Zis A P, Remick R A, Clark C M, Goldner E, Grant B E, Brown G M
Department of Psychiatry, University of British Columbia, University Hospital, Vancouver, Canada.
Clin Endocrinol (Oxf). 1989 Apr;30(4):421-7. doi: 10.1111/j.1365-2265.1989.tb00441.x.
Endogenous opioid peptides are involved in feeding regulation, and alterations in opioidergic regulation have been implicated in the pathophysiology of eating disorders. To investigate further this hypothesis, we conducted a placebo-controlled study of the effect of the opiate alkaloid morphine on cortisol and prolactin secretion in six patients with anorexia nervosa and six age-matched healthy volunteers, and compared the results with those obtained in nine depressed patients. Basal cortisol but not basal prolactin levels were elevated in patients with anorexia nervosa and patients with depression. Following the administration of morphine plasma concentrations of cortisol levels declined progressively and at a similar rate in all three groups. The prolactin response to morphine was attenuated significantly in patients with depression. Neither the cortisol and prolactin response to morphine in the anorectic patients nor the cortisol response in the depressed patients we observed in this study suggests altered opiate receptor sensitivity. However, the decreased prolactin response to morphine in depressed patients remains compatible with this hypothesis.
内源性阿片肽参与进食调节，且阿片能调节的改变与饮食失调的病理生理学有关。为进一步研究这一假说，我们进行了一项安慰剂对照研究，观察阿片生物碱吗啡对6名神经性厌食症患者和6名年龄匹配的健康志愿者皮质醇和催乳素分泌的影响，并将结果与9名抑郁症患者的结果进行比较。神经性厌食症患者和抑郁症患者的基础皮质醇水平升高，但基础催乳素水平未升高。给予吗啡后，三组患者血浆皮质醇水平均逐渐下降，且下降速率相似。抑郁症患者对吗啡的催乳素反应显著减弱。在本研究中，我们观察到厌食症患者对吗啡的皮质醇和催乳素反应以及抑郁症患者的皮质醇反应均未提示阿片受体敏感性改变。然而，抑郁症患者对吗啡的催乳素反应降低仍与这一假说相符。
