Waldhauser F, Toifl K, Spona J, Zeitlhuber U, Waldhauser M, Frisch H
J Clin Endocrinol Metab. 1984 Sep;59(3):538-41. doi: 10.1210/jcem-59-3-538.
Although patients with anorexia nervosa (AN) have a variety of endocrine disturbances, it generally is believed that the PRL response to stimulation is not altered in this disorder. We measured basal serum PRL values and serum PRL values after stimulation either with TRH (200 micrograms/m2) or with insulin (4 IU/m2) in 27 women with AN and 9 normal women. Basal values in anorexic women and normal women did not differ significantly, whereas all stimulation variables (mean PRL stimulation values, maximum PRL values, sum of increments, and area under the stimulation curve) were significantly lower in AN patients than in normal women. Furthermore, after TRH stimulation most of these variables correlated positively with the percentage of ideal body wt of the patients, indicating that the diminished PRL response was wt dependent. This diminished PRL response in the patients may accompany starvation and low estradiol values. Both conditions per se are known for their association with diminished PRL responses. Hence, no hypothesis which posits hypothalamic dopamine excess as the basic disturbance in AN seems justified. Moreover, diminished PRL responses in AN are not consistent with an assumption of hypothalamic dopamine depletion in this disorder.
尽管神经性厌食症（AN）患者存在多种内分泌紊乱，但一般认为该疾病中催乳素（PRL）对刺激的反应未发生改变。我们测量了27名患AN的女性和9名正常女性的基础血清PRL值，以及用促甲状腺激素释放激素（TRH，200微克/平方米）或胰岛素（4国际单位/平方米）刺激后的血清PRL值。厌食女性和正常女性的基础值无显著差异，而所有刺激变量（PRL刺激均值、PRL最大值、增量总和以及刺激曲线下面积）在AN患者中均显著低于正常女性。此外，TRH刺激后，这些变量中的大多数与患者理想体重百分比呈正相关，表明PRL反应减弱与体重有关。患者中PRL反应减弱可能与饥饿和低雌二醇值有关。这两种情况本身都与PRL反应减弱有关。因此，没有任何假设认为下丘脑多巴胺过多是AN的基本紊乱似乎是合理的。此外，AN中PRL反应减弱与该疾病中下丘脑多巴胺耗竭的假设不一致。
