Hebebrand J, Remschmidt H
Department of Child and Adolescent Psychiatry, Philipp's University Marburg, Germany.
Hum Genet. 1995 Jan;95(1):1-11. doi: 10.1007/BF00225065.
In anorexia nervosa, psychopathological features and reduced body weight are inseparable, suggesting a prominent role of behavioral factors in achievement and maintenance of extreme underweight. Due to the considerably higher prevalence of this eating disorder in females, anorexia nervosa contributes to the left end of the distribution of the body mass index, especially in the female sex. By reviewing the relevant literature we examined whether genetic research in anorexia nervosa can profit from considering this disorder as an extreme weight condition. For this purpose we compared genetic studies pertaining to both anorexia nervosa and the heritability of the body mass index. Whereas previous genetic studies in anorexia nervosa have mostly concentrated on the assessment of the familial psychopathology, further studies are warranted that additionally attempt to analyze the complex phenotype body weight in relatives of affected probands. Further insight into pathogenetic mechanisms underlying anorexia nervosa might be gained by contrasting the epidemiological, psychopathological and prognostic factors with those in severe obesity. Thus, epidemiological studies suggest that females are more likely to develop both extreme underweight and extreme obesity. A possible explanation for this phenomenon is that the, on average, higher percentage of total body weight composed of fat mass might predispose females towards the development of both extreme weight conditions.
在神经性厌食症中，精神病理学特征与体重减轻密不可分，这表明行为因素在实现和维持极低体重方面起着重要作用。由于这种饮食失调在女性中的患病率显著更高，神经性厌食症导致体重指数分布的左端出现异常，尤其是在女性群体中。通过回顾相关文献，我们探讨了将神经性厌食症视为一种极端体重状况是否有助于该疾病的基因研究。为此，我们比较了有关神经性厌食症和体重指数遗传度的基因研究。以往关于神经性厌食症的基因研究大多集中在家族性精神病理学评估上，因此有必要进一步开展研究，尝试额外分析患病先证者亲属的复杂表型体重。通过对比神经性厌食症与重度肥胖症的流行病学、精神病理学和预后因素，或许能够更深入地了解神经性厌食症的发病机制。因此，流行病学研究表明，女性更有可能同时出现极低体重和极度肥胖。对此现象的一种可能解释是，平均而言，女性体内脂肪量占总体重的百分比更高，这可能使她们更容易患上这两种极端体重状况。
