Genes for adiponectin and resistin are candidate genes of insulin resistance and type 2 diabetes mellitus. The aim of our study was to determine the frequency of single nucleotide polymorphisms (SNP) 45T>G and 276G>T of the adiponectin gene and 62G>A and -180C>G of the resistin gene in patients with obesity (OB), anorexia nervosa (AN) and in control healthy normal-weight women (NW) and to study the influence of particular genotypes on serum concentrations of these hormones and on insulin sensitivity. Serum adiponectin, resistin, tumor necrosis factor alpha (TNF-alpha), insulin, cholesterol, glycated hemoglobin (HbA1c) and blood glucose levels were measured in 77 patients with OB, 28 with AN and 38 NW. DNA analysis was carried out by polymerase chain reaction with restriction analysis of PCR product. The presence of SNP ADP+276 G>T allele was accompanied by higher cholesterol levels in AN patients, higher adiponectin concentrations in OB patients and lower HbA1c levels in NW. SNP of the resistin gene 62G>A was associated with lower HbA1c in NW and higher cholesterol concentrations in OB group. The carriers of the minor G allele in the position -180 of the resistin gene within AN group had significantly higher BMI relative to non-carriers. We conclude that polymorphisms in adiponectin and resistin genes can contribute to metabolic phenotype of patients with obesity and anorexia nervosa., J. Křížová, M. Dolinková, Z. Lacinová, Š. Sulek, R. Doležalová, J. Housová, J. Krajíčková, D. Haluzíková, L. Bošanská, H. Papežová, M. Haluzík., and Obsahuje bibliografii a bibliografické odkazy
Peptides ghrelin, obestatin and neuropeptide Y (NPY) play an important role in regulation of energy homeostasis, the imbalance of which is associated with eating disorders anorexia (AN) and bulimia nervosa (BN). The changes in ghrelin, obestatin and NPY plasma levels were investigated in AN and BN patients after administration of a high-carbohydrate breakfast (1604 kJ). Eight AN women (aged 25.4±1.9; BMI: 15.8±0.5), thirteen BN women (aged 22.0±1.05; BMI: 20.1±0.41) and eleven healthy women (aged 25.1±1.16; BMI: 20. 9±0.40) were recruited for the study. We demonstrated increased fasting ghrelin in AN, but not in BN patients, while fasting obestatin and NPY were increased in both AN and BN patients compared to the controls. Administration of high-carbohydrate breakfast induced a similar relative decrease in ghrelin and obestatin plasma levels in all groups, while NPY remained increa sed in postprandial period in both patient groups. Ghrelin/obestatin ratio was lower in AN and BN compared to the controls. In conclusions, increased plasma levels of fasting NPY and its unchanged levels after breakfast indicate that NPY is an important marker of eating disorders AN and BN. Different fasting ghrelin and obestatin levels in AN and BN could demonstrate their diverse functions in appetite and eating suppression., D. Sedláčková ... [et al.]., and Obsahuje bibliografii a bibliografické odkazy
Anorexia nervosa (AN) is characterized by self-induced starvation leading to severe weight and fat loss. In the present study, we measured fasting plasma levels of adiponectin, leptin, resistin, insulin and glucose in 10 women with a restrictive type of AN and in 12 healthy women (C). Insulin sensitivity was determined according to homeostasis model assessment of insulin resistance (HOMA-R). Plasma resistin, leptin and insulin levels were significantly decreased, whereas plasma adiponectin levels were significantly increased in patients with AN compared to the C. HOMA-R was significantly decreased in patients with AN compared to the C group. Plasma adiponectin and leptin concentrations negatively and positively correlated with the body mass index and percentage body fat in both groups. Plasma adiponectin levels were negatively related to plasma insulin levels in the AN group only. In conclusion, we demonstrated that AN is associated with significantly decreased plasma leptin and resistin levels, markedly increased plasma adiponectin levels and increased insulin sensitivity. Plasma leptin and adiponectin levels were related to the body size and adiposity. Hyperadiponectinemia could play a role in increased insulin sensitivity of patients with AN. Neither body size and adiposity nor insulin sensitivity are the major determinants of plasma resistin levels in AN. and Obsahuje bibliografii a bibliografické odkazy
Cílem studie je prezentovat případovou studii založenou na protokolu Rorschachovy metody adolescentní pacientky s mentální anorexií, demonstrující hypervigilantní prožívání a zkreslené vzorce myšlení. Na základě psychologických charakteristik věku dospívání a kvantitativních výzkumů sledujících poruchy příjmu potravy s využitím Rorschachovy metody jsou vymezeny klíčové proměnné v aplikované metodě a jejich očekávaná konfigurace. Případová studie prezentuje anamnestická data 17leté pacientky s mentální anorexií a informace o kontextu provedené psychologické diagnostiky. Dále je prezentován protokol zahrnující 37 odpovědí získaných v souladu s pravidly Komprehenzivního systému. Vyhodnocení je provedeno v souladu s požadavky Komprehenzivního systému a navíc zahrnuje škály reflektované v předcházejících studiích. Nově je konzultován také skórovací systém Bariér a Penetrací. Vedle zhodnocení shody s očekávanou konfigurací proměnných (introverze, pozitivní PTI, zvýšené Wsum6, Mp a dysforické prožívání, snížené H a Hd, zvýšená agrese a S) je pozornost zvláště věnována dynamice protokolu a významu dílčích proměnných v celkovém obrazu protokolu s důrazem na zkreslené myšlení, téma těla a agresivitu. Případová studie přináší pohled na dynamiku hypervigilantního a fantazií zkresleného prožívání tělesných témat. Vedle omezení vyplývajících z idiografického přístupu k osobnosti je limitem absence dalších protokolů pacientky reflektujících vývoj onemocnění. and The aim of this study is to present a case report based on the Rorschach protocol of an adolescent patient with anorexia nervosa, demonstrating hypervigilant experiencing and distorted thinking patterns. Based on the psychological characteristics of adolescence and quantitative research on the monitoring of eating disorders with the Rorschach test, the key variables of the applied method and their expected configuration are defined. The case study presents anamnestic data of a seventeen-year-old patient with anorexia nervosa and information about the context of the psychological diagnosis performed. The protocol contains 37 responses collected according to the rules of the Comprehensive System. The scoring is done according to the Comprehe nsive System rules and includes the scales used in previous studies. The scoring system for barriers and penetrations is also newly used. In addition to assessing agreement with the expected configuration of variables (introversion; high PTI, Wsum6, Mp; low H and Hd; high dysphoric experiencing, aggression and S), particular attention is paid to the dynamics of the protocol and the importance of partial variables in the overall protocol picture, focusing on distorted thinking, body theme and aggression. The case study offers insight into the dynamics of hypervigilant and fantasy-distorted experiences of body themes. In addition to the limitations of the idiographic approach to personality, the limitation is the absence of other patient protocols reflecting the disease's development
Obestatin is a recently discovered peptide produced in the stomach, which was originally described to suppress food intake and decrease body weight in experimental animals. We investigated fasting plasma obestatin levels in normal weight, obese and anorectic women and associations of plasma obestatin levels with anthropometric and hormonal parameters. Hormonal (obestatin, ghrelin, leptin, insulin) and anthropometric parameters and body composition were examined in 15 normal weight, 21 obese and 15 anorectic women. Fasting obestatin levels were significantly lower in obese than in normal weight and anorectic women, whereas ghrelin to obestatin ratio was increased in anorectic women. Compared to leptin, only minor differences in plasma obestatin levels were observed in women who greatly differed in the amount of fat stores. However, a negative correlation of fasting obestatin level with body fat indexes might suggest a certain role of obestatin in the regulation of energy homeostasis. A significant relationship between plasma obestatin and ghrelin levels, independent of anthropometric parameters, supports simultaneous secretion of both hormones from the common precursor. Lower plasma obestatin levels in obese women compared to normal weight and anorectic women as well as increased ghrelin to obestatin ratio in anorectic women might play a role in body weight regulation in these pathologies., H. Zamrazilová, V. Hainer, D. Sedláčková, H. Papežová, M. Kunešová, F. Bellisle, M. Hill, J. Nedvídková., and Obsahuje bibliografii a bibliografické odkazy
Preadipocyte factor-1 (Pref-1) is a member of epidermal growthfactor like family of proteins that regulates adipocyte and osteoblast differentiation. Experimental studies suggest that circulating Pref-1 levels may be also involved in the regulation of lipid and glucose metabolism and energy homeostasis. We hypothesized that alterations in Pref-1 levels may contribute to the ethiopathogenesis of anorexia nervosa or its underlying metabolic abnormalities. We measured Pref-1 concentrations and other hormonal, biochemical and anthropometric parameters in eighteen patients with anorexia nervosa and sixteen healthy women and studied the influence of partial realimentation of anorexia nervosa patients on these parameters. The mean duration of realimentation period was 46±2 days. At baseline, anorexia nervosa patients had significantly decreased body mass index, body weight, body fat content, fasting glucose, serum insulin, TSH, free T4, leptin and total protein. Partial realimentation improved these parameters. Baseline serum Pref-1 levels did not significantly differ between anorexia nervosa and control group (0.26±0.02 vs. 0.32±0.05 ng/ml, p=0.295) but partial realimentation significantly increased circulating Pref-1 levels (0.35±0.04 vs. 0.26±0.02 ng/ml, p<0.05). Postrealimentation Pref-1 levels significantly positively correlated with the change of body mass index after realimentation (r=0.49, p<0.05). We conclude that alterations in Pref-1 are not involved in the ethiopathogenesis of anorexia nervosa but its changes after partial realimentation could be involved in the regulation of adipose tissue expansion after realimentation., P. Kaválková ... [et al.]., and Obsahuje seznam literatury
Práce je zaměřena na posouzení výskytu anorektických příznaků u reprezentativního vzorku školní mládeže (N = 4653). Kromě vyplnění dotazníku byli respondenti změřeni a zváženi. Jako screeningové kritérium anorexie bylo využito nízké BMI. 1 % chlapců a 2,1 % dívek ve věku 11, 13 a 15 let mělo tělesnou hmotnost nižší než je kritická hodnota BMI stanovená pro danou věkovou skupinu odpovídající BMI 17,5 u dospělé populace. Všechna MKN-10 kritéria splňovalo 0,17 % děvčat a 0,04 % chlapců. Bez ohledu na kritérium amenorey, které nebylo k dispozici, splňovalo kritéria mentální anorexie 0,35 % děvčat. 0,84 % děvčat splňovalo širší kritéria mentální anorexie (nízká tělesná hmotnost, narušená představa o svém těle). Výsledky studie ukazují na velkou variabilitu základních diagnostických kritérií mentální anorexie, resp. na obtíž jasně stanovit hranici mezi normou a patologií ve vztahu k tělu a jídelním zvyklostem.
Serum adipocyte fatty acid-binding protein (FABP) concentrations are linked to human obesity and other features of metabolic syndrome. Whether FABP associates with metabolic alterations in chronic malnutrition is unknown. In the present study, we measured fasting serum levels of FABP, leptin, soluble leptin receptor, adiponectin, resistin, C-reactive protein (CRP), insulin, glucose, cholesterol and triglycerides in 19 patients with a restrictive type of anorexia nervosa (AN) and in 16 healthy age-matched control women (C). Body mass index, serum leptin, and CRP concentrations were significantly lower, while serum adiponectin and soluble leptin receptor levels were significantly higher in AN relative to C group. Serum insulin, glucose, cholesterol and triglyceride levels did not differ between the groups studied. Serum FABP leve ls were unchanged in patients with AN and were not related to any of parameters studied. We conclude that, in contrast to patients with obesity where FAPB is a prominent marker of metabolic alterations, chronic malnutrition in AN does not significantly affect its serum levels., D. Haluzíková ... [et al.]., and Obsahuje seznam literatury