Walsh B T, Katz J L, Levin J, Kream J, Fukushima D K, Hellman L D, Weiner H, Zumoff B
Psychosom Med. 1978 Oct;40(6):499-506. doi: 10.1097/00006842-197810000-00005.
Adrenocortical activity was studied in 19 emaciated women with anorexia nervosa. Relative to body size the patients' mean cortisol production rates of 0.591 mg/kg/day and 16.4 mg m2/day were significantly elevated compared to those of 0.322 mg/kg/day and 11.4 mg/m2/day for age and sex matched normal controls (p less than 0.001 and 0.02, respectively). The 24-hr mean plasma cortisol concentration in 18 patients was 10.6 microgram/dl and was significantly higher than that of the controls (6.8 microgram/dl, p less than 0.001). The average excretion of urinary free cortisol in nine patients was 205 microgram/day, significantly greater than that of 65 microgram/day in the controls (less than 0.01). Three patients underwent overnight suppression with 1 mg of dexamethasone and had inadequate responses. These data suggest that cortisol production is excessive in emaciated patients with anorexia nervosa due to a disturbance of the hypothalamic-pituitary mechanisms regulating adrenocortical function. The excessive adrenal activity may reflect certain psychobiological disturbances as well as the effects of malnutrition.
对19名患有神经性厌食症的消瘦女性的肾上腺皮质活动进行了研究。相对于体型而言，患者的平均皮质醇产生率为0.591毫克/千克/天和16.4毫克/平方米/天，与年龄和性别匹配的正常对照组的0.322毫克/千克/天和11.4毫克/平方米/天相比显著升高（分别为p<0.001和0.02）。18名患者的24小时平均血浆皮质醇浓度为10.6微克/分升，显著高于对照组（6.8微克/分升，p<0.001）。9名患者的尿游离皮质醇平均排泄量为205微克/天，显著高于对照组的65微克/天（p<0.01）。3名患者接受了1毫克地塞米松的过夜抑制试验，反应不足。这些数据表明，由于调节肾上腺皮质功能的下丘脑-垂体机制紊乱，患有神经性厌食症的消瘦患者的皮质醇产生过多。肾上腺活动过度可能反映了某些心理生物学紊乱以及营养不良的影响。
