Abstract
Objective: The aim of this study was to examine somatic and psychological factors related to the body mass index (BMI) of anorexia nervosa (AN) patients. Method: The analysis was of 24 hospitalized AN patients from the day after admission to the 4th day. The somatic factors analyzed were duration of AN, daily food intake, eating regulatory substances in blood (acylated ghrelin, desacyl ghrelin, leptin), serum cortisol, insulin and estimated creatinine clearance (CCr). The psychological factors analyzed were depression, anxiety, Eating Disorder Inventory (EDI), and hunger/fullness feeling. Measurement of BMI and collection of blood samples were done on the morning after hospitalization. Statistical analysis was by multiple linear regression analysis. Results: BMI showed a reverse correlation with desacyl ghrelin (β=-0.486, p=0.015) and maturity fears (β=-0.375, p=0.046), but was not associated with any other factor by multiple regression analysis. Conclusion: The results suggest that desacyl ghrelin and maturity fears play important roles in the prolonged malnutrition state seen in AN patients.
Similar content being viewed by others
References
Kishi T., Elmquist J.K.: Body weight is regulated by the brain: a link between feeding and emotion. Mol. Psychiatry, 10, 132–146, 2005.
Klok M.D., Jakobsdottir S., Drent M.L.: The role of leptin and ghrelin in the regulation of food intake and body weight in humans: a review. Obes. Rev., 8, 21–34, 2007.
Zhang Y., Proenca R., Maffei M., Barone M., Leopold L., Friedman J.M.: Positional cloning of the mouse gene and its human homolog. Nature, 372, 425–432, 1994.
Kojima M., Hosoda H., Date Y., Nakazato H., Kangawa K.: Ghrelin is a growth-hormone-releasing acylated peptide from the stomach. Nature, 402, 656–660, 1999.
Grinspoon S., Gulick T., Askari H., Landt M., Lee K., Anderson E., Ma Z., Vignati L., Bowsher R., Herzog D., Klibanski A.: Serum leptin levels in women with anorexia nervosa. J. Clin. Endocrinol. Metab., 81, 3861–3863, 1996.
Tolle V., Kadem M., Bluet-Pajot M.T., Frere D., Foulon C., Bossu C., Dardennes R., Mounier C., Zizzari P., Lang F., Epelbaum J., Estour B.: Balance in ghrelin and leptin plasma levels in anorexia nervosa patients and constitutionally thin women. J. Clin. Endocrinol. Metab., 88, 109–116, 2003.
Tanaka M., Naruo T., Yasuhara D., Takebe Y., Nagai N., Shiiya T., Nakazato M., Matsukura S., Nozoe S.: Fasting plasma ghrelin levels in subtypes of anorexia nervosa. Psychoneuroendocrinology, 28, 829–835, 2003.
Hebebrand J., Muller T.D., Holtkamp K., Herpertz-Dahlmann B.: The role of leptin in anorexia nervosa: clinical implications Mol. Psychiatry, 12, 23–35, 2007.
Misra M., Miller K.K., Kuo K., Griffin K., Stewart V., Hunter E., Herzog D.B., Klibanski A.: Secretory dynamics of ghrelin in adolescent girls with anorexia nervosa and healthy adolescents. Am. J. Physiol. Endocrinol. Metab., 289, E347–E356, 2005.
Misra M., Miller K.K., Kuo K., Griffin K., Stewart V., Hunter E., Herzog D.B., Klibanski A.: Secretory dynamics of leptin in adolescent girls with anorexia nervosa and healthy adolescents. Am. J. Physiol. Endocrinol. Metab., 289, E373–E381, 2005.
Hosoda H., Kojima M., Matsuo H., Kangawa K.: Ghrelin and des-acyl ghrelin: two major forms of rat ghrelin peptide in gastrointestinal tissue. Biochem. Biophys. Res. Commun., 279, 909–913, 2000.
Nedvidkova J., Krykorkova I.: Loss of meal-induced decrease in plasma ghrelin levels in patients with anorexia nervosa. J. Clin. Endocrinol. Metab., 88, 1678–1682, 2003.
Hotta M., Ohwada R., Katakami H., Shibasaki T., Hizuka N., Takano K.: Plasma levels of intact and degraded ghrelin and their responses to glucose infusion in anorexia nervosa. J. Clin. Endocrinol. Metab., 89, 5707–5712, 2004.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. Washington, DC, American Psychiatric Association, 1994.
First M.B., Gibbon M., Spitzer R.L., Williams J.B.W.: User’s Guide for the Structured Clinical Interview for DSM-IV AXIS I Disorders: Research Version. New York, Biometrics Research Department, Columbia University, 1996.
Garner D.M., Vitousek K.M., Pike K.M.: Cognitivebehavioral therapy for anorexia nervosa. In: Garner D.M., Garfinkel P.E. (eds.), Handbook of treatment for eating disorders, 2nd Ed. New York, Guilford, 1997, pp. 94–141.
Cockcroft D.W., Gault M.H.: Prediction of creatinine clearance from serum creatinine. Nephron, 16, 31–41, 1976.
Garner D.M., Olmsted M.P.: Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. Int. J. Eat. Disord., 2, 15–34, 1983.
Zung W.W.K.: The depression status inventory: an adjunct to the Self-Rating Depression Scale. J. Clin. Psychol., 28, 539–543, 1972.
Spielberger C.D., Gorsuch R.L., Lushene R., Vagg P.R., Jacob G.A.: Manual for the State Trait Anxiety Inventory (Form Y). Palo Alto, CA, Consulting Psychology Press, 1983.
Stock S., Leichner P., Wong A., Ghatei M.A., Kieffer T.J., Bloom S.R., Chanoine J.P.: Ghrelin, peptide YY, glucose-dependent insulinotropic polypeptides, and hunger responses to a mixed meal in anorexic, obese, and control female adolescents. J. Clin. Endocrinol. Metab., 90: 2161–2168, 2005.
Yoshimoto A., Mori K., Sugawara A., Mukoyama M., Yahata K., Suganami T., Takaya K., Hosoda H., Kojima M., Kangawa K., Nakao K.: Plasma ghrelin and desacyl ghrelin concentrations in renal failure. J. Am. Soc. Nephrol., 13, 2748–2752, 2002.
Asakawa A., Inui A., Fujimiya M., Sakamaki R., Shinfuku N., Ueta Y., Meguid M.M., Kasuga M.: Stomach regulates energy balance via acylated ghrelin and desacyl ghrelin. Gut, 54, 18–24, 2005.
Chen C.-Y., Chao Y., Chang F.Y., Chien E.J., Lee S.D., Doong M.L.: Intracisternal desacyl ghrelin inhibits food intake and non-nutrient gastric emptying in conscious rats. Int. J. Mol. Med., 16, 695–699, 2005.
Tschop M., Smiley D.L., Heiman M.L.: Ghrelin induces adiposity in rodents. Nature, 407, 908–913, 2000.
Crisp A.H.: Anorexia nervosa as flight from growth: Assessment and treatment based on the model. Cognitive-behavioral Therapy for Anorexia Nervosa. In: Garner D.M., Garfinkel P.E. (eds), Handbook of treatment for eating disorders, 2nd Ed. New York, Guilford, 1997, pp. 248–268.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kawai, K., Yamanaka, T., Yamashita, S. et al. Somatic and psychological factors related to the body mass index of patients with anorexia nervosa. Eat Weight Disord 13, 198–204 (2008). https://doi.org/10.1007/BF03327507
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03327507