Fukata S, Tamai H, Takaichi Y, Mori K, Matsubayashi S, Nakagawa T
Department of Psychosomatic Medicine, Faculty of Medicine, Kyushu University, Fukuoka.
Jpn J Psychiatry Neurol. 1988 Mar;42(1):59-64. doi: 10.1111/j.1440-1819.1988.tb01956.x.
A one-mg oral overnight dexamethasone suppression test (DST) was conducted on 22 inpatients with eating disorders. To confirm that the dexamethasone tablets had been ingested, we measured the plasma concentrations of dexamethasone the next morning (at 0900 hr after DST). The diagnosis of anorexia nervosa and bulimia was made according to the criteria for DSM-III, respectively. Of the 22 patients with eating disorders, 16 satisfied the criteria for anorexia nervosa and 6 for bulimia. The DST was carried out within 2 weeks of hospitalization on each patient. The subjects were given 1 mg of dexamethasone in the evening (at 2300 hr) and blood samples were collected the following day (at 0900, 1600 and 2100 hr, respectively). The plasma cortisol and dexamethasone levels were concurrently determined by RIA. The criterion for non-suppression was a failure to suppress the plasma cortisol levels below 5.0 micrograms/dl in any one of the three samples. All but one patient with bulimia had ingested the dexamethasone. Thirteen (62%) of 21 patients with eating disorders were nonsuppressors. We found a significant positive correlation between the plasma cortisol levels at 1600 hr or 2100 hr and a decrease in ideal body weight (n = 16, r = 0.613, p less than 0.05; r = 0.75, p less than 0.01, respectively) and a significant inverse relationship between the plasma dexamethasone levels at 0900 hr and the plasma cortisol levels at 1600 hr was recognized (n = 21, r = 0.631, p less than 0.01). These results suggest that the blood dexamethasone levels as well as body weight might contribute to the abnormalities of DST seen in patients with eating disorders.
对22名进食障碍住院患者进行了1毫克口服过夜地塞米松抑制试验（DST）。为确认地塞米松片已被摄入，我们于次日早晨（DST后09:00）测量了地塞米松的血浆浓度。神经性厌食症和贪食症的诊断分别依据《精神疾病诊断与统计手册》第三版（DSM-III）的标准进行。在这22名进食障碍患者中，16名符合神经性厌食症标准，6名符合贪食症标准。每位患者均在住院2周内进行了DST。研究对象于晚上（23:00）服用1毫克地塞米松，并于次日（分别在09:00、16:00和21:00）采集血样。通过放射免疫分析法同时测定血浆皮质醇和地塞米松水平。非抑制标准为三个样本中的任何一个未能将血浆皮质醇水平抑制至5.0微克/分升以下。除一名贪食症患者外，其他患者均已摄入地塞米松。21名进食障碍患者中有13名（62%）为非抑制者。我们发现，16:00或21:00时的血浆皮质醇水平与理想体重下降之间存在显著正相关（n = 16，r = 0.613，p < 0.05；r = 0.75，p < 0.01），且09:00时的血浆地塞米松水平与16:00时的血浆皮质醇水平之间存在显著负相关（n = 21，r = 0.631，p < 0.01）。这些结果表明，血液地塞米松水平以及体重可能与进食障碍患者中出现的DST异常有关。
