Elegido Ana, Gheorghe Alina, Sepúlveda Ana R, Andrés Patricia, Díaz-Prieto Ligia E, Graell Montserrat, Marcos Ascensión, Nova Esther
Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN) - CSIC, C/José Antonio Novais 10, 28040 Madrid, Spain.
Faculty of Psychology, Autonomous University of Madrid, C/ Ivan Pavlov n°6, 28049 Madrid, Spain.
Endocrinol Diabetes Nutr (Engl Ed). 2019 Nov;66(9):571-578. doi: 10.1016/j.endinu.2019.02.003. Epub 2019 Apr 11.
Psychological and neuroendocrine alterations are typical characteristics in anorexia nervosa patients. The role of adipokines and cytokines as mediators of body systems' adaptations to the patients' abnormal eating behavior is not well understood. The duration of disease seems to be a determinant of nutritional status and associated hormone changes. We aimed to assess whether alterations in adipokines, cytokines and cortisol do already exist in patients with a recent disease onset by means of a case-control study.
Forty-one adolescent female patients on their first-episode and diagnosed with anorexia nervosa, were matched by age and socioeconomic status (SES) (1:1) with healthy girls. Leptin, soluble leptin receptor (sOB-R), adiponectin, cortisol, and the cytokines IL-1β, IL-2, IL-6 and TNF-α were examined.
The results showed reduced leptin and increased sOB-R and cortisol levels in AN patients. Adiponectin was also increased but opposite to the previous biomarkers did not correlate with BMI Z-score. Serum TNF-α and IL-2 showed significantly lower and higher values, respectively, in the AN patients than in the controls. Cortisol showed the strongest correlation with sOB-R (r=0.436; P=0.005).
Our study confirms previous findings on adipokine and cortisol alterations in AN patients, while overall cytokine results did not show a clear disruption in AN patients with short disease duration. The results highlight the need to disentangle the role of the sOB-R in the interactions between leptin and cortisol secretion.
心理和神经内分泌改变是神经性厌食症患者的典型特征。脂肪因子和细胞因子作为身体系统适应患者异常饮食行为的介质，其作用尚未得到充分了解。疾病持续时间似乎是营养状况及相关激素变化的一个决定因素。我们旨在通过病例对照研究评估近期发病的患者是否已经存在脂肪因子、细胞因子和皮质醇的改变。
41名首次发作且被诊断为神经性厌食症的青春期女性患者，按年龄和社会经济地位（SES）（1:1）与健康女孩进行匹配。检测了瘦素、可溶性瘦素受体（sOB-R）、脂联素、皮质醇以及细胞因子IL-1β、IL-2、IL-6和TNF-α。
结果显示，神经性厌食症患者的瘦素水平降低，sOB-R和皮质醇水平升高。脂联素也升高，但与之前的生物标志物不同，它与BMI Z评分无关。与对照组相比，神经性厌食症患者血清TNF-α水平显著降低，IL-2水平显著升高。皮质醇与sOB-R的相关性最强（r=0.436；P=0.005）。
我们的研究证实了之前关于神经性厌食症患者脂肪因子和皮质醇改变的研究结果，而总体细胞因子结果显示病程较短的神经性厌食症患者并未出现明显紊乱。结果突出了需要弄清楚sOB-R在瘦素和皮质醇分泌相互作用中的作用。
