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Agouti-related protein in patients with acute and weight-restored anorexia nervosa

Published online by Cambridge University Press:  22 March 2011

J. V. Merle ,
V. Haas ,
R. Burghardt ,
N. Döhler ,
N. Schneider ,
U. Lehmkuhl  and
S. Ehrlich
J. V. Merle
Affiliation:
Charité – Universitätsmedizin Berlin, CVK, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Berlin, Germany
V. Haas
Affiliation:
Charité – Universitätsmedizin Berlin, CVK, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Berlin, Germany Charité – Universitätsmedizin Berlin, ECRC, Franz-Volhard Clinical Research Center, Berlin, Germany
R. Burghardt
Affiliation:
Charité – Universitätsmedizin Berlin, CVK, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Berlin, Germany
N. Döhler
Affiliation:
Charité – Universitätsmedizin Berlin, CVK, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Berlin, Germany
N. Schneider
Affiliation:
Charité – Universitätsmedizin Berlin, CVK, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Berlin, Germany
U. Lehmkuhl
Affiliation:
Charité – Universitätsmedizin Berlin, CVK, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Berlin, Germany
S. Ehrlich*
Affiliation:
Charité – Universitätsmedizin Berlin, CVK, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Berlin, Germany Harvard Medical School, Massachusetts General Hospital, Department of Psychiatry, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA Dresden University of Technology, Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Dresden, Germany
*
*Address for correspondence: S. Ehrlich, M.D., Massachusetts General Hospital/Harvard Medical School, Athinoula A. Martinos Center for Biomedical Imaging, Psychiatric Neuroimaging Research Program, CNY Building 120, Suite 100, Charlestown, Massachusetts 02129-2000, USA. (Email: [email protected])
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Abstract

Background

An imbalance in appetite-regulating neuropeptides of the central nervous system has been associated with anorexia nervosa (AN), but the mechanisms of action are poorly understood. Agouti-related protein (AGRP), an orexigenic mediator of the hypothalamus, increases food intake and decreases energy expenditure in times of negative energy balance. The aim of the present study was to investigate AGRP in acute and fully weight-restored patients with AN, as well as during weight gain.

Method

Plasma AGRP and leptin levels were assessed using an enzyme-linked immunosorbent assay kit in a total of 175 female participants, including 75 patients with acute AN, 37 weight-restored AN patients and 63 healthy controls. Of the patients with acute AN, 33 were reassessed after partial weight gain.

Results

In weight-restored AN patients plasma AGRP levels were similar to those in healthy controls, whereas in patients with acute AN, AGRP was elevated. AGRP was inversely correlated with indicators of undernutrition such as body mass index and plasma leptin. In addition, AGRP levels normalized during weight gain of longitudinally assessed AN patients.

Conclusions

Our results underline the significance of undernutrition and hypoleptinemia for the interpretation of peripheral AGRP concentrations. This provides support for the hypothesis that abnormal AGRP plasma levels in AN patients reflect undernutrition, rather than disease-specific traits.

Keywords

Agouti-related proteinanorexia nervosaleptinneuroendocrinologyundernutrition
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 10 , October 2011 , pp. 2183 - 2192
Copyright
Copyright © Cambridge University Press 2011

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