Department of Psychology, Michigan State University, East Lansing, Michigan.
Department of Psychology, University of Nevada, Las Vegas, Nevada.
Curr Opin Psychiatry. 2019 Nov;32(6):484-490. doi: 10.1097/YCO.0000000000000543.
Females experience eating disorders at substantially higher rates than males. Although sociocultural factors have traditionally been thought to underlie this sex disparity, accumulating evidence implicates differential exposure to gonadal hormones early in life. Gonadal hormones also impact within-sex variability in disordered eating, helping to explain why not all women develop an eating disorder, and some men do. We review recent findings regarding these gonadal hormone effects and their implications for the etiology of eating disorders.
Males are exposed to significantly higher testosterone levels than females perinatally, and this exposure appears to protect against later binge eating in males relative to females. Within-sex, higher estradiol levels among females and higher testosterone levels among males appear to be protective. Progesterone exhibits minimal direct phenotypic effects on disordered eating but appears to counteract the protective effects of estrogen in adult females. Importantly, gonadal hormone effects may be moderated by psychosocial factors.
Evidence suggests that gonadal hormones play a critical role in the etiology of disordered eating. Overall, higher testosterone and estrogen appear to be protective across development. Additional research is needed to identify mechanisms underlying these effects and further explore interactions between hormonal and psychosocial risk.
目的综述:女性患饮食失调症的比例远高于男性。尽管传统上认为社会文化因素是造成这种性别差异的原因,但越来越多的证据表明,性腺激素在生命早期的差异暴露是导致这种差异的原因。性腺激素也会影响性别内饮食失调的可变性,这有助于解释为什么并非所有女性都会患上饮食失调症,而有些男性却会。我们回顾了最近关于这些性腺激素影响及其对饮食失调症病因学的影响的研究结果。
最新发现:男性在围产期暴露于比女性高得多的睾丸激素水平,这种暴露似乎可以预防男性日后暴饮暴食,而女性则不然。在同一性别中,女性的雌二醇水平较高,男性的睾丸激素水平较高,似乎具有保护作用。孕激素对饮食失调症的直接表型影响较小,但似乎可以抵消成年女性雌激素的保护作用。重要的是,性腺激素的作用可能受到心理社会因素的调节。
总结:有证据表明,性腺激素在饮食失调症的发病机制中起着关键作用。总的来说,睾丸激素和雌激素水平较高在整个发育过程中似乎都有保护作用。需要进一步的研究来确定这些影响的机制,并进一步探讨激素和心理社会风险之间的相互作用。