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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Autores principales:	Fuad Lechin, Bertha van der Dijs, Betty Pardey-Maldonado, et al
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2010
Materias:	Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/d33278cfec2440f3a7802cb438569762
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spelling	oai:doaj.org-article:d33278cfec2440f3a7802cb4385697622021-12-02T09:00:27ZAnorexia nervosa depends on adrenal sympathetic hyperactivity: opposite neuroautonomic profile of hyperinsulinism syndrome1178-7007https://doaj.org/article/d33278cfec2440f3a7802cb4385697622010-09-01T00:00:00Zhttp://www.dovepress.com/anorexia-nervosa-depends-on-adrenal-sympathetic-hyperactivity-opposite-a5243https://doaj.org/toc/1178-7007Fuad 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 Cl&iacute;nico 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 &plusmn; 10.1% versus 98 &plusmn; 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 &plusmn; 2 versus 29 &plusmn; 1 pg/mL) but also during orthostasis (67 &plusmn; 3 versus 32 &plusmn; 2 pg/mL, P &lt; 0.05) and after exercise challenge (84 &plusmn; 4 versus 30 &plusmn; 3 pg/mL, P &lt; 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 Fuad LechinBertha van der DijsBetty Pardey-Maldonadoet alDove Medical PressarticleSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol 2010, Iss default, Pp 311-317 (2010)
institution	DOAJ
collection	DOAJ
language	EN
topic	Specialties of internal medicine RC581-951
spellingShingle	Specialties of internal medicine RC581-951 Fuad Lechin Bertha van der Dijs Betty Pardey-Maldonado et al Anorexia nervosa depends on adrenal sympathetic hyperactivity: opposite neuroautonomic profile of hyperinsulinism syndrome
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 Cl&iacute;nico 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 &plusmn; 10.1% versus 98 &plusmn; 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 &plusmn; 2 versus 29 &plusmn; 1 pg/mL) but also during orthostasis (67 &plusmn; 3 versus 32 &plusmn; 2 pg/mL, P &lt; 0.05) and after exercise challenge (84 &plusmn; 4 versus 30 &plusmn; 3 pg/mL, P &lt; 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
format	article
author	Fuad Lechin Bertha van der Dijs Betty Pardey-Maldonado et al
author_facet	Fuad Lechin Bertha van der Dijs Betty Pardey-Maldonado et al
author_sort	Fuad Lechin
title	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_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_sort	anorexia nervosa depends on adrenal sympathetic hyperactivity: opposite neuroautonomic profile of hyperinsulinism syndrome
publisher	Dove Medical Press
publishDate	2010
url	https://doaj.org/article/d33278cfec2440f3a7802cb438569762
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Anorexia nervosa depends on adrenal sympathetic hyperactivity: opposite neuroautonomic profile of hyperinsulinism syndrome

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