Glucose regulates [H](+)-amphetamine binding and NaK ATPase activity in the hypothalamus: A proposed mechanism for the glucostatic control of feeding and satiety

Binding sites for [3H](+)-amphetamine in the hypothalamus may mediate the anorectic actions of amphetamine and related phenylethylamines. To investigate further the role of these sites in the central control of appetite, the binding of [3H](+)-amphetamine to the hypothalamus and brainstem was measured following food deprivation and refeeding, the onset of genetic obesity, or the administration of 2-deoxy-D-glucose. Food deprivation for 24 to 72 hours reduced the Bmax for [3H](+)-amphetamine binding in the hypothalamus and brainstem but not in other brain areas or peripheral tissues. The decrease in hypothalamic and brainstem [3H](+)-amphetamine binding observed following food deprivation was time-dependent and rapidly reversed by brief refeeding with either rat chow or a 10% glucose solution. Moreover the changes in [3H](+)-amphetamine binding were highly correlated to corresponding alterations in blood glucose concentration. Furthermore, D-glucose, but not L-glucose increases the number of hypothalamic [3H](+)-amphetamine binding sites when administered in vivo or when added to hypothalamic slices in vitro. These data suggest that the [3H](+)-amphetamine binding site in the hypothalamus and (or) brainstem may be coupled to a central "glucostat."     

Evaluation of anorexia and analysis of related factors in patients with COVID-19

ObjectiveCOVID-19 may cause an anorexic situation. This in turn leads to underfeeding, puts the patient in an energy protein malnutrition state, develops the hyperinflammation, weakens the immunity, and makes COVID-19 conditions more dangerous. Meanwhile, the more severe inflammation conditions in the body, the more severe the anorexia, which in turn affect the disease severity. Studies evaluating appetite in COVID-19 patients are very rare; therefore, we evaluated anorexia and analyzed the related factors in patients with COVID-19.Material and methodsIn this cross sectional study, adult patients’ ≥18 years old with the positive real-time fluorescence polymerase chain reaction for COVID-19 were included. The patients were classified as mild, moderate, and severe based on the WHO classification. We measured the appetite score, weight, height, body mass index (BMI), depression and anxiety score, at admission for every patient.ResultsA total of 301 patients participated in the study. The prevalence of admission anorexia was 58%, and this rate was significantly more in the severe group compared to the mild and moderate groups (P < 0.001). Comorbidities, depression and anxiety were independently correlated with anorexia risk [(OR = 3.6, 95% CI 1.68–7.70, P = 0.001), (OR = 1.23, 95% CI 1.16–1.30, P < 0001), and (OR = 1.24, 95% CI 1.17–1.31, P < 0001)], respectively. This correlation was adherence to a U-shape association for BMI, which means BMI < 18.5 (OR = 3.35, 95% CI 1.8–10.42, P < 0001) and BMI ≥30 (OR = 2.45, 95% CI 1.02–6.53, P = 0.048) were related to higher risk of anorexia.ConclusionWe reported a high prevalence of anorexia (58%) in COVID-19 patients, which was positively correlated with disease severity. Furthermore, any factor worsening inflammatory state, including underweight, obesity, comorbidities, depression and anxiety can exacerbate anorexia in these patients.     

Infant and Early Child Appetite Traits and Child Weight and Obesity Risk in Low-Income Hispanic Families

BackgroundChild appetite traits (ATs) are associated with later child weight and obesity risk. Less research has focused on ATs in low-income Hispanic children or included longitudinal associations with infant weight.ObjectiveTo determine stability of ATs during infancy and childhood and their relationship with subsequent weight and obesity risk at age 3 years among low-income Hispanic children.DesignA secondary longitudinal analysis of data from the Starting Early Program randomized controlled obesity prevention trial.Participants/settingThree hundred twenty-two low-income, Hispanic mother–child pairs enrolled between 2012 and 2014 in a public hospital in New York City.Main outcome measuresATs, including Slowness in Eating, Satiety Responsiveness, Food Responsiveness, and Enjoyment of Food were assessed using the Baby and Child Eating Behavior Questionnaires at ages 3 months, 2 years, and 3 years. Main outcome measures were child standardized weight-for-age z score (WFAz) and obesity risk (WFA≥95th percentile) at age 3 years.Statistical analyses performedAT stability was assessed using correlations and multilevel modeling. Linear and logistic regression analyses examined associations between ATs and child WFAz and obesity risk at age 3 years.ResultsThere was limited stability for all ATs measured over time. During infancy, Slowness in Eating was associated with lower 3-year WFAz (B = –0.18, 95% CI –0.33 to –0.04; P = 0.01). At age 2 years, Slowness in Eating and Satiety Responsiveness were associated with lower WFAz (B = –0.29, 95% CI –0.47 to –0.12; P < 0.01; B = –0.36, 95% CI –0.55 to –0.17; P < 0.01) and obesity risk (adjusted odds ratio 0.49, 95% CI 0.28 to 0.85; adjusted odds ratio 0.61, 95% CI 0.38 to 0.99) at 3 years. Increased Slowness in Eating and Satiety Responsiveness over time were associated with lower 3-year WFAz (B = –0.74, 95% CI –1.18 to –0.2 [Slowness in Eating]; B = –1.19, 95% CI –1.87 to –0.52 [Satiety Responsiveness], both P values = 0.001). Higher Enjoyment of Food over time was associated with higher 3-year WFAz (B = 0.62, 95% CI 0.24 to 1.01; P = 0.002).ConclusionsInfants with lower Slowness in Eating and Satiety Responsiveness may have higher levels of obesity risk and need more tailored approaches to nutrition counseling and obesity prevention.     

肿瘤患者食欲评价和调节的专家共识

食欲下降是肿瘤患者常见症状，癌性厌食/恶液质综合征在晚期肿瘤患者中发病率较高。肿瘤患者因营养摄入不足，会出现全血细胞减少、体重下降、脂肪组织和骨骼肌减少，导致患者免疫力降低，治疗耐受性下降，治疗机会减少，并发症增加，不利于抗肿瘤治疗措施的实施。准确评估癌性厌食的过程，无论对研究还是临床救治都极为重要，科学的食欲评价方法和技术不仅是营养工作者客观评价食欲的工具，也是进一步认识和预测营养不良的基础，对改善肿瘤患者营养不良具有积极意义。本共识根据国内外现有研究证据，对该领域的研究结果进行系统总结。从肿瘤、营养与食欲的关系出发，分析癌性厌食的发生发展机制，总结不同情况下肿瘤患者的食欲评价方法，并给出专家推荐意见。结合我国膳食现状和特点，从临床、营养、护理、中医的角度提出调节食欲的方法，科学规范癌性厌食管理策略，以便临床医师、临床营养专业人员、护士等医疗保健人员应用，更好地为肿瘤患者服务。     

Effects of Ambient Particulate Matter (PM2.5) Exposure on Calorie Intake and Appetite of Outdoor Workers

Malaysia has been experiencing smoke-haze episodes almost annually for the past few decades. PM_2.5 is the main component in haze and causes harmful impacts on health due to its small aerodynamic size. This study aimed to explore the implications of PM_2.5 exposure on the dietary intake of working individuals. Two phased 13-weeks follow-up study was conducted involving 440 participants, consisting of two cohorts of outdoor and indoor workers. Ambient PM_2.5 concentrations were monitored using DustTrakTM DRX Aerosol Monitor. Data on Simplified Nutritional Appetite Questionnaire (SNAQ) and 24 h diet recall were collected weekly. The highest PM_2.5 concentration of 122.90 ± 2.07 µg/m³ was recorded in August, and it vastly exceeded the standard value stipulated by US EPA and WHO. SNAQ scores and calorie intake were found to be significantly (p < 0.05) associated with changes in PM_2.5 exposure of outdoor workers. Several moderate and positive correlations (R-value ranged from 0.4 to 0.6) were established between SNAQ scores, calorie intake and PM_2.5 exposure. Overall findings suggested that long hours of PM_2.5 exposure affect personal dietary intake, potentially increasing the risk of metabolic syndromes and other undesired health conditions. The current policy should be strengthened to safeguard the well-being of outdoor workers.     

中文版肿瘤患者食欲症状问卷信度、效度分析

目的 对中文版肿瘤患者食欲症状问卷（CASQ）的信度和效度进行研究。方法 翻译、回译形成CASQ中文问卷,对88例肿瘤患者使用CASQ进行问卷调查,并对中文版CASQ进行条目区分度检验,同时采用PG-SGA评估纳入研究对象的营养风险,将PG-SGA与CASQ比较并进行效度检验。在第一次测量之后,间隔7天进行第二次测量,并同时对前后两次的CASQ进行信度研究。结果 CASQ各条目得分与问卷总分的相关系数在0.242~0.653之间,差异有统计学意义（P<0.05）,重测信度系数结果表明数据行为良好,分半信度结果为0.560,内部一致性信度系数为0.436,中文版CASQ总分与PG-SGA总分的rs值为-0.475。结论 中文版的肿瘤患者食欲症状问卷具有较好的信度和效度。     

What is the role of dopamine in reward: hedonic impact, reward learning, or incentive salience?

What roles do mesolimbic and neostriatal dopamine systems play in reward? Do they mediate the hedonic impact of rewarding stimuli? Do they mediate hedonic reward learning and associative prediction? Our review of the literature, together with results of a new study of residual reward capacity after dopamine depletion, indicates the answer to both questions is `no'. Rather, dopamine systems may mediate the incentive salience of rewards, modulating their motivational value in a manner separable from hedonia and reward learning. In a study of the consequences of dopamine loss, rats were depleted of dopamine in the nucleus accumbens and neostriatum by up to 99% using 6-hydroxydopamine. In a series of experiments, we applied the `taste reactivity' measure of affective reactions (gapes, etc.) to assess the capacity of dopamine-depleted rats for: 1) normal affect (hedonic and aversive reactions), 2) modulation of hedonic affect by associative learning (taste aversion conditioning), and 3) hedonic enhancement of affect by non-dopaminergic pharmacological manipulation of palatability (benzodiazepine administration). We found normal hedonic reaction patterns to sucrose vs. quinine, normal learning of new hedonic stimulus values (a change in palatability based on predictive relations), and normal pharmacological hedonic enhancement of palatability. We discuss these results in the context of hypotheses and data concerning the role of dopamine in reward. We review neurochemical, electrophysiological, and other behavioral evidence. We conclude that dopamine systems are not needed either to mediate the hedonic pleasure of reinforcers or to mediate predictive associations involved in hedonic reward learning. We conclude instead that dopamine may be more important to incentive salience attributions to the neural representations of reward-related stimuli. Incentive salience, we suggest, is a distinct component of motivation and reward. In other words, dopamine systems are necessary for `wanting' incentives, but not for `liking' them or for learning new `likes' and `dislikes'.     

肿瘤恶液质的药物治疗研究进展

当恶性肿瘤发展到晚期的时候,肿瘤恶液质是其中较为常见的一类并发症,临床症状表现为肌肉、骨骼量减少,或存在脂肪含量降低、食欲下降、人体代谢失调,进而导致器官功能缺失。研究发现约五分之一的恶性肿瘤患者因肿瘤恶液质导致死亡,肿瘤恶液质的发生对患者生活造成严重影响,增加治疗时间、提高治疗成本、生活质量下降、减少生存时间。肿瘤恶液质发病机制较为复杂,目前已知的发病机制包括在肿瘤组织的长期刺激下引发的不可逆转性慢性炎症;炎症反应后影响人体代谢平衡;炎性因子抑制中枢神经有益物质的分泌,减少人体食欲信号等。现阶段临床上对于该疾病的发病原理取得一定研究成果,随着研究的不断深入,对其治疗药物具有一定的认识。针对其发病机制治疗肿瘤恶液质需要多种渠道共同作用,给予患者充分的营养以及药物联用等。本文将从目前使用较多的食欲刺激类药物（孕激素、胃饥饿素）、抗炎类（非甾体抗炎药、沙利度胺、ω-3脂肪酸）、蛋白降解抑制类、代谢调节类（雄激素受体调节剂、β-受体阻滞剂）药物治疗的效果展开分析,并针对目前药物联合治疗的研究进展进行讨论。