University of California, San Diego, Eating Disorders Center for Treatment and Research, Department of Psychiatry, United States.
University of California, San Diego, Eating Disorders Center for Treatment and Research, Department of Psychiatry, United States.
Mol Cell Endocrinol. 2019 Nov 1;497:110320. doi: 10.1016/j.mce.2018.10.018. Epub 2018 Nov 2.
The pathophysiology of anorexia nervosa (AN) and bulimia nervosa (BN) are still poorly understood, but psychobiological models have proposed a key role for disturbances in the neuroendocrines that signal hunger and satiety and maintain energy homeostasis. Mounting evidence suggests that many neuroendocrines involved in the regulation of homeostasis and body weight also play integral roles in food reward valuation and learning via their interactions with the mesolimbic dopamine system. Neuroimaging data have associated altered brain reward responses in this system with the dietary restriction and binge eating and purging characteristic of AN and BN. Thus, neuroendocrine dysfunction may contribute to or perpetuate eating disorder symptoms via effects on reward circuitry. This narrative review focuses on reward-related neuroendocrines that are altered in eating disorder populations, including peptide YY, insulin, stress and gonadal hormones, and orexins. We provide an overview of the animal and human literature implicating these neuroendocrines in dopaminergic reward processes and discuss their potential relevance to eating disorder symptomatology and treatment.
神经性厌食症（AN）和神经性贪食症（BN）的病理生理学仍未被充分理解，但心理生物学模型提出，饥饿和饱腹感信号的神经内分泌紊乱以及维持能量平衡起着关键作用。越来越多的证据表明，许多参与调节体内平衡和体重的神经内分泌激素，通过与中脑边缘多巴胺系统的相互作用，在食物奖励评估和学习中也起着重要作用。神经影像学数据表明，该系统中大脑奖励反应的改变与 AN 和 BN 中饮食限制、暴食和催吐的特征有关。因此，神经内分泌功能障碍可能通过对奖励回路的影响导致或持续存在饮食失调症状。本综述重点介绍了在饮食失调人群中发生改变的与奖励相关的神经内分泌激素，包括肽 YY、胰岛素、应激和性腺激素以及食欲素。我们概述了动物和人类文献中这些神经内分泌激素在多巴胺奖励过程中的作用，并讨论了它们与饮食失调症状和治疗的潜在相关性。
