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Appetite regulatory hormones in women with anorexia nervosa: binge-eating/purging versus restricting type.

AbstractOBJECTIVE:
Anorexia nervosa is a psychiatric illness characterized by low weight, disordered eating, and hallmark neuroendocrine dysfunction. Behavioral phenotypes are defined by predominant restriction or bingeing/purging; binge-eating/purging type anorexia nervosa is associated with poorer outcome. The pathophysiology underlying anorexia nervosa types is unknown, but altered hormones, known to be involved in eating behaviors, may play a role.
METHOD:
To examine the role of anorexigenic hormones in anorexia nervosa subtypes, we examined serum levels of peptide YY (PYY; total and active [3-36] forms), brain-derived neurotrophic factor (BDNF), and leptin as primary outcomes in women with DSM-5 restricting type anorexia nervosa (n = 50), binge-eating/purging type anorexia nervosa (n = 25), and healthy controls (n = 22). In addition, women completed validated secondary outcome measures of eating disorder psychopathology (Eating Disorder Examination-Questionnaire) and depression and anxiety symptoms (Hamilton Rating Scales for Depression [HDRS] and Anxiety [HARS]). The study samples were collected from May 22, 2004, to February 7, 2012.
RESULTS:
Mean PYY 3-36 and leptin levels were lower and BDNF levels higher in binge-eating/purging type anorexia nervosa than in restricting type anorexia nervosa (all P values < .05). After controlling for body mass index, differences in PYY and PYY 3-36 between anorexia nervosa types were significant (P < .05) and differences in BDNF were at the trend level (P < .10). PYY 3-36 was positively (r = 0.27, P = .02) and leptin was negatively (r = -0.51, P < .0001) associated with dietary restraint; BDNF was positively associated with frequency of purging (r = 0.21, P = .04); and leptin was negatively associated with frequency of bingeing (r = -0.29, P = .007) and purging (r = -0.31, P = .004).
CONCLUSIONS:
Among women with anorexia nervosa, the anorexigenic hormones PYY, BDNF, and leptin are differentially regulated between the restricting and binge/purge types. Whether these hormone pathways play etiologic roles with regard to anorexia nervosa behavioral types or are compensatory merits further study.
AuthorsKamryn T Eddy, Elizabeth A Lawson, Christina Meade, Erinne Meenaghan, Sarah E Horton, Madhusmita Misra, Anne Klibanski, Karen K Miller
JournalThe Journal of clinical psychiatry (J Clin Psychiatry) Vol. 76 Issue 1 Pg. 19-24 (Jan 2015) ISSN: 1555-2101 [Electronic] United States
PMID25098834 (Publication Type: Comparative Study, Journal Article, Research Support, N.I.H., Extramural)
Copyright© Copyright 2015 Physicians Postgraduate Press, Inc.
Chemical References
  • Brain-Derived Neurotrophic Factor
  • Leptin
  • Peptide YY
Topics
  • Adult
  • Anorexia Nervosa (blood, classification, epidemiology)
  • Appetite (physiology)
  • Binge-Eating Disorder (blood, epidemiology)
  • Brain-Derived Neurotrophic Factor (blood)
  • Comorbidity
  • Female
  • Humans
  • Leptin (blood)
  • Peptide YY (blood)
  • Young Adult

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