Department of Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Psychoneuroendocrinology. 2020 Aug;118:104713. doi: 10.1016/j.psyneuen.2020.104713. Epub 2020 May 19.
In this study, we evaluated the changes in leptin and ghrelin concentrations, eating behavior, depression, and impulsivity and their correlations within the luteal phase among women with premenstrual dysphoric disorder (PMDD).
In 63 women with PMDD and 53 healthy controls, we prospectively evaluated serum levels of leptin and ghrelin, Body Mass Index(BMI), and self-reported sweet cravings, cognitive restraint, uncontrolled eating, emotional eating, depression, and impulsivity during the early luteal (EL) and late luteal (LL) phases.
Compared with the controls, the women with PMDD had higher BMI, higher leptin concentrations in the EL and LL phase, and leptin concentrations increased from the EL to the LL phase. However, there is no significant difference in ghrelin. Women with PMDD increased sweet cravings and uncontrolled eating from EL to LL phase. No significant correlation was observed between the EL-LL changes in leptin or ghrelin concentrations and those in eating behaviors. Both depression and impulsivity correlated with sweet craving and uncontrolled eating. Depression mediated the association between PMDD and uncontrolled eating. The BMI of women with PMDD positively correlated with their EL-LL change in leptin, and LL depression levels and emotional eating.
Young women with PMDD had higher leptin concentrations and BMI in the luteal phase. The LL leptin level was not the primary factor responsible for the increased uncontrolled eating of PMDD. Whether the increased eating and depression in the LL phase contribute to the risk of obesity or hyperleptinemia among women with PMDD need to be evaluated in the future.
本研究旨在评估经前期烦躁障碍(PMDD)患者黄体期瘦素和胃饥饿素浓度、摄食行为、抑郁和冲动的变化及其相关性。
在 63 名 PMDD 患者和 53 名健康对照者中,前瞻性评估了血清瘦素和胃饥饿素水平、体重指数(BMI),以及在黄体早期(EL)和黄体晚期(LL)期间自我报告的甜食偏好、认知控制、无法控制的进食、情绪性进食、抑郁和冲动。
与对照组相比,PMDD 患者 BMI 较高,EL 和 LL 期瘦素浓度较高,且从 EL 期到 LL 期瘦素浓度增加。然而,胃饥饿素没有显著差异。PMDD 患者从 EL 期到 LL 期甜食偏好和无法控制的进食增加。EL-LL 期瘦素或胃饥饿素浓度的变化与摄食行为之间无显著相关性。抑郁和冲动均与甜食偏好和无法控制的进食相关。抑郁介导了 PMDD 与无法控制的进食之间的关联。PMDD 患者的 BMI 与 EL-LL 期瘦素、LL 期抑郁水平和情绪性进食呈正相关。
年轻的 PMDD 患者黄体期瘦素浓度和 BMI 较高。LL 期瘦素水平不是 PMDD 患者无法控制进食增加的主要因素。未来需要评估 LL 期进食增加和抑郁是否会增加 PMDD 患者肥胖或高瘦素血症的风险。