Screening for anorexia nervosa via measurement of serum leptin levels.
Due to their sub-normally low fat mass, leptin levels in patients with acute anorexia nervosa (AN) are well below reference levels for age and sex-matched controls. This hypoleptinemia entails endocrinological and behavioral characteristics observed in AN patients during starvation. We aimed to study the appropriateness of hypoleptinemia as a diagnostic marker for AN by assessing sensitivity, specificity and likelihood ratios for different referral serum leptin levels for predicting anorexia nervosa and healthy leanness. For prediction, we additionally generated a score based on a multivariate logistic model including body mass index (BMI; kg/m²) and leptin level. For this purpose, we measured leptin levels in 74 female patients with acute AN upon admission for inpatient or outpatient treatment. Adolescent and adult patients were recruited according to DSM-IV criteria from two multi-center studies. Additionally, leptin levels were measured in 65 female healthy, lean students. Mean serum leptin level was significantly decreased in patients with AN compared to underweight controls (0.87 ± 0.90 vs. 6.43 ± 3.55 μg/L, p < 0.001). Leptin predicted AN independently of BMI; we confirmed a cutoff value in the range of 2 μg/L as having both high specificity and sensitivity. Hypoleptinemia represents a state marker of acute AN and is useful for a laboratory-based diagnostic screening.
Department of Child and Adolescent Psychiatry and Psychotherapy, University of Duisburg-Essen, Virchowstr. 174, 45147, Essen, Germany. Manuel.Foecker@uni-due.de
M
M
Föcker
N
N
Timmesfeld
S
S
Scherag
K
K
Bühren
M
M
Langkamp
A
A
Dempfle
E M
EM
Sheridan
M
M
de Zwaan
C
C
Fleischhaker
W
W
Herzog
K
K
Egberts
S
S
Zipfel
B
B
Herpertz-Dahlmann
J
J
Hebebrand
D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000097:blood* / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D020738:Leptin / Q000097:blood*; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011237:Predictive Value of Tests; D055815:Young Adult
D015415:Biomarkers; D020738:Leptin
J Psychiatr Res. 1994 Jan-Feb;28(1):57-84
8064641
J Clin Endocrinol Metab. 1997 Sep;82(9):2904-10
9284717
Int J Eat Disord. 2005 Dec;38(4):310-22
16254871
Int J Eat Disord. 2007 Apr;40(3):212-7
17173324
Cancer Res. 2008 Feb 1;68(3):645-9
18245462
Obes Facts. 2009;2(1):52-3
20054205
Mol Psychiatry. 1997 Jul;2(4):335-40
9246675
Mol Psychiatry. 1997 Jul;2(4):330-4
9246674
Int J Eat Disord. 1998 Nov;24(3):227-49
9741034
Int J Obes Relat Metab Disord. 1997 Mar;21(3):224-30
9080262
J Clin Invest. 2005 Dec;115(12):3579-86
16322796
J Clin Endocrinol Metab. 2003 Jan;88(1):109-16
12519838
J Clin Endocrinol Metab. 2001 Jul;86(7):2982-8
11443155
Int J Eat Disord. 1998 Apr;23(3):341-5
9547668
J Clin Endocrinol Metab. 1999 Apr;84(4):1226-8
10199758
Physiol Res. 1999;48(3):197-202
10523055
World J Gastroenterol. 2007 Jan 21;13(3):398-402
17230608
Trials. 2009 Apr 23;10:23
19389245
J Clin Endocrinol Metab. 1997 Jun;82(6):1845-51
9177394
Eur Psychiatry. 2001 Feb;16(1):38-48
11246291
Psychosom Med. 2002 Nov-Dec;64(6):874-9
12461192
N Engl J Med. 2004 Sep 2;351(10):987-97
15342807
J Clin Endocrinol Metab. 1996 Nov;81(11):3861-3
8923829
J Clin Endocrinol Metab. 2010 May;95(5):2203-10
20305007
Am J Clin Nutr. 2005 Apr;81(4):889-96
15817868
Clin Endocrinol (Oxf). 1998 Jun;48(6):761-8
9713566
J Psychiatr Res. 2003 Mar-Apr;37(2):165-9
12842170
Int J Eat Disord. 2011 Dec;44(8):665-78
22072403
Int J Clin Oncol. 2009 Aug;14(4):315-20
19705241
Cytokine. 2004 Jun 21;26(6):255-61
15183843
Child Adolesc Psychiatr Clin N Am. 2009 Jan;18(1):117-29
19014861
Psychol Med. 1998 Jan;28(1):109-26
9483687
Arch Gen Psychiatry. 1988 Dec;45(12):1069-77
2848472
J Clin Endocrinol Metab. 2004 Jul;89(7):3486-95
15240636
Physiol Behav. 2003 Jun;79(1):25-37
12818707
Br J Psychiatry. 1989 Nov;155:642-6
2611593
Lancet. 1995 Dec 16;346(8990):1624-5
7500762
Int J Sports Med. 1999 Oct;20(7):451-6
10551340
Mol Psychiatry. 1997 Sep;2(5):420-2
9322239
BMJ. 1997 Aug 30;315(7107):540-3
9329312
N Engl J Med. 1996 Feb 1;334(5):292-5
8532024
Curr Opin Psychiatry. 2006 Jul;19(4):389-94
16721169
J Am Board Fam Pract. 2003 Mar-Apr;16(2):95-101
12665174
J Investig Med. 2010 Mar;58(3):554-9
20215915
J Neural Transm (Vienna). 2003 Apr;110(4):427-35
12658369