Anorexia nervosa depends on adrenal sympathetic hyperactivity: opposite neuroautonomic profile of hyperinsulinism syndrome
Fuad Lechin1,2, Bertha van der Dijs1,2, Betty Pardey-Maldonado1, Jairo E Rivera1, Scarlet Baez1, Marcel E Lechin31Department of Pathophysiology, Sections of Neuroendocrinology, Neuropharmacology, and Neurochemistry, Instituto de Medicina Experimental, Faculty of Medicine, Universidad Central de Vene...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2010-09-01
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| Series: | Diabetes, Metabolic Syndrome and Obesity |
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| Online Access: | https://www.dovepress.com/anorexia-nervosa-depends-on-adrenal-sympathetic-hyperactivity-opposite-peer-reviewed-article-DMSO |
| _version_ | 1797936436911013888 |
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| author | Lechin F |
| author_facet | Lechin F |
| author_sort | Lechin F |
| collection | DOAJ |
| description | Fuad Lechin1,2, Bertha van der Dijs1,2, Betty Pardey-Maldonado1, Jairo E Rivera1, Scarlet Baez1, Marcel E Lechin31Department of Pathophysiology, Sections of Neuroendocrinology, Neuropharmacology, and Neurochemistry, Instituto de Medicina Experimental, Faculty of Medicine, Universidad Central de Venezuela, Caracas; 2Instituto de Vias Digestivas Caracas, Centro Clínico Profesional, Caracas, Venezuela; 3Department of Internal Medicine, Texas A and M Health Science Center, College of Medicine, Texas, USAObjective: The aim of our study was to determine the central and peripheral autonomic nervous system profiles underlying anorexia nervosa (AN) syndrome, given that affected patients present with the opposite clinical profile to that seen in the hyperinsulinism syndrome.Design: We measured blood pressure and heart rate, as well as circulating neurotransmitters (noradrenaline, adrenaline, dopamine, plasma serotonin, and platelet serotonin), using high-performance liquid chromatography with electrochemical detection, during supine resting, one minute of orthostasis, and after five minutes of exercise. In total, 22 AN patients (12 binge-eating/purging type and 10 restricting type) and age-, gender-, and race-matched controls (70 ± 10.1% versus 98 ± 3.0% of ideal body weight) were recruited.Results: We found that patients with AN had adrenal sympathetic overactivity and neural sympathetic underactivity, demonstrated by a predominance of circulating adrenaline over noradrenaline levels, not only during the supine resting state (52 ± 2 versus 29 ± 1 pg/mL) but also during orthostasis (67 ± 3 versus 32 ± 2 pg/mL, P < 0.05) and after exercise challenge (84 ± 4 versus 30 ± 3 pg/mL, P < 0.01).Conclusion: Considering that this peripheral autonomic nervous system disorder depends on the absolute predominance of adrenomedullary C1 adrenergic nuclei over A5 noradrenergic pontine nucleus, let us ratify the abovementioned findings. The AN syndrome depends on the predominance of overwhelming adrenal sympathetic activity over neural sympathetic activity. This combined central and autonomic nervous system profile contrasts with that registered in patients affected by hyperinsulinism, hypoglycemia, and bulimia syndrome which depends on the absolute predominance of neural sympathetic activity.Keywords: anorexia nervosa, adrenal sympathetic activity, adrenaline, noradrenaline, eating disorders |
| first_indexed | 2024-04-10T18:30:45Z |
| format | Article |
| id | doaj.art-301252a4fcca4653a6c7c673ddb63955 |
| institution | Directory Open Access Journal |
| issn | 1178-7007 |
| language | English |
| last_indexed | 2024-04-10T18:30:45Z |
| publishDate | 2010-09-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Diabetes, Metabolic Syndrome and Obesity |
| spelling | doaj.art-301252a4fcca4653a6c7c673ddb639552023-02-02T04:14:22ZengDove Medical PressDiabetes, Metabolic Syndrome and Obesity1178-70072010-09-01Volume 33113175243Anorexia nervosa depends on adrenal sympathetic hyperactivity: opposite neuroautonomic profile of hyperinsulinism syndromeLechin FFuad Lechin1,2, Bertha van der Dijs1,2, Betty Pardey-Maldonado1, Jairo E Rivera1, Scarlet Baez1, Marcel E Lechin31Department of Pathophysiology, Sections of Neuroendocrinology, Neuropharmacology, and Neurochemistry, Instituto de Medicina Experimental, Faculty of Medicine, Universidad Central de Venezuela, Caracas; 2Instituto de Vias Digestivas Caracas, Centro Clínico Profesional, Caracas, Venezuela; 3Department of Internal Medicine, Texas A and M Health Science Center, College of Medicine, Texas, USAObjective: The aim of our study was to determine the central and peripheral autonomic nervous system profiles underlying anorexia nervosa (AN) syndrome, given that affected patients present with the opposite clinical profile to that seen in the hyperinsulinism syndrome.Design: We measured blood pressure and heart rate, as well as circulating neurotransmitters (noradrenaline, adrenaline, dopamine, plasma serotonin, and platelet serotonin), using high-performance liquid chromatography with electrochemical detection, during supine resting, one minute of orthostasis, and after five minutes of exercise. In total, 22 AN patients (12 binge-eating/purging type and 10 restricting type) and age-, gender-, and race-matched controls (70 ± 10.1% versus 98 ± 3.0% of ideal body weight) were recruited.Results: We found that patients with AN had adrenal sympathetic overactivity and neural sympathetic underactivity, demonstrated by a predominance of circulating adrenaline over noradrenaline levels, not only during the supine resting state (52 ± 2 versus 29 ± 1 pg/mL) but also during orthostasis (67 ± 3 versus 32 ± 2 pg/mL, P < 0.05) and after exercise challenge (84 ± 4 versus 30 ± 3 pg/mL, P < 0.01).Conclusion: Considering that this peripheral autonomic nervous system disorder depends on the absolute predominance of adrenomedullary C1 adrenergic nuclei over A5 noradrenergic pontine nucleus, let us ratify the abovementioned findings. The AN syndrome depends on the predominance of overwhelming adrenal sympathetic activity over neural sympathetic activity. This combined central and autonomic nervous system profile contrasts with that registered in patients affected by hyperinsulinism, hypoglycemia, and bulimia syndrome which depends on the absolute predominance of neural sympathetic activity.Keywords: anorexia nervosa, adrenal sympathetic activity, adrenaline, noradrenaline, eating disordershttps://www.dovepress.com/anorexia-nervosa-depends-on-adrenal-sympathetic-hyperactivity-opposite-peer-reviewed-article-DMSOAnorexia nervosaAdrenal sympathetic activityAdrenalineNoradrenalineEating disorders |
| spellingShingle | Lechin F Anorexia nervosa depends on adrenal sympathetic hyperactivity: opposite neuroautonomic profile of hyperinsulinism syndrome Diabetes, Metabolic Syndrome and Obesity Anorexia nervosa Adrenal sympathetic activity Adrenaline Noradrenaline Eating disorders |
| title | Anorexia nervosa depends on adrenal sympathetic hyperactivity: opposite neuroautonomic profile of hyperinsulinism syndrome |
| title_full | Anorexia nervosa depends on adrenal sympathetic hyperactivity: opposite neuroautonomic profile of hyperinsulinism syndrome |
| title_fullStr | Anorexia nervosa depends on adrenal sympathetic hyperactivity: opposite neuroautonomic profile of hyperinsulinism syndrome |
| title_full_unstemmed | Anorexia nervosa depends on adrenal sympathetic hyperactivity: opposite neuroautonomic profile of hyperinsulinism syndrome |
| title_short | Anorexia nervosa depends on adrenal sympathetic hyperactivity: opposite neuroautonomic profile of hyperinsulinism syndrome |
| title_sort | anorexia nervosa depends on adrenal sympathetic hyperactivity opposite neuroautonomic profile of hyperinsulinism syndrome |
| topic | Anorexia nervosa Adrenal sympathetic activity Adrenaline Noradrenaline Eating disorders |
| url | https://www.dovepress.com/anorexia-nervosa-depends-on-adrenal-sympathetic-hyperactivity-opposite-peer-reviewed-article-DMSO |
| work_keys_str_mv | AT lechinf anorexianervosadependsonadrenalsympathetichyperactivityoppositeneuroautonomicprofileofhyperinsulinismsyndrome |