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Zhao Z, Gobrogge K. Neurodevelopmental Model Explaining Associations between Sex Hormones, Personality, and Eating Pathology. Brain Sci 2023; 13:859. [PMID: 37371339 DOI: 10.3390/brainsci13060859] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
Clinical scientists have been investigating the relationships between sex hormones, personality, and eating disorders for decades. However, there is a lack of direct research that addresses whether personality mediates or moderates the relationships between sex hormones and eating pathology. Moreover, the neural mechanisms that underlie the interactive associations between these variables remain unclear. This review aims to summarize the associations between these constructs, describe a neural mechanism mediating these relationships, and offer clinical strategies for the early identification and intervention of eating disorders. The gathered evidence shows that aggressiveness, impulsivity, and obsessive-compulsiveness may mediate or moderate the relationships between sex hormones and eating pathology, but only among females. Furthermore, sex hormone receptor density in the mesocorticolimbic dopamine pathway may explain the neural mechanism of these associations. Future research should use more comprehensive personality measurements and assess the mediation and moderation effects of temperament while taking the hormone levels of women across menstrual cycles into account. Additionally, electroencephalography and functional magnetic resonance imaging should be implemented to directly assess brain activity and corroborate these findings.
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Affiliation(s)
- Ziyu Zhao
- Department of Psychological & Brain Sciences, Boston University, Boston, MA 02215, USA
| | - Kyle Gobrogge
- Department of Psychological & Brain Sciences, Boston University, Boston, MA 02215, USA
- Undergraduate Program in Neuroscience, College of Art & Sciences, Boston University, Boston, MA 02215, USA
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2
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Brain Volume Loss, Astrocyte Reduction, and Inflammation in Anorexia Nervosa. ADVANCES IN NEUROBIOLOGY 2021; 26:283-313. [PMID: 34888839 DOI: 10.1007/978-3-030-77375-5_12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Anorexia nervosa is the third most common chronic disease in adolescence and is characterized by low body weight, body image distortion, weight phobia, and severe somatic consequences. Among the latter, marked brain volume reduction has been linked to astrocyte cell count reduction of about 50% in gray and white matter, while neuronal and other glial cell counts remain normal. Exact underlying mechanisms remain elusive; however, first results point to important roles of the catabolic state and the very low gonadal steroid hormones in these patients. They also appear to involve inflammatory states of "hungry astrocytes" and interactions with the gut microbiota. Functional impairments could affect the role of astrocytes in supporting neurons metabolically, neurotransmitter reuptake, and synapse formation, among others. These could be implicated in reduced learning, mood alterations, and sleep disturbances often seen in patients with AN and help explain their rigidity and difficulties in relearning processes in psychotherapy during starvation.
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3
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Borsdorf B, Dahmen B, Buehren K, Dempfle A, Egberts K, Ehrlich S, Fleischhaker C, Konrad K, Schwarte R, Timmesfeld N, Wewetzer C, Biemann R, Scharke W, Herpertz-Dahlmann B, Seitz J. BDNF levels in adolescent patients with anorexia nervosa increase continuously to supranormal levels 2.5 years after first hospitalization. J Psychiatry Neurosci 2021; 46:E568-E578. [PMID: 34654737 PMCID: PMC8526129 DOI: 10.1503/jpn.210049] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/14/2021] [Accepted: 07/01/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Brain-derived neurotrophic factor (BDNF) influences brain plasticity and feeding behaviour, and it has been linked to anorexia nervosa in numerous studies. Findings in mostly adult patients point to reduced serum BDNF levels in the acute stage of anorexia nervosa and rising levels with weight recovery. However, it is unclear whether this increase leads to normalization or supranormal levels, a difference that is potentially important for the etiology of anorexia nervosa and relapse. METHODS We measured serum BDNF at admission (n = 149), discharge (n = 130), 1-year follow-up (n = 116) and 2.5-year follow-up (n = 76) in adolescent female patients with anorexia nervosa hospitalized for the first time, and in healthy controls (n = 79). We analyzed associations with body mass index, eating disorder psychopathology and comorbidities. RESULTS Serum BDNF was only nominally lower at admission in patients with anorexia nervosa compared to healthy controls, but it increased continuously and reached supranormal levels at 2.5-year follow-up. BDNF was inversely associated with eating disorder psychopathology at discharge and positively associated with previous weight gain at 1-year follow-up. LIMITATIONS We compensated for attrition and batch effects using statistical measures. CONCLUSION In this largest longitudinal study to date, we found only nonsignificant reductions in BDNF in the acute stage of anorexia nervosa, possibly because of a shorter illness duration in adolescent patients. Supranormal levels of BDNF at 2.5-year follow-up could represent a pre-existing trait or a consequence of the illness. Because of the anorexigenic effect of BDNF, it might play an important predisposing role for relapse and should be explored further in studies that test causality.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jochen Seitz
- From the Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital, RWTH University Aachen, Germany (Borsdorf, Dahmen, Buehren, Scharke, Herpertz-Dahlmann, Seitz); the kbo-Heckscher Klinikum, Academic Teaching Hospital, Ludwig Maximilian University, Munich, Germany (Buehren); the Institute of Medical Informatics and Statistics, Kiel University, Germany (Dempfle); the Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Wuerzburg, Germany (Egberts); the Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Germany (Ehrlich); the Eating Disorders Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany (Ehrlich); the Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Freiburg, Germany (Fleischhaker); the Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital, RWTH University Aachen (Konrad); the JARA-Institute Molecular Neuroscience and Neuroimaging (INM-11), Juelich Research Centre, Germany (Konrad); the Oberberg Fachklinik Konraderhof, Cologne-Huerth, Germany (Schwarte); the Institute of Medical Biometry and Epidemiology, Philipps-University Marburg, Germany (Timmesfeld); the Department of Medical Informatics, Biometrics and Epidemiology, Ruhr University Bochum, Germany (Timmesfeld); the Department of Child and Adolescent Psychiatry and Psychotherapy, Cologne City Hospitals, Germany (Wewetzer); the Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Germany (Biemann); the Cognitive and Experimental Psychology, Institute of Psychology, RWTH Aachen University, Germany (Scharke)
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The Role of Puberty and Ovarian Hormones in the Genetic Diathesis of Eating Disorders in Females. Child Adolesc Psychiatr Clin N Am 2019; 28:617-628. [PMID: 31443879 DOI: 10.1016/j.chc.2019.05.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Puberty is a critical risk period for eating disorders (EDs). ED incidence increases across the pubertal period and becomes female predominant, and genetic influences on disordered eating significantly increase. Surges of ovarian hormones, particularly estrogen, may drive this increasing genetic effect for EDs in pubertal girls and contribute to differential phenotypic presentations beyond puberty. In this article, we explain phenotypic associations between puberty and disordered eating and present evidence showing underlying genetic and hormonal influence. Potential benefits of communicating roles of genetic influence to people with or at risk for EDs are also discussed.
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5
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Sex steroid hormones and differential risk for eating pathology: a review of genetic and phenotypic effects across development. Curr Opin Behav Sci 2018. [DOI: 10.1016/j.cobeha.2018.06.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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6
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Klump KL, Fowler N, Mayhall L, Sisk CL, Culbert KM, Burt SA. Estrogen moderates genetic influences on binge eating during puberty: Disruption of normative processes? JOURNAL OF ABNORMAL PSYCHOLOGY 2018; 127:458-470. [PMID: 29927265 DOI: 10.1037/abn0000352] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Puberty is a critical period for changes in genetic effects for binge eating in girls. Previous twin studies show increases in genetic influences on binge eating from prepuberty (∼0%) to midpuberty and beyond (∼50%). However, little is known about the factors that drive these shifts in genetic effects. A small pilot study showed that pubertal activation of estrogen may contribute to increases in genetic influences, possibly via hormonally induced changes in gene expression. However, large-scale studies investigating hormone effects on genetic risk are lacking. Thus, the purpose of the present study was to examine the effects of estrogen on genetic influences for binge eating in 964 female twins (ages 8-16 years) from the Michigan State University Twin Registry. Binge eating was assessed with the Minnesota Eating Behaviors Survey, whereas afternoon saliva samples were assayed for estradiol levels using standard enzyme immunoassays. Twin moderation models showed substantial differences in genetic influences on binge eating across estradiol levels. Stronger genetic effects were observed at lower (rather than higher) estradiol levels, even when controlling for the effects of age, body mass index, the physical changes of puberty, and the onset of menses. Overall, findings suggest that comparatively lower levels of estradiol during this critical period may disrupt normative developmental processes and enhance genetic influences on binge eating. (PsycINFO Database Record
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7
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Viltart O, Duriez P, Tolle V. Metabolic and neuroendocrine adaptations to undernutrition in anorexia nervosa: from a clinical to a basic research point of view. Horm Mol Biol Clin Investig 2018; 36:hmbci-2018-0010. [PMID: 29804101 DOI: 10.1515/hmbci-2018-0010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 03/13/2018] [Indexed: 02/07/2023]
Abstract
The exact mechanisms linking metabolic and neuroendocrine adaptations to undernutrition and the pathophysiology of anorexia nervosa (AN) are not fully understood. AN is a psychiatric disorder of complex etiology characterized by extreme starvation while the disease is progressing into a chronic state. Metabolic and endocrine alterations associated to this disorder are part of a powerful response to maintain whole body energy homeostasis. But these modifications may also contribute to associated neuropsychiatric symptoms (reward abnormalities, anxiety, depression) and thus participate to sustain the disease. The current review presents data with both a clinical and basic research point of view on the role of nutritional and energy sensors with neuroendocrine actions in the pathophysiology of the disease, as they modulate metabolic responses, reproductive functions, stress responses as well as physical activity. While clinical data present a full description of changes occurring in AN, animal models that integrate either spontaneous genetic mutations or experimentally-induced food restriction with hyperactivity and/or social stress recapitulate the main metabolic and endocrine alterations of AN and provide mechanistic information between undernutrition state and symptoms of the disease. Further progress on the central and peripheral mechanism involved in the pathophysiology of eating disorders partly relies on the development and/or refinement of existing animal models to include recently identified genetic traits and better mimic the complex and multifactorial dimensions of the disease.
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Affiliation(s)
- Odile Viltart
- Centre de Psychiatrie et Neurosciences, INSERM UMR 894, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Université de Lille (Sciences et technologies), Lille, France
| | - Philibert Duriez
- Centre de Psychiatrie et Neurosciences, INSERM UMR 894, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Clinique des Maladies Mentales et de l'Encéphale (CMME), Hôpital Sainte-Anne, Paris, France
| | - Virginie Tolle
- Centre de Psychiatrie et Neurosciences, INSERM UMR 894, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
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8
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Lee TJ, Kinzig KP. Reprint of "Repeated adolescent activity-based anorexia influences central estrogen signaling and adulthood anxiety-like behaviors in rats". Physiol Behav 2017; 178:179-186. [PMID: 28341321 DOI: 10.1016/j.physbeh.2017.02.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 11/28/2016] [Accepted: 12/17/2016] [Indexed: 11/18/2022]
Abstract
Anorexia nervosa (AN) typically presents in adolescence and is highly comorbid with anxiety and depression, which often persist after elimination of AN symptomology. The activity-based anorexia (ABA) paradigm allows for evaluation of behavioral and neuroendocrine consequences of AN-like behaviors, including voluntary anorexia, hyperactivity, and disruption of the hypothalamic-pituitary-gonadal (HPG) and the hypothalamic pituitary adrenal (HPA) axis. Because ABA in adolescent females results in increased anxiety-like behavior in adulthood and the estrogen signaling system has been shown to play a role in anxiety and food intake, we investigated the role of ovarian hormones in adolescent ABA-treated rats, and long-term effects of mid- and late adolescent ABA exposure on behavior and estrogen signaling. While previous research demonstrated that two bouts of ABA during adolescence resulted in decreased time in the open arm of the elevated plus maze (EPM) and increased activity of the HPA axis in response to a novel stressor, here we show that one bout of ABA in mid-or late-adolescence did not result in the same behavioral outcome. Two exposures to ABA during adolescence were necessary to produce long-term anxiety-like behavior on the EPM. Finally, removal of ovarian hormones by ovariectomy (OVX) prior to puberty did not attenuate long-term behavioral consequences of ABA in adolescence, and estrogen receptor β (ERβ) expression level in the amygdala of ABA rats was significantly lower than control subjects. Taken together, these studies identify enduring effects of ABA in adolescent females that may be mediated by ABA-induced changes to CNS ERβ signaling that increase anxiety-like behaviors.
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Affiliation(s)
- Tien-Jui Lee
- Department of Psychological Sciences, Purdue University, 703 Third Street, West Lafayette, IN 47907, United States.
| | - Kimberly P Kinzig
- Department of Psychological Sciences, Purdue University, 703 Third Street, West Lafayette, IN 47907, United States.
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9
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Lee TJ, Kinzig KP. Repeated adolescent activity-based anorexia influences central estrogen signaling and adulthood anxiety-like behaviors in rats. Physiol Behav 2017; 171:199-206. [PMID: 28069464 DOI: 10.1016/j.physbeh.2016.12.039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 11/28/2016] [Accepted: 12/17/2016] [Indexed: 12/31/2022]
Affiliation(s)
- Tien-Jui Lee
- Department of Psychological Sciences, Purdue University, 703 Third Street, West Lafayette, IN 47907, United States.
| | - Kimberly P Kinzig
- Department of Psychological Sciences, Purdue University, 703 Third Street, West Lafayette, IN 47907, United States.
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10
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Hoffmann S, Beyer C. Gonadal steroid hormones as therapeutic tools for brain trauma: the time is ripe for more courageous clinical trials to get into emergency medicine. J Steroid Biochem Mol Biol 2015; 146:1-2. [PMID: 25196186 DOI: 10.1016/j.jsbmb.2014.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Stefanie Hoffmann
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, 52074 Aachen, Germany
| | - Cordian Beyer
- Institute of Neuroanatomy, RWTH Aachen University, 52074 Aachen, Germany.
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11
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del Mar Grasa M, Villarreal L, Granero R, Vilà R, Penelo E, Agüera Z, Jiménez-Murcia S, del Mar Romero M, Menchón JM, Remesar X, Fernández-Aranda F, Alemany M. Purging behavior modulates the relationships of hormonal and behavioral parameters in women with eating disorders. Neuropsychobiology 2014; 67:230-40. [PMID: 23689731 DOI: 10.1159/000350473] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Accepted: 02/17/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS There is ample consensus that there is a neurophysiological basis for eating disorders (ED). Traits of personality translate into behavioral traits, purging being a well-defined transversal example. The direct implication of steroid hormones on ED has seldom been studied, despite their effects on behavior. METHODS After psychological interview analysis, 57 ED female patients (31 purgative and 26 nonpurgative) and 17 female controls were studied. Metabolic parameters and analysis of androgen, estrogen and glucocorticoid hormones were determined in parallel to the psychopathological profile (EDI-2 and SCL-90-R) and anthropometric measurements. RESULTS Psychometric tests showed clear differences between ED and controls, but there were few hormonal-metabolic significant differences. In purgative ED there were repeated (significant) positive correlations with corticosteroid-binding globulin (CBG) and negative correlations with sex hormone-binding globulin (SHBG) versus eating and general psychopathology. In nonpurging ED there were positive correlations for deoxycortisol, free fatty acids and albumin and negative for aspartate aminotransferase and psychopathological traits. CONCLUSION The data suggest that CBG/corticosteroids and sexual hormones/SHBG are involved in purging behavior and its psychopathology and severity scores. Correlations of selected psychometric data and the CBG/SHBG levels in purging may eventually result in clinical markers. This approach may provide additional clues for understanding the pathogenesis of ED.
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Affiliation(s)
- Maria del Mar Grasa
- Department of Nutrition and Food Science, Faculty of Biology, University of Barcelona, Barcelona, Spain
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12
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Scott-Van Zeeland AA, Bloss CS, Tewhey R, Bansal V, Torkamani A, Libiger O, Duvvuri V, Wineinger N, Galvez L, Darst BF, Smith EN, Carson A, Pham P, Phillips T, Villarasa N, Tisch R, Zhang G, Levy S, Murray S, Chen W, Srinivasan S, Berenson G, Brandt H, Crawford S, Crow S, Fichter MM, Halmi KA, Johnson C, Kaplan AS, La Via M, Mitchell JE, Strober M, Rotondo A, Treasure J, Woodside DB, Bulik CM, Keel P, Klump KL, Lilenfeld L, Plotnicov K, Topol EJ, Shih PB, Magistretti P, Bergen AW, Berrettini W, Kaye W, Schork NJ. Evidence for the role of EPHX2 gene variants in anorexia nervosa. Mol Psychiatry 2014; 19:724-32. [PMID: 23999524 PMCID: PMC3852189 DOI: 10.1038/mp.2013.91] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 06/19/2013] [Accepted: 06/24/2013] [Indexed: 01/08/2023]
Abstract
Anorexia nervosa (AN) and related eating disorders are complex, multifactorial neuropsychiatric conditions with likely rare and common genetic and environmental determinants. To identify genetic variants associated with AN, we pursued a series of sequencing and genotyping studies focusing on the coding regions and upstream sequence of 152 candidate genes in a total of 1205 AN cases and 1948 controls. We identified individual variant associations in the Estrogen Receptor-ß (ESR2) gene, as well as a set of rare and common variants in the Epoxide Hydrolase 2 (EPHX2) gene, in an initial sequencing study of 261 early-onset severe AN cases and 73 controls (P=0.0004). The association of EPHX2 variants was further delineated in: (1) a pooling-based replication study involving an additional 500 AN patients and 500 controls (replication set P=0.00000016); (2) single-locus studies in a cohort of 386 previously genotyped broadly defined AN cases and 295 female population controls from the Bogalusa Heart Study (BHS) and a cohort of 58 individuals with self-reported eating disturbances and 851 controls (combined smallest single locus P<0.01). As EPHX2 is known to influence cholesterol metabolism, and AN is often associated with elevated cholesterol levels, we also investigated the association of EPHX2 variants and longitudinal body mass index (BMI) and cholesterol in BHS female and male subjects (N=229) and found evidence for a modifying effect of a subset of variants on the relationship between cholesterol and BMI (P<0.01). These findings suggest a novel association of gene variants within EPHX2 to susceptibility to AN and provide a foundation for future study of this important yet poorly understood condition.
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Affiliation(s)
- A A Scott-Van Zeeland
- The Scripps Translational Science Institute, La Jolla, CA, USA,Scripps Health, La Jolla, CA, USA
| | - C S Bloss
- The Scripps Translational Science Institute, La Jolla, CA, USA,Scripps Health, La Jolla, CA, USA
| | - R Tewhey
- Scripps Health, La Jolla, CA, USA,Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA, USA
| | - V Bansal
- The Scripps Translational Science Institute, La Jolla, CA, USA,Scripps Health, La Jolla, CA, USA
| | - A Torkamani
- The Scripps Translational Science Institute, La Jolla, CA, USA,Scripps Health, La Jolla, CA, USA,Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA, USA
| | - O Libiger
- The Scripps Translational Science Institute, La Jolla, CA, USA,Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA, USA
| | - V Duvvuri
- Department of Pediatrics, The University of California, San Diego, La Jolla, CA, USA
| | - N Wineinger
- The Scripps Translational Science Institute, La Jolla, CA, USA,Scripps Health, La Jolla, CA, USA
| | - L Galvez
- The Scripps Translational Science Institute, La Jolla, CA, USA
| | - B F Darst
- The Scripps Translational Science Institute, La Jolla, CA, USA,Scripps Health, La Jolla, CA, USA
| | - E N Smith
- Department of Pediatrics, The University of California, San Diego, La Jolla, CA, USA
| | - A Carson
- The Scripps Translational Science Institute, La Jolla, CA, USA,Scripps Health, La Jolla, CA, USA
| | - P Pham
- The Scripps Translational Science Institute, La Jolla, CA, USA,Scripps Health, La Jolla, CA, USA
| | - T Phillips
- The Scripps Translational Science Institute, La Jolla, CA, USA,Scripps Health, La Jolla, CA, USA
| | - N Villarasa
- The Scripps Translational Science Institute, La Jolla, CA, USA,Scripps Health, La Jolla, CA, USA
| | - R Tisch
- The Scripps Translational Science Institute, La Jolla, CA, USA,Scripps Health, La Jolla, CA, USA
| | - G Zhang
- The Scripps Translational Science Institute, La Jolla, CA, USA,Scripps Health, La Jolla, CA, USA
| | - S Levy
- The Scripps Translational Science Institute, La Jolla, CA, USA,Scripps Health, La Jolla, CA, USA,Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA, USA
| | - S Murray
- The Scripps Translational Science Institute, La Jolla, CA, USA,Scripps Health, La Jolla, CA, USA,Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA, USA
| | - W Chen
- Department of Epidemiology, Tulane University, New Orleans, LA, USA
| | - S Srinivasan
- Department of Epidemiology, Tulane University, New Orleans, LA, USA
| | - G Berenson
- Department of Epidemiology, Tulane University, New Orleans, LA, USA
| | - H Brandt
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - S Crawford
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - S Crow
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - M M Fichter
- Roseneck Hospital for Behavioral Medicine, Prien, Germany
| | - K A Halmi
- Eating Disorder Research Program Weill Cornell Medical College, White Plains, NY, USA
| | - C Johnson
- Eating Recovery Center, Denver, CO, USA
| | - A S Kaplan
- Center for Addiction and Mental Health, Toronto, ON, Canada,Department of Psychiatry, Toronto General Hospital, University Health Network, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - M La Via
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - J E Mitchell
- Neuropsychiatric Research Institute, Fargo, ND, USA,Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA
| | - M Strober
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - A Rotondo
- Department of Psychiatry, Neurobiology, Pharmacology, and Biotechnology, University of Pisa, Pisa, Italy
| | - J Treasure
- Department of Academic Psychiatry, Bermondsey Wing Guys Hospital, University of London, London, UK
| | - D B Woodside
- Department of Psychiatry, Toronto General Hospital, University Health Network, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada,Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - C M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - P Keel
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - K L Klump
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - L Lilenfeld
- Clinical Psychology Program, American School of Professional Psychology at Argosy University, Washington, DC, USA
| | - K Plotnicov
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - E J Topol
- The Scripps Translational Science Institute, La Jolla, CA, USA,Scripps Health, La Jolla, CA, USA,Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA, USA
| | - P B Shih
- Department of Pediatrics, The University of California, San Diego, La Jolla, CA, USA
| | - P Magistretti
- Laboratory of Neuroenergetics and Cellular Dynamics, The University of Lausanne, Lausanne, Switzerland
| | - A W Bergen
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - W Berrettini
- Department of Psychiatry, The University of Pennsylvania, Philadelphia, PA, USA
| | - W Kaye
- Department of Pediatrics, The University of California, San Diego, La Jolla, CA, USA
| | - N J Schork
- The Scripps Translational Science Institute, La Jolla, CA, USA,Scripps Health, La Jolla, CA, USA,Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA, USA,Department of Molecular and Experimental Medicine, The Scripps Research Institute, 3344 N Torrey Pines Court, Room 306, La Jolla, CA 92037, USA. E-mail:
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13
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Pohl A, Cassidy S, Auyeung B, Baron-Cohen S. Uncovering steroidopathy in women with autism: a latent class analysis. Mol Autism 2014; 5:27. [PMID: 24717046 PMCID: PMC4022124 DOI: 10.1186/2040-2392-5-27] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 03/10/2014] [Indexed: 11/30/2022] Open
Abstract
Background Prenatal exposure to increased androgens has been implicated in both polycystic ovary syndrome (PCOS) and autism spectrum conditions (ASC), suggesting that PCOS may be increased among women with ASC. One study suggested elevated steroidopathic symptoms (‘steroidopathy’) in women with ASC. As the symptoms are not independent, we conducted a latent class analysis (LCA). The objectives of the current study are: (1) to test if these findings replicate in a larger sample; and (2) to use LCA to uncover affected clusters of women with ASC. Methods We tested two groups of women, screened using the Autism Spectrum Quotient - Group 1: n = 415 women with ASC (mean age 36.39 ± 11.98 years); and Group 2: n = 415 controls (mean age 39.96 ± 11.92 years). All participants completed the Testosterone-related Medical Questionnaire online. A multiple-group LCA was used to identify differences in latent class structure between women with ASC and controls. Results There were significant differences in frequency of steroid-related conditions and symptoms between women with ASC and controls. A two-class semi-constrained model best fit the data. Based on response patterns, we identified the classes as ‘Typical’ and ‘Steroidopathic’. The prevalence of the ‘Steroidopathic’ class was significantly increased within the ASC group (ΔG2 = 15, df =1, P = 0.0001). In particular, we confirmed higher frequencies of epilepsy, amenorrhea, dysmenorrhea, severe acne, gender dysphoria, and transsexualism, and differences in sexual preference in women with ASC. Conclusions Women with ASC are at increased risk for symptoms and conditions linked to steroids. LCA revealed this steroidopathy despite the apparent underdiagnosis of PCOS.
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Affiliation(s)
- Alexa Pohl
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18B Trumpington Road, Cambridge CB2 8AH, UK
| | - Sarah Cassidy
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18B Trumpington Road, Cambridge CB2 8AH, UK ; Department of Psychology and Behavioural Sciences, Coventry University, James Starley Building, Cox Street, Coventry CV1 5LW, UK
| | - Bonnie Auyeung
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18B Trumpington Road, Cambridge CB2 8AH, UK ; Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh EH8 9 AD, UK
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18B Trumpington Road, Cambridge CB2 8AH, UK ; CLASS Clinic, Cambridgeshire and Peterborough Mental Health Foundation NHS Trust, The Chitra Sethia Autism Centre, The Gatehouse, Fulborn Hospital, Fulborn, Cambridge CB21 5EF, UK
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Zhang C, Chen J, Jia X, Yu S, Jiang W, Zhang R, Yuan A, Qian Y, Fan J, Zhang M, Fang Y, Xiao Z. Estrogen receptor 1 gene rs2295193 polymorphism and anorexia nervosa: new data and meta-analysis. Asia Pac Psychiatry 2013; 5:331-5. [PMID: 24106242 DOI: 10.1111/appy.12100] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 08/06/2013] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Estrogen plays essential roles in the regulation of food intake, adiposity, and body weight control. The estrogen alpha receptor, encoded by estrogen receptor 1 gene (ESR1), has been implicated with anorexia nervosa (AN). A previous study indicated that the rs2295193 polymorphism in ESR1 may confer a genetic susceptibility to AN. METHODS In a case-control study, we assessed 195 AN probands and 93 healthy controls; 99 trios were studied in a family-based association analysis through genotyping the rs2295193 polymorphism in ESR1. Additionally, we carried out a meta-analysis of the combined sample groups. RESULTS There were no significant differences in the genotype or allele frequencies of the rs2295193 polymorphism between the AN and control groups (Ps > 0.05). In the transmission disequilibrium test (TDT) analyses, there was no evidence for biased transmission of the G allele of rs2295193 polymorphism (P = 0.32). In female-only samples, no significant association was observed between the rs2295193 polymorphism and AN in either case-control or transmission disequilibrium test analyses (Ps > 0.05). The meta-analysis revealed that no excess of transmission of the G allele in AN families (pooled odds ratio = 1.10, P = 0.79). DISCUSSION Meta-analytically combined evidence from the present genotyping and the literature showed that rs2295193 polymorphism in ESR1 is not a major genetic susceptibility factor in AN.
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Affiliation(s)
- Chen Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, China
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Asarian L, Geary N. Sex differences in the physiology of eating. Am J Physiol Regul Integr Comp Physiol 2013; 305:R1215-67. [PMID: 23904103 DOI: 10.1152/ajpregu.00446.2012] [Citation(s) in RCA: 350] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Hypothalamic-pituitary-gonadal (HPG) axis function fundamentally affects the physiology of eating. We review sex differences in the physiological and pathophysiological controls of amounts eaten in rats, mice, monkeys, and humans. These controls result from interactions among genetic effects, organizational effects of reproductive hormones (i.e., permanent early developmental effects), and activational effects of these hormones (i.e., effects dependent on hormone levels). Male-female sex differences in the physiology of eating involve both organizational and activational effects of androgens and estrogens. An activational effect of estrogens decreases eating 1) during the periovulatory period of the ovarian cycle in rats, mice, monkeys, and women and 2) tonically between puberty and reproductive senescence or ovariectomy in rats and monkeys, sometimes in mice, and possibly in women. Estrogens acting on estrogen receptor-α (ERα) in the caudal medial nucleus of the solitary tract appear to mediate these effects in rats. Androgens, prolactin, and other reproductive hormones also affect eating in rats. Sex differences in eating are mediated by alterations in orosensory capacity and hedonics, gastric mechanoreception, ghrelin, CCK, glucagon-like peptide-1 (GLP-1), glucagon, insulin, amylin, apolipoprotein A-IV, fatty-acid oxidation, and leptin. The control of eating by central neurochemical signaling via serotonin, MSH, neuropeptide Y, Agouti-related peptide (AgRP), melanin-concentrating hormone, and dopamine is modulated by HPG function. Finally, sex differences in the physiology of eating may contribute to human obesity, anorexia nervosa, and binge eating. The variety and physiological importance of what has been learned so far warrant intensifying basic, translational, and clinical research on sex differences in eating.
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Affiliation(s)
- Lori Asarian
- Institute of Veterinary Physiology and Center for Integrated Human Physiology, University of Zurich, Zurich, Switzerland; and
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Klump KL. Puberty as a critical risk period for eating disorders: a review of human and animal studies. Horm Behav 2013; 64:399-410. [PMID: 23998681 PMCID: PMC3761220 DOI: 10.1016/j.yhbeh.2013.02.019] [Citation(s) in RCA: 149] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 02/27/2013] [Accepted: 02/27/2013] [Indexed: 11/25/2022]
Abstract
This article is part of a Special Issue "Puberty and Adolescence". Puberty is one of the most frequently discussed risk periods for the development of eating disorders. Prevailing theories propose environmentally mediated sources of risk arising from the psychosocial effects (e.g., increased body dissatisfaction, decreased self-esteem) of pubertal development in girls. However, recent research highlights the potential role of ovarian hormones in phenotypic and genetic risk for eating disorders during puberty. The goal of this paper is to review data from human and animal studies in support of puberty as a critical risk period for eating disorders and evaluate the evidence for hormonal contributions. Data are consistent in suggesting that both pubertal status and pubertal timing significantly impact risk for most eating disorders in girls, such that advanced pubertal development and early pubertal timing are associated with increased rates of eating disorders and their symptoms in both cross-sectional and longitudinal research. Findings in boys have been much less consistent and suggest a smaller role for puberty in risk for eating disorders in boys. Twin and animal studies indicate that at least part of the female-specific risk is due to genetic factors associated with estrogen activation at puberty. In conclusion, data thus far support a role for puberty in risk for eating disorders and highlight the need for additional human and animal studies of hormonal and genetic risk for eating disorders during puberty.
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Affiliation(s)
- Kelly L Klump
- Department of Psychology, Michigan State University, 316 Physics Rd., East Lansing, MI 48824-1116, USA.
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Klump KL, Culbert KM, Slane JD, Burt SA, Sisk CL, Nigg JT. The effects of puberty on genetic risk for disordered eating: evidence for a sex difference. Psychol Med 2012; 42:627-37. [PMID: 21854699 PMCID: PMC3697115 DOI: 10.1017/s0033291711001541] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Differences in genetic influences on disordered eating are present across puberty in girls. Heritability is 0% before puberty, but over 50% during and after puberty. Emerging data suggest that these developmental differences may be due to pubertal increases in ovarian hormones. However, a critical piece of evidence is lacking, namely, knowledge of genetic influences on disordered eating across puberty in boys. Boys do not experience increases in ovarian hormones during puberty. Thus, if pubertal increases in genetic effects are present in boys, then factors in addition to ovarian hormones may drive increases in heritability in girls. The current study was the first to examine this possibility in a sample of 1006 male and female twins from the Michigan State University Twin Registry. METHOD Disordered eating was assessed with the Minnesota Eating Behavior Survey. Pubertal development was assessed with the Pubertal Development Scale. RESULTS No significant differences in genetic influences on disordered eating were observed in males across any developmental stage. Heritability was 51% in boys during pre-puberty, puberty and young adulthood. By contrast, in girls, genetic factors accounted for 0% of the variance in pre-puberty, but 51% of the variance during puberty and beyond. Sex differences in genetic effects were only significant during pre-puberty, as the best-fitting models constrained heritability to be equal across all males, pubertal females and young adult females. CONCLUSIONS The results highlight sex-specific effects of puberty on genetic risk for disordered eating and provide indirect evidence of a role for ovarian hormones and/or other female-specific factors.
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Affiliation(s)
- K L Klump
- Department of Psychology, Michigan State University, East Lansing, MI 48824-1116, USA.
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Chi JH, Narita K, Ichimaru T, Murata T. Estrogen Increases c-Fos expression in the paraventricular nucleus along with its anorexic effect in developing rats. J Reprod Dev 2011; 57:365-72. [PMID: 21358146 DOI: 10.1262/jrd.10-189e] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Estrogen inhibits food intake in cycling females in a variety of species. To determine how the development of the anorexic system by estrogen is regulated, rat pups at four developmental stages, postnatal day 11 (P11)-13, P20-22, P25-27 and P29-31, and adult ovariectomized (OVX) rats received a daily subcutaneous injection of 20 µg/kg of estradiol benzoate (EB) or vehicle for three days. Food intake, body weight gain and immunohistochemical c-Fos expression in the brain were measured after each injection. EB treatment decreased both food intake and body weight gain from P27 onwards and significantly increased c-Fos expression in the parvocellular division of the paraventricular nucleus of the hypothalamus (pPVN), which is coincident with its anorexic effect in developing rats. The pattern of EB-induced c-Fos activation in other feeding-related nuclei did not coincide with its anorexic effect in developing pups. However, in adult OVX rats, EB treatment increased c-Fos expression in the nucleus tractus solitarius (NTS), the central nucleus of the amygdala (CeA), and, to a lesser degree, the ventromedial nucleus of the hypothalamus (VMH). These results suggested that the pPVN is an essential site in the brain for controlling the anorexic effect of estrogen and that the feeding system of rat begins to respond to estrogen before the onset of puberty (P25-28).
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Affiliation(s)
- Jing Hua Chi
- Department of Integrative Physiology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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Horner KC, Troadec JD, Blanchard MP, Dallaporta M, Pio J. Receptors for leptin in the otic labyrinth and the cochlear-vestibular nerve of guinea pig are modified in hormone-induced anorexia. Hear Res 2010; 270:48-55. [PMID: 20875846 DOI: 10.1016/j.heares.2010.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2010] [Revised: 09/20/2010] [Accepted: 09/22/2010] [Indexed: 01/13/2023]
Abstract
Metabolic syndromic inner ear pathology is a recognized condition in clinical practice but the possible causes remain controversial. We have previously reported that chronically-implanted estrogen implants in guinea pig results in hyperprolactinemia and hearing loss together with otic bone dysmorphology. The animals also present with anorexia. The hormone leptin has major roles in the regulation of satiety as well as bone metabolism and so we hypothesized that leptin might contribute to pathology of the otic labyrinth. We employed immunohistochemistry to investigate leptin receptor (ObR) expression. In control animals, ObR immunolabeling was not detected in the bone of the otic capsule but immunolabeling was observed in the cochlear-vestibular nerve. The labeling was associated with the astrocytic glial dome area, which marks the transition between central and peripheral parts of the nerve. In estrogen-treated animals, positive-ObR immunolabeling was observed in osteoblasts in new bone of the otic capsule and the ObR labeling was reduced in the cochlear-vestibular nerve compared to controls. The data provide evidence that leptin may target the labyrinth - affecting the bone and the nerve - and so could contribute to ongoing protection of the inner ear. Leptin disturbance might contribute to metabolic syndromes involving the audiovestibular system.
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Affiliation(s)
- Kathleen C Horner
- CRN2M-Dept Physiologie Neurovégétative, Université Paul Cézanne, Faculté des Sciences et Techniques, Avenue Escadrille Normandie-Niémen, 13397 Marseille Cedex 20, France.
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