Walsh B T, Roose S P, Katz J L, Dyrenfurth I, Wright L, Vande Wiele R, Glassman A H
Psychoneuroendocrinology. 1987;12(2):131-40. doi: 10.1016/0306-4530(87)90043-6.
We studied hypothalamic-pituitary-adrenal-cortical (HPA) activity in nine underweight women with anorexia nervosa, 12 women of normal body weight with bulimia, and nine control subjects. The measures of HPA activity were the pattern of plasma cortisol secretion over 24 hr and the responses of plasma cortisol to dexamethasone suppression and to low dose ACTH stimulation. The patients with anorexia nervosa had significantly elevated 24 hr concentrations of plasma cortisol compared to the controls and showed significantly less cortisol suppression following dexamethasone. There was no difference between patients with anorexia nervosa and controls in the rise in plasma cortisol following ACTH. On most measures of HPA activity, the normal weight patients with bulimia were indistinguishable from the controls. These results suggest that HPA activity is normal in most patients of normal body weight with bulimia and that the psychological and behavioral disturbances common to both anorexia nervosa and bulimia are, in the absence of significant weight loss, insufficient to produce major alterations in HPA activity.
我们研究了9名体重过轻的神经性厌食症女性、12名体重正常的贪食症女性以及9名对照受试者的下丘脑 - 垂体 - 肾上腺 - 皮质（HPA）活性。HPA活性的测量指标包括24小时血浆皮质醇分泌模式、血浆皮质醇对地塞米松抑制和低剂量促肾上腺皮质激素（ACTH）刺激的反应。与对照组相比，神经性厌食症患者的24小时血浆皮质醇浓度显著升高，且地塞米松抑制后皮质醇抑制作用明显减弱。神经性厌食症患者与对照组在ACTH刺激后血浆皮质醇升高方面没有差异。在大多数HPA活性测量指标上，体重正常的贪食症患者与对照组没有区别。这些结果表明，大多数体重正常的贪食症患者的HPA活性正常，并且在没有显著体重减轻的情况下，神经性厌食症和贪食症共有的心理和行为障碍不足以导致HPA活性发生重大改变。
