Wingenfeld Katja, Kuehl Linn K, Boeker Anita, Schultebraucks Katharina, Ritter Kristin, Hellmann-Regen Julian, Otte Christian, Spitzer Carsten
Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
Psychoneuroendocrinology. 2017 Jun;80:122-130. doi: 10.1016/j.psyneuen.2017.03.014. Epub 2017 Mar 12.
Adverse childhood experiences (ACE) increase the risk to develop major depressive disorder (MDD) and obesity or metabolic syndrome in adulthood. In addition, ACE may be associated with an exaggerated endocrine response to stress, which, in turn, may lead to enhanced food intake resulting in obesity and metabolic problems.
We systematically examined the stress response and consecutive food intake in 32 women with MDD and ACE as determined by a clinical interview (Early Trauma Inventory), 52 women with MDD without ACE, 22 women with ACE but no current or lifetime MDD and 37 healthy women without either MDD or ACE. All participants underwent a psychosocial stress test (Trier Social Stress Test, TSST) and a control condition (Placebo-TSST) before they were offered a buffet of snacks. Participants were not aware that the primary outcome variable was the amount of consumed kilocalories (kcal).
The four groups did not differ in demographic variables. Stress resulted in higher cortisol release and higher blood pressure compared to the control condition. Patients with MDD without ACE had a significantly lower cortisol response to stress compared to controls. Across groups, we found higher kcal intake after stress compared to the control condition. Comparing high and low cortisol responders to stress, higher kcal intake after stress was only seen in those with low cortisol release.
This study provides evidence that blunted rather than enhanced cortisol release to stress might lead to increased food intake, independent from MDD and ACE.
童年不良经历（ACE）会增加成年后患重度抑郁症（MDD）以及肥胖或代谢综合征的风险。此外，ACE可能与对应激的内分泌反应过度有关，进而可能导致食物摄入量增加，从而引发肥胖和代谢问题。
我们通过临床访谈（早期创伤量表）确定了32名患有MDD且有ACE的女性、52名患有MDD但无ACE的女性、22名有ACE但目前或终生未患MDD的女性以及37名既无MDD也无ACE的健康女性，系统地研究了她们的应激反应和随后的食物摄入量。所有参与者在接受零食自助餐之前，都接受了心理社会应激测试（特里尔社会应激测试，TSST）和对照条件（安慰剂-TSST）。参与者并不知道主要结局变量是消耗的千卡热量（kcal）。
四组在人口统计学变量上没有差异。与对照条件相比，应激导致皮质醇释放增加和血压升高。与对照组相比，患有MDD但无ACE的患者对应激的皮质醇反应明显较低。在所有组中，我们发现与对照条件相比，应激后千卡摄入量更高。比较对应激的高皮质醇反应者和低皮质醇反应者，应激后更高的千卡摄入量仅出现在皮质醇释放低的人群中。
本研究提供的证据表明，对应激的皮质醇释放减弱而非增强可能导致食物摄入量增加，这与MDD和ACE无关。
