Golden N H, Shenker I R
Eating Disorders Center, Schneider Children's Hospital, Long Island Jewish Medical Center, New Hyde Park, New York.
Int J Eat Disord. 1994 Jul;16(1):53-60. doi: 10.1002/1098-108x(199407)16:1<53::aid-eat2260160105>3.0.co;2-v.
Amenorrhea is one of the cardinal features of anorexia nervosa and is associated with hypothalamic dysfunction. Earlier theories of weight loss, decreased body fat, or exercise do not fully explain the etiology of amenorrhea in anorexia nervosa. Disturbances in central dopaminergic and opioid activity have been described in anorexia nervosa and both these substances are known to modulate gonadotropin-releasing hormone (GnRH)-mediated luteinizing hormone (LH) release. Serum LH, follicle-stimulating hormone (FSH), estradiol, and prolactin levels were measured at baseline and after administration of metoclopramide (a central D-2 dopamine receptor blocker) in 10 newly diagnosed women with anorexia nervosa and in 10 healthy age-matched controls. Basal prolactin levels and the prolactin response to metoclopramide were significantly impaired in the group with anorexia nervosa. Metoclopramide did not induce a significant rise in LH levels in either the anorexic or the control groups. Neurotransmitter abnormalities may influence hypothalamic dysfunction in anorexia nervosa but the exact mechanism remains to be determined.
闭经是神经性厌食症的主要特征之一，与下丘脑功能障碍有关。早期关于体重减轻、体脂减少或运动的理论并不能完全解释神经性厌食症闭经的病因。在神经性厌食症中已发现中枢多巴胺能和阿片样物质活性紊乱，且已知这两种物质均可调节促性腺激素释放激素（GnRH）介导的黄体生成素（LH）释放。对10名新诊断的神经性厌食症女性患者和10名年龄匹配的健康对照者在基线时以及给予甲氧氯普胺（一种中枢D-2多巴胺受体阻滞剂）后测定血清LH、促卵泡生成素（FSH）、雌二醇和催乳素水平。神经性厌食症组的基础催乳素水平及催乳素对甲氧氯普胺的反应明显受损。甲氧氯普胺在厌食症组或对照组中均未引起LH水平显著升高。神经递质异常可能影响神经性厌食症中的下丘脑功能障碍，但确切机制仍有待确定。
