研究胃饥饿素及其在饮食失调中的亚型：一项网络荟萃分析

IF 3.9 2区医学 Q1 CLINICAL NEUROLOGY

Progress in Neuro-Psychopharmacology & Biological Psychiatry Pub Date : 2025-09-10 DOI:10.1016/j.pnpbp.2025.111489

Cristiano Dani , Sara Giachetti , Matteo Mura , Sara Tedesco , Eleonora Rossi , Emanuele Cassioli , Livio Tarchi , Nadia Micali , Valdo Ricca , Giovanni Castellini

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引用次数: 0

摘要

进食障碍（EDs）是一种以食欲调节和能量平衡障碍为特征的严重精神疾病。在涉及其病理生理的生物学因素中，摄氧激素ghrelin及其亚型（酰基ghrelin [AG]和去酰基ghrelin [DAG]）已被证明在食欲调节中发挥关键作用，并可能有助于维持紊乱的饮食行为。方法对现有文献进行系统回顾和荟萃分析，包括80项研究，检测不同ED诊断类别和健康对照（HC）的空腹血液ghrelin、AG和DAG水平，包括AN-rec恢复个体。采用网络元分析（NMA）方法，通过多水平线性混合效应元回归模型来估计激素水平，同时考虑协变量如体重指数（BMI）、性别、血液成分和化验类型。结果神经性厌食症（AN）和神经性贪食症（BN）患者的胃饥饿素水平显著高于HC患者，而暴食症（BED）患者的胃饥饿素水平低于BN和HC患者。与HC相比，AN患者的AG和DAG水平显著升高，AN-rec水平也高于HC。在回避/限制性食物摄入障碍（ARFID）中，胃饥饿素、AG和DAG水平无显著差异。本荟萃分析强调了不同ED亚组和HC中ghrelin及其亚型水平的显著差异，强调了它们在这些疾病的病理生理中的潜在作用，并从潜在的靶向治疗意义的角度出发。

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Investigating ghrelin and its isoforms in eating disorders: a network meta-analysis

Background

Eating disorders (EDs) are serious psychiatric conditions disorders characterized by impairments in appetite regulation and energy balance. Among the biological factors implicated in their pathophysiology, the orexigenic hormone ghrelin and its isoforms (acyl-ghrelin [AG] and desacyl-ghrelin [DAG]) have been shown to play a key role in appetite regulation and may contribute to the maintenance of disordered eating behaviors.

Methods

A systematic review of existing literature and meta-analysis were conducted, including 80 studies examining fasting blood levels of ghrelin, AG, and DAG across various ED diagnostic categories and healthy controls (HC), including also individuals with recovered AN (AN-rec). A network meta-analysis (NMA) approach through a multilevel linear mixed-effects meta-regression model was employed to estimate hormone levels, while accounting for covariates such as body mass index (BMI), sex, blood composition and assay type.

Results

Ghrelin levels were significantly elevated in individuals with anorexia nervosa (AN) and bulimia nervosa (BN) when compared to HC, while binge eating disorder (BED) was associated with lower ghrelin levels than individuals with BN and HC. AG and DAG levels were significantly elevated in individuals with AN compared to HC, and confirmed higher in AN-rec if compared to HC. No significant differences in ghrelin, AG and DAG levels were observed for avoidant/restrictive food intake disorder (ARFID).

Conclusions

This meta-analysis highlighted significant differences in the levels of ghrelin and its isoforms across various ED subgroups and HC, emphasizing their potential roles in the pathophysiology of these disorders, in a perspective of potential targeted therapeutic implications.

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来源期刊

Progress in Neuro-Psychopharmacology & Biological Psychiatry 医学-精神病学

CiteScore

12.00

自引率

1.80%

发文量

153

审稿时长

56 days

期刊介绍： Progress in Neuro-Psychopharmacology & Biological Psychiatry is an international and multidisciplinary journal which aims to ensure the rapid publication of authoritative reviews and research papers dealing with experimental and clinical aspects of neuro-psychopharmacology and biological psychiatry. Issues of the journal are regularly devoted wholly in or in part to a topical subject. Progress in Neuro-Psychopharmacology & Biological Psychiatry does not publish work on the actions of biological extracts unless the pharmacological active molecular substrate and/or specific receptor binding properties of the extract compounds are elucidated.