title: Ghrelin increases hunger and food intake in patients with restricting-type anorexia nervosa: a pilot study.
abstract: Ghrelin increases hunger sensation and food intake in various patients with appetite loss. Anorexia nervosa (AN) begins with psychological stress-induced anorexia and some patients cannot increase their food intake partly because of malnutrition-induced gastrointestinal dysfunction. The effects of ghrelin on appetite, food intake and nutritional parameters in anorexia nervosa (AN) patients were examined. Five female restricting- type AN patients (age: 14-35 y; body mass index: 10.2-14.6 kg/m(2)) had persistently complained of gastrointestinal symptoms and failed to increase body weight. They were hospitalized for 26 days (6 days' pretreatment, 14 days' ghrelin-treatment, and 6 days' post-treatment) and received an intravenous infusion of 3 microg/kg ghrelin twice a day. Ghrelin infusion improved epigastric discomfort or constipation in 4 patients, whose hunger scores evaluated by visual analogue scale questionnaires also increased significantly after ghrelin infusion. Daily energy intake during ghrelin infusion increased by 12-36 % compared with the pre-treatment period. Serum levels of total protein and triglyceride as nutritional parameters significantly increased after ghrelin treatment. There were no serious adverse effects including psychological symptoms. We found that ghrelin decreases gastrointestinal symptoms and increases hunger sensation and daily energy intake without serious adverse events in AN patients. Although the present study had major limitations of the lack of a randomized, placebo-controlled group, non-blindness of the investigators and the small number of patients recruited, it would contribute to further investigations for therapeutic potential of ghrelin in AN patients.
authors.affiliation: Health Services Center, National Graduate Institute For Policy Studies, Tokyo, Japan. marihs@grips.ac.jp
authors.forename: Mari
authors.initials: M
authors.lastname: Hotta
authors.forename: Rina
authors.initials: R
authors.lastname: Ohwada
authors.forename: Takashi
authors.initials: T
authors.lastname: Akamizu
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Shibasaki
authors.forename: Kazue
authors.initials: K
authors.lastname: Takano
authors.forename: Kenji
authors.initials: K
authors.lastname: Kangawa
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000150:complications / Q000188:drug therapy*; D019167:Appetite Stimulants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015992:Body Mass Index; D003248:Constipation / Q000209:etiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004032:Diet; D002149:Energy Intake / Q000187:drug effects; D005260:Female; D054439:Ghrelin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D006815:Hunger / Q000187:drug effects*; D007262:Infusions, Intravenous; D007564:Japan; D009752:Nutritional Status / Q000187:drug effects; D010865:Pilot Projects; D015430:Weight Gain / Q000187:drug effects; D055815:Young Adult
chemical_list: D019167:Appetite Stimulants; D054439:Ghrelin