Andries Alin, Gram Bibi, Støving René Klinkby
Department of Endocrinology, Centre for Eating Disorders, Odense University Hospital, 5000, Odense, Denmark,
Eat Weight Disord. 2015 Mar;20(1):13-21. doi: 10.1007/s40519-014-0132-5. Epub 2014 Jun 3.
The level of physical activity is inappropriately high in up to 80% of the patients suffering of anorexia nervosa (AN), as a result of conscious efforts to lose weight, affect regulation and biological adaptive changes to starvation induced by hypothermia and neuroendocrine mechanisms. The purposes of this paper were to (1) assess the effect of dronabinol-a synthetic cannabinoid agonist-on physical activity in patients with chronic and stable AN, and to (2) unravel the role of leptin and cortisol in this process.
This prospective, randomised, double-blind, crossover study was conducted at a specialised care centre for eating disorders. Twenty-four adult women with AN of at least 5-year duration received either the dronabinol-placebo or placebo-dronabinol sequence. Physical activity was monitored during the fourth week of each intervention. Body weight, leptin and urinary free cortisol excretion were measured repeatedly during the trial. Changes in behavioural dimensions related to AN were assessed by Eating Disorder Inventory-2.
The total duration of physical activity did not change, while its average intensity increased by 20% (P = 0.01) during dronabinol therapy, resulting in an increased energy expenditure with 68.2 kcal/day (P = 0.01) above placebo.
This randomised, double-blind study revealed that cannabinoid agonist treatment was associated with a modest increase in physical activity in adult women with severe and longstanding AN. Additionally, we detected a strong relationship between the circulating levels of leptin and physical activity in these chronically undernourished patients.
由于有意识地努力减肥、影响调节以及低温和神经内分泌机制引发的对饥饿的生物适应性变化，高达80%的神经性厌食症（AN）患者的身体活动水平过高。本文的目的是：（1）评估屈大麻酚（一种合成大麻素激动剂）对慢性稳定型AN患者身体活动的影响；（2）阐明瘦素和皮质醇在此过程中的作用。
这项前瞻性、随机、双盲、交叉研究在一家专门的饮食失调护理中心进行。24名病程至少5年的成年AN女性患者接受了屈大麻酚-安慰剂或安慰剂-屈大麻酚序列治疗。在每次干预的第四周监测身体活动。在试验期间反复测量体重、瘦素和尿游离皮质醇排泄量。通过饮食失调量表-2评估与AN相关的行为维度变化。
身体活动的总时长没有变化，而在屈大麻酚治疗期间其平均强度增加了20%（P = 0.01），导致能量消耗比安慰剂组每天增加68.2千卡（P = 0.01）。
这项随机双盲研究表明，大麻素激动剂治疗与严重且长期患AN的成年女性身体活动适度增加有关。此外，我们在这些长期营养不良的患者中检测到瘦素循环水平与身体活动之间存在密切关系。
