Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Nutrition. 2013 Jan;29(1):203-6. doi: 10.1016/j.nut.2012.07.011.
Anorexia nervosa (AN) continues to be a refractory disease because of its unknown pathogenesis. The role of adiponectin in AN has not been clarified. Moreover, few reports have described the relations between adiponectin isoforms and AN in the physical and psychological states. Therefore, we measured plasma adiponectin and its isoforms levels in patients with AN to examine their roles in AN.
Eighteen women participated in this study: nine patients with AN and nine age-matched healthy controls. We examined plasma adiponectin and its isoforms levels in all subjects and administered three types of psychological test to patients with AN: the Eating Disorders Inventory-2, the Maudsley Obsessional-Compulsive Inventory, and the Beck Depression Inventory-2.
We found that the percentage of high-molecular-weight (HMW) to total adiponectin (%HMW) was significantly low and the percentage of low-molecular-weight (LMW) to total adiponectin (%LMW) was significantly high in the AN group compared with the control group. The %HMW positively and the %LMW negatively correlated with body mass index in the entire study population. The %HMW was also positively correlated with psychological symptoms such as social insecurity or cleaning evaluated with the Eating Disorders Inventory-2 or the Maudsley Obsessional-Compulsive Inventory.
Our study indicates that all adiponectin isoforms should be evaluated in patients with AN in addition to total adiponectin. The decreased %HMW and the increased %LMW that were correlated with the body mass index and some components of psychopathology in our patients may indicate a complex role of adiponectin isoforms in maintaining energy homeostasis and emotion during extreme malnourishment.
由于厌食症(AN)的发病机制尚不清楚,因此它仍然是一种难治性疾病。脂联素在 AN 中的作用尚未阐明。此外,很少有报道描述脂联素异构体与 AN 在生理和心理状态下的关系。因此,我们测量了 AN 患者的血浆脂联素及其异构体水平,以研究其在 AN 中的作用。
本研究纳入 18 名女性,其中 9 名为 AN 患者,9 名年龄匹配的健康对照者。我们检测了所有受试者的血浆脂联素及其异构体水平,并对 AN 患者进行了三种类型的心理测试:饮食失调问卷-2、Maudsley 强迫性量表和贝克抑郁自评量表-2。
与对照组相比,我们发现 AN 组的高分子量(HMW)与总脂联素的百分比(%HMW)显著降低,而低分子量(LMW)与总脂联素的百分比(%LMW)显著升高。%HMW 与整个研究人群的体重指数呈正相关,%LMW 与体重指数呈负相关。%HMW 还与饮食失调问卷-2 或 Maudsley 强迫性量表评估的社会不安或清洁等心理症状呈正相关。
我们的研究表明,除了总脂联素之外,还应该在 AN 患者中评估所有脂联素异构体。我们患者的%HMW 降低和%LMW 升高与体重指数和某些精神病理学成分相关,这可能表明脂联素异构体在维持极端营养不良期间的能量平衡和情绪方面具有复杂的作用。