动力的临床试验提供了一个细致入微的、现实生活中的结果测量指标。
