title: Satiety-related hormonal dysregulation in behavioral variant frontotemporal dementia.
abstract: OBJECTIVE
  To investigate whether patients with behavioral variant frontotemporal dementia (bvFTD) have dysregulation in satiety-related hormonal signaling using a laboratory-based case-control study.
  
  
  METHODS
  Fifty-four participants (19 patients with bvFTD, 17 patients with Alzheimer disease dementia, and 18 healthy normal controls [NCs]) were recruited from a tertiary-care dementia clinic. During a standardized breakfast, blood was drawn before, during, and after the breakfast protocol to quantify levels of peripheral satiety-related hormones (ghrelin, cortisol, insulin, leptin, and peptide YY) and glucose. To further explore the role of patients' feeding abnormalities on hormone levels, patients were classified into overeating and nonovereating subgroups based on feeding behavior during separate laboratory-based standardized lunch feeding sessions.
  
  
  RESULTS
  Irrespective of their feeding behavior in the laboratory, patients with bvFTD, but not patients with Alzheimer disease dementia, have significantly lower levels of ghrelin and cortisol and higher levels of insulin compared with NCs. Furthermore, while laboratory feeding behavior did not predict alterations in levels of ghrelin, cortisol, and insulin, only patients with bvFTD who significantly overate in the laboratory demonstrated significantly higher levels of leptin compared with NCs, suggesting that leptin may be sensitive to particularly severe feeding abnormalities in bvFTD.
  
  
  CONCLUSIONS
  Despite a tendency to overeat, patients with bvFTD have a hormonal profile that should decrease food intake. Aberrant hormone levels may represent a compensatory response to the behavioral or neuroanatomical abnormalities of bvFTD.
authors.affiliation: From the Departments of Psychiatry (J.D.W.), Physiology (M.D.), and Neuroscience (M.D.), and Department of Neurology, Memory and Aging Center (B.K.K., A.N., A.K., B.L.M., K.P.R.), University of California, San Francisco; Department of Psychiatry (J.D.W.), San Francisco Veterans Affairs Medical Center; and Departments of Molecular Biosciences and Nutrition (P.H.), School of Veterinary Medicine, University of California, Davis.
authors.forename: Josh D
authors.initials: JD
authors.lastname: Woolley
authors.forename: Baber K
authors.initials: BK
authors.lastname: Khan
authors.forename: Alamelu
authors.initials: A
authors.lastname: Natesan
authors.forename: Anna
authors.initials: A
authors.lastname: Karydas
authors.forename: Mary
authors.initials: M
authors.lastname: Dallman
authors.forename: Peter
authors.initials: P
authors.lastname: Havel
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Miller
authors.forename: Katherine P
authors.initials: KP
authors.lastname: Rankin
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000097:blood / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood*; D001786:Blood Glucose; D016022:Case-Control Studies; D005247:Feeding Behavior; D005260:Female; D057180:Frontotemporal Dementia / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D054439:Ghrelin / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006963:Hyperphagia / Q000097:blood* / Q000209:etiology / Q000503:physiopathology; D007328:Insulin / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D019894:Peptide YY / Q000097:blood
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D054439:Ghrelin; D007328:Insulin; D020738:Leptin; D019894:Peptide YY; D006854:Hydrocortisone