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Doua S, Germain N, Merabet M, Redouté J, Boutet C, Schneider F, Hammour A, Gay A, Massoubre C, Estour B, Galusca B. Circadian copeptin and oxytocin profiles in anorexia nervosa: Exploring the interplay with neurohypophysis opioid tone. EUROPEAN EATING DISORDERS REVIEW 2024. [PMID: 39032117 DOI: 10.1002/erv.3125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 05/21/2024] [Accepted: 06/29/2024] [Indexed: 07/22/2024]
Abstract
CONTEXT Neurohypophysis (NH) function in eating disorders (ED) remains poorly elucidated. Studies on vasopressin and oxytocin display inconclusive findings regarding their levels and associations with psychological complications in ED. The profile of opioid tone, a crucial NH activity regulator, is also unknown. OBJECTIVE To characterise the circadian profile of NH hormones and NH opioid tone using positron emission tomography/MRI (PET/MRI) imaging in patients with ED compared to healthy controls. METHODS Twelve-point plasma circadian profiles of copeptin and oxytocin, alongside nutritional and psychological scores, were assessed in age-matched female participants: 13 patients with anorexia nervosa restrictive-type (ANR), 12 patients recovered from AN (ANrec), 14 patients with bulimia nervosa and 12 controls. Neurohypophysis PET/MRI [11C] diprenorphin binding potential (BPND) was evaluated in AN, ANrec and controls. RESULTS Results revealed lower copeptin circadian levels in both ANR and ANrec compared to controls, with no oxytocin differences. Bulimia nervosa exhibited elevated copeptin and low oxytocin levels. [11C] diprenorphin pituitary binding was fully localised in NH. Anorexia nervosa restrictive-type displayed lower NH [11C] diprenorphin BPND (indicating higher opioid tone) and volume than controls. In ANR, copeptin inversely correlated with osmolarity. Neurohypophysis [11C] diprenorphin BPND did not correlated with copeptin or oxytocin. CONCLUSION Copeptin demonstrated significant group differences, highlighting its potential diagnostic and prognostic value. Oxytocin levels exhibited conflicting results, questioning the reliability of peripheral blood assessment. Increased NH opioid tone in anorexia nervosa may influence the vasopressin or oxytocin release, suggesting potential therapeutic applications.
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Affiliation(s)
- Sandra Doua
- TAPE Research Group, Jean Monnet University, Lyon University, Saint-Etienne, France
- Endocrinology Department, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Natacha Germain
- TAPE Research Group, Jean Monnet University, Lyon University, Saint-Etienne, France
- Endocrinology Department, University Hospital of Saint-Etienne, Saint-Etienne, France
- Eating Disorder Reference Center, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Manel Merabet
- TAPE Research Group, Jean Monnet University, Lyon University, Saint-Etienne, France
- Endocrinology Department, University Hospital of Saint-Etienne, Saint-Etienne, France
| | | | - Claire Boutet
- TAPE Research Group, Jean Monnet University, Lyon University, Saint-Etienne, France
- Imaging Department, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Fabien Schneider
- TAPE Research Group, Jean Monnet University, Lyon University, Saint-Etienne, France
- Imaging Department, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Amira Hammour
- TAPE Research Group, Jean Monnet University, Lyon University, Saint-Etienne, France
- Endocrinology Department, University Hospital of Saint-Etienne, Saint-Etienne, France
- Eating Disorder Reference Center, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Aurélia Gay
- TAPE Research Group, Jean Monnet University, Lyon University, Saint-Etienne, France
- Eating Disorder Reference Center, University Hospital of Saint-Etienne, Saint-Etienne, France
- Psychiatry Department, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Catherine Massoubre
- TAPE Research Group, Jean Monnet University, Lyon University, Saint-Etienne, France
- Eating Disorder Reference Center, University Hospital of Saint-Etienne, Saint-Etienne, France
- Psychiatry Department, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Bruno Estour
- TAPE Research Group, Jean Monnet University, Lyon University, Saint-Etienne, France
- Endocrinology Department, University Hospital of Saint-Etienne, Saint-Etienne, France
- Eating Disorder Reference Center, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Bogdan Galusca
- TAPE Research Group, Jean Monnet University, Lyon University, Saint-Etienne, France
- Endocrinology Department, University Hospital of Saint-Etienne, Saint-Etienne, France
- Eating Disorder Reference Center, University Hospital of Saint-Etienne, Saint-Etienne, France
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Amorim T, Khiyami A, Latif T, Fazeli PK. Neuroendocrine adaptations to starvation. Psychoneuroendocrinology 2023; 157:106365. [PMID: 37573628 PMCID: PMC10543597 DOI: 10.1016/j.psyneuen.2023.106365] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 08/15/2023]
Abstract
Famine and starvation have punctuated the evolutionary past of the human species. As such, we have developed hormonal responses to undernutrition that minimize energy expenditure on processes that are not critical for the survival of the individual, such as reproduction. In this review, we discuss neuroendocrine adaptations to starvation including hypogonadotropic hypogonadism, growth hormone resistance, hypercortisolemia, and the downregulation of the hypothalamic-pituitary-thyroid axis. We review the time-course of these adaptations by describing studies involving the short-term fasting of healthy individuals as well as studies describing the hormonal changes in states of chronic undernutrition, using individuals with anorexia nervosa as a model of chronic starvation. Lastly, we review representative clinical effects of chronic undernutrition.
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Affiliation(s)
- Tânia Amorim
- Neuroendocrinology Unit, Division of Endocrinology and Metabolism University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Center for Human Integrative Physiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Anamil Khiyami
- Neuroendocrinology Unit, Division of Endocrinology and Metabolism University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Tariq Latif
- Neuroendocrinology Unit, Division of Endocrinology and Metabolism University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Pouneh K Fazeli
- Neuroendocrinology Unit, Division of Endocrinology and Metabolism University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Center for Human Integrative Physiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
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Abdelmageed M, Güzelgül F. Copeptin: Up-to-date diagnostic and prognostic role highlight. Anal Biochem 2023:115181. [PMID: 37247750 DOI: 10.1016/j.ab.2023.115181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 05/31/2023]
Abstract
Arginine Vasopressin (AVP) is one of the key hormones in the human body. AVP is clinically important because it maintains body fluid balance and vascular tone. Unfortunately, AVP laboratory measurements are always difficult and with low accuracy. Copeptin, the C-terminal of the AVP precursor, is released in equal amounts with AVP, making it a sensitive marker of AVP release. Despite being a non-specific biomarker, copeptin earned a lot of attention as a novel biomarker due to easy and quick laboratory measurements. Recent studies have reported the critical role of copeptin as a clinical indicator, especially in the diagnosis and prognosis of many diseases. Besides, it was reported that the combination between copeptin and gold standard biomarkers improved the prognostic values of those biomarkers. In this review, the role of copeptin as a new predictive diagnostic and prognostic biomarker of various diseases is highlighted according to the most recent studies. In addition, the importance of using copeptin as a marker in different medical departments and the impact of this on improving healthcare service was discussed.
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Affiliation(s)
- Marwa Abdelmageed
- Tokat Gaziosmanpasa University, Faculty of Medicine, Department of Medical Biochemistry, Tokat City, Turkiye.
| | - Figen Güzelgül
- Tokat Gaziosmanpasa University, Faculty of Pharmacy, Department of Biochemistry, Tokat City, Turkiye.
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Rosen E, Wiley E, Hung P, Song D, Sharma Y, Moscicki AB, Wesseling-Perry K. Renal fluid and acid/base balance during refeeding in restrictive eating disorders. Int J Eat Disord 2023; 56:574-581. [PMID: 36571431 DOI: 10.1002/eat.23873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 11/28/2022] [Accepted: 11/28/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND OBJECTIVES Fluid shifts have been ascribed to central diabetes insipidus in patients with anorexia nervosa hospitalized for refeeding. Recent data, however, suggest that vasopressin production is not dysregulated in this population. Our objective was to describe the trajectory of fluid imbalances in relationship to kidney function, electrolyte disturbances, and acid/base balance during refeeding. METHODS A retrospective review of daily fluid balance and biochemical values was performed in 70 sequential unique patients admitted to University of California at Los Angeles Hospital Medical Stabilization Program for Eating Disorders from December 2018 to November 2020. RESULTS Participants (2 males/68 females) were between 10 and 24 years of age and with a median body mass index of 16.1 (14.3, 18.1) kg/m2 . A severe negative fluid balance (>-900 ml/day) was observed in 80% of patients at some point during hospitalization. Serum sodium concentrations were normal on admission and remained stable during refeeding. Serum bicarbonate concentrations were 25 ± 1 mEq/dl on admission and increased above the normal range in 31% of patients. Metabolic alkalosis was inversely associated with the development of a negative fluid balance. Estimated glomerular filtration rate was impaired in 54% of patients, improved with refeeding, and was not associated with the development of a severe negative fluid balance or metabolic alkalosis. DISCUSSION Chronic energy deprivation alters the physiology of renal fluid and bicarbonate handling in ways that are independent of vasopressin and glomerular filtration. Further studies are warranted to understand the renal adaptations that occur during energy restriction and subsequent refeeding. PUBLIC SIGNIFICANCE Massive urinary fluid losses occur in patients with restrictive eating disorders hospitalized for refeeding. In addition, many patients have impaired renal bicarbonate excretion. These findings suggest that chronic energy deprivation impairs the kidney's ability to handle the shifts in fluid and acid/base balance that occur when appropriate oral nutrition is re-introduced.
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Affiliation(s)
- Elaine Rosen
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Evan Wiley
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Phoebe Hung
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Dana Song
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Yamini Sharma
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Anna-Barbara Moscicki
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Katherine Wesseling-Perry
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.,Division of Nephrology, Phoenix Children's Hospital, Phoenix, Arizona, USA.,Department of Pediatrics, University of Arizona College of Medicine, Tucson, Arizona, USA
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Review novel insights into the diagnostic and prognostic function of copeptin in daily clinical practice. Mol Biol Rep 2023; 50:3755-3765. [PMID: 36662451 PMCID: PMC9853489 DOI: 10.1007/s11033-023-08246-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/04/2023] [Indexed: 01/21/2023]
Abstract
As is shown in previous reports, arginine vasopressin (AVP), as one of the most important hormones within circulation in human beings, is of great clinically significance given that it could maintain the body fluid balance and vascular tone. However, the laboratory measurements AVP in daily clinical practice are shown to be difficult and with low accuracy. Concerning on this notion, it is unpractical to use the serum levels of AVP in diagnosing multiple diseases. On the other hand, another key serum biomarker, copeptin, is confirmed as the C-terminal of the AVP precursor which could be released in equal amounts with AVP, resultantly making it as a sensitive marker of arginine vasopressin release. Notably, emerging recent evidence has demonstrated the critical function of copeptin as a clinical indicator, especially in the diagnosis and prognosis of several diseases in diverse organs, such as cardiovascular disease, kidney disease, and pulmonary disease. In addition, copeptin was recently verified to play an important role in diagnosing multiple acute diseases when combined it with other gold standard serum biomarkers, indicating that copeptin could be recognized as a vital disease marker. Herein, in the current review, the functions of copeptin as a new predictive diagnostic and prognostic biomarker of various diseases, according to the most recent studies, are well summarized. Furthermore, the importance of using copeptin as a serum biomarker in diverse medical departments and the impact of this on improving healthcare service is also summarized in the current review.
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Plomgaard P, Hansen JS, Townsend LK, Gudiksen A, Secher NH, Clemmesen JO, Støving RK, Goetze JP, Wright DC, Pilegaard H. GDF15 is an exercise-induced hepatokine regulated by glucagon and insulin in humans. Front Endocrinol (Lausanne) 2022; 13:1037948. [PMID: 36545337 PMCID: PMC9760804 DOI: 10.3389/fendo.2022.1037948] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/14/2022] [Indexed: 12/07/2022] Open
Abstract
OBJECTIVE Growth differentiation factor (GDF)-15 is implicated in regulation of metabolism and circulating GDF15 increases in response to exercise. The source and regulation of the exercise-induced increase in GDF15 is, however not known. METHOD Plasma GDF15 was measured by ELISA under the following conditions: 1) Arterial-to-hepatic venous differences sampled before, during, and after exercise in healthy male subjects (n=10); 2) exogenous glucagon infusion compared to saline infusion in resting healthy subjects (n=10); 3) an acute exercise bout with and without a pancreatic clamp (n=6); 4) healthy subjects for 36 hours (n=17), and 5) patients with anorexia nervosa (n=25) were compared to healthy age-matched subjects (n=25). Tissue GDF15 mRNA content was determined in mice in response to exhaustive exercise (n=16). RESULTS The splanchnic bed released GDF15 to the circulation during exercise and increasing the glucagon-to-insulin ratio in resting humans led to a 2.7-fold (P<0.05) increase in circulating GDF15. Conversely, inhibiting the exercise-induced increase in the glucagon-to-insulin ratio blunted the exercise-induced increase in circulating GDF15. Fasting for 36 hours did not affect circulating GDF15, whereas resting patients with anorexia nervosa displayed elevated plasma concentrations (1.4-fold, P<0.05) compared to controls. In mice, exercise increased GDF15 mRNA contents in liver, muscle, and adipose tissue. CONCLUSION In humans, GDF15 is a "hepatokine" which increases during exercise and is at least in part regulated by the glucagon-to-insulin ratio. Moreover, chronic energy deprivation is associated with elevated plasma GDF15, which supports that GDF15 is implicated in metabolic signalling in humans.
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Affiliation(s)
- Peter Plomgaard
- Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- *Correspondence: Peter Plomgaard,
| | - Jakob S. Hansen
- Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Logan K. Townsend
- Department of Human Health and Nutritional Sciences, University of Guelph, Copenhagen, ON, Canada
| | - Anders Gudiksen
- Section for Cell Biology and Physiology, Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Niels H. Secher
- Department of Anaesthesiology, Copenhagen Muscle Research Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jens O. Clemmesen
- Department of Hepatology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Rene K. Støving
- Center for Eating Disorders, Elite Research Center for Medical Endocrinology, Odense University Hospital, Odense, Denmark
- Mental Health Services in the Region of Southern Denmark, Odense, Denmark
- Clinical Institute, University of Southern Denmark, Odense, Denmark
| | - Jens P. Goetze
- Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - David C. Wright
- Department of Human Health and Nutritional Sciences, University of Guelph, Copenhagen, ON, Canada
- School of kinesiology, Faculty of Land and Food Systems and British Columbia (BC) Children’s Hospital Research Foundation, University of British Columbia, Vancouver, BC, Canada
| | - Henriette Pilegaard
- Section for Cell Biology and Physiology, Department of Biology, University of Copenhagen, Copenhagen, Denmark
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Abstract
Vasopressin (AVP) and copeptin are released in equimolar amounts from the same precursor. Due to its molecular stability and countless advantages as compared with AVP, copeptin perfectly mirrors AVP presence and has progressively emerged as a reliable marker of vasopressinergic activation in response to osmotic and hemodynamic stimuli in clinical practice. Moreover, evidence highlighting the prognostic potential of copeptin in several acute diseases, where the activation of the AVP system is primarily linked to stress, as well as in psychologically stressful conditions, has progressively emerged. Furthermore, organic stressors induce a rise in copeptin levels which, although non-specific, is unrelated to plasma osmolality but proportional to their magnitude: suggesting disease severity, copeptin proved to be a reliable prognostic biomarker in acute conditions, such as sepsis, early post-surgical period, cardiovascular, cerebrovascular or pulmonary diseases, and even in critical settings. Evidence on this topic will be briefly discussed in this article.
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Goetze JP, Støving RK. Copeptin in anorexia nervosa. Brain Behav 2020; 10:e01551. [PMID: 32073757 PMCID: PMC7177552 DOI: 10.1002/brb3.1551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 12/17/2019] [Accepted: 01/04/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Antidiuretic hormone (ADH) is involved in the response to stress and in depression and anxiety. However, studies on ADH in anorexia nervosa (AN) show conflicting results. A major reason for this may be methodological challenges due to short half-life of ADH in circulation and rapid degradation in vitro. To overcome these obstacles, copeptin, the C-terminal fragment stemming from the ADH precursor, has been increasingly used as a stable clinical measure for ADH. Furthermore, copeptin has been recognized as a biomarker of insulin resistance in obesity. METHODS We measured fasting copeptin in plasma from 25 normohydrated, stable women with AN (BMI 13.0 ± 2.0) and 25 age-matched women. RESULTS No difference in copeptin levels was found (6.8 ± 1.8 vs. 5.5 ± 0.5 pmol/L). Confirmatory, copeptin concentrations were correlated to insulin resistance assessed by the homeostasis model assessment of insulin resistance. DISCUSSION We report for the first time that copeptin level as a marker of ADH activity is not altered in fluid- and electrolyte-stabilized patients with severe AN patients, indicating that ADH may not be crucial in the pathophysiological involvement of psychologic stress in AN.
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Affiliation(s)
- Jens P Goetze
- Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - René Klinkby Støving
- Center for Eating Disorders, Odense University Hospital, Odense, Denmark.,Elite Research Center for Medical Endocrinology, Odense University Hospital, Odense, Denmark.,Mental Health Services in the Region of Southern Denmark, Odense, Denmark.,Clinical Institute, University of Southern Denmark, Odense, Denmark
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