Strömbom U, Krotkiewski M, Blennow K, Månsson J E, Ekman R, Björntorp P
Department of Pharmacology, Sahlgren's Hospital, Göteborg, Sweden.
Int J Obes Relat Metab Disord. 1996 Apr;20(4):361-8.
Several studies suggest neuroendocrine abnormalities in, particularly, abdominal, central obesity in humans, a condition with high morbidity and mortality. Therefore the concentrations of neuropeptides and catecholamines in cerebrospinal fluid (CSF) were analysed in 48 obese women, subdivided into groups with central, abdominal and gluteo-femoral distribution of body fat, utilising the waist-to-hip circumference ratio (WHR) for division.
In comparisons with non-obese control women concentration of 5-hydroxyindol acetic acid (5-HIAA), methoxyhydroxyphenylglycol (MHPG), corticotropin releasing hormone (CRH), beta-endorphins (END) and neuropeptide Y (NPY) were lower, while homovanillic acid (HVA) was not different in obese women, HIAA, HVA and END correlated negatively with the WHR only in abdominally obese women, suggesting a threshold effect. HIAA vs HVA as well as CRF vs END correlated strongly in the total and both subgroups. An interrelationship between all these four substances was found in abdominal but not in gluteo-femoral obesity, suggesting a tighter functional coupling in the former group. Several correlations were found between CSF substance levels and appetite registrations, including END vs voracious eating, and for carbohydrate craving vs HIAA and vs HVA (negatively). This was also found only in abdominally obese women.
Although the concentrations of monoamine metabolites and neuropeptides in the CSF sampled at the level of the lumber spine might not be representative for those at regulatory centers in the brain, the findings suggest that low 5-HIAA is characteristic of human obesity, and coupled to CRH as well as eating abnormalities, particularly in abdominal obesity. Since CRH is regulating the balance between the autonomic nervous systems, insulin secretion and thermogenesis in animals, corresponding anomalies in abdominal obesity in humans may have a central origin.
多项研究表明，尤其是腹部、中心性肥胖的人群存在神经内分泌异常，这种情况具有较高的发病率和死亡率。因此，对48名肥胖女性的脑脊液（CSF）中的神经肽和儿茶酚胺浓度进行了分析，这些女性根据腰臀围比（WHR）分为身体脂肪呈中心性、腹部性和臀股部分布的几组。
与非肥胖对照女性相比，肥胖女性脑脊液中5-羟吲哚乙酸（5-HIAA）、甲氧基羟基苯乙二醇（MHPG）、促肾上腺皮质激素释放激素（CRH）、β-内啡肽（END）和神经肽Y（NPY）的浓度较低，而高香草酸（HVA）无差异。仅在腹部肥胖女性中，HIAA、HVA和END与WHR呈负相关，提示存在阈值效应。在总体人群和两个亚组中，HIAA与HVA以及CRF与END之间均存在强相关性。在腹部肥胖而非臀股部肥胖中发现了这四种物质之间的相互关系，提示前一组存在更紧密的功能耦合。脑脊液物质水平与食欲记录之间存在多种相关性，包括END与贪吃，以及对碳水化合物的渴望与HIAA和HVA（呈负相关）。这也仅在腹部肥胖女性中发现。
尽管在腰椎水平采集的脑脊液中，单胺代谢产物和神经肽的浓度可能不代表大脑调节中心的浓度，但研究结果表明，低5-HIAA是人类肥胖的特征，并且与CRH以及饮食异常有关，尤其是在腹部肥胖中。由于CRH在动物中调节自主神经系统、胰岛素分泌和产热之间的平衡，人类腹部肥胖中的相应异常可能起源于中枢。
