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[神经性厌食症青少年中神经肽Y、瘦素及瘦素受体浓度的评估]

[Assessment of neuropeptide Y, leptin and leptin-receptor concentrations in teenagers suffering from anorexia nervosa].

作者信息

Niedźwiedzka Beata, Jagielska Gabriela, Bartoszewicz Zbigniew, Kondracka Agnieszka, Brzozowska Aleksandra, Karowicz-Bilińska Agata

机构信息

Klinika Patologii Ciazy, I Katedry Ginekologii i Połoznictwa Uniwersytetu Medycznego w Łodz, Polska.

出版信息

Ginekol Pol. 2013 Apr;84(4):268-76. doi: 10.17772/gp/1575.

Abstract

INTRODUCTION

Anorexia nervosa (AN) is the third most common chronic disorder affecting adolescents and is associated with high mortality risk. The predominant symptom of anorexia nervosa is persistent and intentional striving to achieve weight loss initiated and/or sustained by the patient, leading to cachexia. Until now the cause of the condition remains unknown, but seems to be multifactoral. Patients with AN develop multi-organ complications and endocrine disorders affecting multiple disturbances of energy metabolism. Neuropeptide Y and leptin can be found between chemical substances regulating feelings of hunger and satiety. Neuropeptide Y plays the main role in the regulation of energetic homeostasis of the organism, feeding customs, sexual and reproductive functions. Concentration of neuropeptide Y increases during starvation and decreases after feeding. In anorexia nervosa the concentration of neuropeptide Y increases and, by doing that, decreases the excrection of gonadoliberines and gonadotropines. Leptin influences the feeling of hunger and its synthesis takes part, among others, in adiposal tissue. It also influences the menstruation disturbances. Rising leptin concentrations, with accompanying increasing adiposity is known to be the main factor influencing the puberty and the reverse of the malfunction of hypothalamic-pituitary-gonadal axis in malnourished persons. During hunger and low calorie intake, leptin concentration decreases, independently of adiposity.

AIM

The main aim of the study was to assess concentrations of neuropeptide Y, leptin and leptin receptor in teenagers treated for anorexia nervosa.

MATERIALS AND METHODS

The study was conducted between 2007- 2011 in a group of 45 female teenagers with anorexia nervosa and a control group consisting of 59 healthy regularly menstruating female age peers. Concentrations of leptin, leptin receptor and neuropeptide Y (NPY) have been determined by using immunoenzymatic tests. Blood samples were obtained in fasting state. The Ethics Committee of the Medical University of Lodz approved of the study.

RESULTS

There were statistically significant differences between mean values of BMI (14.6 vs. 19.83), median value of leptin concentration (3.79 vs. 12.09), proportions of LEP/BMI (0.1986 vs. 0.5701) in the study group when compared to controls. Higher values were found in the study group if compared to the percentage of body mass insufficiency--(23.09 vs. 3.97), neuropeptide Y concentration--(0.33 vs. 0.19), proportions of NPY/BMI--(0.023 vs. 0.0095), concentration of leptin receptor--(30.25 vs. 19.45), proportions of LR/BMI--(2.1048 vs. 0.9744).

CONCLUSIONS

Low concentrations of leptine correlate to high concentrations of leptin receptor. A positive correlation between low body mass index and leptin receptor concentration and proportions of LR to BMI was found. A negative correlation was found between body mass loss and leptin concentration. The increasing concentration of neuropeptide Y, correlated to body mass deficency with existing high concentrations of leptin, could suggest disturbances of their regulatory axis.

摘要

引言

神经性厌食症(AN)是影响青少年的第三大常见慢性疾病,且与高死亡风险相关。神经性厌食症的主要症状是患者主动发起和/或维持的持续且刻意追求体重减轻,进而导致恶病质。迄今为止,该病的病因尚不清楚,但似乎是多因素的。患有神经性厌食症的患者会出现多器官并发症和内分泌紊乱,影响能量代谢的多种紊乱。神经肽Y和瘦素是调节饥饿和饱腹感的化学物质。神经肽Y在调节机体能量稳态、进食习惯、性功能和生殖功能方面起主要作用。饥饿时神经肽Y浓度升高,进食后降低。在神经性厌食症中,神经肽Y浓度升高,从而降低促性腺激素释放素和促性腺激素的分泌。瘦素影响饥饿感,其合成主要发生在脂肪组织中。它还会影响月经紊乱。瘦素浓度升高以及随之而来的肥胖增加是影响青春期以及营养不良者下丘脑 - 垂体 - 性腺轴功能障碍逆转的主要因素。在饥饿和低热量摄入期间,瘦素浓度会下降,与肥胖无关。

目的

本研究的主要目的是评估接受神经性厌食症治疗的青少年体内神经肽Y、瘦素和瘦素受体的浓度。

材料与方法

该研究于2007年至2011年在一组45名患有神经性厌食症的女性青少年以及由59名月经正常的健康同龄女性组成的对照组中进行。通过免疫酶法测定瘦素、瘦素受体和神经肽Y(NPY)的浓度。在空腹状态下采集血样。罗兹医科大学伦理委员会批准了该研究。

结果

与对照组相比,研究组的体重指数平均值(14.6对19.83)、瘦素浓度中位数(3.79对12.09)、LEP/BMI比例(0.1986对0.5701)存在统计学显著差异。与体重不足百分比(23.09对3.97)、神经肽Y浓度(0.33对0.19)、NPY/BMI比例(0.023对0.0095)、瘦素受体浓度(30.25对19.45)、LR/BMI比例(2.1048对0.9744)相比,研究组的值更高。

结论

低浓度的瘦素与高浓度的瘦素受体相关。发现低体重指数与瘦素受体浓度以及LR与BMI的比例呈正相关。发现体重减轻与瘦素浓度呈负相关。神经肽Y浓度的增加与体重不足以及现有的高浓度瘦素相关,这可能表明它们的调节轴存在紊乱。

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