J Clin Invest:研究揭示下丘脑的葡萄糖反应性钝化可能与神经性厌食症的病理生理学有关

2021-05-08 MedSci原创 MedSci原创

神经性厌食症(AN)患者对自我饥饿的耐受性增强,研究假设下丘脑对能量和葡萄糖平衡的调节功能失调。为验证此假设,研究人员进行了一项单盲、随机、病例对照的交叉研究,探究下丘脑对葡萄糖代谢的反应性是否在AN

神经性厌食症(AN)患者对自我饥饿的耐受性增强,研究假设下丘脑对能量和葡萄糖平衡的调节功能失调。为验证此假设,研究人员进行了一项单盲、随机、病例对照的交叉研究,探究下丘脑对葡萄糖代谢的反应性是否在AN中受损,研究结果已发表于J Clin Invest。

研究共安入了24名AN患者、28名正常体重者和24名肥胖者,接受2次MRI检查。使用葡萄糖和水的胃内灌注来绕过食物摄入的头部阶段。使用高分辨率MRI研究了下丘脑的反应性以及下丘脑与奖励相关脑区的串扰。

 

结果显示,正常体重的对照组参与者显示出预期的葡萄糖诱导的下丘脑激活的失活,而AN患者和肥胖症者显示出下丘脑反应性的减弱。此外,AN患者的阿肯色核和杏仁核的反应钝化。与正常体重的参与者和有肥胖症的对照参与者相比,AN患者在输水期间未能显示出下丘脑和奖励相关脑区之间相对于葡萄糖输注的功能连接。最后,AN患者在能量负平衡时显示出典型的外周食欲激素的基线水平。

综上所述,这些结果表明,下丘脑的葡萄糖反应性钝化可能与AN的病理生理学有关。这项研究为未来的研究提供了启示,因为它是对该疾病的传统的原发性非同质性理解的一个延伸视角。

 

原始出处:

 

Joe J Simon, et al., Neuroimaging of hypothalamic mechanisms related to glucose metabolism in anorexia nervosa and obesity. J Clin Invest. 2020 Aug 3;130(8):4094-4103. doi: 10.1172/JCI136782.

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