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The Journal of Nutrition Vol. 128 No. 12 December 1998, pp. 2520-2525

Neuropeptide Y and Corticotropin-Releasing Hormone Concentrations within Specific Hypothalamic Regions of Lean but Not Ob/ob Mice Respond to Food-Deprivation and Refeeding1,2,3

Miyoung Jang and Dale R. Romsos4

Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824-1224

    ABSTRACT
Abstract
Introduction
Methods
Results
Discussion
References

Leptin is proposed to control food intake at least in part by regulating hypothalamic neuropeptide Y (NPY), a stimulator of food intake, and corticotropin-releasing hormone (CRH), an inhibitor of food intake. Ob/ob mice are leptin-deficient and would thus be expected to exhibit alterations in hypothalamic NPY and CRH. We therefore measured concentrations of NPY and CRH in discrete regions of the hypothalamus (i.e., ARC, arcuate nucleus; PVN, paraventricular nucleus; VMH, ventromedial nucleus; DMH, dorsomedial nucleus; and SCN, suprachiasmatic nucleus) of 6.5-7-wk-old ob/ob and lean mice with free access to stock diet, 24 h after food deprivation, and 1 h after refeeding. Fed ob/ob mice had 55-75% higher concentrations of NPY in the ARC, VMH and SCN than lean mice. Food deprivation increased NPY concentrations ~70% in the ARC, PVN and VMH of lean mice, and refeeding lowered NPY concentrations ~70% in the PVN of these mice. NPY in these hypothalamic regions of ob/ob mice was unresponsive to food deprivation or refeeding. The most pronounced change in CRH concentrations within the regions examined (i.e., ARC, PVN and VMH) occurred in the ARC of lean mice where refeeding lowered CRH concentrations by 75% without influencing ARC CRH concentrations in ob/ob mice. The hypothalamic concentrations of two neuropeptides involved in body weight regulation (i.e., NPY and CRH) in leptin-deficient ob/ob mice respond abnormally to abrupt changes in nutritional status.

KEY WORDS: neuropeptide Y · corticotropin-releasing hormone · hypothalamus · ob/ob mice · feeding status

    INTRODUCTION
Abstract
Introduction
Methods
Results
Discussion
References

A nonsense mutation in the ob gene in ob/ob mice (Zhang et al. 1994) causes severe obesity. Administration of the ob gene product leptin to these leptin-deficient ob/ob mice decreases their food intake as well as increases their energy expenditure, resulting in a restoration of normal body weight regulation (Halaas et al. 1995, Hwa et al. 1996, Pelleymounter et al. 1995). Leptin likely acts within the central nervous system, in particular the hypothalamus, to regulate body weight since central administration of leptin produced pronounced effects on food intake with lower doses than those required during peripheral injection (Campfield et al. 1995, Halaas et al. 1995, Stephens et al. 1995).

Neuropeptide Y (NPY)5 increases food intake and decreases energy expenditure (Billington et al. 1994, Clark et al. 1984, Stanley et al. 1986), whereas corticotropin-releasing hormone (CRH) has opposite actions (Arase et al. 1988, Krahn et al. 1988, Rohner-Jeanrenaud et al. 1989). NPY and CRH have thus logically emerged as candidates to mediate leptin actions within the hypothalamus (Mercer et al. 1996, Schwartz et al. 1996a and 1996b, Stephens et al. 1995, Wang et al. 1997). Centrally administered leptin decreases NPY mRNA and increases CRH mRNA within the hypothalamus of rats and mice (Schwartz et al. 1996a and 1996b, Stephens et al. 1995, Wang et al. 1997). Leptin has also been reported to decrease in vitro secretion of NPY (Stephens et al. 1995) and increase CRH release from the rat hypothalamus (Costa et al. 1997, Raber et al. 1997). These actions of leptin on hypothalamic NPY and CRH support the hypothesis that leptin, NPY and CRH are linked in the regulation of food intake and energy expenditure.

 
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Table 1. Plasma insulin and glucose in fed, food-deprived or refed ob/ob and lean mice1,2


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Fig 1. Neuropeptide Y (NPY) concentrations in specific hypothalamic regions of fed, food-deprived, or refed ob/ob and lean mice. Each bar represents means ± SE of six to nine mice per group. Mice were given free access to food, food deprived for 24 h or refed for 1 h after 24 h food deprivation. Abbreviations for the hypothalamic nuclei punched are as follows: ARC, arcuate nucleus; PVN, paraventricular nucleus; VMH, ventromedial nucleus; DMH, dorsomedial nucleus; SCN, suprachiasmatic nucleus. Two-way factorial ANOVA was used to determine significant effects of phenotype, feeding status and interaction. Significant effects of phenotype, feeding status and phenotype-feeding status interaction were observed in the PVN (P < 0.05). Significant phenotype-feeding status interactions were also observed in the VMH and SCN (P < 0.05). P indicates significant phenotype differences within the same feeding states with the least significant difference (LSD) test (P < 0.05). D indicates significant effect of food deprivation, and R indicates significant effect of refeeding within phenotype as determined by LSD test (P < 0.05).


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Fig 2. Corticotropin-releasing hormone (CRH) concentrations in specific hypothalamic regions of fed, food-deprived or refed ob/ob and lean mice. Values are means ± SE of six to nine mice per group. Mice were given free access to food, food deprived for 24 h or refed for 1 h after 24 h food deprivation. See Figure 1 for list of abbreviations. Two-way factorial ANOVA was used to determine significant effects of phenotype, feeding status and interaction. A significant phenotype and feeding-status interaction was observed in the ARC (P < 0.05). P indicates significant phenotype differences within the same feeding state with least significant difference (LSD) test (P < 0.05). R indicates significant effect of refeeding within phenotype as determined by LSD test (P < 0.05).

If leptin regulates food intake and energy expenditure via hypothalamic NPY and/or CRH, leptin-deficient ob/ob mice would be expected to exhibit alterations in NPY and CRH within the hypothalamus. Only a few studies have examined hypothalamic NPY in ob/ob mice, and to our knowledge none have examined CRH in these mice (Mistry et al. 1994, Qu et al. 1996, Stephens et al. 1995, Wilding et al. 1993, Williams et al. 1991). Hypothalamic NPY mRNA abundance is elevated in ob/ob mice (Qu et al. 1996, Stephens et al. 1995, Wilding et al. 1993) with no reported alterations in NPY protein in the whole hypothalamus of these mice compared to lean controls (Wilding et al. 1993, Williams et al. 1991). Since specific hypothalamic regions are involved in regulation of metabolism by NPY (Morley 1987, Stanley et al. 1986), measurements utilizing the whole hypothalamus may mask regional differences.

Disturbances in hypothalamic NPY have also been observed in leptin-resistant db/db mice (Chua Jr. et al. 1991, Mizuno et al. 1997), and considerable evidence has accumulated to demonstrate abnormal regulation of NPY and CRH in leptin-resistant fa/fa rats (Bchini-Hooft van Huijsduijnen et al. 1993, Beck et al. 1990a and 1993, Fukushima et al. 1992, McKibbin et al. 1991, Nakaishi et al. 1990 and 1993, Pesonen et al. 1992). Hypothalamic NPY mRNA abundance is higher in db/db mice and fa/fa rats than in the respective lean controls (Chua Jr. et al. 1991, Mizuno et al. 1997, Pesonen et al. 1992). NPY protein in specific hypothalamic nuclei including the ARC, PVN, VMH, DMH and SCN is also elevated in fa/fa rats compared to lean controls (Beck et al. 1990a and 1993, McKibbin et al. 1991). Similar measurements have not been reported for ob/ob or db/db mice. Hypothalamic CRH mRNA abundance is unaltered in fa/fa rats (Pesonen et al. 1992), but CRH protein is lower in these rats than in lean controls (Nakaishi et al. 1990 and 1993). Together these results are consistent with a linkage between leptin and the regulation of NPY and CRH.

Hypothalamic NPY and CRH are reported to change with the feeding status of the animals (Beck et al. 1990b, Brady et al. 1990, Sahu et al. 1988, Schwartz et al. 1993), a condition that is now known to alter plasma leptin concentrations (Hardie et al. 1996, Saladin et al. 1995, Trayhurn et al. 1995). Food deprivation increases NPY mRNA abundance in the ARC or in the whole hypothalamus of rats and mice including ob/ob and db/db mice (Brady et al. 1990, Chua Jr. et al. 1991, Mizuno et al. 1997, Qu et al. 1996, Schwartz et al. 1993) but not in leptin-resistant fa/fa rats (Sanacora et al. 1990). NPY protein is also known to increase with food deprivation and decrease with refeeding in site-specific manners within the hypothalamus of control rats (Beck et al. 1990b, Sahu et al. 1988) but not in leptin-resistant fa/fa rats (Beck et al. 1992, Sanacora et al. 1990). Food deprivation decreases CRH mRNA in the PVN of rats (Brady et al. 1990). We are not aware of any reports on food intake-induced regulation of hypothalamic NPY and CRH concentrations in leptin-deficient ob/ob mice. The present study was thus designed to determine whether any alterations are present in NPY and CRH concentrations within specific hypothalamic nuclei of ob/ob mice, and if hypothalamic NPY and CRH concentrations of ob/ob mice change in response to food deprivation and refeeding.

    MATERIALS AND METHODS
Abstract
Introduction
Methods
Results
Discussion
References

Animals and diet.  Male obese (ob/ob) and lean mice (ob/+ or +/+) were obtained from our breeding colony of C57BL/6J ob/+ mice. The Guide for the Care and Use of Laboratory Animals (NRC 1985) and local institutional guidelines were followed for the care and treatment of the mice. Mice were weaned at 3-3.5 wk of age, group-housed in solid-bottom plastic cages with wood shavings for bedding and fed a nonpurified diet (Teklad Rodent Diet 8640; 22% protein, 5% fat and 4.5% crude fiber; Harlan, Bartonville, IL). Room temperature was 23-25°C and lights were on from 07:00 to 19:00 h.

Reagents.  Coating antiserums (rabbit anti-guinea pig Ig G for insulin ELISA and goat anti-rabbit Ig G for NPY and CRH ELISA) were purchased from EY Lab (San Mateo, CA). Guinea pig anti-rat insulin was from Linco Research (St. Louis, MO). Rabbit anti-NPY (human, rat) Ig G, rabbit anti-CRH (human, rat) Ig G, biotinyl-NPY (human, rat) and biotinyl-CRH were obtained from Peninsula Lab (Belmont, CA). NPY (human) and CRH (human, rat) were purchased from Bachem (Torrance, CA). Avidin-peroxidase, 2,2'-azino-bis(3-ethylbenz-thiazoline-6-sulfonic acid) (ABTS) and glucose diagnostic kits were obtained from Sigma Chemical (St. Louis, MO).

Experimental design.  At 6-6.5 wk of age, ob/ob and lean mice were individually housed for 3 days and then randomly distributed into one of three groups: group 1 was fed, group 2 was food deprived for 24 h and group 3 was food deprived for 24 h and then refed for 1 h. Food intake and body weight were recorded. Mice were killed by decapitation between 10:00 and 11:00 h. Blood was collected, and plasma was separated and stored at -20°C for measurement of glucose and insulin. The brains were quickly removed from the skulls. A cut was made perpendicular to the midline of the mid-hind brain to prepare the tissue for mounting on the specimen holder. The brain was then immediately frozen on dry ice and stored at -80°C.

Brain dissection and micropunch.  The frozen brain was glued (Tissue-Tek, 1988 Miles, Elkhart, IN) to a specimen holder and placed in a cryostat (Cryocut 1800, Leica, Deerfield, IL) at -10°C. After equilibration for about 30 min, the brain was repeatedly sectioned until the anterior commissure was clearly visible. From this reference point serial sections of 400-500 µm were made according to the stereotaxic atlas of the albino mouse forebrain (Slotnick and Leonard 1975). The brain sections were placed on glass slides and kept frozen on dry ice. Discrete hypothalamic nuclei were micropunched under a microscope by the technique of Palkovits (1973). Hypothalamic nuclei sampled included the arcuate nucleus (ARC), paraventricular nucleus (PVN), ventromedial nucleus (VMH), dorsomedial nucleus (DMH) and suprachiasmatic nucleus (SCN) (Slotnick and Leonard 1975). A 20-gauge, oval-shaped needle was used to micropunch the ARC and PVN, and a round 24-gauge needle was used for the other nuclei.

Bilateral tissue samples were immediately placed in 100 µL of HCl (0.1 mol/L) containing a protease inhibitor (aprotinin, 900,000 KIU/L). The tissue samples were sonicated for 15 s and centrifuged at 10,000 × g for 15 min at 4°C. Supernatants were then lyophilized and stored at -20°C until measurement for NPY and CRH. Tissue pellets were dissolved in 200 µL of NaOH (0.1 mol/L), and protein was determined by a modified method of Lowry (Bio-Rad DC protein kit, Hercules, CA).

Assays.  Plasma glucose was measured with a glucose oxidase-peroxidase kit (Sigma Chemical). Plasma insulin, NPY and CRH in discrete regions of hypothalamus were measured by competitive ELISAs as described below. Immulon 4 polystyrene microtiter plates with flat-bottomed wells (Dynatech Lab, Chantilly, VA) were used for these assays. Preparation of coating buffer (0.05 mol/L carbonate bicarbonate, pH 9.6), washing buffer (0.15 mol/L PBS, pH 7.2) and citrate buffer (0.1 mol/L, pH 4.0) used in these ELISAs and other buffers used in the insulin ELISA followed procedures described by Kekow et al. (1988).

Insulin was measured as described by Kekow et al. (1988) with some modifications. Rabbit anti-guinea pig Ig G (10 mg/L of coating buffer) in a volume of 150 µL was added to each well and dried at 37°C overnight. Wells were washed thrice with washing buffer. One hundred microliters of anti-insulin antibody (1000 radioimmunoassay-tube quantity/L of insulin incubation buffer) was added to each well and incubated overnight at 4°C. Rat insulin standards or plasma samples in 100 µL of sample buffer [incubation buffer with 60 g bovine serum albumin (BSA)/L] were added and incubated at 37°C for 50 min. One hundred microliters of peroxidase-labeled insulin (1.2 mg/L sample buffer) was added to each well and incubated at 37°C for 50 min followed by three washings. One hundred microliters of citrate buffer (0.1 mol/L, pH 4.0) containing substrate for peroxidase, H2O2 (8 mmol/L) and a chromogen, ABTS (660 µmol/L), were then added to the wells. Color was developed at room temperature and optical density was measured at 405 nm. Intra- and interassay variations were 4% and 10%, respectively.

NPY and CRH assays were developed in our laboratory. Wells were coated with goat anti-rabbit Ig G (12.5 mg/L for NPY or 6.25 mg/L for CRH) in 200 µL of coating buffer at 37°C overnight. Plates were then washed thrice with washing buffer. Rabbit anti-NPY Ig G (2 mg/L) or rabbit anti-CRH Ig G (0.5 mg/L) in 100 µL of sample buffer (0.15 mol/L PBS with 1 mL/L Tween-20 and 10 g/L BSA, pH 7.3) was added, and plates were incubated at 37°C for 3-3.5 h. After three additional washings, standards (NPY or CRH) or brain samples in 100 µL sample buffer were added and held at 4°C overnight. Biotinyl-NPY (220 nmol/L) or biotinyl-CRH (80 nmol/L) in 50 µL of sample buffer was subsequently added and incubated for 2.5 h at 4°C. After six washings, 100 µL of avidin peroxidase (2 mg/L sample buffer) was added, and the plate was incubated for 1 h at room temperature, followed by six washings. Citrate buffer (100 µL, pH 4.0) containing H2O2 and ABTS was then added (same as for insulin ELISA). Optical density was subsequently measured at 405 nm. The sensitivity of the NPY and CRH ELISA was 1 fmol/well. Intra- and interassay variations were <5% and 10%, respectively, for both NPY and CRH ELISA.

Statistics.  Data are expressed as means ± SE and were analyzed with SAS/STAT (version 6.11, SAS Institute, Cary, NC). Body weight and food intake comparisons were analyzed with Student's t test. Comparisons of insulin, glucose, NPY and CRH during the different feeding states in ob/ob and lean mice were performed by two-way ANOVA with the least-significant difference (LSD) test used for post hoc comparisons. Data for insulin were log transformed before two-way ANOVA because of unequal variances. Differences were considered significant at P < 0.05.

    RESULTS
Abstract
Introduction
Methods
Results
Discussion
References

Food intake, body weight, plasma insulin and glucose.  As expected, the 6.5-7-wk-old ob/ob mice weighed more (30 ± 1 g body wt versus 22 ± 1 g, n = 10 for each group) and consumed more food than the lean mice; daily food intake for the 3-d period before the experiment averaged 6.5 ± 0.3 g/day for ob/ob mice and 3.9 ± 0.1 g/day for lean mice (n = 10 for each group). Both ob/ob and lean mice lost ~3 g body wt during 24 h of food deprivation. Food intake during the 1-h refeeding period did not differ in ob/ob and lean mice [0.69 ± 0.04 g/h and 0.67 ± 0.03 g/h (n = 10) for each group, respectively].

Plasma insulin concentrations, as expected, were elevated in ob/ob mice (Table 1). Food deprivation lowered plasma insulin concentrations in ob/ob mice (P < 0.05) and tended to do so in lean mice (P = 0.17), and refeeding elevated plasma insulin. Plasma glucose concentrations were unaffected by phenotype, lowered by food deprivation and elevated by refeeding.

Hypothalamic NPY.  Ob/ob mice with free access to food had ~55-75% higher NPY concentrations in the ARC (P = 0.11), VMH and SCN (P < 0.05) than lean mice (Fig. 1). NPY concentrations changed with food deprivation and refeeding in site-specific manners in ob/ob and lean mice. Only in the SCN of ob/ob mice did food deprivation influence NPY contents: food deprivation lowered NPY contents in this nucleus of ob/ob mice. Food deprivation elevated NPY contents in the ARC, PVN and VMH of lean, but not ob/ob, mice. Refeeding lean mice, but not ob/ob mice, significantly lowered (-71%) NPY concentrations in the PVN.

Hypothalamic CRH.  CRH concentrations in the three regions examined of fed mice were not affected by phenotype even though lean mice tended (P = 0.18) to have twice the CRH concentrations in the ARC than ob/ob mice (Fig. 2). CRH concentrations were not modified by food deprivation or refeeding in any region of the hypothalamus of the ob/ob mice. CRH contents in the ARC of lean mice were lowered by 75% with refeeding.

    DISCUSSION
Abstract
Introduction
Methods
Results
Discussion
References

Results of the present study may be summarized as follows. First, concentrations of NPY in selected hypothalamic nuclei of leptin-deficient ob/ob mice were elevated. Second, food deprivation and short-term refeeding caused less dramatic changes in hypothalamic NPY concentrations in these ob/ob mice than in lean mice. Third, hypothalamic CRH concentrations were less affected by phenotype and feeding status than NPY concentrations.

Our measurements of neuropeptide concentrations in specific hypothalamic nuclei reflect the balance of peptide synthesis and transport/release/degradation rates. NPY mRNA abundance and presumably NPY synthesis is elevated in the hypothalamus of fed leptin-deficient ob/ob mice (Qu et al. 1996, Stephens et al. 1995, Wilding et al. 1993), consistent with their hyperphagia and hypometabolism (Erickson et al. 1996b, Halaas et al. 1995, Pelleymounter et al. 1995). The ARC is enriched in NPY-containing neuron cell bodies (Chronwall et al. 1985), suggesting that the trend for elevated NPY concentrations in the ARC of fed ob/ob mice (Fig. 1) was secondary to elevated rates of NPY synthesis in this nucleus of these mice. Interestingly, NPY was not elevated in the PVN of ob/ob mice (Fig. 1). This would be consistent with increased release of NPY from this region of ob/ob mice, in agreement with the well established role of NPY in the PVN to promote food intake (Kalra et al. 1991, Stanley and Leibowitz 1984). It is difficult to interpret the physiological importance of elevated NPY concentrations in the VMH and SCN of fed ob/ob mice. These findings, however, agree with observations in leptin-resistant fa/fa rats (Beck et al. 1990a and 1993, McKibbin et al. 1991). NPY concentrations in selected hypothalamic regions appear to respond similarly to leptin deficiency and leptin resistance.

Food deprivation and refeeding are well-characterized modulators of NPY concentrations in selected hypothalamic regions of rats (Beck et al. 1990b, Brady et al. 1990, Sahu et al. 1988, Schwartz et al. 1993). Our lean mice responded similarly. The increases in NPY concentrations in the ARC, PVN and VMH of these lean mice after food deprivation (Fig. 1) are consistent with reported elevations in hypothalamic NPY mRNA, and presumably NPY synthesis, during food deprivation (Brady et al. 1990, Schwartz et al. 1993). In contrast, NPY concentrations in these hypothalamic regions of ob/ob mice were unchanged during food deprivation. Consequently, food-deprived lean and ob/ob mice had similar NPY concentrations in the various hypothalamic nuclei examined, except for the PVN where NPY concentrations were now even higher in lean mice than in ob/ob mice (Fig. 1). There is now considerable evidence that food deprivation lowers plasma leptin concentrations (Hardie et al. 1996, Saladin et al. 1995, Trayhurn et al. 1995). This may contribute to the observed changes in hypothalamic NPY in lean mice with food deprivation. Ob/ob mice, however, are in a chronic state of leptin deficiency. Consistent with this, NPY concentrations in the ARC, VMH and SCN of fed ob/ob mice were as high as in these regions of food-deprived lean mice, and food deprivation failed to further influence hypothalamic NPY concentrations in ob/ob mice.

The PVN is an important site for NPY regulation of food intake (Kalra et al. 1991, Stanley and Leibowitz 1984). Within 1 h of food consumption following 24 h of food deprivation, the NPY concentration in the PVN of lean mice declined by ~70% (Fig. 1). In contrast, NPY concentrations in the PVN of similarly treated ob/ob mice failed to change. This occurred even though both groups of mice consumed similar amounts of food and had similar changes in plasma glucose during this refeeding period. Thus, within this time frame the observed phenotype differences in NPY within the PVN did not translate to differences in food intake. It is not clear whether refeeding the lean mice slowed transport of NPY from cell bodies to terminal regions within the PVN or accelerated NPY release and degradation within the PVN.

We expected that ob/ob mice might contain lower hypothalamic CRH concentrations than lean mice since corticosterone, high in ob/ob mice, possesses inhibitory actions on CRH synthesis and release within the hypothalamus (Beyer et al. 1988, Sawchenko 1987a and 1987b). Though CRH concentrations tended to be lower in the ARC of fed ob/ob mice than in lean mice, no significant alterations were observed in any hypothalamic nuclei of ob/ob mice examined (Fig. 2). This finding is consistent with the observation that leptin-resistant fa/fa rats and control rats also had similar CRH concentrations in many regions of hypothalamus, except in the median eminence (Nakaishi et al. 1993). Refeeding lean mice for only 1 h lowered CRH concentrations in the ARC by 75% without influencing CRH in this nucleus of ob/ob mice, findings analogous to changes in NPY within the PVN of these mice upon refeeding.

Leptin is proposed to be a sensor of nutritional status (Flier and Maratos-Flier 1998). The leptin-deficient ob/ob mice exhibited less pronounced changes in hypothalamic concentrations of NPY and CRH in response to food deprivation and abrupt refeeding than did lean mice. These results are consistent with a role for leptin-NPY-CRH interaction in the regulation of body weight. Other factors undoubtedly participate in this complex regulatory system. For example, leptin still exerts effects on food intake in NPY-knockout mice (Erickson et al. 1996a), and leptin-deficient ob/ob mice regulate food intake within the normal range when glucocorticoids are removed by adrenalectomy (Feldkircher et al. 1996). An understanding of how the various factors contributing to food intake regulation are integrated remains a formidable challenge.

    FOOTNOTES
1   Presented at the 16th International Congress of Nutrition, 1997, Montreal, Canada. Jang, M. and Romsos, D. R. (1997) Neuropeptide Y concentrations within specific hypothalamic regions of lean mice, but not ob/ob mice, increase after food deprivation.
2   Supported by National Institutes of Health Grant DK-15847.
3   The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked "advertisement" in accordance with 18 USC section 1734 solely to indicate this fact.
4   To whom correspondence should be addressed.
5   Abbreviations used: ABTS, 2,2'-azino-bis(3-ethylbenz-thiazoline-6-sulfonic acid); ARC, arcuate nucleus; BSA, bovine serum albumin; CRH, corticotropin-releasing hormone; DMH, dorsomedial nucleus; NPY, neuropeptide Y; PVN, paraventricular nucleus; SCN, suprachiasmatic nucleus; VMH, ventromedial nucleus.

Manuscript received 3 June 1998. Initial reviews completed 27 July 1998. Revision accepted 1 September 1998.

    LITERATURE CITED
Abstract
Introduction
Methods
Results
Discussion
References

0022-3166/98 $3.00 ©1998 American Society for Nutritional Sciences



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