Abstract

The abuse of volatile solvents such as toluene is a significant public health concern, predominantly affecting adolescents. To date, inhalant abuse research has primarily focused on the central nervous system; however, inhalants also exert effects on other organ systems and processes, including metabolic function and energy balance. Adolescent inhalant abuse is characterized by a negative energy balance phenotype, with the peak period of abuse overlapping with the adolescent growth spurt. There are multiple components within the central and peripheral regulation of energy balance that may be affected by adolescent inhalant abuse, such as impaired metabolic signaling, decreased food intake, altered dietary preferences, disrupted glucose tolerance and insulin release, reduced adiposity and skeletal density, and adrenal hypertrophy. These effects may persist into abstinence and adulthood, and the long‐term consequences of inhalant‐induced metabolic dysfunction are currently unknown. The signs and symptoms resulting from chronic adolescent inhalant abuse may result in a propensity for the development of adult‐onset metabolic disorders such as type 2 diabetes, however, further research investigating the long‐term effects of inhalant abuse upon energy balance and metabolism are needed. This review addresses several aspects of the short‐ and long‐term effects of inhalant abuse relating to energy and metabolic processes, including energy balance, intake and expenditure; dietary preferences and glycemic control; and the dysfunction of metabolic homeostasis through altered adipose tissue, bone, and hypothalamic‐pituitary‐adrenal axis function.

Highlights

  • While this review focuses on inhalant abuse, it is acknowledged that some of the data pertaining to the toxicology of toluene has been determined using occupational exposure studies and these should be interpreted with caution relative to effects in the abuse setting; these studies are highlighted when discussed

  • Toluene‐induced anorexia has been attributed in part to the observed decrease in the hypothalamic expression of neuropeptide Y (NPY), a peptide which stimulates food intake.[30]

  • Some of the energy balance effects arising from adolescent inhalant abuse, including reduced body weight and linear growth, persist into abstinence.[26,27,31]

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Summary

Introduction

There is evidence that incidental inhalation of petrol fumes may have an acute anorectic effect, and in a food‐constrained environment, a desire to suppress feelings of hunger could be a driver for intentional petrol sniffing behavior.[56] These data support previous anecdotal reports that petrol sniffing in Australian Indigenous communities is partly driven by a desire to suppress appetite.[25] In adult rats, toluene‐induced anorexia has been attributed in part to the observed decrease in the hypothalamic expression of neuropeptide Y (NPY), a peptide which stimulates food intake.[30] energy intake is moderated by absorption of nutrients occurring in the gut, FIGURE 3 Key metabolic organs are affected by inhalant abuse, including the brain, pancreas, adipose tissue, bone, and adrenal glands

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