Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
The Open University, Milton Keynes, UK.
World J Biol Psychiatry. 2022 Oct;23(8):582-600. doi: 10.1080/15622975.2021.2015432. Epub 2022 Jan 19.
Growth factors are signalling molecules that play roles in the survival, proliferation, migration, and differentiation of cells. Studies have found alterations in specific growth factors in anorexia nervosa (AN).
This systematic review and meta-analysis examined articles from three databases, measuring growth factors in AN cross-sectionally and longitudinally, and in recovered AN (rec-AN) cross-sectionally. Random-effects meta-analyses were conducted for brain-derived neurotrophic factor (BDNF) and insulin growth factor-I (IGF-1) for cross-sectional and longitudinal studies.
A total of 82 studies were included: 56 cross-sectional (BDNF: = 15; IGF-1: = 41) and 24 longitudinal (BDNF: = 5; IGF-1: = 19) were meta-analysed and 20 studies were narratively synthesised. In cross-sectional analyses, BDNF and IGF-1 were lower in AN compared to controls, and BDNF was marginally greater in rec-AN compared to controls. In longitudinal meta-analyses, BDNF and IGF-1 increased from baseline to follow-up. Cross-sectional subgroup analyses revealed no differences in BDNF between controls and AN binge-eating/purging subtypes.
It is likely that the low BDNF and IGF-1 levels found in AN are consequences of starvation, which are reversible with weight restoration. The increase in BDNF and IGF-1 during therapeutic weight restoration might improve neuroplasticity, which is the basis of learning, and thus psychotherapeutic success.
生长因子是一类信号分子，在细胞的存活、增殖、迁移和分化中发挥作用。研究发现神经性厌食症（AN）中存在特定生长因子的改变。
本系统评价和荟萃分析检查了来自三个数据库的文章，这些文章分别从横断面和纵向研究了 AN 中生长因子的变化，以及恢复性 AN（rec-AN）的横断面研究。对横断面和纵向研究中的脑源性神经营养因子（BDNF）和胰岛素样生长因子-1（IGF-1）进行了随机效应荟萃分析。
共纳入 82 项研究：56 项横断面研究（BDNF： = 15；IGF-1： = 41）和 24 项纵向研究（BDNF： = 5；IGF-1： = 19）进行荟萃分析，20 项研究进行了叙述性综合。在横断面分析中，与对照组相比，AN 中的 BDNF 和 IGF-1 水平较低，而与对照组相比，rec-AN 中的 BDNF 水平略高。在纵向荟萃分析中，BDNF 和 IGF-1 从基线到随访均增加。横断面亚组分析显示，BDNF 在对照组和 AN 暴食/清除亚型之间无差异。
AN 中发现的低 BDNF 和 IGF-1 水平可能是饥饿的后果，随着体重恢复，这些水平是可逆的。在治疗性体重恢复期间 BDNF 和 IGF-1 的增加可能会改善神经可塑性，这是学习的基础，从而提高心理治疗的成功率。
