Loss of Meal-Induced Decrease in Plasma Ghrelin Levels in Patients with Anorexia Nervosa

• Published in: The journal of clinical endocrinology and metabolism Vol. 88; no. 4; pp. 1678 - 1682
• Main Authors: Nedvídková, Jara, Krykorková, Ivana, Barták, Vladimír, Papezová, Hana, Gold, Philip W., Alesci, Salvatore, Pacak, Karel
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Endocrine Society 01.04.2003
• Subjects: Adipose Tissue; Adult; Adult and adolescent clinical studies; Anorexia nervosa; Anorexia Nervosa - blood; Biological and medical sciences; Body Composition; Dietary Fiber - administration & dosage; Eating behavior disorders; Energy Intake; Fasting; Female; Food; Ghrelin; Humans; Medical sciences; Nutritive Value; Peptide Hormones - blood; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Human; Pathophysiology; Postprandial; Somatotropin hormone; Anorexia nervosa; Eating disorder; Fat mass; Body composition; Blood plasma; Adenohypophyseal hormone; Ghrelin; Orexigen hormone; Young adult; Female; Hormonal investigation; Hormone releasing factor; Fast; Comparative study
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/jc.2002-021669

Studies have shown that ghrelin plays a major role in energy homeostasis and modulation of feeding behavior. However, little is known about the influence of food consumption on plasma ghrelin levels in humans. Therefore, we investigated responses of plasma ghrelin to food intake, meal volume and meal nutritional value in healthy volunteers and women with anorexia nervosa (AN). After overnight fasting, all subjects received either a standardized breakfast or fiber. Plasma ghrelin levels were measured before and after the meal. Fasting plasma ghrelin was significantly higher in AN patients than in controls (1,800.6 ± 47.0 vs. 795.9 ± 24.3 pg/ml, P < 0.001) (606.8 ± 15.8 vs. 268.2 ± 8.2 pmol/l, P < 0.001), and correlated negatively with percentage of body fat in both groups. Ghrelin levels markedly fell after consumption of either a standardized meal or fiber in controls, but not in anorexic women. Thus, we concluded that the acute plasma ghrelin response to food intake, which in healthy individuals is independent of meal caloric value, is impaired in women with AN. This abnormality may be part of a chronic adaptation to prolonged food restriction, which attempts to restore a normal feeding conduct by maintaining the drive to eat.