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
Článek se zabývá problematikou vztahu mentální anorexie a rodinného prostředí. V teoretickém úvodu podávám krátké vymezení mentální anorexie (diagnostická kritéria, prognóza nemoci, teorie vzniku mentální anorexie, somatické komplikace a terapeutické přístupy). Dále se stručně věnuji problematice rodiny, jež tvoří první sociální prostředí dítěte, nejvíce formuje osobnost jedince a ve své podstatě je nenahraditelná.
Cílem výzkumu bylo zmapovat rodinné vztahy a jejich dynamiku z pohledu dívek a mladých žen s mentální anorexií. Těžiště spočívalo v kvalitativní metodologii. Použité metody: polostrukturovaný rozhovor a Test rodinného systému (FAST), který na tuto problematiku ještě nebyl v České republice aplikován. Výzkumný soubor tvořilo osm respondentek ve věkovém rozmezí 18-28 let. Kritérii bylo, aby byly svobodné, bezdětné, pocházely z úplných rodin a s mentální anorexií se léčily ambulantně nebo byly kvůli ní hospitalizovány.
Dále článek obsahuje výsledky Testu rodinného systému, který je zaměřen na hodnocení těchto dimenzí: koheze, hierarchie, adaptabilita a flexibilita. Jsou uvedeny výsledky polostrukturovaného rozhovoru s dívkami. Jak z rozhovoru, tak z Testu rodinného systému vyplynulo, že dívky pocházejí z dysfunkčního prostředí, v němž byly hádky a nedorozumění na denním pořádku. Necítily oporu, citové zázemí, zájem. Navíc se v rodinách ve zvýšené míře vyskytovala agrese jak verbální, tak i fyzická. Proto není žádným překvapením, že se dívky v rodinách necítily dobře a na své dětství s radostí nevzpomínají.
Z výzkumu vyplynulo, že v terapii mentální anorexie je nutné pracovat s rodinou, nebo, pokud to není možné, alespoň s rodinnými tématy. Řešení rodinných problémů totiž napomáhá k dosažení terapeutického cíle. K diagnostice rodinných vztahů a ke sledování účinnosti rodinné terapie považuji za vhodné použít Test rodinného systému. and The article deals with relations between the anorexia nervosa and the family settings. In a theoretical introduction I present a short definition of anorexia nervosa (diagnostic criteria, prognosis of the disease, theories on the origin of mental anorexy, somatic complications and therapeutic attitudes). Then I briefly pursue the family area, which constitutes the primary social background for the child, which most of all forms the personality of an individual and which is irreplaceable in its nature.
The aim of the research was to chart family relations and their dynamics from the view of girls and young women suffering from mental anorexy. The focus lies on qualitative methodology. Methods used were: semi-structured interview and the Family System Test, which hasn't been applied on this matter in the Czech Republic yet. The research sample consisted of eight female respondents between 18 and 28 years old. The criteria were: to be single, childless, to come from complete families, and to be treated from anorexia nervosa in an ambulatory way or in the hospital.
The article also includes results of the Family System Test, which is focused on evaluation of these dimensions: coherence, hierarchy, adaptability and flexibility. Results of the semistructured interview with girls are also presented. Either from the interview and the Family System Test emerged that the girls come from the dysfunctional background, where arguments and misunderstandings were in the daily order. They didn't feel support, emotional background, involvement. Moreover in the families the verbal and bodily aggression occurred. That is why there is no surprise that the girls didn't feel well in the families and they don't remember their childhood with pleasure.
The research indicates that in the anorexia nervosa treatment it is necessary to work with the family, if it is not possible, with the family themes at least. Family problems solution actually helps to achieve the therapeutical aims. I consider the Family System Test as suitable for the family relations diagnosis and for the appraisal of the effectivity of family therapies.
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
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
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.
Studie se primárně zabývá otázkou, zda může být kresebná projektivní technika Kresba lidské postavy Figure Drawing Test (FDT) vhodným alternativním diagnostickým nástrojem pro detekci a hodnocení osobnosti i specifické patologie u žen s diagnózou Mentální anorexie (MA). Dílčím záměrem práce bylo postihnout, jakým způsobem se avizovaná psychická porucha projevuje v jednotlivých kresebných prvcích (znacích) v FDT a následně snaha o nástin možných interpretací znaků z hlediska zhodnocení osobnostních a emocionálních charakteristik pacientek s avizovanou psychiatrickou poruchou. Pro účely výzkumu byly sestaveny dvě skupiny – klinická (ženy s dg. MA; 43 osob) a komparativní (ženy z normální populace; 43 osob). Pro sledování vybraných proměnných byla využita technika FDT, data byla zpracovávána kvantitativně pomocí vybraných statistických metod. Bylo detekováno celkem 37 znaků v FDT, v jejichž četnosti výskytu se obě skupiny statisticky významně lišily, přičemž přibližně osm kresebných znaků považujeme za diagnosticky cenných. Vzhledem ke zjištěným skutečnostem lze předpokládat, že FDT může být vhodnou pomocnou diagnostickou metodou pro hodnocení osobnosti a patologie přítomné u žen s dg. MA, lze ji např. využít pro stanovení prognózy i jako nástroje pro hodnocení úspěšnosti terapie a změn pacientova psychického stavu v průběhu léčby, v rámci arteterapie atp. and The study is primarily focused on question whether the projective technique Figure Drawing Test (FDT) could be an appropriate alternative diagnostic tool for an assessment of the personality and the specific psychopathology for the women with diagnosis of the Anorexia Nervosa (AN). Another aim of the study was the possibility of interpreting the detected signs in a context of the presented disorder. Two groups were assembled – the clinical one (the women with the diagnosis AN; 43 people) and the comparative one (the women from the general population, 43 people). We used the common known method of Figure Drawing Test in order to monitor selected variables. The quantitative approach was used to obtain the results from the FDT. As a whole we detected 37 signs where the frequency in both groups differed statistically in the significant level. About the eight signs of total seemed to be diagnostically valuable. Based on the results we assume that the FDT would be the useful diagnostic tool for assessing the personal psychopathology that can be found between the women with the AN diagnosis and can be used for determining of the prognosis. It is assumed that it may serve as the tool for evaluating of the success in the therapy and in the changes of the patient's mental state during treatment as well or in the Art Therapy etc.
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