Kiyohara K, Tamai H, Karibe C, Kobayashi N, Fujii S, Fukino O, Nakagawa T, Kumagai L F, Nagataki S
Psychoneuroendocrinology. 1987;12(1):21-8. doi: 10.1016/0306-4530(87)90018-7.
Serum thyrotropin (TSH) responses to thyrotropin-releasing hormone (TRH) were studied in 47 women with anorexia nervosa (AN) (group I) and in 11 bulimic patients of normal weight (group II). In group I, TSH responses were low in nine patients, delayed in 32 and normal in six. Patients with a normal TSH response had a lesser degree of anorexia than those with a delayed TSH response. Bulimia and vomiting were more frequently observed in the low response group. The maximum increase in TSH concentrations following TRH administration in the group I patients with vomiting (4.0 +/- 0.90 microU/ml, mean +/- S.E.) was significantly lower than that in the group I patients without vomiting or in normal controls (11.2 +/- 0.82 microU/ml and 11.1 +/- 2.34 microU/ml, respectively). Twenty-five patients with abnormal TSH responses in group I were retested after weight gain. Initially, TSH responses were low in six and delayed in 19. Following weight recovery, responses continued to be abnormal in five of the six and in eight of the 19, respectively. The symptoms of eating disorders continued in all patients with abnormal TSH responses even after weight recovery, whereas patients with normal responses after weight gain recovered from all symptoms. Of 11 patients in group II, six had abnormal TSH responses to TRH; the responses were delayed in four and low in two. Patients with normal responses had a lesser degree of eating disorder, compared with abnormal responders. These observations suggest that abnormal TSH responses in patients with AN were not necessarily due to weight loss alone; rather, they may be related to the eating disorder itself.
对47名神经性厌食症（AN）女性患者（第一组）和11名体重正常的贪食症患者（第二组）进行了血清促甲状腺激素（TSH）对促甲状腺激素释放激素（TRH）反应的研究。在第一组中，9名患者的TSH反应低，32名患者的反应延迟，6名患者的反应正常。TSH反应正常的患者厌食程度低于TSH反应延迟的患者。低反应组中更频繁地观察到贪食和呕吐现象。第一组有呕吐症状的患者在注射TRH后TSH浓度的最大增幅（4.0±0.90微单位/毫升，均值±标准误）显著低于第一组无呕吐症状的患者或正常对照组（分别为11.2±0.82微单位/毫升和11.1±2.34微单位/毫升）。第一组中25名TSH反应异常的患者在体重增加后重新进行了检测。最初，6名患者的TSH反应低，19名患者的反应延迟。体重恢复后，这6名患者中有5名、19名患者中有8名的反应仍异常。即使体重恢复后，所有TSH反应异常的患者饮食失调症状仍持续存在，而体重增加后反应正常的患者所有症状均已恢复。在第二组的11名患者中，6名对TRH的TSH反应异常；4名患者的反应延迟，2名患者的反应低。与反应异常的患者相比，反应正常的患者饮食失调程度较轻。这些观察结果表明，AN患者TSH反应异常不一定仅归因于体重减轻；相反，它们可能与饮食失调本身有关。
