Mavitamini. 2014 Oct; 6 (10): 4338-4353.
Idasindikizidwa pa intaneti 2014 Oct 16. do: 10.3390 / nu6104338
PMCID: PMC4210920
Caroline Davis1,* ndi Natalie J. Loxton2
Kudalirika
Ngakhale kuti chizoloŵezi cha zakudya chilibe tanthawuzo lovomerezeka, zimakhala zovomerezeka malinga ndi zizindikiro zomwe zimayikidwa ndi Yale Food Addiction Scale-Magwiritsidwe ntchito pogwiritsa ntchito chizindikiro chovomerezeka ku DSM-IV. Pakalipano, pali kafukufuku wochepa wokhudzana ndi zamoyo zomwe zimawonekeratu chifukwa chowopsya. Zomwe zilipo zakhala zapadera pa njira za mphotho za dopaminergic mu ubongo. Pamene ubongo chizindikiro cha opioid zakhala zikukhudzidwa kwambiri ndikuyendetsa chakudya, palibe kafukufuku wakuyang'anira dera lozungulira la neural pokhala ndi chizoloŵezi cha zakudya. Cholinga cha phunziroli chinali kuyesa chitsanzo cholongosola kuti mphamvu zowonjezera zowonjezera ma opioid-monga momwe ziwonetsedwera ndi chizindikiro cha A118G cha mu-opioid receptor geni-ingakhale ngati njira yodzidzimutsa yomwe ingayambitsire kudya mowa mwauchidakwa chokhala ndi chakudya chokoma. Zotsatira zinatsimikizira ubalewu. Kuwonjezera apo, zomwe tinapeza kuti gulu lachizoloŵezi cha zakudya zomwe zili ndi machitidwe okhudzana ndi chakudya cha hedonic zimasonyeza kuti khalidweli lachikhalidwe limapangitsa kuti anthu adye chakudya, kudya zakudya zolimbitsa thupi, komanso potsiriza chakudya chokwanira kudya.
1. Introduction
Kuzindikira kuti kudyetsa kudya mopitirira muyeso kungabweretse mavuto aakulu m'maganizo mwa anthu ena omwe adachititsa kuti American Psychiatric Association (APA) iwonetse Binge Eating Disorder (BED) ovomerezeka matenda opatsirana mu "Kudyetsa ndi Kudyetsa Matenda" chaputala cha kope lachisanu lasindikizidwa posachedwapa Buku Lophatikiza ndi Kuwerenga (DSM-5) [1]. Panthawi imodzimodziyo, DSM-5 inadziwanso, kwa nthawi yoyamba, kukhalapo kwa Matenda Osagwirizana ndi Zomwe Zili M'gulu lake pamutu wakuti "Kugonana ndi Matenda Okhudzana ndi Matenda", ngakhale kutchova njuga ndilo vuto lokhalo lomwe lili m'gulu lino kabuku [2].
Kusintha kwa malingaliro a maganizo, omwe amapezeka m'machaputala onsewa a DSM-5, kukhoza kuchititsa kuti chiwerengero cha matenda okhudzidwa ndi chithandizo chachipatala ndi chodziwikiratu kuledzera kwa zakudya. Izi zimakhala zosiyana, komabe, potsutsana zokhudzana ndi mankhwala ndi zosakhudzana ndi mankhwala mavuto osokoneza bongo. Kumbali imodzi, pali kuvomereza kwowonjezereka kuti ambiri amagwiritsa ntchito zakudya-makamaka omwe awo amatha kupindula ndi shuga zambiri, shuga, ndi mchere-ali ndi katundu wofanana ndi zinthu monga cocaine, nikotini, ndi mowa momwe amatha kupotoza ubongo umapereka njira (onani [3,4]). Komanso, akawongolera mopitirira muyeso angayambitse mazira omwe amachititsa kuti munthu adye, azidalira, komanso azilakalaka, mofanana ndi mankhwala osokoneza bongo. Komabe, kudya kumeneku kungawonedwe ngati khalidwe lodzudzula chifukwa chakuti limatha kudzutsa mphamvu zonse mu njira yokondweretsa, kuchokera kumvekedwe ndi kununkhira kophika, kupita ku zokongoletsera zokongola ndi zochititsa chidwi chakudya chokonzedwa. Ngakhalenso zamanyala za zakudya zina m'kamwa zingakhale zopindulitsa kwambiri musanayambe kumwa.
Chochititsa chidwi ndi chakuti, umboni wina wotsutsana ndi anthu umasonyeza kuti lingaliro la kuledzeretsa kwa zakudya limakhala loopsya kwambiri ku chikhalidwe chachisokonezo kusiyana ndi kusuta kapena kumwa mowa mwauchidakwa, ndipo kuti nthawi zambiri amawoneka ngati khalidwe labwino osati vuto logwirizana ndi mankhwala [5]. Mwa kuyankhula kwina, kuledzera kawirikawiri kumawoneka ngati "vuto la malingaliro" komwe zimayambitsa kudya monga kusankha kwaumwini ndi njira yothetsera kusokonezeka kwaumwini. Malingana ndi maganizo awa, matendawa ndi obvuta kudya; ndi osati zogwirizana kwambiri ndi khalidwe loledzera la zakudya zina. Komabe, kafukufuku wina wamakono wofufuza anapeza kuti pamene osankhidwa akuluakulu osankhidwa mwadzidzidzi anali ndi zakudya zowonongeka ndi kuganizira za njira zowonongeka, kunyalanyaza ndi kulakwitsa kuti anthu ochepa kwambiri adachepetsedwa poyerekeza ndi kuwerengera kwa gulu lina la ophunzira omwe anapatsidwa chitsanzo choletsa kunenepa kwambiri. Mgulu lakale, kunalinso kuchepetsa kuganiza kuti anthu ovutika kwambiri amakhala osokonezeka maganizo, ndipo kuchepa kwa ophunzirawo kumaopa kulemera kwaumwini [6].
1.1. Kuyankha kwa Hedonic ndi Mphamvu ya Mphoto
Mchitidwe wa Hedonic ndi khalidwe lopindulitsa kwambiri lomwe limasonyeza kusamvana payekha chifukwa cholimbikitsidwa kufunafuna zokopa zabwino m'madera a munthu, komanso kukhala ndi mwayi wokondwera ndi zochitikazi [7]. Natural Mphotho zimaphatikizapo zolimbikitsa zonse zofunika kuti tipulumuke monga kudya, kubereka, ndi kusamalira. Kuyesera kumvetsetsa chilengedwe cha hedonic response makamaka pa mphamvu, kapena kukhumudwa, ya mesocorticolimbic dopamine njira [7]. Kusalidwa kosatha pokhala ndi dzina loyenera anhedonia-kuyamba kufotokoza zachipatala kumapeto kwa zaka za 19th monga zofunikira za matenda ambiri a matenda a maganizo kuphatikizapo kuvutika maganizo, schizophrenia, ndi kuchotsa mankhwala [8]. Kaŵirikaŵiri amagwirizana kuti hypo-kugwira ntchito kwa mphotho zowonjezera ubongo kungakhale chikhalidwe cha umunthu chokhazikika chomwe chimatsimikiziridwa ndi kugwirizana kwa zotsatira za majini zomwe zimagwirizanitsa kuti zikhale zochepa [9]. Komabe, chikhalidwe choterechi chingasokonezedwe ndi njira zowonongeka za dopaminergic kudzera mwachangu za dopamine agonist monga zinthu zoponderezedwa ndi / kapena ndizopweteka-zomwe zimapangitsa kuti anthu asamayende bwino [10].
Posachedwa, bipolar motsutsana ndi anhedonia-high mphotho yokhudzidwa-kugwirizana ndi chiopsezo cha kudya mowa mwauchidakwa ndi zovuta zina zowonongeka, potsutsana ndi mfundo yakuti omwe ali ndi cholinga cholimbikitsira mphotho amakhala otheka kuchita zinthu zosangalatsa ndi zochepa zoletsedwa poyerekeza ndi anzawo ena a anedonic [11,12,13]. Zakudya zomwe zimadya pamapikowa nthawi zambiri zimakhala zotsika kwambiri komanso zimakhala zosangalatsa kwambiri [14], kutanthauza ntchito yofunika kwambiri kwa oyendetsa magalimoto a neural omwe amachititsa kuti anthu azidya mowa mwauchidakwa chifukwa chodya mopitirira muyeso. Hedonic kumvetsera chakudya ndi mawonekedwe enieni a khalidwe lofotokozedwa pamwambapa, ndipo amasonyeza kukula kwa chilakolako chodya, komanso zosangalatsa zomwe zimachokera ku zakudya zomwe zimakhala bwino kwambiri, komanso zowoneka bwino komanso zokongola. Chifukwa chake, imodzi yokhala ndi mphamvu yowonjezera chakudya imayesedwa kudya ngakhale kuti palibe njala kapena caloric [15], ndikumva zolakalaka zazikulu za chakudya [16].
1.2. Chilengedwe Chachilengedwe Cha Chakudya Chogonjetsa
Pakalipano, pali chiwerengero cha kafukufuku wa biologically wofufuza zomwe zimayambitsa chiopsezo cha kuledzera. Zomwe zilipo zakhala zapadera pa njira za mphotho za dopaminergic mu ubongo. Mwachitsanzo, kafukufuku waposachedwapa anawonetsa kuti akuluakulu omwe ali ndi chizoloŵezi cha zakudya ali ndi mapepala apamwamba kwambiri ponena za mphamvu ya genetic ya dopamine yozindikiritsa mphamvu poyerekezera ndi zaka zawo ndi zofanana ndi zolemera zawo [16]. Kafukufuku wina anapeza kuti mphotho yowonjezereka m'magulu otchedwa amygdala ndi pulezidenti, poyang'anira chakudya, idalumikizidwa bwino ndi zizindikiro zokhudzana ndi zakudya m'gulu la akazi achikulire [17]. Onsewa akupeza mesh ndi maumboni ena okhudza khalidwe labwino kuti zakudya zowonongeka [18], monga BED, ndi phwando lopindula kwambiri la mphotho ya kunenepa kwambiri [9]. Palinso chithandizo choyambirira cha lingaliro lakuti zizoloŵezi zina za chizoloŵezi cha zakudya zingakhale zowonjezereka komanso zopanikizika za BED m'malo mosiyana ndi chipatala chosiyana [19]. Kuonjezera apo, kugwirizana kwa zakudya zamagulu ndi bulimia nervosa (BN) yakhala ikugwirizana ndi matenda oopsa kwambiri [20]. Komabe, palinso anthu omwe ali ndi vuto lodya zakudya zomwe zimawonetsa BMI (Mitambo ya Misa ya Thupi) ndi kuwonongeka kwa kachipangizo ngakhale kuti sizinakwaniritse zofunikira za BN kapena BED, zomwe zikusonyeza kuti nthawi zambiri anthu amatha kudya zakudya zolimbitsa thupi nthawi zambiri.20]. Umboni waposachedwawu umatsindiranso ndi zofukufuku za maphunziro awiri oyambirira kumene hafu theka akuluakulu omwe anapezeka kuti ali ndi chizoloŵezi cha zakudya anakumana ndi zofunikira za BED [18,21].
Njira ya ubongo wa Opioid ndi Chakudya Chakudya
pamene chizindikiro cha opioid M'dera la ubongo lakhala likuphatikizidwa kwambiri kuti azidya zakudya, komabe palibe kafukufuku wakuyesa kukopa kwa magalimoto oyendetsa nyerere omwe ali pa chiopsezo cha zakudya. Komabe, kafukufuku wapadera kwambiri amasonyeza kuti kutsegulira mu-opioid receptor (MOR) mu nucleus accumbens amachititsa kuti anthu azidya mowa mwauchidakwa ngati akudya zakudya zokoma ndi zonenepa [22,23]. Kuonjezera apo, kuwonetsa kudzera mwa accumbens MOR kumawoneka kuti akuyang'anira zokonda zomwe ophunzira amaphunzira, ndipo miyezo yowonjezera yapezeka kuti ikulimbikitsanso kudya moyenera komanso zakudya zosakondera [24]. Mosiyana ndi zimenezo, muOtsutsana ndi oopioid amachepetsa kuchepa kwa hedonic, komanso kudya, zakudya zokoma pa anthu odyera ndi olemera kwambiri [25]. Palinso umboni wosonyeza kuti kupititsa patsogolo mwambo wa MOR chifukwa chodya zakudya zowonongeka kwambiri kungayambitse chizindikiro cha opioid chifukwa cha kusintha kwa nthawi yaitali m'ntchito ya receptor [26]. Komabe, kafukufuku wamakono watsopano anapeza kuti ntchito yofooka ya opioid inali yogwirizana ndi kudya kwakukulu kwa hedonic, kudya kwakukulu kwa zakudya zamakono, komanso kudya kwambiri, ngakhale kuti zofukufukuzi zikuphatikizidwa chifukwa kuyesa kunkagwiritsidwa ntchito mwachindunji ntchito [27]. Mwachidule, kafufuzidwe kafukufuku amasonyeza kuti ntchito yayikulu ya opioid imakhala ndi zizindikiro zowonongeka zokhudzana ndi zakudya zopatsa thanzi-kuphatikizapo kudya, kukhumba, ndi kuchotsa ngakhale kuti palibe chifukwa chodziwiratu [27].
Pa mitundu yambiri ya ma genetic yomwe imapezeka pa MOR gene (OPRM1), nucleotide polymorphism (A118G (rs1799971) yosakanikirana ndi nucleotide polymorphism (SNP), yomwe ili m'dera la coding ya exon 1, yakhala yophunzira kwambiri, makamaka pokhudzana ndi mankhwala osokoneza bongo Ngakhale kuti Njira zeniyeni sizidziwika bwino, a mu m'galasi Kafukufuku wasonyeza kuti kachilombo kaching'ono G kamapangitsa kuti kuwonjezeka katatu kumangirire mgwirizano wa mapeto otchedwa beta-endorphins ndipo amachititsa kuti mapuloteni oyambitsa mapuloteni a G [28]. Posachedwa mu vivo Umboni umatsimikiziranso lingaliro la G lokha ndilo "kupindula" kwa anthu omwe ali ndi vutoli laling'ono [29]. Mwachitsanzo, kafukufuku wina adawonetsa kuchulukitsa kwa chiwerengero cha G chochuluka mwa oledzeretsa ndi opioid ku India poyerekezera ndi anthu ambiri [30], zofanana ndi zomwe zinafukufuku wa ku Sweden wakale [31]. Gulu la oledzera omwe amanyamula G allele ananenanso kuti akumwa mowa mwauchidakwa poyerekeza ndi anzawo omwe ali ndi kachilombo ka AA, ngakhale kuti sanasiyana ndi zotsatira zoledzeretsa za mowa [32]. Komabe, si maphunziro onse, komabe, apeza mayanjano oterowo mu kafukufuku wosokoneza bongo [33,34].
Kafukufuku wa bungwe la majeremusi awonanso zochepa zizindikiro zogwiritsa ntchito kuchipatala cha makhalidwe oledzera. Mwachitsanzo, zonyamulira achinyamata za G allele anali ndi mavuto ambiri oledzera mowa komanso zopangira kumwa mowa mopitirira malire kuposa omwe sanakhale nawo [35]. Mofananamo, monga momwe ziwonetsedwera ndi kukhazikitsidwa kwa maofesi a ubongo, akuluakulu a G akuluakulu amasonyeza kuti amadalira kwambiri kumwa mowa, komanso kumvetsetsa mowa kwambiri [36,37].
Palinso umboni wina wosonyeza kuti kusiyana kwa ntchito ya OPRM1 kumatanthawuza kuzindikira achilengedwe mphoto. Pakati pa anyani aang'ono, G ogwira ntchito zothandizira anagwirizana kwambiri ndi mazimayi awo ndipo amasonyeza kupweteka kwakukulu panthawi yolekanitsa amayi [29]. Zowonjezereka, zonyamulira za anthu G zasonyeza kuti ali ndi mphamvu zowonjezera za chikhalidwe monga momwe amasonyezera ndi chizoloŵezi chowonjezeka chokhala ndi chiyanjano chokondana ndi kusonyeza kwakukulu kwa chisangalalo m'makhalidwe achikhalidwe [38]. Kuwonjezera pamenepo, tapeza, kwa nthawi yoyamba, muKusiyanasiyana kwa mitundu yosiyanasiyana ya majoka poyerekeza ndi kukonda zakudya zokoma ndi zonenepa ndi gulu lodziwika bwino la gulu la GG lipoti lapamwamba kwambiri la chakudya poyerekeza ndi magulu ena awiri [18]. Zosiyana, komabe, kuchokera ku maphunziro ena kumene magulu a GG ndi GA genotype amasonkhana pamodzi mu kufufuza kwa chiŵerengero, zomwe tinapeza zimapereka njira yowonjezereka yopititsira patsogolo kumene makope awiri a G allele akufunikira kufotokoza zotsatira.
1.3. Phunziro Lachidule
Ngakhale kuti chizoloŵezi cha zakudya sichikutanthauza kutanthauzira kwachidziwitso, kawirikawiri chimagwiritsidwa ntchito mogwirizana ndi zizindikiro zomwe zimayambitsidwa panthawi yopititsa patsogolo Yale Food Addiction Scale (YFAS) [39] -Kudziŵerengera nokha kafukufuku wokhudzana ndi chizindikiro choyenerera kuti munthu azidalira kwambiri DSM-IV [40]. Kawirikawiri, amadziwika ndi matenda osapitirira malire, omwe amakula kwambiri, komanso amadzimangirira mopitirira muyeso, nthawi zambiri monga mawonekedwe a binge, monga kutsimikiziridwa ndi kugwidwa kwake kwakukulu ndi BED [18,21].
Kafukufuku wamakono ndi woyamba kuyang'ana chiwonetsero cha chiwalo cha ubongo opioid mu chiopsezo cha YFAS chakumwa kwa zakudya. Mwachindunji, cholinga chinali kuyesa njira yosayimilira ya zotsatira zomwe zikuwonetsedwa Chithunzi 1. Mwachindunji, tinaneneratu kuti njira yowonjezera yogwiritsira ntchito opioid yoyendetsa njira yowonjezera mphoto-monga momwe amasonyezera ndi GG polymorphism ya chizindikiro cha A118G cha MOR-chikanakhala ngati chiopsezo cha kuledzera kwa zakudya. Mpangidwe wa conduction unasokonezedwa kuti ukhale mgwirizano wosagwirizana ndi njira yowonjezera ya hedonic chakudya chokoma. Mwachindunji, GG genotype idzaphatikizidwa ndi kutengera kwakukulu kwa hedonic, yomwe ikuwonetsedwa ngati kusintha kwakukulu ndi zizindikiro zitatu zosiyana-viz. hedonic kudya, zilakolako za zakudya, ndi zokonda chakudya chokoma ndi mafuta. Chotsatira chake, kutengeredwa kwa uzimu kunaneneratu kuti kugwirizanitsa bwino ndi zizindikiro za kusokonezeka kwa zakudya monga zikusonyezedwa ndi zambiri pa YFAS.
2. Njira
2.1. Ophunzira
Akulu zana limodzi makumi anayi ndi zisanu (akazi: 100; amuna: 45) pakati pa zaka za 25 ndi zaka 47 adagwira nawo phunziro. Kugawidwa kwa mafuko kunali 80% Caucasian, 16% Afirika, ndi 4% ena. Ophunzirawo adatumizidwa kuchokera ku posters omwe anaikidwa m'mabungwe a boma akupempha odzipereka kuti aphunzire za makhalidwe odyera. Zofalitsa zinayambanso ku nyuzipepala zamakono ndi malo ochezera pa intaneti. Ophunzira adafunikila kuti azikhala bwino mu Chingerezi, ndipo akhala ku North America kwa zaka zosachepera zisanu asanalowe kulembetsa chakudya chokhala ndi chiyanjano kwa nthawi yambiri yolembetsa mu phunziro. Amayi anafunikanso kukhala mchitidwe wam'mbuyomu wam'mbuyo wamtunduwu monga mwadzidzidzimwini wokhudzana ndi zochitika za nthawi ya kusamba, komanso osakhala ndi mimba mkati mwa miyezi isanu ndi umodzi yapitayi. Njira zochotsedweramo zikuphatikizapo matenda (psychotic) kapena matenda osokoneza bongo amasiku ano (kapena mbiri). Anthu omwe ali ndi matenda aakulu / matenda monga khansara kapena matenda a mtima adatulutsidwa, komanso omwe amatenga mankhwala omwe amakhudza njala (mwachitsanzo, mankhwala osokoneza bongo). Njira zomwe zagwiritsidwa ntchito mu phunziro lino zinavomerezedwa ndi bungwe la Research Ethics ndipo linayendetsedwa molingana ndi Declaration of Helsinki.
2.2. Njira
2.2.1. Kujambula
Kuchotsa DNA kuchokera ku magazi onse kunatsirizidwa ndi mchere wosakhala ndi enzymatic, wamchere wambiri monga momwe Lahiri ndi Nurnberger anafotokozera [41]. Ife tinayesa ntchito ya A118G imodzi yokha ya nucleotide polymorphism (SNP), yomwe imayambitsa amino acid osasintha kuchokera ku malo otsala a aspartate kupita kumalo osungunuka, kotero kuti akhoza kuchotsa N-glycosylation site [42]. SNP iyi inali genotyped pogwiritsira ntchito malonda ogwiritsira ntchito magetsi (Applied Biosystems Inc., Foster City, CA, USA). Genomic DNA (20 ng) inakula mu zotsatira za 10-μL ndi polymerase chain reaction ndi zinthu zotsatirazi: 95 ° C 10 min, yotsatira 50 miyendo ya 92 ° C 15 s, 60 ° C 1min. Ndondomeko Yopondereza Yopatsa Pakati pa ABI7000 Prism Sequence Detection System inagwiritsidwa ntchito kuti mudziwe za genotype za munthu aliyense. Zolemba zapadera zinayesedwa kuti zikhale zolimba ku Hardy-Weinberg Equilibrium pogwiritsa ntchito Haploview version 4.2 (Broad Institute, Cambridge, MA, USA) [43].
2.2.2. Mafunso Odziimira Odzidzimvera
Chakudya Chakudya anapezeka akugwiritsa ntchito YFAS. Njirayi imakhala yodalirika kwambiri ndi zizindikiro zina zoyenera kudya, makamaka kudya mowa, ndipo zikhoza kukhala chida chothandiza kuzindikira anthu omwe ali ndi chizoloŵezi chosokoneza chakudya [39]. Chiwerengero cha 25-chinthucho chinapangidwa kuti chigwiritse ntchito mankhwala osokoneza bongo malinga ndi zizindikiro za 7 zokhudzana ndi mankhwala omwe analembedwa mu DSM-IV, ndipo amasinthidwa kuti azidya. YFAS imapereka zonse zoyenerera (binary) komanso zowerengera zamakono. Mofanana ndi momwe DSM imadalira anthu, zimakhala zovuta kuti munthu adziwe kuti ali ndi vuto lodya zakudya ngati wodwalayo atakhala ndi zizindikiro zitatu kapena zingapo pa chaka chatha, ndipo ngati chiwerengero cha "vuto lachirema" chikupezeka. Mapulogalamuwa amapezeka polemba chiwerengero cha zizindikiro zomwe zimaperekedwa, choncho zimachokera ku 0 mpaka 7. Kwa chitsanzo ichi, alpha coefficient ya Cronbach kuti chizindikiritso cha chizindikiro chikhale 0.78.
Kukonda Fat High and High Sugar Foods adayesedwa ndi Kafukufuku Wosakondera Chakudya [44], yomwe ndi chiwerengero cha 72-chinthu chopangidwa ngati 2 (FAT: mkulu vs. ochepa) × 3 (CARBOHYDRATE: apamwamba kwambiri, apamwamba kwambiri, otsika kwambiri m'thupi / mapuloteni apamwamba) mlingo wokonda mitundu yambiri ya macronutrients. Otsutsawo amasonyeza zomwe amakonda pa chakudya chirichonse pazitsulo zisanu ndi zinayi za Likert. The Kusankha Kwakukulu kwa Fat ndi High Sugar Malipiro ndi matanthauzo a mafuta a 12 ndi zakudya zowonjezera chakudya (mwachitsanzo, keke ya chokoleti, ndi pecan pie). Olemba amanena kuti kudalirika ndi zowona zazigawozi, ndipo chiwerengero cha alpha pa chiwerengero ichi mu phunziro lathu chinali 0.81.
Hedonic Kudya adayesedwa ndi Mphamvu ya Chakula Chakudya [45], lomwe liri funso la 21-chinthu chomwe chimasonyeza kusiyana kwayekha mukumvetsera kwa chakudya chodetsa nkhaŵa m'madera ndi chakudya chochuluka chokoma, osagwiritsa ntchito moyenera chakudya cha munthu. Mwa kuyankhula kwina, zimasiyanitsa zoyendetsa komanso zoyendetsa galimoto kuti zipeze chakudya kuchokera ku chizoloŵezi cha (pa) kudya chakudya. Fupi ya alpha ya Cronbach mu phunziro ili linali 0.96.
Kukonda Zakudya anayesedwa ndi Pepala la Kufuna Chakudya-Makhalidwe [46]. Chiwerengero ichi cha 39 chimaonetsa mbali zakuthupi ndi zamaganizo zokhumba zakudya-mwachitsanzo, monga njala, kukhudzidwa ndi chakudya, ndi kusowa mphamvu. Chigawo cha alpha chinali 0.97.
2.3. Ndondomeko
Pofuna kutsimikizira koyambirira, foni yoyamba kufufuza ikuyendetsa limodzi ndi iwo omwe amasonyeza chidwi chochita nawo phunziroli. Pa tsiku lachisankhulo, kuyankhulana kwachipatala, maso ndi maso, kuyankhulana kwachipatala kunayambanso kupatsimikizira kutsimikizirika, pambuyo pake chilolezo chodziwitsidwa ndi chidziwitso chonse chodziŵika cha anthu chinapezedwa. Kutalika ndi kulemera kunayesedwa ndi wophunzirayo atayima kusunga mapazi ndi kuvala zovala zoyera. Chitsanzo chamagazi choopsa kwambiri chinatengedwa kuchipatala cha chipatala, ndipo phukusi la mafunsoli linamaliza kunyumba ndipo linabwereranso tsiku linalake.
2.4. Kusanthula Kwasanthu
Matenda a Hardy-Weinberg ndi matenda ogwirizanitsa anayesedwa pogwiritsa ntchito chi-squared test kudzera Haploview, version 4.2 (Broad Institute, Cambridge, MA, USA) [43]. Kusiyanasiyana pakati pa ma OPRM1 A118G ndi mitundu yosiyanasiyana yapamwamba yapadera inayesedwa ku IBM SPSS Statistics Mac, Version 22 (IBM Corp., Armonk, NY, USA) pogwiritsa ntchito njira za Analysis of Variance (ANOVA). Pofuna kuyesa ngati panalibe chizindikiro chodziwika bwino cha chizindikiro cha A118G ndi chiwerengero cha zizindikiro zowonjezera chakudya mwa njira ya hedonic, njira zomwe Hayes ndi Preacher akufotokoza [47] adatsatiridwa. Njirayi imalola kugwiritsa ntchito mitundu yosiyanasiyana yodziimira, ndikuyesa kufunikira kwa njira yosagwiritsiridwa ntchito pogwiritsa ntchito bootstrapping yokonzedwanso. SPSS "MEDIATE" yopangidwa patsogolo kuti ikhale limodzi ndi pepala la Hayes ndi Preacher [47] -Wagwiritsidwa ntchito kuti azindikire kufunika kwa zotsatira zake mwachindunji. Pomwe pali magulu atatu a ma genotype, zolemba zolembera zinayesedwa ndi GA heterozygous monga gulu lofotokozera (Zomwezo zimapezeka poika GG allele gulu ngati gulu lofotokozera). Njira iyi yoyesera zotsatira zosawoneka imayambitsa mtengo wopangidwa ndi njira a (chiyanjano pakati pa zowonongeka, mwachitsanzo, gulu la genotype ndi kusintha kwapakatikati mwachitsanzo, hedonic response) ndi njira b (mgwirizano pakati pa kusintha pakati pa osamalitsa ndi zotsatira zake zosinthika, mwachitsanzo, zizindikiro za kuledzera). Mu phunziro ili, nthawi zokhudzana ndi bootstrap zokonzedweratu (n = 1000) idakhazikitsidwa pa 95%, ndipo idagwiritsidwa ntchito kufufuza tanthauzo la zotsatira zosawoneka. Chifukwa pali magulu atatu a genotype, pali awiri a Njira (GG vs. GA ndi AA vs. GA) ndipo pambuyo pake, mayesero awiri a zotsatira zosawonekera. Kupezeka kwa zero mu nthawi ya chidaliro kumasonyeza zotsatira zosaoneka bwino.
3. Zotsatira
3.1. Mafotokozedwe Otsindika
Gulu 1 imapereka maulendo omwe amathandiza kuti awonetsere kuti ali ndi kachilombo koyambitsa matenda a A118G SNP. Zotsatira zinatsimikiziranso kuti chizindikiro ichi chinali ku Hardy-Weinburg. Kafukufuku wam'mbuyomo amasonyeza kuti maulendo omwe amatha kukhalapo pamtundu umenewu amasiyana kwambiri ndi mitundu yonse [30]. Popeza kuchuluka kwa zitsanzo zomwe zilipo ndi Caucasus, komabe chifukwa chakuti chitsanzo sichikwanira kwambiri kuti chikhale chachiyanjano, tawonanso zochitika zonse pamodzi. Zitha kuwonetseka kuti nthawi zambiri za G zomwe zimakhalapo muzitsanzo zathu zonse zimakhala zofanana ndi zitsanzo zina za ku Caucasus zomwe zafotokozedwa mwachidule mu Deb ndi momwe anzanu akuyendera [30], komanso mu phunziro lapitalo pogwiritsa ntchito chitsanzo chomwecho [12].
Mitundu itatu ya kutengera kwa hedonic (mwachitsanzo, zilakolako zakudya, hedonic kudya, ndi mafuta apamwamba / shuga amakonda) mwaulere kuti kwambiri inter-correlated monga kuyembekezera. Choncho ziwerengero zambiri zinagwiritsidwa ntchito pogwiritsa ntchito Mutu Waukulu Wophatikizapo. Chigawo chochotsedweramo chinayimira 66% ya kusiyana pakati pa miyeso itatu, ndipo onse atatu atanyamula kwambiri pa chinthu ichi (kulemetsa pakati pa 0.52 ndi 0.93). Njirayi imathetsa mavuto omwe akugwirizana ndi miyambo yambiri yomwe ingasokoneze zotsatira zowonjezereka ngati zitsanzo zitatuzi zinawonjezeredwa pa chitsanzo pawokha. Ikuonjezeretsanso kukhulupirika kwake [48].
Gulu 2 ziwonetsero zotsatila komanso zosiyana siyana za msinkhu, BMI, hedonic-response (factor score) ndi zizindikiro zowonjezera zakudya. Njira imodzi ya ANOVA njira sizinapeze kusiyana kwakukulu pakati pa magulu a genotype pa msinkhu, BMI, kapena zizindikiro za mankhwala osokoneza bongo. Komabe, panali kusiyana kwakukulu mu hedonic-response. Lowani zolemba Kuyerekezera, pogwiritsa ntchito njira yosiyana kwambiri yosiyana, anapeza kuti magulu awiri a GG ndi AA anali ndi chiwerengero chachikulu cha hedonic-responsiveness kuposa gulu la GA (GG vs. GA, p = 0.026; AA vs. GA, p = 0.004), koma sanali kusiyana wina ndi mnzake (GG vs. AA, p = 0.368). Kuyankha kwa Hedonic kunayanjaniranso bwino ndi zizindikiro za chizindikiro cha YFAS (r = 0.68, p 0.001). Kugonjetsedwa kwapadera kwazinthu kunachitanso kuti awonetsetse mgwirizano pakati pa kuteteza kwa hedonic ndi matenda a YFAS. Monga ananenedweratu, ziwerengero zapamwamba zambiri zinkakhudzidwa ndi mwayi wochuluka wopeza chidziwitso cha mankhwala osokoneza bongo (B = 1.89, Bse = 0.36, Wald = 28.22, p 0.001). Komabe, kupatsidwa kwafupipafupi kwa anthu omwe ali m'gulu la mankhwala ozunguza bongo x magulu a genotype, zinali zoyenera kwambiri kuti asagwiritsire ntchito mapepala a chizindikiro cha YFAS monga momwe amachitira pofufuza.
Chiyeso cha zotsatira za kugonana, pogwiritsa ntchito njira zodziyesera zovomerezeka, sizinayambe kusiyana pakati pa magulu pa mapepala ovomerezeka a hedonic kapena chiwerengero cha YFAS Symptom.
3.2. Zotsatira Zosawoneka
Chifukwa cha kugwirizana kwakukulu pakati pa magulu a genotype komanso chiwerengero cha hedonic, komanso chifukwa chakuti mapulogalamuwa amathandizidwa kwambiri ndi zizindikiro za chizindikiro cha YFAS, zotsatira zake zowonongeka mwachindunji zinachitidwa kuti ziwone ngati kuthamanga kwa hedonic kungakhale njira yothetsera pakati pa chizindikiro cha A118G ndi kuledzera kwa zakudya. Zotsatira za gulu la genotype ndi kuledzera kwa zakudya (posakhala "kusiyana") sizinali zofunikira. Tiyenera kukumbukira, kuti, mayesero a zotsatira zosaoneka bwino angathe kuchitidwa pokhapokha ngati palibe mgwirizano wodzinso pakati pa chiwerengero chosinthika ndi zotsatira zake zosinthika [49,50]. Izi ndizo makamaka pazinthu zosiyana siyana zomwe zimakhala zosiyana kwambiri ndi zotsatira zake, monga momwe zilili pakati pa ma genetic ndi zizindikiro za kuledzera. Zotsatira za chitsanzocho ziyesedwa zikuwonetsedwa Chithunzi 2. Monga magulu a maginito amagawidwe, ali ndi zizindikiro zolembera (zomwe zimatchedwanso dummy kuwerengera) kunagwiritsidwa ntchito motsatira ndondomeko ya Hayes ndi Preacher [47]. Ma GG ndi AA amagwiritsidwa ntchito poyesedwa motsutsana ndi GA genotype. Monga momwe taonera Gulu 3, anthu omwe ali ndi GG kapena AA genotype anali apamwamba mu hedonic-kutengera kwa GA genotype (njira a), zomwe zinagwirizanitsidwa ndi apamwamba YFAS chizindikiro chizindikiro (njira b). Zotsatira zosawoneka bwino kuchokera ku ma GG ndi AA zofanana (zofanana ndi GA) zinali zosiyana kwambiri ndi zero. Chithandizo chomwecho chinapezedwa poyesera zotsatira zosawoneka pazitsulo za YFAS zogwiritsira ntchito monga momwe zimagwiritsira ntchito Hayes [50] PROCESS macro (Chidziŵitso Chosazindikira GG vs. GA = 1.83, 95% CI = 0.23-3.75; Zotsatira Zosaoneka AA vs. GA = 1.13, 95% CI = 0.42-2.00). Chitsanzochi chimagwirizana ndi lingaliro lakuti GG genotype (ngakhale yosavuta) imakhudzana ndi zizindikiro zapamwamba zowonjezera chakudya ndi njira yowonjezera yogwira chakudya chopatsa thanzi. Mwadzidzidzi, mawonekedwe a AA amagwiritsidwa ntchito ndi chiopsezo chowonjezereka cha kuledzera kwa zakudya kudzera mu zofanana ndi zomwe zimayambitsa khalidwe. vs. GG allele magulu anasonyezera kuti panalibe kusiyana pakati pa magulu awiriwa (Zowonongeka Mwachindunji = -0.44, 95% CI = -1.56-0.53). Kulamulira kugonana ndi BMI sikunasinthe kwambiri zotsatirazi.
4. Kukambirana
Zotsatira za phunziro ili zinathandizirapo chitsanzo chomwe chawonetsedwa Chithunzi 1, ndi maulosi athu kuti G "kupindula-ntchito" kumapeto kwa chizindikiro cha A118G chikugwirizanitsidwa ndi kudya kwapamwamba kwa hedonic ndi chakudya chokoma. Mosiyana ndi kafukufuku wathu wakale, komabe, kumene njira yowonjezera yowonjezera yopezeka yopezeka pa G lokha komanso zakudya zomwe zimakonda [12], deta yamakono ikuwonetsa kuti ngakhale kuti GG genotype inali ndi mphamvu yapamwamba yowonetsera hedonic, siinali yosiyana kwambiri kuchokera kwa gulu la AA lodzidzimutsa. Komanso, heterozygous GA genotype inasonyeza kwambiri m'munsi kuthamanga kwa hedonic kusiyana ndi imodzi mwa magulu awiri ogonjera, kutanthauza oposa kwambiri (Kulamulira kwakukulu amatanthauza chikhalidwe chimene gulu la heterozygous limakhala kunja kwa gulu la phenotypic la magulu awiri ogonana, ndipo angaganizedwe kuti ali ndi chiopsezo chochepa chokhala ndi khalidwe losasokoneza-mwa kuyankhula kwina, kukhala ndi thanzi labwino kuposa anthu omwe amadzikonda okha) zotsatira za chizindikiro. Chochititsa chidwi n'chakuti pali umboni wochuluka wa maubwenzi a heterozygosity-bodyitness pakati pa anthu ambiri, ndipo ena amakhulupirira kuti izi zimachitika chifukwa inbreeding amachulukitsa chiwerengero cha homozygosity pamtundu wonse, ndipo amasonyezanso kuchepa pa ziwalo-kugwirizana makhalidwe [51]. Mwamwayi, zovuta zathu za chibadwa zimakhala zovuta kutsimikiziranso ndi kufufuza kwina kofanana kuyambira kafukufuku wambiri wofufuza A118G SNP mu kafukufuku wokhudzana ndi chizoloŵezi cha kugwiritsidwa ntchito mowa mwadongosolo akuyendetsa njira yowonjezereka kwa G, potero kupanga pulogalamu ya A118G yodabwitsa (viz GG ndi GA vs. AA) chifukwa cha kusanthula (mwachitsanzo, [32,52,53]). Njira yoyenera yothetsera njirayi tsopano ikhonza kufunsidwa, osati chifukwa cha zomwe zafukufukuwa, komanso chifukwa cha meta-yeniyeni yokhudzana ndi mchitidwe wa A118G ndi opioids pansi pa olamulira kwambiri or zowonjezera chitsanzo [54]. Chifukwa chake, ochita kafukufuku amtsogolo m'derali amalimbikitsidwa kuti azisanthula A118G SNP pogwiritsa ntchito atatu mmalo mwa magulu awiri a maginito. Kuonjezera apo, popatsidwa chidziwitso chochepa m'magulu a homozygous (gulu laling'ono) G, zikutheka kuti phunziro lathu linapatsidwa mphamvu kuti azindikire kusiyana kwakukulu pakati pa magulu a GG ndi AA ngakhale kuti mapeto ake ndi apamwamba kwambiri. Choncho, kufufuza ndi zitsanzo zikuluzikulu ndizofunikira kuti tipitirize kuyesa mayendedwe athu omwe timapanga ndi mabungwe omwe adaneneratu.
Zotsatira zathu zowonjezera zimatsimikiziranso kuti kuteteza kwa hedonic kunali kwakukulu ndipo kumagwirizanitsidwa bwino ndi zizindikiro zozizwitsa pa YFAS komanso ndi YFAS. Zofukufukuzi zimatsimikizira umboni wochuluka wosonyeza kuti machitidwe a ubongo a hedonic ali ndi mphamvu kwambiri poyendetsa kuyamwa kwa zakudya zowonjezereka [55]. Zoonadi, kudya zakudya zamakono zapamwamba zowonjezera zakudya kungapangitse kuti anthu azidya zakudya zolimbitsa thupi polimbikitsa zakudya zopanda phindu komanso zabwino kwambiri pa tsiku ndi tsiku, komanso poletsa kuyesayesa kupewa kudya zakudya zoterezi. Mwachitsanzo, umboni wamakono waposachedwapa umasonyeza kuti makoswe omwe adzidya mofulumira komanso mopitirira muyeso mwa zakudya zamakono amasonyeza kuti zowonjezereka zowonjezera mphoto zimagwiritsira ntchito mphamvu zamagetsi (zomwe zimasonyeza kuchepetsa kuchepetsa mphamvu)56], komanso chakudya chokhalitsa chokhalitsa chomwechi chinapangitsanso kuchepa mu-opioid mRNA mawu mu nucleus accumbens-ndikuwonetsanso dongosolo pansi-malamulo [57].
Ena adanena kuti kuchepetsa kuchepa kwa mphotho kumayambitsa kulimbikitsidwa kwakukulu kuti athetsere vutoli mwa kudya kwambiri [58,59]. Komabe, malingaliro athu, kufotokozera koteroko ndi kosavuta, makamaka potsata umboni wotsindika wakuti anhedonia imakhudzidwa ndi kukhumudwa, kuchepa kwa chilakolako, ndi zochepa zomwe zimachititsa kuti mukhale ndi zochitika zokhutiritsa monga chiyanjano ndi makolo kusamalira ana [60,61]. Tsatanetsatane yowonjezereka yokhudza mgwirizano pakati pa mphotho yokhutiritsa ndi kudya kwa chakudya kumaperekedwa ndi chitsanzo chachiwiri [62]. Kuchokera kwa munthu payekha-kuthekera kwachidziwitso, kuthamangitsidwa kwa chakudya chapamwamba cha chakudya chapamwamba chokhudzana ndi chakudya chokwanira, ndi kudya zakudya zosangalatsa kuposa caloric zofunikira, makamaka m'malo a zakudya ndi kupezeka kwina kulikonse kwa chakudya chokoma. Kuwonjezera apo, kupitirira kwakukulu kwa mphoto ya ubongo yoyendayenda ndikumwa mopitirira muyeso kungathetse pansi-kuyambitsa njira yowonjezera ya mesocorticolimbic njira (monga tafotokozera pamwambapa) panthawi imodzimodziyo kulimbikitsa kulimbika kwa zakudya zabwino ndi zokoma, zomwe zimapanga zikhumbo zolimba ndi zofunafuna chakudya [62]. Zotsatira za malipiro omwe angapereke ndalama zowonjezereka zimathandiza kuti pakhale zakudya zowonjezera komanso kuchepetsa kubwezeretsa zakudya m'thupi [63]. Zoonadi, awo omwe ali ndi zizindikiro za chizolowezi cha zakudya amadziwika kuti amalephera kugwiritsira ntchito zizoloŵezi zawo zoyenera kudya [14].
Mphamvu yeniyeni ya phunziroli tsopano ndiyeso yeniyeni yowonongeka ya OPRM1 SNP ndi kuledzeretsa kwa zakudya kudzera mwachangu. Mwachindunji, mayeserowa anathandizira kuti tipeze njira zosawonetsera mosavuta zowonongeka pogwiritsa ntchito "chikoka cha hedonic" cha zakudya zabwino kwambiri. Kupeza izi kuli kofanana ndi zitsanzo zam'mbuyomu zomwe zakhala zikuyendera bwino zoganizira za maganizo ndi makhalidwe monga njira zopezeka m'mabuku osiyana-siyana ndi zakudya zowonongeka ndi chiopsezo cha kunenepa kwambiri [16,64]. Monga momwe zilili ndi zitsanzo zonse zowonongeka, komabe deta yomwe ikuyembekezeredwa ikuyenera kutsimikizira izi.
Ngakhale kuti zofukufuku zofunika ndi zolemba kuchokera mu kafukufukuyu, ndizofunikira kutchula zolephera zake. Zowoneka kuti zowonjezera zomwe zimafunika kuwona ziyenera kuwonedwa mosamalitsa komanso mosamalitsa monga choyambirira chifukwa cha chiwerengero chaching'ono cha gulu la GG genotype ndi magulu ena awiri, komanso chifukwa cha kuchepa kwa anthu omwe ali mu gulu la YDAS. Kuphatikizidwa ndi zitsanzo zikuluzikulu zidzakuthandizani kudalira kwambiri, ndi kudalirika kwa, zomwe zapezeka pano.
5. Zotsatira
Mwachidule, zotsatira za phunziroli zasonyeza; mwanjira yoyamba, mgwirizano pakati pa mphamvu ya ubongo ya opioid ndi kusiyana kwa anthu mu hedonic kumvetsera zakudya zokoma komanso zamakono. Iwo amachitanso mwachindunji ophioid activation-omwe angathe kukhala pangozi yowakakamiza kudya kwambiri. Adakalipobe; komabe; Umboni wosakwanira woonetsetsa kuti mawonekedwe a OPRM1 A118G aperekedwa molimba mtima kuti apitirize kukhala ovomerezeka ndi odwala opioid monga zakudya zabwino komanso mankhwala osokoneza bongo. Kuphatikiza apo; Kupititsa patsogolo kuonetsetsa kuti chizoloŵezi chokonzekera chakudya chimaperekedwa ndi zomwe tapeza kuti gulu lachizoloŵezi cha zakudya limakhala ndi chiwerengero chokwanira cha chakudya cha hedonic-chizoloŵezi chokhala ndi chizolowezi chomwe chingayambitse kutchuka; pazigawo zodyera; ndipo pomalizira pake amayamba kudya zakudya zopatsa thanzi.
Zopereka za Wolemba
Wolemba woyamba anali ndi udindo wopeza deta. Olemba onsewa adapereka pamodzi potsata ndondomeko ndi kulemba kwa pepala.
Zothandizira
