1
|
Marks KP, Aalders J, Liu S, Broadley M, Thastum M, Jensen MB, Ibfelt EH, Birkebaek NH, Pouwer F. Associations between Disordered Eating Behaviors and HbA 1c in Young People with Type 1 Diabetes: A Systematic Review and Meta-analysis. Curr Diabetes Rev 2024; 20:e220823220144. [PMID: 37608674 DOI: 10.2174/1573399820666230822095939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/25/2023] [Accepted: 07/03/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND In type 1 diabetes, disordered eating behaviors (DEB) can adversely impact HbA1c. Diabetes-adapted DEB questionnaires assess intentional insulin omission, whereas generic questionnaires do not. Given the number of studies describing DEB-HbA1c associations published over the past decade, an updated systematic review is warranted. OBJECTIVE The study aimed to examine the associations between DEBs assessed by generic and diabetes- adapted questionnaires (and subscales) and HbA1c among young people (<29 years) with type 1 diabetes. METHODS A systematic search was conducted in PubMed, Embase, PsycInfo, and CINAHL databases. Observational studies examining associations between DEB as assessed by questionnaires and HbA1c were included. Publication information, DEB and HbA1c characteristics, and DEBHbA1c associations were extracted. Hedges' g was calculated for mean HbA1c differences between groups with and without DEB. RESULTS The systematic search yielded 733 reports, of which 39 reports representing 35 unique studies met the inclusion criteria. Nineteen studies assessing DEB by diabetes-adapted questionnaires (n=5,795) and seven using generic questionnaires (n=2,162) provided data for meta-analysis. For diabetes-adapted questionnaires, DEB was associated with higher HbA1c (g=0.62 CI=0.52; 0.73) with a similar effect size when restricted to validated questionnaires (g=0.61; CI=0.50; 0.73). DEB was not associated with HbA1c for generic questionnaires (g=0.19; CI=-0.17; 0.55), but significantly associated with higher HbA1c for validated generic questionnaires (g=0.32; 95% CI=0.16-0.48). Participant and HbA1c collection characteristics were often inadequately described. CONCLUSION Diabetes-adapted DEB questionnaires should be used in youth with type 1 diabetes because they capture intentional insulin omission and are more strongly associated with HbA1c than generic DEB questionnaires.
Collapse
Affiliation(s)
- Kevin P Marks
- Department of Clinical Medicine - Paediatrics, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Jori Aalders
- Steno Diabetes Center Odense, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Shengxin Liu
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Solna, Sweden
| | - Melanie Broadley
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Mikael Thastum
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | | | - Else Helene Ibfelt
- The Danish Clinical Quality Program - National Clinical Registries (RKKP), Copenhagen, Denmark
| | - Niels H Birkebaek
- Department of Paediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Frans Pouwer
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Department of Medical Psychology, Amsterdam UMC, The Netherlands
- Steno Diabetes Center Odense, Odense, Denmark
| |
Collapse
|
2
|
Taş D, Mengen E, Kocaay P, Uçaktürk SA. The Effects of Risk Behaviors and Orthorexic Behavior on Glycemic Control in Adolescents with Type 1 Diabetes. J Clin Res Pediatr Endocrinol 2020; 12:233-240. [PMID: 31722516 PMCID: PMC7499139 DOI: 10.4274/jcrpe.galenos.2019.2019.0128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 11/14/2019] [Indexed: 12/15/2022] Open
Abstract
Objective Adolescents with chronic disease are as likely to exhibit risk-taking behavior as their peers. The aim was to investigate the risk behaviors of adolescents with type 1 diabetes (T1D) and the effect of orthorexic eating behaviors (OEB) on glycemic control (GC). Methods This cross-sectional study was conducted with 107 adolescents with T1D, aged between 13-18 years and attending high school. The Risk Behavior Scale (RBS) and Orthorexic Behavior Scale (ORTO-11) were administered. A high RBS score indicates risky behavior; a low ORTO-11 score suggests a tendency to OEB. Participants hemoglobin A1c (HbA1c) status was used to assess GC: optimal GC (HbA1c ≤7%); or poor GC (HbA1c >7%). Results Among females, those with poor GC had significantly lower (p=0.031) ORTO-11 scores than those with optimal GC, which was not the case in males. A significant correlation (r=0.358, p<0.001) was found between HbA1c and total RBS, eating habits subscale, and suicidal tendency subscale scores. Participants with poor GC had significantly higher eating habits subscale, alcohol use, and tobacco use subscale scores (p<0.05). Among females, total RBS and suicidal tendency subscale score was found to be significantly higher in those with poor GC; among males, alcohol subscale score was found to be significantly higher in those with poor GC. Conclusion This study is the first to show the effect of the tendency for OEB on GC among female adolescents with T1D. The study showed that, along with inappropriate eating behaviors, adolescents with T1D should also be assessed for other risk behaviors to help achieve optimal GC.
Collapse
Affiliation(s)
- Demet Taş
- Ankara City Hospital, Children’s Hospital, Clinic of Pediatrics, Ankara, Turkey
| | - Eda Mengen
- Ankara City Hospital, Children’s Hospital, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Pınar Kocaay
- Ankara City Hospital, Children’s Hospital, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Seyit Ahmet Uçaktürk
- Ankara City Hospital, Children’s Hospital, Department of Pediatric Endocrinology, Ankara, Turkey
| |
Collapse
|
3
|
Sun JK, Shen X, Sun XP, Wang X, Zhang WH, Shi QK, Mu XW. Heparin-binding protein as a biomarker of gastrointestinal dysfunction in critically ill patients: a retrospective cross-sectional study in China. BMJ Open 2020; 10:e036396. [PMID: 32624474 PMCID: PMC7337894 DOI: 10.1136/bmjopen-2019-036396] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To investigate the association of plasma heparin-binding protein (HBP) with the development of acute gastrointestinal injury (AGI) in critically ill patients. DESIGN Clinical retrospective cross-sectional study. SETTING A general teaching hospital in China. PARTICIPANTS Adult patients (age ≥18 years) admitted to our department with an intensive care unit (ICU) stay ≥5 days. MAIN OUTCOME MEASURES HBP levels were recorded twice or more within 5 days after admission. The initial AGI grades and the worst AGI grades within 5 days after admission, the number of patients receiving total enteral nutrition (TEN) and the number of patients with feeding intolerance (FI) and with sepsis were also recorded, along with some clinical severity and outcome variables. RESULTS From June 2018 to May 2019, 221 patients were enrolled in this study. We divided patients into four groups based on the HBP values: HBP ≤20 ng/mL, 20<HBP ≤50 ng/mL, 50<HBP ≤100 ng/mL and HBP >100 ng/mL. Significant differences were found in the ratios of AGI deterioration and TEN and the incidence rates of FI and sepsis among the four groups. Differences were also found among the groups regarding the worst AGI grades. The area under receiver operating characteristic curves for AGI deterioration, severe AGI (grades II or above), TEN and FI were 0.738 (p=0.001), 0.774 (p<0.001), 0.810 (p<0.001) and 0.729 (p=0.001), respectively. The optimal HBP cut-off values for AGI deterioration and severe AGI were 53.27 ng/mL and 41.26 ng/mL, respectively. However, no differences in ICU duration or 28-day mortality were found. CONCLUSIONS HBP levels were associated with gastrointestinal dysfunction in critically ill patients. Increased HBP was positively correlated with sepsis but it was not correlated with 28-day mortality.
Collapse
Affiliation(s)
- Jia-Kui Sun
- Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing 210006, Jiangsu Province, China
| | - Xiao Shen
- Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing 210006, Jiangsu Province, China
| | - Xin-Pei Sun
- Department of General Office, Productivity Center of Jiangsu Province, 175 Longpan Road, Nanjing 210042, Jiangsu Province, China
| | - Xiang Wang
- Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing 210006, Jiangsu Province, China
| | - Wen-Hao Zhang
- Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing 210006, Jiangsu Province, China
| | - Qian-Kun Shi
- Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing 210006, Jiangsu Province, China
| | - Xin-Wei Mu
- Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing 210006, Jiangsu Province, China
| |
Collapse
|
4
|
Borda MG, Castellanos-Perilla N, Aarsland D. [Relationship between loss of appetite and albumin levels in older adults with mild Alzheimer's disease]. Rev Esp Geriatr Gerontol 2020; 55:123-124. [PMID: 31607398 DOI: 10.1016/j.regg.2019.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 07/31/2019] [Accepted: 08/06/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Miguel Germán Borda
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Rogaland, Noruega; Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia; Faculty of Health Sciences, University of Stavanger, Stavanger, Rogaland, Noruega.
| | - Nicolás Castellanos-Perilla
- Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Londres, Reino Unido
| |
Collapse
|
5
|
Byrne ME, Tanofsky-Kraff M, Jaramillo M, Shank LM, LeMay-Russell S, Rubin SG, Ramirez S, Altman DR, Schvey NA, Brady SM, Shomaker LB, Courville AB, Yang SB, Kozlosky M, Broadney MM, Yanovski SZ, Yanovski JA. Relationships of Trait Anxiety and Loss of Control Eating with Serum Leptin Concentrations among Youth. Nutrients 2019; 11:nu11092198. [PMID: 31547319 PMCID: PMC6771081 DOI: 10.3390/nu11092198] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/05/2019] [Accepted: 09/06/2019] [Indexed: 01/13/2023] Open
Abstract
Loss of control (LOC) eating in youth is associated with elevated fasting serum leptin, even after accounting for adiposity. Anxiety is closely linked to, and may exacerbate, LOC eating. Yet, it remains unclear how anxiety relates to leptin, or if the relationship is moderated by the presence of LOC eating. We examined whether self-reported trait anxiety interacted with LOC eating in relation to leptin in a convenience sample of youths (n = 592; 13.1 ± 2.7 years; body mass index z-score (BMIz) = 0.9 ± 1.1; 61.8% girls; 53.5% non-Hispanic White; 36.6% with LOC eating). LOC eating was assessed by interview. Leptin was measured after an overnight fast. Exploratory analyses were conducted to examine anxiety and LOC eating in relation to laboratory intake patterns in three sub-samples. In a generalized linear model adjusting for relevant covariates, anxiety significantly interacted with LOC eating in relation to leptin (p = 0.02), such that greater trait anxiety related to higher concentrations of leptin only among youth with LOC eating. Trait anxiety was not significantly related to fasting serum leptin independently in a generalized linear model adjusting for age, race, height, sex, study type, and fat mass (kg). Exploratory mechanistic analyses of food intake patterns did not identify consistent results for participants with both anxiety and LOC eating. Among youth with LOC eating, anxiety may be associated with higher serum leptin. Prospective data are required to elucidate the directionality and mechanisms of these relationships.
Collapse
Affiliation(s)
- Meghan E. Byrne
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; (M.E.B.); (M.J.); (L.M.S.); , (N.A.S.)
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA; (S.G.R.); (S.R.); , (S.M.B.); (M.M.B.); (J.A.Y.)
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; (M.E.B.); (M.J.); (L.M.S.); , (N.A.S.)
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA; (S.G.R.); (S.R.); , (S.M.B.); (M.M.B.); (J.A.Y.)
- Correspondence: ; Tel.: +1-301-295-1482
| | - Manuela Jaramillo
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; (M.E.B.); (M.J.); (L.M.S.); , (N.A.S.)
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA; (S.G.R.); (S.R.); , (S.M.B.); (M.M.B.); (J.A.Y.)
| | - Lisa M. Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; (M.E.B.); (M.J.); (L.M.S.); , (N.A.S.)
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA; (S.G.R.); (S.R.); , (S.M.B.); (M.M.B.); (J.A.Y.)
- Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - Sarah LeMay-Russell
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; (M.E.B.); (M.J.); (L.M.S.); , (N.A.S.)
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA; (S.G.R.); (S.R.); , (S.M.B.); (M.M.B.); (J.A.Y.)
| | - Sarah G. Rubin
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA; (S.G.R.); (S.R.); , (S.M.B.); (M.M.B.); (J.A.Y.)
| | - Sophie Ramirez
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA; (S.G.R.); (S.R.); , (S.M.B.); (M.M.B.); (J.A.Y.)
| | - Deborah R. Altman
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA; (S.G.R.); (S.R.); , (S.M.B.); (M.M.B.); (J.A.Y.)
| | - Natasha A. Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA; (M.E.B.); (M.J.); (L.M.S.); , (N.A.S.)
| | - Sheila M. Brady
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA; (S.G.R.); (S.R.); , (S.M.B.); (M.M.B.); (J.A.Y.)
| | - Lauren B. Shomaker
- Department of Human Development and Family Studies, College of Health and Human Sciences, Colorado State University, Fort Collins, CO 80523, USA;
| | - Amber B. Courville
- Nutrition Department, Clinical Center, NIH, 10 Center Drive, Bethesda, MD 20892, USA; (A.B.C.); (S.B.Y.); (M.K.)
| | - Shanna B. Yang
- Nutrition Department, Clinical Center, NIH, 10 Center Drive, Bethesda, MD 20892, USA; (A.B.C.); (S.B.Y.); (M.K.)
| | - Merel Kozlosky
- Nutrition Department, Clinical Center, NIH, 10 Center Drive, Bethesda, MD 20892, USA; (A.B.C.); (S.B.Y.); (M.K.)
| | - Miranda M. Broadney
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA; (S.G.R.); (S.R.); , (S.M.B.); (M.M.B.); (J.A.Y.)
| | - Susan Z. Yanovski
- Division of Digestive Diseases & Nutrition, National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK), NIH, 6707 Democracy Blvd, Rm 6025, Bethesda, MD 20892, USA;
| | - Jack A. Yanovski
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD 20892, USA; (S.G.R.); (S.R.); , (S.M.B.); (M.M.B.); (J.A.Y.)
| |
Collapse
|
6
|
Satogami K, Tseng PT, Su KP, Takahashi S, Ukai S, Li DJ, Chen TY, Lin PY, Chen YW, Matsuoka YJ. Relationship between polyunsaturated fatty acid and eating disorders: Systematic review and meta-analysis. Prostaglandins Leukot Essent Fatty Acids 2019; 142:11-19. [PMID: 30773209 DOI: 10.1016/j.plefa.2019.01.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 01/02/2019] [Accepted: 01/10/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Eating disorders result in poor nutrition, poor physical conditions and even suicidality and mortality. Although polyunsaturated fatty acids (PUFAs) have attracted attention in the emerging field of nutritional psychiatry, their role in eating disorders remains unknown. This meta-analysis investigates the differences of PUFA levels between patients with eating disorders and healthy controls, and the potentially beneficial effects of PUFAs in such patients. METHODS We conducted a systematic literature search and meta-analysis under the random effects model. RESULT Eleven studies were included in the current meta-analysis. Compared with controls, 379 patients with eating disorders had significantly higher plasma levels of alpha-linolenic acid, eicosapentaenoic acid, stearidonic acid, osbond acid, palmitoleic acid, oleic acid, and total omega-3 fatty acids; and lower levels of total omega-6 fatty acids and omega-6/omega-3 ratio. Eating disorders were associated with significantly higher red blood cell membrane levels of palmitoleic acid and oleic acid and lower levels of adrenic acid, arachidonic acid, and total omega-6 fatty acids. In addition, PUFA supplements were associated with a benefit to body weight outcomes but not disease severity and mood symptoms in interventional trials. DISCUSSION This meta-analysis indicates abnormal levels of PUFAs in peripheral blood tissues in patients with eating disorders. The relationship between PUFAs and eating disorders should be interpreted cautiously considering the specific lipid metabolism under starvation state. To investigate the role of PUFAs on psychopathological and therapeutic effects in eating disorders, further larger clinical studies are warranted.
Collapse
Affiliation(s)
- Kazumi Satogami
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan
| | - Ping-Tao Tseng
- WinShine Clinics in Specialty of Psychiatry, Kaohsiung, Taiwan
| | - Kuan-Pin Su
- College of Medicine, China Medical University, Taichung, Taiwan; Department of Psychiatry & Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan.
| | - Shun Takahashi
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan
| | - Satoshi Ukai
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan
| | - Dian-Jeng Li
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Tien-Yu Chen
- Department of Psychiatry, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Yen-Wen Chen
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung, Taiwan
| | - Yutaka J Matsuoka
- College of Medicine, China Medical University, Taichung, Taiwan; Division of Health Care Research, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan
| |
Collapse
|
7
|
Garnica-Siqueira MC, Martins AB, Zaia DAM, Leite CM, Uchôa ET, Zaia CTBV. Corticotrophin-releasing factor mediates vasoactive intestinal peptide-induced hypophagia and changes in plasma parameters. Horm Behav 2018; 105:138-145. [PMID: 30138609 DOI: 10.1016/j.yhbeh.2018.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 07/26/2018] [Accepted: 08/18/2018] [Indexed: 01/13/2023]
Abstract
Vasoactive intestinal peptide (VIP) and corticotrophin-releasing factor (CRF) are anorexigenic neuropeptides that act in the hypothalamus to regulate food intake. Intracerebroventricular (ICV) microinjection of VIP promotes increased plasma adrenocorticotrophic hormone (ACTH) and corticosterone, indicating that VIP activates hypothalamic-pituitary-adrenal axis. The aim of this study was to evaluate the interaction between VIP and CRF, by verifying the effects of ICV administration of VIP on the activity of neurons and CRF mRNA expression in paraventricular nucleus of hypothalamus (PVN). In addition, it was evaluated the effects of pretreatment with CRF type 1 receptor (CRFR1) antagonist (Antalarmin, ANT) or CRF type 2 receptor (CRFR2) antagonist (Antisauvagine-30, AS30) on VIP-induced changes on food intake and plasma parameters of male rats. Compared to Saline group, VIP increased not only the number of Fos-related antigens (FRA)-immunoreactive neurons in the PVN but also CRF mRNA levels in this nucleus. Both ANT and AS30 treatment attenuated the inhibition of food intake promoted by VIP, ANT showing a more pronounced effect. Both antagonists also attenuated VIP-induced reduction and enhancement of free fatty acids and corticosterone plasma levels, respectively, and only AS30 was able to attenuate the hyperglycemia. These results suggest that CRF is an important mediador of VIP effects on energy balance, and CRFR1 and CRFR2 are involved in these responses.
Collapse
Affiliation(s)
- Marcela Cristina Garnica-Siqueira
- Laboratory of Neuroendocrine Physiology and Metabolism, Department of Physiological Sciences, State University of Londrina, Londrina, PR, Brazil
| | - Andressa Busetti Martins
- Laboratory of Neuroendocrine Physiology and Metabolism, Department of Physiological Sciences, State University of Londrina, Londrina, PR, Brazil
| | - Dimas Augusto Morozin Zaia
- Laboratory of Prebiotic Chemistry, Department of Chemistry, State University of Londrina, Londrina, PR, Brazil
| | | | - Ernane Torres Uchôa
- Laboratory of Neuroendocrine Physiology and Metabolism, Department of Physiological Sciences, State University of Londrina, Londrina, PR, Brazil.
| | - Cássia Thaïs Bussamra Vieira Zaia
- Laboratory of Neuroendocrine Physiology and Metabolism, Department of Physiological Sciences, State University of Londrina, Londrina, PR, Brazil.
| |
Collapse
|
8
|
Wróblewska B, Szyc AM, Markiewicz LH, Zakrzewska M, Romaszko E. Increased prevalence of eating disorders as a biopsychosocial implication of food allergy. PLoS One 2018; 13:e0198607. [PMID: 29944672 PMCID: PMC6019672 DOI: 10.1371/journal.pone.0198607] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 05/22/2018] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The study evaluates the impact of biopsychosocial factors involved in food allergy (FA) on the prevalence of eating disorders (ED). For the 5-year follow-up studies, 75 participants (aged 1-14 years) with early-onset FA and 81 healthy peers were included. METHOD Participants were diagnosed with FA using antibody/cytokine content immunoassay tests. Medical history, including BMI z-scores, was completed using data obtained in response to a validated allergic questionnaire that incorporated the SCOFF and EAT-8 screening questionnaires for ED. FA was confirmed if total IgE was elevated, specific sIgE to food allergens exceeded 0.7 kUA/L and if manifestations were observed. Screening for ED was considered positive if two or more SCOFF and EAT-8 items were confirmed. RESULTS In the FA+ group, 50% of female participants and 6.7% of their healthy female peers reported ED. An ED+ result was more frequent in FA+ individuals than in their healthy peers (p = 0.046) although the association is weak. In the FA+/ED+ group, 25.3% of the participants were underweight, and 14.7% were overweight compared to their peers where this reached respectively 4.2% and 2.8% (p<0.005). 74% of the FA+/ED+ individuals reported elimination diet implementation and only 15% declared it was medically consulted. The prevalence of ED in the FA+ male group was consistently correlated with lack of confidence in FA issues (r = 0.5424) and in the FA+ female group with applied medical procedures (r = 0.7069; p<0.005). CONCLUSION These findings suggest that participants with FA especially struggling with lack of confidence in FA issues and those following an uncontrolled, restrictive elimination diet are more prone to food aversion and ED than their healthy peers. Applied procedures are necessary, and their neglect is associated with FA deterioration; however, the possibility of ED and biopsychosocial implications development should not be underestimated.
Collapse
Affiliation(s)
- Barbara Wróblewska
- Institute of Animal Reproduction and Food Research of Polish Academy of Sciences, Department of Immunology and Food Microbiology, Olsztyn, Poland
| | - Anna Maria Szyc
- Institute of Animal Reproduction and Food Research of Polish Academy of Sciences, Department of Immunology and Food Microbiology, Olsztyn, Poland
- * E-mail:
| | - Lidia Hanna Markiewicz
- Institute of Animal Reproduction and Food Research of Polish Academy of Sciences, Department of Immunology and Food Microbiology, Olsztyn, Poland
| | | | - Ewa Romaszko
- Non-Public Health Care Clinic “ATARAX”, Olsztyn, Poland
| |
Collapse
|
9
|
Abstract
Copper deficiency is a disease that causes cytopaenia and neuropathy and can be treated by copper supplementation. Long-term tube feeding, long-term total parenteral nutrition, intestinal resection and ingestion of zinc are known copper deficiency risk factors; however, alcohol abuse is not. In this case, a 71-year-old man had difficulty waking. He had a history of drinking more than five glasses of spirits daily. He was well until 3 months ago. A month before his visit to our hospital, he could not eat meals but continued drinking. He had macrocytic anaemia on admission. Copper and ceruloplasmin levels were markedly low, and we diagnosed copper deficiency. There were no other known risk factors for copper deficiency. After he began drinking cocoa as a copper supplement, the anaemia ameliorated and he was able to walk. This is the first report showing alcohol abuse as a risk factor for copper deficiency.
Collapse
Affiliation(s)
- Shunichi Shibazaki
- Department of Emergency and General Internal Medicine, Hitachinaka General Hospital, Hitachinaka, Ibaraki, Japan
| | - Shuhei Uchiyama
- Department of General Internal Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Chiba, Japan
| | - Katsuji Tsuda
- Department of Nephrology, Suwa Central Hospital, Chino, Nagano, Japan
| | - Norihide Taniuchi
- Department of Gastroenterology and Internal Medicine, Suwa Central Hospital, Chino, Nagano, Japan
| |
Collapse
|
10
|
Baird MF, Grace F, Sculthorpe N, Graham SM, Fleming A, Baker JS. Evidence of direct cardiac damage following high-intensity exercise in chronic energy restriction: A case report and literature review. Medicine (Baltimore) 2017; 96:e7030. [PMID: 28682862 PMCID: PMC5502135 DOI: 10.1097/md.0000000000007030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
RATIONALE Following prolonged endurance events such as marathons, elevated levels of cardiospecific biomarkers are commonly reported. Although transiently raised levels are generally not considered to indicate clinical myocardial damage, comprehension of this phenomenon remains incomplete. The popularity of high-intensity interval training highlights a paucity of research measuring cardiac biomarker response to this type of exercise. This a posteriori case report discusses the elevation of cardiac troponins (cTn) associated with short interval, high-intensity exercise. PATIENT CONCERNS In this case report, an apparently healthy 29-year-old recreationally active female presented clinically raised cardiac troponin I (cTnI) levels (>0.04 ng/mL), after performing high-intensity cycle ergometer sprints. As creatine kinase (CK) is expressed by multiple organs (e.g., skeletal muscle, brain, and myocardium), cTnI assays were performed to determine any changes in total serum CK levels not originating from skeletal muscle damage. DIAGNOSIS A posteriori the individual's daily energy expenditure indicated chronically low-energy availability. Psychometric testing suggested that the individual scored positive for disordered eating, highly for fatigue levels, and low in mental health components. OUTCOMES The current case report provides novel evidence of elevated cTnI occurring as a result of performing short duration, high intensity, cycle ergometer exercise in an individual with self-reported chronically depleted energy balance. A schematic to identify potentially "at risk" individuals is presented. LESSONS Considering this as a case report, results cannot be generalized; however, the main findings suggest that individuals who habitually restrict their calorie intake below their bodies' daily energy requirements, may have elevated biomarkers of exercise induced myocardial stress from performing high-intensity exercise.
Collapse
Affiliation(s)
- Marianne F. Baird
- Institute of Clinical Exercise and Health Science, University of the West of Scotland, Hamilton, UK
| | - Fergal Grace
- Faculty of Health, Federation University, Ballarat, Victoria, Australia
| | - Nicholas Sculthorpe
- Institute of Clinical Exercise and Health Science, University of the West of Scotland, Hamilton, UK
| | - Scott M. Graham
- School of Applied Sciences, Edinburgh Napier University, Edinburgh
| | - Audrey Fleming
- Faculty of Humanities and Social Sciences, Strathclyde University, Glasgow, UK
| | - Julien S. Baker
- Institute of Clinical Exercise and Health Science, University of the West of Scotland, Hamilton, UK
| |
Collapse
|
11
|
Wanby P, Berglund J, Brudin L, Hedberg D, Carlsson M. Increased ferritin levels in patients with anorexia nervosa: impact of weight gain. Eat Weight Disord 2016; 21:411-417. [PMID: 26830429 DOI: 10.1007/s40519-015-0246-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 11/12/2015] [Indexed: 01/12/2023] Open
Abstract
PURPOSE A few recent studies have found elevated ferritin levels in patients with anorexia nervosa (AN), indicating ferritin as a potential biomarker of disease severity. The purpose of this study was to study how body mass index (BMI) and changes in BMI affect plasma ferritin concentrations in Swedish patients with eating disorders. MATERIALS AND METHODS In a retrospective computer search from 2009 to 2014, 662 patients with an eating disorder were identified from more than 200,000 individuals with electronic medical records. Three hundred and eighty-nine patients (374 females and 15 males) were found to have at least one p-ferritin value with a corresponding BMI value. Patients with AN were compared to a combined group consisting of patients with bulimia nervosa (BN) and patients with an eating disorder not otherwise specified (EDNOS). RESULTS Patients with AN had lower BMI compared to the combined group of patients with other eating disorders (BMI = 16.5 ± 1.5, n = 77 vs. 21.0 ± 4.7, n = 312, p < 0.001). Patients with AN also had higher plasma ferritin levels (median 42 μg/L (range 3.3-310) vs. 31 μg/L (range 2.8-280); p < 0.001). As BMI increased in patients with AN, ferritin levels decreased (from a median of 40 μg/L (7-400) to 26 (4-170), n = 47; p < 0.001). DISCUSSION Measuring ferritin in patients with AN could be valuable in monitoring improvements of nutritional status, but the full clinical value of following ferritin in individual patients has yet to be determined. The study also shows how research can benefit from electronically captured clinical data using electronic health records.
Collapse
Affiliation(s)
- P Wanby
- Department of Internal Medicine, Section of Endocrinology, County Hospital of Kalmar, 391 85, Kalmar, Sweden.
| | - J Berglund
- University Hospital of Linköping, Linköping, Sweden
| | - L Brudin
- Department of Clinical Physiology, County Hospital of Kalmar, Kalmar, Sweden
| | - D Hedberg
- Department of IT-Administration, County Council of Kalmar, Kalmar, Sweden
| | - M Carlsson
- Department of Clinical Chemistry, County Hospital of Sweden, Kalmar, Sweden
| |
Collapse
|
12
|
Hofmann T, Elbelt U, Ahnis A, Obbarius A, Rose M, Klapp BF, Stengel A. The exercise-induced myokine irisin does not show an association with depressiveness, anxiety and perceived stress in obese women. J Physiol Pharmacol 2016; 67:195-203. [PMID: 27226179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 03/21/2016] [Indexed: 06/05/2023]
Abstract
Irisin has recently been proposed to act as a myokine secreted from skeletal muscle following exercise and to exert several health-beneficial effects, although its role is far from being established. In contrast to the growing body of literature on the biological regulation and function of irisin, there is no evidence on potential associations with mental functions. Since physical activity has been reported to have favorable impact on mental functions, we investigated the association of irisin with depressiveness, perceived stress, and anxiety as well as eating disorder symptoms in obese women. We included 98 female obese inpatients (age: mean ± S.D. 43.9 ± 12.5 years; body mass index 49.2 ± 8.3 kg/m(2)) covering a broad spectrum of psychopathology. Depressiveness (PHQ-9), perceived stress (PSQ-20), anxiety (GAD-7), and eating disorder symptoms (EDI-2) were assessed psychometrically. Plasma irisin obtained at the same time was determined by ELISA. Irisin did not correlate with depressiveness (r = -0.03, P = 0.80), anxiety (r = 0.14, P = 0.17) and perceived stress (r = -0.14, P = 0.18) as well as eating disorder symptoms in general (r = -0.09, P = 0.39). No correlation of irisin was observed with any subscales of the PSQ-20 and EDI-2 (after Bonferroni correction). In conclusion, irisin is not associated with depressiveness, anxiety and perceived stress in female obese patients. These results do not support the assumption of irisin being involved in psychoendocrine pathways of the regulation of depression or other mental functions such as anxiety and perceived stress.
Collapse
Affiliation(s)
- T Hofmann
- Center for Internal Medicine and Dermatology, Department of Psychosomatic Medicine; Charite-Universitaetsmedizin Berlin, Berlin, Germany.
| | - U Elbelt
- Center for Internal Medicine and Dermatology, Department of Psychosomatic Medicine; Charite-Universitaetsmedizin Berlin, Berlin, Germany
- Center for Internal Medicine with Gastroenterology and Nephrology, Division for Endocrinology, Diabetes and Nutrition, Charite-Universitaetsmedizin Berlin, Berlin, Germany
| | - A Ahnis
- Center for Internal Medicine and Dermatology, Department of Psychosomatic Medicine; Charite-Universitaetsmedizin Berlin, Berlin, Germany
| | - A Obbarius
- Center for Internal Medicine and Dermatology, Department of Psychosomatic Medicine; Charite-Universitaetsmedizin Berlin, Berlin, Germany
| | - M Rose
- Center for Internal Medicine and Dermatology, Department of Psychosomatic Medicine; Charite-Universitaetsmedizin Berlin, Berlin, Germany
| | - B F Klapp
- Center for Internal Medicine and Dermatology, Department of Psychosomatic Medicine; Charite-Universitaetsmedizin Berlin, Berlin, Germany
| | - A Stengel
- Center for Internal Medicine and Dermatology, Department of Psychosomatic Medicine; Charite-Universitaetsmedizin Berlin, Berlin, Germany
| |
Collapse
|
13
|
Baskaran C, Eddy KT, Miller KK, Meenaghan E, Misra M, Lawson EA. Leptin secretory dynamics and associated disordered eating psychopathology across the weight spectrum. Eur J Endocrinol 2016; 174:503-12. [PMID: 26903591 PMCID: PMC4764871 DOI: 10.1530/eje-15-0875] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Leptin secretory dynamics across the weight spectrum and their relationship with disordered eating psychopathology have not been studied. Our objective was to compare leptin secretory dynamics in 13 anorexia nervosa (AN), 12 overweight/obese (OB) and 12 normal-weight women using deconvolution analysis. METHODS In this cross-sectional study conducted at a tertiary referral center, serum leptin levels were obtained every 20 min from 2000 to 0800 h. Dual energy X-ray absorptiometry was used to measure percent body fat. Disordered eating psychopathology was assessed by the Eating Disorders Examination-Questionnaire (EDE-Q) and the Eating Disorders Inventory-2 (EDI-2). RESULTS The groups differed for basal leptin secretion (BASAL) (P=0.02). Mean leptin pulse amplitude, pulse mass, total pulsatile secretion (TPS) and area under the curve (AUC) were significantly different between groups before and after adjustment for BASAL (P<0.0001 for all). Leptin AUC correlated strongly with TPS (r=0.97, P<0.0001) and less with BASAL (r=0.35, P=0.03). On multivariate analysis, only TPS was a significant predictor of leptin AUC (P<0.0001). TPS was inversely associated with most EDE-Q and EDI-2 parameters and the associations remained significant for EDE-Q eating concern (P=0.01), and EDI-2 asceticism, ineffectiveness and social insecurity (P<0.05) after adjusting for BASAL. These relationships were not significant when controlled for percent body fat. CONCLUSION Secretory dynamics of leptin differ across weight spectrum, with mean pulse amplitude, mean pulse mass and TPS being low in AN and high in OB. Pulsatile, rather than basal secretion, is the major contributor to leptin AUC. Decreased pulsatile leptin is associated with disordered eating psychopathology, possibly reflecting low percent body fat in AN.
Collapse
Affiliation(s)
- Charumathi Baskaran
- Pediatric Endocrine UnitMassachusetts General Hospital for Children and Harvard Medical School, 101 Merrimac, Suite 615, Boston, Massachusetts 02114, USANeuroendocrine UnitEating Disorder Clinical Research ProgramMassachusetts General Hospital for Children and Harvard Medical School, Boston, Massachusetts, USA Pediatric Endocrine UnitMassachusetts General Hospital for Children and Harvard Medical School, 101 Merrimac, Suite 615, Boston, Massachusetts 02114, USANeuroendocrine UnitEating Disorder Clinical Research ProgramMassachusetts General Hospital for Children and Harvard Medical School, Boston, Massachusetts, USA
| | - Kamryn T Eddy
- Pediatric Endocrine UnitMassachusetts General Hospital for Children and Harvard Medical School, 101 Merrimac, Suite 615, Boston, Massachusetts 02114, USANeuroendocrine UnitEating Disorder Clinical Research ProgramMassachusetts General Hospital for Children and Harvard Medical School, Boston, Massachusetts, USA
| | - Karen K Miller
- Pediatric Endocrine UnitMassachusetts General Hospital for Children and Harvard Medical School, 101 Merrimac, Suite 615, Boston, Massachusetts 02114, USANeuroendocrine UnitEating Disorder Clinical Research ProgramMassachusetts General Hospital for Children and Harvard Medical School, Boston, Massachusetts, USA
| | - Erinne Meenaghan
- Pediatric Endocrine UnitMassachusetts General Hospital for Children and Harvard Medical School, 101 Merrimac, Suite 615, Boston, Massachusetts 02114, USANeuroendocrine UnitEating Disorder Clinical Research ProgramMassachusetts General Hospital for Children and Harvard Medical School, Boston, Massachusetts, USA
| | - Madhusmita Misra
- Pediatric Endocrine UnitMassachusetts General Hospital for Children and Harvard Medical School, 101 Merrimac, Suite 615, Boston, Massachusetts 02114, USANeuroendocrine UnitEating Disorder Clinical Research ProgramMassachusetts General Hospital for Children and Harvard Medical School, Boston, Massachusetts, USA Pediatric Endocrine UnitMassachusetts General Hospital for Children and Harvard Medical School, 101 Merrimac, Suite 615, Boston, Massachusetts 02114, USANeuroendocrine UnitEating Disorder Clinical Research ProgramMassachusetts General Hospital for Children and Harvard Medical School, Boston, Massachusetts, USA
| | - Elizabeth A Lawson
- Pediatric Endocrine UnitMassachusetts General Hospital for Children and Harvard Medical School, 101 Merrimac, Suite 615, Boston, Massachusetts 02114, USANeuroendocrine UnitEating Disorder Clinical Research ProgramMassachusetts General Hospital for Children and Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
14
|
Abstract
Objective To evaluate some risk factors for cardiovascular diseases in feeding and eating disorders, the degree of lipid abnormalities was investigated in a large Japanese cohort of different groups of feeding and eating disorders, according to the Japan Atherosclerosis Society Guidelines for the Prevention of Atherosclerotic Cardiovascular Diseases 2012 (JAS Guidelines 2012). Methods Participants in the current study included 732 women divided into four groups of feeding and eating disorders: anorexia nervosa, restricting type (AN-R); anorexia nervosa, binge-eating/purging type; bulimia nervosa (BN); and binge-eating disorder (BED). We measured the serum levels of total cholesterol, high-density-lipoprotein (HDL) cholesterol, and triglyceride in these participants. Low-density-lipoprotein (LDL) cholesterol and non-HDL cholesterol levels were also calculated. Results The concentrations of LDL cholesterol and non-HDL cholesterol were widely distributed in all groups. When the LDL cholesterol risk was defined as ≥120 mg/dL and the non-HDL cholesterol risk as ≥150 mg/dL, according to the JAS Guidelines 2012, the proportion of LDL cholesterol risk ranged from 29.6% (BN) to 38.6% (AN-R), and the proportion of non-HDL cholesterol risk ranged from 17.8% (BN) to 30.1% (BED). Conclusion The present findings suggest the existence of LDL cholesterol risk and non-HDL cholesterol risk in all groups of eating disorders. Given the chronicity of this condition, the development of elevated concentrations of LDL cholesterol and non-HDL cholesterol at an early age may increase the risk of cardiovascular diseases.
Collapse
|
15
|
Pedram P, Sun G. Hormonal and dietary characteristics in obese human subjects with and without food addiction. Nutrients 2014; 7:223-38. [PMID: 25558907 PMCID: PMC4303835 DOI: 10.3390/nu7010223] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 12/19/2014] [Indexed: 01/08/2023] Open
Abstract
The concept of food addiction (FA) is a potentially important contributing factor to the development of obesity in the general population; however, little is known about the hormonal and dietary differences between obesity with and without FA. Therefore, the aim of our study was to explore potential biomarkers, including various hormones and neuropeptides, which regulate appetite and metabolism, and dietary components that could potentially differentiate obesity with and without FA. Of the 737 adults recruited from the general Newfoundland population, 58 food-addicted and non-food-addicted overweight/obese individuals (FAO, NFO) matched for age, sex, BMI and physical activity were selected. A total of 34 neuropeptides, gut hormones, pituitary polypeptide hormones and adipokines were measured in fasting serum. We found that the FAO group had lower levels of TSH, TNF-α and amylin, but higher levels of prolactin, as compared to NFO group. The total calorie intake (per kg body weight), the dietary intake of fat (per g/kg body weight, per BMI and per percentage of trunk fat) and the percent calorie intake from fat and carbohydrates (g/kg) was higher in the FAO group compared to the NFO group. The FAO subjects consumed more sugar, minerals (including sodium, potassium, calcium and selenium), fat and its components (such as saturated, monounsaturated and trans fat), omega 3 and 6, vitamin D and gamma-tocopherol compared to the NFO group. To our knowledge, this is the first study indicating possible differences in hormonal levels and micro-nutrient intakes between obese individuals classified with and without food addiction. The findings provide insights into the mechanisms by which FA could contribute to obesity.
Collapse
Affiliation(s)
- Pardis Pedram
- Faculty of medicine, Memorial University, 300 Prince Philip Drive, St. John's, NL A1B3V6, Canada.
| | - Guang Sun
- Faculty of medicine, Memorial University, 300 Prince Philip Drive, St. John's, NL A1B3V6, Canada.
| |
Collapse
|
16
|
Anisimova EV, Kozlova IV, Volkov SV. [Clinical and ultrasound features of gallbladder pathology in patients with a weight deficit]. Klin Med (Mosk) 2014; 92:43-47. [PMID: 25269181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We undertook analysis of clinical and instrumental features of gallbladder pathology in patients with a weight deficit for the elucidation of peculiarities of eating behavior, blood leptin level, and cytokine content of gastric biopsies. Underweight patients with inflammatory and dysfunctional diseases of gallbladder more frequently than others presented with abdominal pain syndrome. All patients enrolled in the study showed every type of eating disorders with the predominance of the limiting behavior. Weight deficit in patients with chronic cholecystitis was associated with hyperleptinemia and increased production of proinflammatory cytokines.
Collapse
|
17
|
D'Andrea G, Ostuzzi R, Bolner A, Colavito D, Leon A. Is migraine a risk factor for the occurrence of eating disorders? Prevalence and biochemical evidences. Neurol Sci 2013; 33 Suppl 1:S71-6. [PMID: 22644175 DOI: 10.1007/s10072-012-1045-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The eating disorders (ED), anorexia nervosa (AN) and bulimia nervosa (BN), are severe psychiatric and somatic conditions occurring mainly in young woman. Although the aetiology is largely unknown, same evidences suggest that biological and psychological factors play a relevant role in the pathogenesis, along with monoamine, indole and same hypothalamic hormonal dysfunctions. Migraine is characterized by similar metabolic and psychological anomalies suggesting that a possible relationship exists between the two pathological conditions. To understand the possible relationship between migraine and ED, we have investigated the prevalence of migraine and the other primary headaches in a large group of AN and BN patients. In addition, we have studied the role of tyrosine metabolism in the same group of AN and BN young woman sufferers. In particular, we measured plasma levels of elusive amines: tyramine (Tyr) and octopamine (Oct) and catecholamines: noradrenalin (NE), dopamine (DA). The results of this study show that the prevalence of migraine in the woman affected by ED is very high (<75 %). The levels of Tyr and DA were higher and levels of NE were lower in the ED patients in respect to the control subjects. These biochemical findings suggest that abnormalities of limbic and hypothalamic circuitries play a role in the pathogenesis of ED. The very high prevalence of migraine in our group of ED sufferers and the biochemical profile of migraine, similar to that of ED patients shown in this study, suggest that migraine may constitute a risk factor for the occurrence of ED in young females. This hypothesis is supported by the onset of migraine attacks that initiated, in the majority of the patients, before the occurrence of ED symptoms.
Collapse
Affiliation(s)
- Giovanni D'Andrea
- Biochemistry Laboratory for the Study of Primary Headaches and Neurological Diseases, Research and Innovation SpA, Padova, Italy.
| | | | | | | | | |
Collapse
|
18
|
Abstract
AIM Essential fatty acid status is altered in eating disorders with weight loss, and deficiencies in polyunsaturated omega-3 essential fatty acids have been implicated in the development of depression and other psychopathologies. Presently, recovery of essential fatty status during the treatment of adolescent girls with eating disorders has been investigated. METHODS Fatty acids were analysed in erythrocyte membranes of 24 adolescents girls with eating disorders of short duration, and on the average >10 kg weight loss at presentation. Blood samples were obtained at presentation and following weight recovery on standard diet without supplementation with essential fatty acids. RESULTS Alterations of essential fatty status observed at presentation largely normalized during treatment. Omega-3 status improved following weight gain. CONCLUSION Adequate nutrition, normalization of eating behaviours, weight gain and the consequent return to normalization of metabolism and endocrine function are sufficient to ensure normalization of essential fatty acid status. Supplementation with omega-3 polyunsaturated fatty acids does not appear warranted.
Collapse
Affiliation(s)
- Ingemar Swenne
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
| | | |
Collapse
|
19
|
Swenne I, Rosling A, Tengblad S, Vessby B. Omega-3 polyunsaturated essential fatty acids are associated with depression in adolescents with eating disorders and weight loss. Acta Paediatr 2011; 100:1610-5. [PMID: 21732977 DOI: 10.1111/j.1651-2227.2011.02400.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM To study the relationship between polyunsaturated fatty acids (PUFA) status and depression in adolescents with eating disorders (ED) and weight loss. METHODS Erythrocyte membranes from 217 adolescents (209 girls, eight boys) with ED were analysed for fatty acids (FA). ED and depression were diagnosed by clinical interviews and supported by self-report instruments. RESULTS Adolescents with ED and depression did not differ from those with ED only in terms of age, BMI, weight loss and duration of disease. In their FA profile, depressed adolescents had lower proportions of eicosapentanoic acid (EPA) and docosahexanoic acid (DHA), the end products of the ω3 PUFA series. The ratio of long-chain (>18 carbons) ω6/ω3 PUFA was therefore higher in depressed adolescents. Indices of desaturase activities did not differ between depressed and not depressed adolescents. CONCLUSION Low ω3 status is related to depression in adolescents with ED. This cannot be explained by differences in weight (loss) and duration of disease, nor by differences in PUFA processing by desaturases. Data suggest a lower dietary intake of ω3 PUFA in those with depression. Further investigations should determine whether ω3 PUFA status improves by refeeding only or whether supplementation with PUFA is warranted.
Collapse
Affiliation(s)
- Ingemar Swenne
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
| | | | | | | |
Collapse
|
20
|
Pistorio E, Luca M, Luca A, Messina V, Calandra C. Autonomic nervous system and lipid metabolism: findings in anxious-depressive spectrum and eating disorders. Lipids Health Dis 2011; 10:192. [PMID: 22034981 PMCID: PMC3215932 DOI: 10.1186/1476-511x-10-192] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Accepted: 10/28/2011] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To correlate lipid metabolism and autonomic dysfunction with anxious-depressive spectrum and eating disorders. To propose the lipid index (LI) as a new possible biomarker. METHODS 95 patients and 60 controls were enrolled from the University Psychiatry Unit of Catania and from general practitioners (GPs). The patients were divided into four pathological groups: Anxiety, Depression, Anxious-Depressive Disorder and Eating Disorders [Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR) official/appendix criteria]. The levels of the cholesterol, triglycerides and apolipoproteins A and B were determined. The LI, for each subject, was obtained through a mathematical operation on the values of the cholesterol and triglycerides levels compared with the maximum cut-off of the general population. The autonomic functioning was tested with Ewing battery tests. Particularly, the correlation between heart rate variability (HRV) and lipid metabolism has been investigated. RESULTS Pathological and control groups, compared among each other, presented some peculiarities in the lipid metabolism and the autonomic dysfunction scores. In addition, a statistically significant correlation has been found between HRV and lipid metabolism. CONCLUSIONS Lipid metabolism and autonomic functioning seem to be related to the discussed psychiatric disorders. LI, in addition, could represent a new possible biomarker to be considered.
Collapse
Affiliation(s)
- Elisabetta Pistorio
- Department of Medical and Surgery Specialties-Psychiatry Unit, University Hospital "Policlinico-Vittorio Emanuele", (Via S. Sofia 78), Catania, (95100), Italy
| | - Maria Luca
- Department of Medical and Surgery Specialties-Psychiatry Unit, University Hospital "Policlinico-Vittorio Emanuele", (Via S. Sofia 78), Catania, (95100), Italy
| | - Antonina Luca
- Department of Neuroscience, University Hospital "Policlinico-Vittorio Emanuele", (Via S. Sofia 78), Catania, (95100), Italy
| | - Vincenzo Messina
- Department of Medical and Surgery Specialties-Psychiatry Unit, University Hospital "Policlinico-Vittorio Emanuele", (Via S. Sofia 78), Catania, (95100), Italy
| | - Carmela Calandra
- Department of Medical and Surgery Specialties-Psychiatry Unit, University Hospital "Policlinico-Vittorio Emanuele", (Via S. Sofia 78), Catania, (95100), Italy
| |
Collapse
|
21
|
Lenz B, Heberlein A, Bayerlein K, Frieling H, Kornhuber J, Bleich S, Hillemacher T. The TTTAn aromatase (CYP19A1) polymorphism is associated with compulsive craving of male patients during alcohol withdrawal. Psychoneuroendocrinology 2011; 36:1261-4. [PMID: 21414724 DOI: 10.1016/j.psyneuen.2011.02.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Revised: 02/16/2011] [Accepted: 02/16/2011] [Indexed: 11/18/2022]
Abstract
Alcoholism is associated with alterations of the hypothalamus-pituitary-gonadal hormone axis. We recently reported a leptin-mediated relation between the CAGn polymorphism of the androgen receptor and craving during alcohol withdrawal. This study investigated whether the TTTAn polymorphism of the aromatase (CYP19A1) is equally linked to craving. An association between TTTAn and compulsive craving (p=0.029) was revealed in our sample of 118 male alcohol addicts at day of hospital admission. Genotype-dependent subgroups showed differences in that the patients with short alleles suffered from lower compulsive craving during withdrawal than those with the longer alleles (p=0.027). The additional inclusion of leptin revealed no further significant association in the present study. Our finding is a further step on the way to elucidate the genesis of craving for alcohol with its extensive underlying interactions of different genetic and non-genetic factors. Future investigations should enrol women and consider sex hormone levels for further clarification of the observed TTTAn-craving relationship.
Collapse
Affiliation(s)
- Bernd Lenz
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany.
| | | | | | | | | | | | | |
Collapse
|
22
|
Abstract
Ghrelin is the only known circulating hormone that acts on peripheral and central targets to increase food intake and promote adiposity. The present review focuses on the possible clinical relevance of ghrelin in the regulation of human feeding behavior in individuals with obesity and other eating disorders such as Prader-Willi syndrome, anorexia nervosa, bulimia nervosa and binge-eating.
Collapse
Affiliation(s)
- Chun-Xia Yi
- Department of Medicine, University of Cincinnati, Cincinnati, OH 45226, USA.
| | | | | |
Collapse
|
23
|
Abstract
AIM To explore the relationship between essential fatty acids (FA) and weight changes in adolescent girls with eating disorders (ED). METHODS Blood samples were obtained from 220 girls with ED and 39 healthy controls. The girls with ED were 15.3 ± 1.5 years of age and weighed 49.8 ± 8.7 kg (BMI 18.3 ± 2.8 kg/m(2)) after a weight loss of 6.8 ± 6.4 kg. FA were analysed in plasma phospholipids (PPL) and erythrocyte membranes (ERY). RESULTS The proportions of saturated and monounsaturated FA were increased during weight loss, while linoleic acid (18:2ω6) was decreased. The proportions of eicosapentanoic acid (EPA) (20:5ω3) and docosahexanoic acid (DHA) (22:6ω3) in PPL and ERY did not differ from controls. The activity of stearoyl-CoA-desaturase was increased as evidenced by an increased product/precursor ratio and correlated with the rate of weight loss. The activities of delta-6-desaturase and delta-5-desaturase did not differ from controls. The rate of weight loss was inversely correlated with delta-6-desaturase and directly correlated with delta-5-desaturase. CONCLUSION The FA profile indicates low-fat intake, fat mobilization from stores and an increased conversion of essential FA at the delta-5-desaturase step during weight loss in adolescent girls with ED. Normal levels of EPA and DHA were maintained.
Collapse
Affiliation(s)
- I Swenne
- Department of Women's and Children's Health, Uppsala University, Sweden.
| | | | | | | |
Collapse
|
24
|
Abstract
PURPOSE OF REVIEW Disturbances in gastrointestinal hormones have been implicated in the pathogenesis of eating disorders such as anorexia nervosa and bulimia nervosa. However, the contribution of these hormonal changes to the onset and maintenance of eating disorder remains unclear. We focus our review on a selective number of gastrointestinal hormones that are known to play a role in the regulation of short-term or long-term energy balance and examine their association with eating disorder in recently published literature. RECENT FINDINGS Several new studies reported differential changes of ghrelin isoforms during fasting and following nutrient ingestion. New findings on other appetite-regulating hormones (peptide YY, cholecystokinin, incretin hormones and pancreatic polypeptide) at different nutritional states and disease stage have also been reported in subtypes of eating disorder. Most of the changes in peripheral hormones disappeared or partially recovered after the restoration of weight with nutritional and behavioral therapy. SUMMARY Dysregulation of gastrointestinal hormones is more likely to contribute to the maintenance of the disordered eating behavior and related metabolic outcomes as well as the clinical course rather than causing them. A better understanding of this relationship also carries implications for developing targeted hormone-base treatment for eating disorder.
Collapse
Affiliation(s)
- Jenny Tong
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | | |
Collapse
|
25
|
Lawson EA, Eddy KT, Donoho D, Misra M, Miller KK, Meenaghan E, Lydecker J, Herzog D, Klibanski A. Appetite-regulating hormones cortisol and peptide YY are associated with disordered eating psychopathology, independent of body mass index. Eur J Endocrinol 2011; 164:253-61. [PMID: 21098684 PMCID: PMC3677777 DOI: 10.1530/eje-10-0523] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Disordered eating occurs in women at both weight extremes of anorexia nervosa (AN) and obesity. Cortisol, peptide YY (PYY), leptin, and ghrelin are hormones involved in appetite and feeding behavior that vary with weight and body fat. Abnormal levels of these hormones have been reported in women with AN, functional hypothalamic amenorrhea (HA), and obesity. The relationship between appetite-regulating hormones and disordered eating psychopathology is unknown. We therefore studied the relationship between orexigenic and anorexigenic hormones and disordered eating psychopathology in women across a range of weights. DESIGN A cross-sectional study of 65 women, 18-45 years: 16 with AN, 12 normal-weight with HA, 17 overweight or obese, and 20 normal-weight in good health. METHODS Two validated measures of disordered eating psychopathology, the Eating Disorders Examination-Questionnaire (EDE-Q) and Eating Disorders Inventory-2 (EDI-2), were administered. Fasting PYY, leptin, and ghrelin levels were measured; cortisol levels were pooled from serum samples obtained every 20 min from 2000 to 0800 h. RESULTS Cortisol and PYY levels were positively associated with disordered eating psychopathology including restraint, eating concerns, and body image disturbance, independent of body mass index (BMI). Although leptin levels were negatively associated with disordered eating psychopathology, these relationships were not significant after controlling for BMI. Ghrelin levels were generally not associated with EDE-Q or EDI-2 scores. CONCLUSIONS Higher levels of cortisol and PYY are associated with disordered eating psychopathology independent of BMI in women across the weight spectrum, suggesting that abnormalities in appetite regulation may be associated with specific eating disorder pathologies.
Collapse
Affiliation(s)
- Elizabeth A Lawson
- Neuroendocrine Unit, Bulfinch 457B Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Raspopow K, Abizaid A, Matheson K, Anisman H. Psychosocial stressor effects on cortisol and ghrelin in emotional and non-emotional eaters: influence of anger and shame. Horm Behav 2010; 58:677-84. [PMID: 20540943 DOI: 10.1016/j.yhbeh.2010.06.003] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Revised: 06/02/2010] [Accepted: 06/02/2010] [Indexed: 10/19/2022]
Abstract
Food consumption in stressful situations vary as a function of individual difference factors (e.g., emotional vs. non-emotional eating), and may be related to hormonal responses elicited by the stressful event. These hormonal responses may be tied to specific emotions elicited by the stressful event. The present investigation examined the emotional and hormonal (cortisol, ghrelin) responses of high and low emotional eaters following a laboratory stressor (Trier Social Stress Test; TSST). Women (n=48) either high or low in emotional eating status were tested in a TSST or served as controls during which blood samples were taken for analysis of cortisol and ghrelin, both of which have been implicated in eating and in response to stressors. The TSST promoted elevated cortisol levels, being somewhat more pronounced in emotional than in non-emotional eaters. Both shame and anger were provoked by the TSST, and although both these emotions were correlated with cortisol levels, only anger significantly mediated the relationship between the stressor and cortisol levels. As well, baseline ghrelin levels in low emotional eaters exceeded that of high emotional eaters, and increased moderately in response to the stressor situation, irrespective of emotional eating status. Interestingly, when provided with food, ghrelin levels declined in the non-emotional eaters, but not in emotional eaters. The possibility is offered that the lack of a decline of ghrelin in emotional eaters may sustain eating in these individuals.
Collapse
Affiliation(s)
- Kate Raspopow
- Institute of Neuroscience, Carleton University, Ottawa, Ontario, Canada
| | | | | | | |
Collapse
|
27
|
|
28
|
Frieling H, Römer KD, Beyer S, Hillemacher T, Wilhelm J, Jacoby GE, de Zwaan M, Kornhuber J, Bleich S. Depressive symptoms may explain elevated plasma levels of homocysteine in females with eating disorders. J Psychiatr Res 2008; 42:83-6. [PMID: 17182057 DOI: 10.1016/j.jpsychires.2006.10.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2006] [Revised: 10/13/2006] [Accepted: 10/18/2006] [Indexed: 11/23/2022]
Abstract
Elevated plasma homocysteine levels have been found in different psychiatric disorders, including major depression and eating disorders. The aim of the present study was to evaluate whether presence of depression or depressive symptoms is associated with elevated homocysteine levels in patients with eating disorders. Total plasma homocysteine levels were assessed in 44 females with anorexia nervosa (n = 21) or bulimia nervosa (n = 23). Comorbid major depressive disorder (MDD) was diagnosed according to DSM-IV criteria using a semi-structured interview (SCID-I). Furthermore, depressive symptoms were assessed using Beck's depression inventory (BDI). Presence of MDD was not associated with elevated homocysteine levels (t-test: T = 0.42; df = 42; P = 0.68). However, self-rated presence of clinically relevant depressive symptoms (BDI score18) was associated with elevated homocysteine (T = -2.8; df = 42; P = 0.008). Presence of depressive symptoms may explain elevated homocysteine levels previously reported in patients with eating disorders or vice versa. Longitudinal studies are needed to unravel this hen or egg problem.
Collapse
Affiliation(s)
- Helge Frieling
- Department of Psychiatry and Psychotherapy, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054 Erlagen, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Pinelli G, Tagliabue A. Nutrition and fertility. MINERVA GASTROENTERO 2007; 53:375-382. [PMID: 18043554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The first studies about fertility and nutrition date back to the 70ies and already showed a strict relation among female fertility, weight and body composition. However, the mechanisms of this connection started to be explained only after leptin's discovery. According to some authors' opinion, leptin could interact with reproductive axis at multiple sites with stimulatory effects at the hypothalamus and pituitary and stimulatory or inhibitory actions at the gonads. Leptin could play a role in other physiologic processes such as menstruation and pregnancy, and could initiate the complex process of puberty. It has been showed that conditions in which nutritional status is suboptimal, such as eating disorders, exercise induced amenhorrea, functional hypothalamic amenhorrea and polycystic ovarian syndrome, are associated with abnormal leptin levels. These conditions, are characterized by severe changes in body composition and dietary habits. Since leptin is regulated by body composition and dietary factors, (such as energy intake and macronutrient composition), a strict connection between nutritional intake and fertility regulated by leptin is confirmed. This review focuses on the current knowledge about nutritional factors that influence leptin levels. Since clinical and subclinical nutritional imbalance can determine the development and the maintenance of neuroendocrine and metabolic aberrations, studies on fertility need a deeper attention about dietary habits and nutritional status.
Collapse
Affiliation(s)
- G Pinelli
- Study and Research Center on Human Nutrition and Eating Disorders, University of Pavia, Pavia, Italy.
| | | |
Collapse
|
30
|
Abstract
AIM The use of serum insulin-like growth factor-1 (IGF-1) concentrations as an index of nutrition has been analysed in teenage girls with eating disorders and weight loss. METHOD Blood samples for analysis of IGF-1 were obtained at 349 assessments of 302 patients and biweekly during 56 treatment periods in 46 patients. IGF-1 was related to body size, weight loss, degree of leanness (BMI standard deviation score) and rate of weight loss. RESULTS At assessment, when most of the girls were on a weight-losing course, serum IGF-1 concentrations were low. Weight loss immediately prior to assessment was the most important predictor of IGF-1. Together with measurements of weight, height, weight loss and BMI standard deviation score the rate of weight loss predicted IGF-1 to 32-55%. During treatment when there was net weight gain, IGF-1 increased in parallel with the BMI standard deviation score, a measure of leanness, and was also influenced by the short-term weight trend. CONCLUSION The serum IGF-1 concentration is an indicator of nutritional status in adolescents with eating disorders. It is sensitive to short-term weight changes measured in a clinical setting and could be used at assessment and to monitor nutritional rehabilitation.
Collapse
Affiliation(s)
- Ingemar Swenne
- Department of Women's and Children's Health, Uppsala University, Children's Hospital, Uppsala, Sweden.
| | | | | | | |
Collapse
|
31
|
Ferrero S. Roles of leptin and ghrelin in eating disorders? Fertil Steril 2007; 88:250; author reply 250-1. [PMID: 17548078 DOI: 10.1016/j.fertnstert.2007.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2006] [Indexed: 10/23/2022]
|
32
|
Janas-Kozik M, Krupka-Matuszczyk I, Malinowska-Kolodziej I, Lewin-Kowalik J. Total ghrelin plasma level in patients with the restrictive type of anorexia nervosa. ACTA ACUST UNITED AC 2007; 140:43-6. [PMID: 17187877 DOI: 10.1016/j.regpep.2006.11.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2006] [Revised: 11/06/2006] [Accepted: 11/10/2006] [Indexed: 11/17/2022]
Abstract
Ghrelin is produced mainly in the stomach and is an essential link of the brain-gut axis. Ghrelin stimulates hunger centers in hypothalamus controlling food intake and body mass gain. The aim of the study is to analyze the total ghrelin plasma level in patients suffering from restrictive type of anorexia nervosa (AN-R). According to DSM-IV classification a group of 30 AN-R patients was investigated before and after 3 and 6 months of therapy. Therapy included normocaloric diet and cognitive-behavioral psychotherapy (CBT). The control group consisted of 20 girls without any eating disorders. Before the therapy the total ghrelin plasma level in AN-R patients was significantly higher than in the control group. After 3 and 6 months of treatment the total ghrelin plasma level in AN-R patients was significantly lower than in the control group. In AN-R patients, the total ghrelin plasma level is connected with the pathological feeding behavior.
Collapse
Affiliation(s)
- Malgorzata Janas-Kozik
- Department and Clinic of Psychiatry and Psychotherapy, Medical University of Silesia, Katowice, ul. Ziolowa 45/47, 40-635 Katowice, Poland.
| | | | | | | |
Collapse
|
33
|
Abstract
AIM To study haematological changes and iron stores in teenage girls with eating disorders and weight loss. METHODS Blood haemoglobin concentration, white blood cell and thrombocyte count and serum ferritin concentration were measured at assessments of 446 subjects. RESULTS Haemoglobin concentrations, leukocyte and thrombocyte counts were related to weight and rate of weight loss but were largely within reference ranges. Serum ferritin concentrations were high in girls with amenorrhea and related to weight and rate of weight loss. Girls who retained menstruations had low serum ferritin concentrations and 37% had depleted iron stores (serum ferritin<16 microg/L). CONCLUSION Anaemia, leukopenia and thrombocytopenia are uncommon in teenage girls with eating disorders and weight loss. When present, other diseases causing haematological changes should be considered. In amenorrhoic girls muscle catabolism increases serum ferritin concentrations which may give a false impression of an adequate iron status. This is unmasked in girls with retained menstruations who often have depleted iron stores.
Collapse
Affiliation(s)
- Ingemar Swenne
- Department of Women's and Children's Health, Uppsala University Children's Hospital, Uppsala, Sweden.
| |
Collapse
|
34
|
Levine J, Gur E, Loewenthal R, Vishne T, Dwolatzky T, van Beynum IM, Sela BA, Vered I, Yosef G, Stein D. Plasma homocysteine levels in female patients with eating disorders. Int J Eat Disord 2007; 40:277-84. [PMID: 17262817 DOI: 10.1002/eat.20361] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To examine plasma homocysteine, vitamin B(12), and folate levels in females with restricting and bingeing/purging eating disorders (EDs). METHOD Adolescent and adult female patients were compared to appropriate control groups with regard to plasma homocysteine levels. RESULTS The plasma homocysteine level of the adult ED patients was higher than that of controls for all age groups examined. In adolescents, no significant difference was found comparing ED patients younger than 16 years of age to control data, whereas in the 16-20 year age group, the plasma homocysteine level was significantly higher among the ED group, regardless of the type of ED. Vitamin B(12) and folate levels were within normal limits in all ED groups. CONCLUSION Elevated plasma homocysteine levels were found in adult and older adolescent female ED patients (but not in younger adolescents) compared to controls. This finding is not related to deficiencies in vitamin B(12) or folate.
Collapse
Affiliation(s)
- Joseph Levine
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Gáti A, Pászthy B, Wittman I, Abrahám I, Jeges S, Túry F. [Leptin and glucose metabolism in eating disorders]. Psychiatr Hung 2007; 22:163-9. [PMID: 17895538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
AIM Leptin, which was discovered only a decade ago, is a peptide that informs hypothalamic areas about the energy balance of the body. New research findings, has suggested a possible role of leptin in eating disorders as well. Few data are available about the relationship between leptin, insulin and glucose metabolism in the pathomechanism of eating disorders. The authors were searching for answers to these relationships in their investigations. METHODS The study groups included 56 patients with eating disorders and 22 healthy subjects served as controls. The diagnosis was based on DSM-IV criteria. For measuring leptin, insulin and C-peptide serum concentrations a radioimmunoassay method was applied, and serum glucose concentrations were detected by spectrofluorimetry. Detailed statistical analysis of the results was carried out. RESULTS A correlation between BMI and serum leptin concentration could be proved only in anorectic patients. In contrast to former findings, there was no correlation between BMI and leptin concentration in the bulimia group, and the leptin concentrations were significantly higher in bulimic patients than in the control group. During the glucose tolerance test, leptin levels showed a significant decrease in the anorexia group. CONCLUSION The results raise the possibility of a direct effect of central regulatory mechanisms of food intake in the pathomechanism of anorexia nervosa.
Collapse
Affiliation(s)
- Agnes Gáti
- Pecsi Tudomanyegyetem, Pszichiatriai es Pszichoterapias Klinika, 7623 Pecs, Ret u. 2., Hungary.
| | | | | | | | | | | |
Collapse
|
36
|
Díaz-Marsa M, Lozano C, Herranz AS, Asensio-Vegas MJ, Martín O, Revert L, Saiz-Ruiz J, Carrasco JL. [Acute tryptophan depletion in eating disorders]. Actas Esp Psiquiatr 2006; 34:397-402. [PMID: 17117337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
INTRODUCTION This work describes the rational bases justifying the use of acute tryptophan depletion technique in eating disorders (ED) and the methods and design used in our studies. Tryptophan depletion technique has been described and used in previous studies safely and makes it possible to evaluate the brain serotonin activity. Therefore it is used in the investigation of hypotheses on serotonergic deficiency in eating disorders. Furthermore, and given the relationship of the dysfunctions of serotonin activity with impulsive symptoms, the technique may be useful in biological differentiation of different subtypes, that is restrictive and bulimic, of ED. METHODS 57 female patients with DSM-IV eating disorders and 20 female controls were investigated with the tryptophan depletion test. A tryptophan-free amino acid solution was administered orally after a two-day low tryptophan diet to patients and controls. Free plasma tryptophan was measured at two and five hours following administration of the drink. Eating and emotional responses were measured with specific scales for five hours following the depletion. A study of the basic characteristics of the personality and impulsivity traits was also done. Relationship of the response to the test with the different clinical subtypes and with the temperamental and impulsive characteristics of the patients was studied. RESULTS The test was effective in considerably reducing plasma tryptophan in five hours from baseline levels (76%) in the global sample. The test was well tolerated and no severe adverse effects were reported. Two patients withdrew from the test due to gastric intolerance. CONCLUSIONS The tryptophan depletion test could be of value to study involvement of serotonin deficits in the symptomatology and pathophysiology of eating disorders.
Collapse
Affiliation(s)
- M Díaz-Marsa
- Servicio de Psiquiatría, Hospital Clínico San Carlos, Madrid.
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Abstract
OBJECTIVE Eating disorders are more common in females than in males. Gender differences may be due to organizational (i.e. prenatal) and activational (i.e. post-natal) gonadal hormone effects that influence sex differences in behavior. This preliminary set of studies examined these effects by investigating relationships between eating disorder symptoms, prenatal testosterone exposure, and adult levels of estrogen in women. METHOD We examined organizational associations by investigating relationships between disordered eating and finger-length ratios, which are known to be somatic markers of prenatal testosterone exposure. Participants included 113 adult female twins drawn from the community. Disordered eating was assessed with the total score from the Minnesota Eating Behavior Survey (MEBS). Finger lengths were hand scored using a ruler and photocopies of both hands. We also investigated activational influences by examining associations between circulating levels of estradiol and disordered eating symptoms. Two independent samples of adult females (n's = 24 and 25) drawn from the community were used for this study. Disordered eating was again assessed with the MEBS total score, while saliva samples were used for assessing estradiol. RESULTS Positive associations were found between disordered eating and both finger-length ratios and circulating estradiol levels. CONCLUSIONS Findings suggest that lower levels of prenatal testosterone exposure and higher adult levels of estradiol are associated with increased eating disorder symptoms. We hypothesize that the relatively low level of testosterone before birth in females permits their brains to respond to estrogens at puberty, when the hormones activate the genes contributing to disordered eating in vulnerable girls.
Collapse
Affiliation(s)
- Kelly L Klump
- Department of Psychology, Michigan State University, East Lansing, MI 48824-1116, USA.
| | | | | | | | | | | |
Collapse
|
38
|
Vannacci A, Ravaldi C, Giannini L, Rotella CM, Masini E, Faravelli C, Ricca V. Increased nitric oxide production in eating disorders. Neurosci Lett 2006; 399:230-3. [PMID: 16495002 DOI: 10.1016/j.neulet.2006.01.060] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2006] [Revised: 01/28/2006] [Accepted: 01/31/2006] [Indexed: 12/13/2022]
Abstract
Animal studies showed that nitric oxide (NO)/cyclic-GMP (cGMP) pathway is involved in the modulation of eating behavior. To address its role in eating disorders (ED), plasma nitrite and cGMP levels were studied in 50 ED patients (25 with Anorexia Nervosa, AN; 25 with Bulimia Nervosa, BN) and 20 sex- and age-matched controls (C). Nitrites (nmol/mg protein, mean+/-S.E.M.: any ED 1.01+/-0.29; AN 1.15+/-0.47; BN 0.88+/-0.36; C 0.25+/-0.07; p<0.01) and cGMP (nmol/ml plasma, mean+/-S.E.M.: any ED 2.58+/-0.60; AN 2.81+/-1.10; BN 2.41+/-0.70; C 0.11+/-0.05; p<0.01) were significantly higher in ED patients than in C. Nitrite and cGMP levels inversely correlated with BMI in AN patients (nitrites: r=-0.62 p<0.01; cGMP r=-0.45 p<0.05) but not in BN patients (nitrites: r=-0.15 p=0.49; cGMP: r=-0.05 p=0.13) or in control subjects (nitrites: r=0.11 p=0.98; cGMP r=0.37 p=0.32). Significant correlations were also present in bulimic patients between nitrite levels, frequency of binges and several psychopathological dimensions, as assessed through the EDE. This is the first evidence of an alteration of the NO pathway in ED patients. Further studies are needed to ascertain whether an increase in NO levels plays a possible role in the pathogenesis of ED.
Collapse
Affiliation(s)
- Alfredo Vannacci
- Department of Preclinical and Clinical Pharmacology, University of Florence, Italy
| | | | | | | | | | | | | |
Collapse
|
39
|
Bruni V, Dei M, Filicetti MF, Balzi D, Pasqua A. Predictors of bone loss in young women with restrictive eating disorders. Pediatr Endocrinol Rev 2006; 3 Suppl 1:219-21. [PMID: 16641864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
OBJECTIVES To evaluate the influence of Body Mass Index, body composition and hormonal factors on bone mass in young women with amenorrhea related to restrictive eating disorders. DESIGN Descriptive study of 55 patients with secondary amenorrhea due to restrictive eating disorders and 14 healthy girls used for comparison. Assessment of Bone Mineral Density, Fat Mass and Lean Mass by DEXA and of the serum hormonal profile. RESULTS Patients had lower BMI, lower Fat Mass and lower Bone Mass compared to controls; their serum levels of LH, FT(3), DHEAS, Insulin and Leptin were significantly reduced. Low Bone Density, especially in the lumbar region, correlated with concentrations of FT(3), Cortisol, Insulin and Leptin, hormones expressive of metabolic adjustment to malnutrition. Lean Mass was a strong predictor of osteopenia and osteoporosis. CONCLUSIONS Hormonal nutritional markers, together with soft tissue composition measurements, are viable options for ongoing monitoring of subjects with eating disorders.
Collapse
Affiliation(s)
- Vincenzina Bruni
- Pediatric and Adolescent Gynecology Service, University of Florence, Italy
| | | | | | | | | |
Collapse
|
40
|
Uehara T, Omori I, Nakamura K, Suda M, Hosoda Y, Minegishi T, Mikuni M, Kangawa K. Plasma des-acyl and acyl ghrelin in patients with eating disorders. Eat Weight Disord 2005; 10:264-6. [PMID: 16755171 DOI: 10.1007/bf03327494] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
A recently recognized peptide, ghrelin, increases appetite and energy retention in human. Previous reports have shown higher plasma level in eating disorder (ED) patients and correlations with body mass index (BMI). This study examined these findings by measuring active (N-RIA) and total (C-RIA) levels of plasma ghrelin. Multipurpose assessments of symptoms were conducted for 11 ED patients and 5 control females. Results revealed significant differences of C-RIA between the groups. The BMI did not correlate with ghrelin, but demonstrated reversal correlation with the ratio of N-RIA and C-RIA (NC ratio) according to the ED or control group. The NC ratio also tended to be associated with a self-rating score. The NC ratio might be related to specific characteristics of ghrelin secretion or clearance in ED patients. Further basic and clinical investigations are necessary.
Collapse
Affiliation(s)
- T Uehara
- Department of Psychiatry and Human Behavior, Gunma University Graduate School of Medicine, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
41
|
Frieling H, Röschke B, Kornhuber J, Wilhelm J, Römer KD, Gruss B, Bönsch D, Hillemacher T, de Zwaan M, Jacoby GE, Bleich S. Cognitive impairment and its association with homocysteine plasma levels in females with eating disorders – findings from the HEaD-study. J Neural Transm (Vienna) 2005; 112:1591-8. [PMID: 16245072 DOI: 10.1007/s00702-005-0392-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2005] [Accepted: 10/01/2005] [Indexed: 11/27/2022]
Abstract
Higher plasma homocysteine levels have been found in females with anorexia nervosa. Furthermore, elevated homocysteine levels are associated with cognitive decline in dementia and healthy elderly people. Aim of this prospective study was to investigate a possible association between homocysteine serum levels and Clinically well known cognitive deficits in females with eating disorders. We found that moderately elevated plasma homocysteine levels were associated with normal short- and long-term verbal memory while normal plasma homocysteine levels were associated with poorer memory performance in 14 females with anorexia nervosa and 12 females with bulimia nervosa (logistic forward regression Wald chi(2)=8.566, OR=24.75, CI 2.89 - 212.23, P=0.003). These results indicate that under the special circumstances of eating disorders elevated homocysteine levels improve memory signaling possibly by facilitating long-term potentiation.
Collapse
Affiliation(s)
- H Frieling
- Department of Psychiatry and Psychotherapy, University Erlangen-Nuremberg, Bad Oeynhausen, Germany.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Allison KC, Ahima RS, O'Reardon JP, Dinges DF, Sharma V, Cummings DE, Heo M, Martino NS, Stunkard AJ. Neuroendocrine profiles associated with energy intake, sleep, and stress in the night eating syndrome. J Clin Endocrinol Metab 2005; 90:6214-7. [PMID: 16131578 DOI: 10.1210/jc.2005-1018] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
CONTEXT Night eating syndrome (NES) is characterized by evening hyperphagia and frequent awakenings with ingestion of food. It is associated with obesity and depressed mood. Greater understanding of hormonal influences on NES is desirable. OBJECTIVE Our objective was to evaluate 25-h profiles of hormones involved in energy balance, sleep, and stress in NES. DESIGN Blood assays for glucose, insulin, ghrelin, leptin, melatonin, cortisol, TSH, and prolactin were sampled repeatedly among NES and control subjects. Food intake and depressive symptoms were assessed. SETTING AND PARTICIPANTS Fifteen NES and 14 matched control participants stayed three nights in a General Clinical Research Center. MAIN OUTCOME MEASURES We assessed differences between NES and control participants in the 25-h profiles of eight hormones. RESULTS Nocturnal food intake was higher among NES participants, although their daily calorie intake was similar to that of controls. Reflecting their increased nocturnal intake, insulin (P < 0.001) and glucose levels (P = 0.07) among NES participants were higher than those of controls. Ghrelin levels were significantly lower in NES participants than in controls from 0100-0900 h (P = 0.003). Levels of plasma cortisol, melatonin, leptin, and prolactin did not differ between groups, but there was a trend for TSH levels (P = 0.07) to be higher during the 25 h in NES. NES participants had greater depressive symptoms than controls (P < 0.001). The differences in the levels of glucose, insulin, and ghrelin between NES and controls are closely associated with nocturnal food intake.
Collapse
Affiliation(s)
- Kelly C Allison
- University of Pennsylvania School of Medicine, Department of Psychiatry, Weight and Eating Disorders Program, 3535 Market Street, Suite 3021, Philadelphia, Pennsylvania 19104, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Jahanfar S, Maleki H, Mosavi AR. Subclinical eating disorder, polycystic ovary syndrome- is there any connection between these two conditions through leptin- a twin study. Med J Malaysia 2005; 60:441-6. [PMID: 16570705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The genetic property of subclinical eating behaviour (SEB) and the link between SEB and polycystic ovary syndrome (PCOS) has been studied before but the role of leptin within this connection has never been investigated. The objective of this study was 1). to study the genetic property of SEB. 2). To find a link between leptin, SEB and PCOS. One hundred and fifty four (77 pairs) female-female Iranian twins including 96 MZ individuals (48 pairs) and 58 DZ individuals (29 pairs) participated in the study. Clinical, biochemical and ultrasound tools were used to diagnose polycystic ovary syndrome. BITE questionnaire was filled out for subjects. Eight percent of subjects were diagnosed for subclinical eating disorder. No significant difference was found between intraclass correlation of MZ and DZ (z = 0.57, P = 0.569). Serum leptin level correlated significantly with bulimia score (P < 0.007). The mean (+/-SD) value for bulimia score was found to be higher among PCOS(positive) subjects (3.27 +/- 5.51) in comparison with PCOS(negative) subjects (2.06 +/- 4.48) (P < 0.001). The genetic property of subclinical eating disorder was not confirmed as shared environment might have played a major role in likeliness of DZ twins as well as MZ. Leptin is linked with both subclinical eating disorder and PCOS.
Collapse
Affiliation(s)
- Sh Jahanfar
- Royal College of Medicine, Perak Ipoh, Malaysia
| | | | | |
Collapse
|
44
|
Abstract
OBJECTIVE We observed that repeated thermal therapy improved appetite loss and general well-being in patients with chronic heart failure. The purpose of this study is to clarify the effects of repeated thermal therapy in mildly depressed patients with appetite loss and subjective complaints. METHODS Twenty-eight mildly depressed inpatients with general fatigue, appetite loss, and somatic and mental complaints were randomly assigned to thermal therapy group (n = 14) or nonthermal therapy group (n = 14). Patients in the thermal therapy group were treated with 60 degrees C far-infrared ray dry sauna for 15 minutes and were then kept at bed rest with a blanket for 30 minutes once a day, 5 days a week for a total of 20 sessions in 4 weeks. RESULTS Four weeks after admission, somatic complaints, hunger, and relaxation scores significantly improved (p < .001, p < .0001, p < .0001, respectively) and mental complaints slightly improved (p = .054) in the thermal therapy group compared with the nonthermal therapy group. Furthermore, the plasma ghrelin concentrations and daily caloric intake in the thermal therapy group significantly increased compared with the nonthermal therapy group (p < .05). CONCLUSIONS These findings suggest that repeated thermal therapy may be useful for mildly depressed patients with appetite loss and subjective complaints.
Collapse
Affiliation(s)
- Akinori Masuda
- Psychosomatic Medicine, Respiratory and Stress Care center, Kagoshima University Hospital, Kagoshima City, Japan.
| | | | | | | | | |
Collapse
|
45
|
Reuben DB, Hirsch SH, Zhou K, Greendale GA. The Effects of Megestrol Acetate Suspension for Elderly Patients with Reduced Appetite After Hospitalization: A Phase II Randomized Clinical Trial. J Am Geriatr Soc 2005; 53:970-5. [PMID: 15935019 DOI: 10.1111/j.1532-5415.2005.53307.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To provide preliminary evidence on the effectiveness and optimal dosage of megestrol acetate for older persons with impaired appetite after hospitalization. DESIGN Randomized clinical trial. SETTING Acute care hospital. PARTICIPANTS Forty-seven older persons (mean age 83) who were recently discharged from an acute care hospital and had fair or poor appetite. INTERVENTION Participants were randomized to placebo or megestrol acetate suspension 200 mg, 400 mg, or 800 mg daily for 9 weeks. MEASUREMENTS Appetite, health-related quality of life, and adverse effects were measured at baseline and 20, 42, and 63 days. Serum nutritional markers were measured at baseline and 20 and 63 days. RESULTS During the course of the study, there were no significant differences between treatment groups on any of the appetite questions, although participants in the 400-mg and 800-mg groups demonstrated significant improvement from baseline on some questions. At 20 days, prealbumin increased in a dose-response relationship across the four groups (by 0.4, 5.1, 7.5, and 9.0 mg/dL, respectively). Participants in the 400-mg and 800-mg groups demonstrated greater improvement in prealbumin levels at 20 days than those receiving placebo (P=.009 and P=.004, respectively) and those in the 400-mg group also demonstrated improvement at 63 days (P=.02). At 20 days, no participant taking placebo had a morning serum cortisol level less than 8 ng/mL (the lower limit of normal). In contrast, 33%, 70%, and 78% of those taking 200 mg, 400 mg and 800 mg, respectively, had values below this level; by 63 days, these percentages were 11%, 30%, 56%, and 37%, respectively. No patient reported clinical symptoms of adrenal insufficiency. Diarrhea developed in three subjects, and thromboembolism occurred in two receiving active treatment. CONCLUSION Megestrol acetate at doses of 400 mg and 800 mg increases prealbumin in recently hospitalized older persons. Cortisol suppression is common at higher doses and may be persistent. In this small study, the drug did not confer benefit on other nutritional or clinical outcomes.
Collapse
Affiliation(s)
- David B Reuben
- UCLA Multicampus Program in Geriatric Medicine and Gerontology, University of California at Los Angeles, Los Angeles, California 90095, USA.
| | | | | | | |
Collapse
|
46
|
|
47
|
Drevon CA. [Somatic aspects of eating disorders]. Tidsskr Nor Laegeforen 2004; 124:3260; author reply 3261. [PMID: 15608787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
|
48
|
Abstract
Routine laboratory investigations that had been performed at disease assessment on 327 teenage girls with eating disorders and weight loss were analyzed. The laboratory investigations included erythrocyte sedimentation rate (ESR), blood haemoglobin concentration (Hb), white blood cell count (WBC), platelet count, serum alkaline phosphatase (ALP) activity, serum aspartate aminotransferase (ASAT) activity, serum alanine aminotransferase (ALAT) activity, serum albumin concentration, glycated haemoglobin (HbA1c) and serum concentrations of sodium, potassium, magnesium, calcium (corrected for albumin), inorganic phosphate, creatinine and urea. The results were for ESR, Hb, WBC, platelet count, ALP, ASAT, ALAT, inorganic phosphate, creatinine, urea and HBA1C related to weight and (ongoing) weight loss. The variations of the biochemical measurements were, however, largely within reference ranges, weight and weight changes predicted the biochemical measurements only to a small degree and in individual patients the results of the analyses often suggested normality. These analyses may therefore not be suited to assess the degree of weight loss and starvation in eating disorders. They may, however, be useful for the exclusion of other diseases which could show weight loss and biochemical abnormalities.
Collapse
Affiliation(s)
- I Swenne
- Department of Women's and Children's Health, Uppsala University Children's Hospital, Uppsala, Sweden.
| |
Collapse
|
49
|
Abstract
Eating disorders are a group of disease states including anorexia nervosa, bulimia nervosa and binge eating on one end as well as episodic or chronic overeating resulting in obesity at the other end of the spectrum. These disorders are characterized by decreased and/or increased energy intake and are frequently associated with hormonal and metabolic disorders. The discovery of leptin, an adipocyte-secreted hormone acting in the brain to regulate energy homeostasis, and its subsequent study in human physiology have significantly advanced our understanding of normal human physiology and have provided new opportunities for understanding and possibly treating disease states, such as anorexia and bulimia nervosa. It has been recently discovered that leptin levels above a certain threshold are required to activate the hypothalamic-pituitary-gonadal and hypothalamic-pituitary-thyroid axes in men, whereas the hypothalamic-pituitary-adrenal, renin-aldosterone, and growth hormone-IGF-1 axes may be largely independent of circulating leptin levels in humans. In this review, we summarize the latest findings related to the role of leptin in the regulation of several neuroendocrine axes, such as the hypothalamic-pituitary-gonadal and the hypothalamic-pituitary-thyroid axes in humans and discuss its potential pathophysiologic role in eating disorders.
Collapse
Affiliation(s)
- Susann Blüher
- Division of Endocrinology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | | |
Collapse
|
50
|
Gibson JH, Mitchell A, Harries MG, Reeve J. Nutritional and exercise-related determinants of bone density in elite female runners. Osteoporos Int 2004; 15:611-8. [PMID: 15048548 DOI: 10.1007/s00198-004-1589-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2003] [Accepted: 01/09/2004] [Indexed: 10/26/2022]
Abstract
Although the female athletic triad is widely recognized clinically, there have been few studies quantitating the effect of disordered eating on bone mineral density. The purpose of this study was to explore the mechanisms through which disordered eating might influence the skeleton in nationally or internationally competitive runners. Fifty British national or higher standard middle and long-distance female runners aged under 36 years were recruited; 24 had amenorrhea (AM), nine had oligomenorrhea (OL) and the others were eumenorrheic (EU). Bone mineral density (BMD g.cm(-2)) of the proximal femur (femoral neck and trochanter) and lumbar spine (L2-L4) was measured by dual energy X-ray absorptiometry (DXA) and compared with population-based European reference data. Dietary eating patterns were assessed with the Eating Attitudes Test (EAT26) and Bulimia Investigatory Test Edinburgh (BITE) questionnaires. High eating disorder scores were common; the EAT26 score predicted menstrual disorders (P=0.014) and correlated with body mass index (BMI). BMD was generally low in the AM group, but was raised in the proximal femur in the EU group. In the AM group, younger age at start of training was associated with higher trochanteric BMD. In addition, years of eumenorrhea were positively associated with spine BMD. Although a high EAT26 score was associated with lower BMD in the proximal femur, this could be explained by the intermediary effect of menstrual disorders. Osteocalcin, a marker of bone formation, was reduced in the AM group and was also reduced by high VO2max and high BITE score, consistent with a central (hypothalamic) pathway for suppressing osteoblastic bone formation. Eumenorrheic runners had increased femoral BMD compared with European controls, consistent with a positive effect of increased mechanical loading. The effect of disordered eating to reduce BMD could be explained by its association with menstrual dysfunction. Lumbar spine BMD was reduced most in those athletes who menstruated for the shortest time in adolescence.
Collapse
Affiliation(s)
- Jane H Gibson
- Olympic Medical Institute, Northwick Park Hospital, HAI 3UJ, Harrow, Middlesex, UK
| | | | | | | |
Collapse
|