Investigation of the Relationship Between Hedonic Hunger and Agouti-Related Peptide, Neuropeptide Y, and Leptin in Patients with Mild Autonomous Cortisol Secretion
Project no. 32388 · Status: Kapanmış (Yayın bekleniyor) · 2024
Summary
<p>Mild Autonomous Cortisol Secretion (MACS) is characterized by moderate hypercortisolemia in patients with adrenal incidentalomas, in the absence of classic signs and symptoms of Cushing's Syndrome (CS) such as moon face, purple striae, plethora, and buffalo hump. Comorbidities including obesity, diabetes, dyslipidemia, cardiovascular disease, and osteoporosis may develop due to cortisol excess, though surgical indications remain unclear.</p><p>Nutrition, a fundamental need, is regulated by homeostatic and hedonic systems. Hedonic hunger is defined as an appetite state that emerges in the absence of metabolic need, triggered by food imagination and the expectation of pleasure from consumption. Food intake is regulated by orexigenic and anorexigenic peptides. The primary orexigenic peptides include Agouti-related peptide (AgRP) and Neuropeptide Y (NPY), while leptin serves as an anorexigenic peptide.</p><p>Glucocorticoids exert effects on the hypothalamus and mesolimbic regions, stimulating Neuropeptide Y and AgRP production while increasing leptin secretion. They also reduce food intake suppression through leptin resistance.</p><p>Studies on patients with CS, a typical example of chronic glucocorticoid exposure, have demonstrated that elevated glucocorticoid levels play a role in promoting eating behaviors such as impulse and desire, resulting in persistent elevations in hedonic hunger and AgRP levels, ultimately leading to comorbidities such as obesity.</p><p>In our study, we aimed to contribute to the literature, which we consider insufficient in this area, by comparing the presence of hedonic hunger in patients diagnosed with MACS, its relationship with eating behaviors, and orexigenic and anorexigenic peptide levels, to those with non-functional adrenal adenomas (NFA).</p><p>We planned to include 64 patients diagnosed with MACS and 64 patients followed with NFA in the study. Hedonic hunger will be assessed using the Power of Food Scale, while the Dutch Eating Behavior Questionnaire and the Three-Factor Eating Questionnaire will be used to evaluate eating behavior. Medical histories will be documented, and blood samples will be collected for peptide level measurements. The patient recruitment process is expected to take approximately 6 months, with a total duration of 12 months including biochemical analysis and manuscript preparation.</p>