Liu Li-Li, Li Bao-Min, Yang Jie, Wang Yu-Wei
Department of Pediatrics, Qilu Hospital of Shandong University, Jinan 250012, China.
Med Hypotheses. 2008;70(6):1118-20. doi: 10.1016/j.mehy.2007.10.012. Epub 2007 Dec 26.
Some recent studies have reported a strong link between obesity and attention-deficit/hyperactivity disorder (ADHD). However, to date, the factors underlying this newly described comorbidity are still unclear and unexplored. In the present article, we proposed that the dopamine system and implicate dopamine genes contribute to explaining the association between ADHD and obesity. The background for this hypothesis comes from studies on the association between ADHD and dopamine, as well as from investigations on dopamine in obese individuals. There is strong evidence that indicate catecholamines dopamine is very important in the pathophysiology of ADHD, as well as in the mechanism of therapeutic action of stimulant drugs. Furthermore, increasing evidence indicated that dopaminergic reward system is significantly associated with obesity. With regard to the therapeutic implications, recent studies indicate that methylphenidate (MPH) - a drug widely used for ADHD reduced overall energy intake with a selective reduction in dietary fat. Findings are consistent with a reward deficiency model of obesity whereby low brain dopamine predicts overeating and obesity, and administering agents that increase dopamine results in reduced feeding behavior. Given the above background, we hypothesize that the increased prevalence of ADHD in obese individual could be explained by the imbalance of dopaminergic reward system.
最近的一些研究报告称,肥胖与注意力缺陷多动障碍(ADHD)之间存在紧密联系。然而,迄今为止,这种新描述的共病背后的因素仍不清楚且未被探索。在本文中,我们提出多巴胺系统以及与之相关的多巴胺基因有助于解释ADHD与肥胖之间的关联。这一假设的背景来自于对ADHD与多巴胺之间关联的研究,以及对肥胖个体中多巴胺的研究。有强有力的证据表明,儿茶酚胺多巴胺在ADHD的病理生理学以及兴奋剂药物的治疗作用机制中都非常重要。此外,越来越多的证据表明多巴胺能奖赏系统与肥胖显著相关。关于治疗意义,最近的研究表明,哌甲酯(MPH)——一种广泛用于治疗ADHD的药物,可减少总体能量摄入,并选择性减少膳食脂肪。这些发现与肥胖的奖赏缺乏模型一致,即大脑多巴胺水平低预示着暴饮暴食和肥胖,而给予增加多巴胺的药物会导致进食行为减少。鉴于上述背景,我们假设肥胖个体中ADHD患病率的增加可以通过多巴胺能奖赏系统的失衡来解释。