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DOI: 10.1055/s-0030-1252017
© Georg Thieme Verlag KG Stuttgart · New York
Changes in Acyl Ghrelin, Des-acyl Ghrelin, and Ratio of Acyl Ghrelin to Total Ghrelin with Short-term Refeeding in Female Inpatients with Restricting-type Anorexia Nervosa
Publication History
received 29.10.2009
accepted 09.03.2010
Publication Date:
21 April 2010 (online)
Abstract
Restricting type of anorexia nervosa (AN-R) is a serious disorder affecting adolescents and young adults and decreases quality of life over a long period. Successful weight restoration is an important prognostic factor for disease outcome; however, the underlying mechanism of refeeding resistance, a core psychopathology relevant to ‘ambivalent’ eating behaviors, remains unclear in this disorder. Ghrelin plays an important role in the regulation of growth hormone release, appetite, and energy metabolism. However, the early progress of these patients and changes in the levels of acyl ghrelin and des-acyl ghrelin during treatment were not reported. The purpose of this study was to determine the changes in ghrelin levels (acyl and des-acyl) during early treatment. As a result, des-acyl ghrelin in AN-R patients is higher than in control subjects before the therapy, but it decreases with treatment. The plasma des-acyl ghrelin level in AN-R patients started decreasing more rapidly and in early stage of the hospitalization than ever reported, and after 8 weeks, it is significantly lower than in control subjects. It means that des-acyl ghrelin is sensitive and changeable with their nutrition state. Furthermore, the ratio of the acyl ghrelin to total ghrelin increases with 8 weeks treatment. Eight weeks after, energy intake of the AN-R patients is recovered near the normal range with a daily energy intake of 1 700±93.54 kcal. These findings may be valuable for future AN-R treatments in order to increase acyl ghrelin and decrease des-acyl ghrelin, thereby influencing the refeeding outcome.
Key words
eating disorders - energy intake - hospitalization - gut hormone
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Correspondence
A. Asakawa
Department of Social and
Behavioral Medicine
Kagoshima University Graduate
School of Medical and Dental
Sciences
8-35-1 Sakuragaoka
890-8520 Kagoshima
Japan
Phone: +81/99/275 5751
Fax: +81/99/275 5749
Email: asakawa@m2.kufm.kagoshima-u.ac.jp