title: Ghrelin activation and neuropeptide Y elevation in response to medium chain triglyceride administration in anorexia nervosa patients.
abstract: OBJECTIVE
  Ghrelin, a peptide found in the stomach, increases appetite and fat-free mass while suppressing energy expenditure. Ghrelin requires modification by medium-chain triglycerides (MCTs) to exert its physiological effects. In this study, we investigated ghrelin activation and the resulting physiological changes following MCT administration.
  
  
  METHODS
  Thirty participants were selected from among inpatients diagnosed with anorexia nervosa (AN). The patients were randomly divided into three groups by the MCT content of their nutritional supplement: (1) 'MCT high' (>6 g/day), (2) 'MCT moderate' (1-6 g/day), and (3) 'MCT low' (<1 g/day). Physical factors such as body weight and composition, as well as levels of nutrition-related serum factors such as acylated (active form) and desacyl (inactive form) ghrelin, leptin, growth hormone, insulin-like growth factor, and neuropeptide Y (NPY) were measured at weeks 0, 2, 4, and 6 of the treatment protocol.
  
  
  RESULTS
  Significantly higher ghrelin activation was found in the 'MCT high' than in the 'MCT low' group (P < 0.05). The amount of consumed MCT had a curvilinear relationship with the active ghrelin level (P = 0.00). NPY levels in the 'MCT high' group were significantly more elevated than in the 'MCT low' group (P < 0.05). MCT administration did not significantly affect the remaining factors.
  
  
  CONCLUSIONS
  This study clearly demonstrated that MCT activates ghrelin and increases NPY, suggesting that nutritional supplementation with MCT may be effective for the treatment of AN patients in an emaciated state.
authors.affiliation: Department of Psychosomatic Medicine, Kohnodai Hospital National Center for Global Health Medicine 1-7-1, Kohnodai, Ichikawa City, Chiba, 272-8516, Japan; Department of Psychosomatic Medicine, Graduate School of Medical Sciences Kyushu University, Fukuoka, 812-8582, Japan. Electronic address: kawai@cephal.med.kyushu-u.ac.jp.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kawai
authors.affiliation: Department of Psychosomatic Medicine, Graduate School of Medical Sciences Kyushu University, Fukuoka, 812-8582, Japan.
authors.forename: Megumi
authors.initials: M
authors.lastname: Nakashima
authors.affiliation: Institute of Life Science, Kurume University, Kurume, 830-0864, Japan.
authors.forename: Masayasu
authors.initials: M
authors.lastname: Kojima
authors.affiliation: Department of Psychosomatic Medicine, Graduate School of Medical Sciences Kyushu University, Fukuoka, 812-8582, Japan.
authors.forename: Sakino
authors.initials: S
authors.lastname: Yamashita
authors.affiliation: Department of Psychosomatic Medicine, Graduate School of Medical Sciences Kyushu University, Fukuoka, 812-8582, Japan.
authors.forename: Shu
authors.initials: S
authors.lastname: Takakura
authors.affiliation: Department of Psychosomatic Medicine, Graduate School of Medical Sciences Kyushu University, Fukuoka, 812-8582, Japan.
authors.forename: Miki
authors.initials: M
authors.lastname: Shimizu
authors.affiliation: Kyushu University, Fukuoka, 819-0315, Japan.
authors.forename: Chiharu
authors.initials: C
authors.lastname: Kubo
authors.affiliation: Department of Psychosomatic Medicine, Graduate School of Medical Sciences Kyushu University, Fukuoka, 812-8582, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Sudo
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D001823:Body Composition; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D005260:Female; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D007564:Japan; D009478:Neuropeptide Y / Q000097:blood*; D015596:Nutrition Assessment; D013997:Time Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000008:administration & dosage* / Q000009:adverse effects; D015854:Up-Regulation; D015430:Weight Gain; D055815:Young Adult
chemical_list: D015415:Biomarkers; C515349:GHRL protein, human; D054439:Ghrelin; D009478:Neuropeptide Y; D014280:Triglycerides
keywords: Activation; Anorexia nervosa; Ghrelin; Medium-chain triglycerides; Neuropeptide Y