Dynesen Anja W, Bardow Allan, Astrup Arne, Petersson Birgit, Holst Jens J, Nauntofte Birgitte
Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Am J Clin Nutr. 2008 Jan;87(1):12-22. doi: 10.1093/ajcn/87.1.12.
Binge eating episodes in persons with bulimia nervosa may to some extent be a result of disturbed sensations of hunger and satiety. It has been hypothesized that abnormal appetite sensations may be due to bulimia nervosa-related alterations in the release of hormones that are known to be involved in the physiologic regulation of appetite and metabolism.
The objective was to investigate whether circulating concentrations of the appetite-regulating peptides leptin and ghrelin and markers of metabolism (glucose and insulin) are different in persons with bulimia nervosa than in controls before and after intake of a meal and whether these changes may be reflected in saliva.
Twenty women with bulimia nervosa and 20 age- and sex-matched healthy controls participated. After an overnight fast, the subjects ate a standardized carbohydrate-rich breakfast. Whole saliva and blood were collected, and visual analogue scales for hunger and satiety were completed once before and continuously for 5 h after the breakfast.
A lower pre- and postprandial whole saliva flow rate was found in subjects with bulimia nervosa, which might have been attributable to a concomitant intake of potentially xerogenic medication. Subjects with bulimia nervosa experienced reduced hunger, which could not be explained by pre- or postprandial alterations in circulating ghrelin, leptin, insulin, or glucose concentrations.
There were no apparent differences in the composition of blood and saliva between bulimia nervosa and control subjects, and meal-induced compositional changes in blood were not directly mirrored in saliva composition.
神经性贪食症患者的暴饮暴食发作在一定程度上可能是饥饿和饱腹感感觉紊乱的结果。据推测,异常的食欲感觉可能是由于与神经性贪食症相关的激素释放改变所致,这些激素已知参与食欲和新陈代谢的生理调节。
目的是调查神经性贪食症患者与对照组在进餐前后,食欲调节肽瘦素和胃饥饿素的循环浓度以及代谢标志物(葡萄糖和胰岛素)是否存在差异,以及这些变化是否可在唾液中得到反映。
20名神经性贪食症女性和20名年龄及性别匹配的健康对照者参与研究。经过一夜禁食后,受试者食用一份标准化的富含碳水化合物的早餐。采集全唾液和血液,并在早餐前完成一次以及早餐后连续5小时完成饥饿和饱腹感的视觉模拟量表。
神经性贪食症患者的餐前和餐后全唾液流速较低,这可能归因于同时服用了可能导致口干的药物。神经性贪食症患者的饥饿感减轻,这无法通过循环中的胃饥饿素、瘦素、胰岛素或葡萄糖浓度在餐前或餐后的变化来解释。
神经性贪食症患者与对照者之间血液和唾液的成分没有明显差异,进餐引起的血液成分变化并未直接反映在唾液成分中。