Functional hypothalamic amenorrhea is associated with elevated ghrelin and disordered eating.
OBJECTIVE
To determine whether ghrelin, an orexigen released by the stomach, is elevated in women with hypothalamic amenorrhea who are of normal weight and whether this is associated with abnormal eating behaviors.


METHODS
Controlled clinical study.


METHODS
Healthy volunteers in an academic research environment.


METHODS
Twenty-seven women with functional hypothalamic amenorrhea (FHA) and 42 normally menstruating women.


METHODS
None.


METHODS
Ghrelin and eating behavior.


RESULTS
Ghrelin was significantly elevated in FHA (648.4 +/- 92.0 pg/mL vs. controls 596.7 +/- 79.0 pg/mL), while leptin, although lower, was not significantly so (FHA 5.4 +/- 2.8 ng/mL vs. controls 6.4 +/- 3 ng/mL). Eating Attitudes Test (EAT) scores were also significantly elevated in FHA (15.3 +/- 10.6 vs. controls 10.3 +/- 8.4), particularly on the subscale that measured bulimic behaviors. However, FHA patients consumed significantly more kilocalories (1,930 kcal/day vs. 1,588 kcal/day).


CONCLUSIONS
High ghrelin in women with FHA may be linked to abnormal dietary behaviors, as reflected in high EAT scores yet characterized by normal caloric intake. Ghrelin may act as a restraining metabolic signal preventing a return to cyclicity in women with both disordered eating and FHA, prolonging amenorrhea when leptin has returned to normal.
Schneider
Lisa F
LF
Department of Obstetrics and Gynecology and Medicine, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA. ls2086@columbia.edu <ls2086@columbia.edu>
Warren
Michelle P
MP
D000328:Adult; D000568:Amenorrhea / Q000097:blood* / Q000150:complications*; D015415:Biomarkers / Q000097:blood; D001068:Feeding and Eating Disorders / Q000097:blood* / Q000209:etiology*; D005260:Female; D054439:Ghrelin; D006801:Humans; D007027:Hypothalamic Diseases / Q000097:blood* / Q000150:complications*; D036361:Peptide Hormones / Q000097:blood*
D015415:Biomarkers; D054439:Ghrelin; D036361:Peptide Hormones