Incomplete restoration of the secretion of ghrelin and PYY compared to insulin after food ingestion following weight gain in anorexia nervosa.
BACKGROUND
In humans, ghrelin has been found to stimulate appetite while PYY3-36 to reduce it; these orexigenic and anorexigenic peptides play significant roles in appetite control. We investigated pre- and postprandial responses of ghrelin and PYY in anorexia nervosa (AN) and the influence of weight gain.


METHODS
Plasma ghrelin, PYY3-36, glucose and insulin responses after ingestion of a 400 kcal standard meal were measured in 14 patients with restricting type of AN and 12 controls. The AN patients were evaluated before therapy and after inpatient therapy. Psychometry was performed by the use of Eating Disorders Inventory.


RESULTS
Ghrelin was suppressed during the meal test, while PYY3-36 was increased in all of the groups. Before therapy, AN patients had significantly increased levels of ghrelin and PYY3-36 compared to the control (P<0.01). After therapeutic intervention, as the nutritional status of AN patients improved, the secretion of these hormones were increased (P<0.05), but not normalized as in psychological testing. In contrast, insulin and glucose responses were normalized after inpatient therapy.


CONCLUSIONS
We found that both ghrelin and PYY3-36 increased in AN patients and these changes were not normalized in contrast to insulin after treatment. The increase in both orexigenic ghrelin and anorexigenic PYY3-36 may have a role in pathological eating behavior in AN.
Nakahara
Toshihiro
T
Department of Behavioral Medicine, Kagoshima University, Graduate School of Medical and Dental Sciences, 8-35-1, Sakuragaoka, Kagoshima City 890-8520, Japan. ayana-n@m3.kufm.kagoshima-u.ac.jp
Kojima
Shinya
S
Tanaka
Muneki
M
Yasuhara
Daisuke
D
Harada
Toshiro
T
Sagiyama
Ken-ichiro
K
Muranaga
Tetsuro
T
Nagai
Nobuathu
N
Nakazato
Masamitsu
M
Nozoe
Shin-ichi
S
Naruo
Tetsuro
T
Inui
Akio
A
D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D001066:Appetite / Q000502:physiology; D001521:Behavior Therapy; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition / Q000502:physiology; D003131:Combined Modality Therapy; D004435:Eating / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D054439:Ghrelin; D006801:Humans; D007328:Insulin / Q000097:blood*; D015596:Nutrition Assessment; D010343:Patient Admission; D010446:Peptide Fragments; D036361:Peptide Hormones / Q000097:blood*; D019894:Peptide YY / Q000097:blood*; D019518:Postprandial Period / Q000502:physiology; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D015430:Weight Gain / Q000502:physiology*
D001786:Blood Glucose; D054439:Ghrelin; D007328:Insulin; D010446:Peptide Fragments; D036361:Peptide Hormones; D019894:Peptide YY; D017367:Selective Serotonin Reuptake Inhibitors; C061785:peptide YY (3-36)