leptin and Bulimia-Nervosa

The pathophysiology of anorexia nervosa (AN) and bulimia nervosa (BN) are still poorly understood, but psychobiological models have proposed a key role for disturbances in the neuroendocrines that signal hunger and satiety and maintain energy homeostasis. Mounting evidence suggests that many neuroendocrines involved in the regulation of homeostasis and body weight also play integral roles in food reward valuation and learning via their interactions with the mesolimbic dopamine system. Neuroimaging data have associated altered brain reward responses in this system with the dietary restriction and binge eating and purging characteristic of AN and BN. Thus, neuroendocrine dysfunction may contribute to or perpetuate eating disorder symptoms via effects on reward circuitry. This narrative review focuses on reward-related neuroendocrines that are altered in eating disorder populations, including peptide YY, insulin, stress and gonadal hormones, and orexins. We provide an overview of the animal and human literature implicating these neuroendocrines in dopaminergic reward processes and discuss their potential relevance to eating disorder symptomatology and treatment.

Topics: Animals; Anorexia Nervosa; Bulimia Nervosa; Ghrelin; Humans; Leptin; Neuroendocrinology; Reward

The biological research predominant in the last decades have not brought a solution in the discovery of risk factors contributing to the development of eating disorders, and elaborating a more effective therapy. The large amount of molecular genetic studies, however, by showing the various genetic vulnerability, contributed significantly to recognizing a more specific effect of the environmental factors. The authors evaluate the genetic studies of eating disorders and present environmental factors having a role in the development of eating disorders. They report about recently published data of gene-environment interaction and conclude from the data clinically applicable consequences.

Topics: Anorexia Nervosa; Brain-Derived Neurotrophic Factor; Bulimia Nervosa; Family; Feeding and Eating Disorders; Genetic Predisposition to Disease; Ghrelin; Humans; Leptin; Melanocortins; Neuropeptide Y; Receptor, Melanocortin, Type 4; Receptors, Dopamine D4; Receptors, Estrogen; Receptors, Serotonin; Serotonin Plasma Membrane Transport Proteins; Social Environment; Twin Studies as Topic

This review focuses on recent publications concerning medical complications in patients with eating disorders, including anorexia nervosa and bulimia nervosa.. Recent literature continues to reflect that multiple organ systems are frequently affected by eating disorders. The literature underscores the frequently cited risk of premature death in those with anorexia nervosa. A plethora of dermatologic changes have been described, some signaling serious underlying pathophysiology, such as purpura, which indicates a bleeding diathesis. Much of the literature continues to delineate the fact that diabetic patients with eating disorders are at high risk of developing diabetic complications. Gastrointestinal complications can be serious, including gastric dilatation and severe liver dysfunction. Acrocyanosis is common, and patients with anorexia nervosa are at risk of various arrhythmias. Low-weight patients are at high risk for osteopenia/osteoporosis. Nutritional abnormalities are also common, including sodium depletion and hypovolemia, hypophosphatemia and hypomagnesemia. Resting energy expenditure, although very low in low-weight patients, increases dramatically early in refeeding.. Medical complications are common and often serious in patients with eating disorders, particularly those with anorexia nervosa.

Topics: Anorexia Nervosa; Bone Diseases; Bulimia Nervosa; Cardiovascular Diseases; Endocrine System Diseases; Gastrointestinal Diseases; Humans; Leptin; Lung Diseases; Nutrition Disorders; Skin Diseases

This study evaluated the efficacy and safety of lamotrigine in binge-eating disorder (BED) associated with obesity. Fifty-one outpatients with BED by Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria, and obesity were randomized to receive either lamotrigine (N=26) or placebo (N=25) in a 16-week, double-blind, flexible-dose study. Lamotrigine (236+/-150 mg/day) and placebo had similar rates of reduction of weekly frequency of binge-eating episodes and binge days, weight and BMI, measures of eating pathology, obsessive-compulsive symptoms, impulsivity, and global severity of illness. However, lamotrigine was associated with a numerically greater amount of weight loss (1.17 vs. 0.15 kg) and significant reductions in fasting levels of glucose, insulin, and triglycerides. It was also well tolerated and associated with no serious adverse events. As a result of an exceptionally high placebo response, it is likely that for efficacy measures except for body weight and metabolic indices, the study was incapable of detecting potentially clinically important drug-placebo difference.

Topics: Adolescent; Adult; Aged; Antimanic Agents; Body Mass Index; Bulimia Nervosa; Double-Blind Method; Female; Ghrelin; Humans; Impulsive Behavior; Lamotrigine; Leptin; Male; Middle Aged; Obesity; Obsessive-Compulsive Disorder; Psychiatric Status Rating Scales; Treatment Outcome; Triazines; Weight Loss; Young Adult

This study is an investigation of neuropsychological performance in patients with anorexia nervosa, bulimia nervosa, and binge eating disorder and hormonal secretion patterns for ghrelin, leptin, insulin, and glucose. An oral glucose tolerance test (OGTT) was performed in a cohort of n = 30 female patients suffering from eating disorders as well as n = 20 control females. All participants underwent the Wisconsin Card Sorting Test (WCST), the Trail Making Test (TMT), and a go/no-go task using food vs. neutral stimuli. Patients with anorexia nervosa differed from controls in their leptin response to the OGTT. While the four groups under investigation did not differ in neuropsychological performance, we found leptin responses to the OGTT to be associated with performance in the food-specific go/no-go task. These preliminary results may indicate a putative association between leptin concentrations and neuropsychological performance, particularly in measures of inhibitory control. Further studies investigating the role of leptin in impulsive behaviors in eating disorders would be useful.

Topics: Adult; Anorexia Nervosa; Binge-Eating Disorder; Blood Glucose; Bulimia Nervosa; Cognition; Feeding and Eating Disorders; Female; Food; Ghrelin; Glucose Tolerance Test; Humans; Insulin; Leptin; Task Performance and Analysis; Young Adult

Longitudinal studies support a prospective relationship between weight suppression (WS) and bulimic syndrome (BN-S) maintenance. Although biobehavioral mechanisms have been proposed to explain this link, such mechanisms have yet to be identified. Given that weight loss would reduce leptin levels which may influence eating, this study examined whether reduced leptin levels mediate the link between greater WS and longer illness duration.. Women (N = 53), ages 18-45 years, were recruited from the community if they met criteria for a BN-S, including either DSM-5 bulimia nervosa (BN; n = 33) or purging disorder (PD: n = 20), and fell within a healthy weight range (18.5-26.5 kg/m. Significant associations were found among greater WS, lower leptin concentrations, and longer duration of illness. Mediation analyses using bootstrapping procedures indicated all paths were significant and that leptin mediated the link between WS and illness duration. An alternative model in which longer illness duration contributed to leptin, via greater WS, was not supported.. Longitudinal research is needed to support temporal associations and explore behavioral mechanisms linking leptin to illness trajectory.

Topics: Adolescent; Adult; Bulimia Nervosa; Female; Humans; Leptin; Middle Aged; Weight Loss; Young Adult

Bulimia nervosa (BN) is characterized by dysregulated eating behaviour and present data suggest adipokines may regulate food intake. We investigated a possible association between BN and adipokine levels and hypothesized that plasma (P)-adiponectin would be elevated and P-leptin and P-leptin-adiponectin-ratio would be reduced in women with BN.. The study was designed as a cross-sectional study with a longitudinal arm for patients with BN. Plasma-adiponectin and leptin was measured in 148 female patients seeking psychiatric ambulatory care and 45 female controls. Fifteen patients were diagnosed with BN and the remaining with other affective and anxiety disorders. P-adiponectin and P-leptin levels were compared between patients with BN, patients without BN and controls. At follow-up 1-2years later, adipokines were reassessed in patients with BN and the Eating Disorder Examination Questionnaire was used to assess symptom severity.. P-adiponectin was elevated in patients with BN at baseline and at follow-up when compared to patients without BN and controls (P<0.004 and <0.008 respectively). The difference remained significant after controlling for body mass index. P-adiponectin was correlated to symptom severity at follow-up in patients with BN without morbid obesity (ρ=0.72, P<0.04). P-leptin-adiponectin-ratio was significantly lower in patients with BN compared to controls (P<0.04) and P-leptin non-significantly lower.. Findings indicate a stable elevation of P-adiponectin in women with BN. P-adiponectin at follow-up correlates to eating disorder symptom severity in patients without morbid obesity, indicating that P-adiponectin should be further investigated as a possible potential prognostic biomarker for BN.

Topics: Adiponectin; Adult; Body Mass Index; Bulimia Nervosa; Cross-Sectional Studies; Feeding Behavior; Female; Humans; Leptin; Longitudinal Studies; Mood Disorders; Psychiatric Status Rating Scales; Statistics as Topic; Sweden

Bulimia nervosa (BN) is a serious eating disorder that can persist for years and contribute to medical complications and increased mortality, underscoring the need to better understand factors maintaining this disorder. Higher levels of weight suppression (WS) have been found to predict both the onset and maintenance of BN; however, no studies have examined mechanisms that may account for the effects of WS on BN. We hypothesized that high WS would lead to reduced leptin levels, which may increase risk of binge eating by modulating reward responses to food. The current study examined the relationship between WS, leptin levels, and the reinforcing value of food in women with BN (n = 32) and noneating disorder controls (n = 30). Participants provided information on WS, completed a fasting blood draw to obtain serum leptin, and completed a progressive ratio task to measure the reinforcing value of food. Individuals with BN had greater WS (p < .01) and reinforcing food value (p < .05) compared with controls. Additionally, higher WS was associated with both lower leptin (p < .05) and increased reinforcing value of food (p < .05). Contrary to hypotheses, BN and control participants did not differ on leptin levels, and leptin levels were not significantly associated with the reinforcing value of food. Findings support that efforts to conform to the thin ideal may alter drive to consume rewarding foods and leave women vulnerable to binge episodes. However, mechanisms through which WS contributes to food reward and binge eating remain unknown.

Topics: Adolescent; Adult; Body Mass Index; Body Weight; Bulimia Nervosa; Female; Humans; Leptin; Reward; Young Adult

Although low weight is a key factor contributing to the high mortality in anorexia nervosa (AN), it is unclear how AN patients sustain low weight compared with bulimia nervosa (BN) patients with similar psychopathology. Studies of genes involved in appetite and weight regulation in eating disorders have yielded variable findings, in part due to small sample size and clinical heterogeneity. This study: (1) assessed the role of leptin, melanocortin, and neurotrophin genetic variants in conferring risk for AN and BN; and (2) explored the involvement of these genes in body mass index (BMI) variations within AN and BN.. Our sample consisted of 745 individuals with AN without a history of BN, 245 individuals with BN without a history of AN, and 321 controls. We genotyped 20 markers with known or putative function among genes selected from leptin, melanocortin, and neurotrophin systems.. There were no significant differences in allele frequencies among individuals with AN, BN, and controls. AGRP rs13338499 polymorphism was associated with lowest illness-related BMI in those with AN (p = 0.0013), and NTRK2 rs1042571 was associated with highest BMI in those with BN (p = 0.0018).. To our knowledge, this is the first study to address the issue of clinical heterogeneity in eating disorder genetic research and to explore the role of known or putatively functional markers in genes regulating appetite and weight in individuals with AN and BN. If replicated, our results may serve as an important first step toward gaining a better understanding of weight regulation in eating disorders.

Topics: Adult; Agouti-Related Protein; Anorexia Nervosa; Body Mass Index; Body Weight; Bulimia Nervosa; Case-Control Studies; Female; Genotyping Techniques; Humans; Leptin; Melanocortins; Membrane Glycoproteins; Middle Aged; Nerve Growth Factors; Polymorphism, Single Nucleotide; Protein Kinases; Protein-Tyrosine Kinases; Receptor, trkB

A relationship between bulimia nervosa and reward-related behavior is supported by several lines of evidence. The dopaminergic dysfunctions in the processing of reward-related stimuli have been shown to be modulated by the neurotrophin brain derived neurotrophic factor (BDNF) and the hormone leptin.. Using a randomized, double-blind, placebo-controlled, crossover design, a reward learning task was applied to study the behavior of 20 female subjects with remitted bulimia nervosa and 27 female healthy controls under placebo and catecholamine depletion with alpha-methyl-para-tyrosine (AMPT). The plasma levels of BDNF and leptin were measured twice during the placebo and the AMPT condition, immediately before and 1 hour after a standardized breakfast.. AMPT-induced differences in plasma BDNF levels were positively correlated with the AMPT-induced differences in reward learning in the whole sample (P=.05). Across conditions, plasma brain derived neurotrophic factor levels were higher in remitted bulimia nervosa subjects compared with controls (diagnosis effect; P=.001). Plasma BDNF and leptin levels were higher in the morning before compared with after a standardized breakfast across groups and conditions (time effect; P<.0001). The plasma leptin levels were higher under catecholamine depletion compared with placebo in the whole sample (treatment effect; P=.0004).. This study reports on preliminary findings that suggest a catecholamine-dependent association of plasma BDNF and reward learning in subjects with remitted bulimia nervosa and controls. A role of leptin in reward learning is not supported by this study. However, leptin levels were sensitive to a depletion of catecholamine stores in both remitted bulimia nervosa and controls.

Topics: Adult; alpha-Methyltyrosine; Association Learning; Body Mass Index; Brain-Derived Neurotrophic Factor; Bulimia Nervosa; Catecholamines; Cross-Over Studies; Double-Blind Method; Female; Humans; Leptin; Neuropsychological Tests; Random Allocation; Reward; Young Adult

The aim of this study was to verify the relationship between eating disorders (binge eating and bulimia nervosa) and body image dissatisfaction with BMI, anorexigenic and orexigenic factors in adolescents. Thirty-two adolescents, (13 obese [BMI=36.65±5.68] and 19 non-obese [BMI=22.18±3.11]), aged between 14 and 19y, were recruited. Symptoms of eating disorders were measured by self-report questionnaires (BSQ, BITE and BES). Hormones, cytokines and neuropeptides were determined by Elisa kits (Phoenix peptide). A positive correlation was found between: leptin and BES (r=.724), BSQ (r=.705) and BITE (r=.696); BMI and BES (r=.663), BSQ (r=.525) and BITE (r=.732); the same pattern was observed to insulin and TNF-α. A negative correlation was found in α-MSH and AgRP with BES, BSQ and BITE. Blood levels of hormones and neuropeptides could be the link between obesity and eating disorders in adolescents. However, it is not clear which is the cause and which is the consequence.

Topics: Adolescent; Agouti-Related Protein; alpha-MSH; Anorexia Nervosa; Body Image; Body Mass Index; Bulimia; Bulimia Nervosa; Cross-Sectional Studies; Female; Humans; Insulin; Leptin; Obesity; Surveys and Questionnaires; Tumor Necrosis Factor-alpha; Young Adult

Purging disorder (PD), a recently recognized eating disorder syndrome, is differentiated from bulimia nervosa (BN) based on the absence of objectively large binge episodes. BN has been associated with low serum leptin levels. This study examined whether PD is also characterized by low serum leptin.. Participants included women with PD (n = 20) or BN (n = 37), and non-eating disorder controls (n = 33). Blood samples for measurement of leptin and total ghrelin were obtained after overnight fast.. In comparison with control values, leptin levels were significantly decreased in PD (p < .01), as well as in BN (p < .02). Plasma ghrelin levels did not differ significantly across groups.. These results provide the first evidence that PD is associated with alteration in a neurobiological pathway influencing eating patterns and body weight. Further research is needed to assess whether low leptin levels in PD and BN are associated with restrained eating and weight suppression.

Topics: Adult; Body Mass Index; Body Weight; Bulimia; Bulimia Nervosa; Case-Control Studies; Eating; Fasting; Female; Ghrelin; Humans; Leptin; Young Adult

The aim of our study was to determine whether eating behaviors and/or physical activity level may explain contradicting results in adipocytokines levels in anorexia nervosa (AN).. Fasting levels of circulating adipocytokines (adiponectin, resistin and leptin), insulin, glucose, C-reactive protein, cytokines (tumor necrosis factor-alpha and interleukin (IL)-1beta), body composition and resting energy expenditure were measured in 24 women AN patients and 14 women controls. These parameters were compared according to AN subtypes: 15 patients with restrictive (R-AN) form versus 9 patients with binge/purge (BP-AN) form; 15 patients with hyperactive (H-AN) form versus 9 patients with nonhyperactive (NH-AN) form.. BP-AN patients had significantly higher serum adiponectin levels compared with R-AN patients (P<0.05), and H-AN patients had higher serum leptin and lower serum resistin levels compared with NH-AN patients (P<0.05 for both).. Our study shows specific adipocytokines profiles depending on the subtype of AN: restrictive versus binge/purge and hyperactive versus Nonhyperactive forms. We suggest that these biological signatures could interfere with the outcome of the disease.

Topics: Adiponectin; Adolescent; Adult; Anorexia Nervosa; Bulimia Nervosa; Female; Humans; Hyperkinesis; Leptin; Motor Activity; Resistin; Young Adult

Visfatin is an adipose tissue-derived hormone shown to correlate with visceral fat mass in patients with obesity. Its possible role in patients with different types of eating disorders is unknown. We measured fasting serum levels of visfatin and leptin and surrogate measures of insulin sensitivity in 10 untreated patients with anorexia nervosa (AN), 10 untreated patients with bulimia nervosa (BN) and 20 age-matched healthy women (C) to study the possible role of visfatin in these disorders. Patients with AN had severely decreased body mass index (BMI) and body fat content. BMI of BN group did not significantly differ from that of C group, whereas body fat content of BN group was significantly lower compared to C and higher compared to AN group, respectively. Serum glucose levels did not significantly differ among the groups studied, whereas serum insulin and leptin levels and HOMA index were significantly decreased in AN group relative to both C and BN group. In contrast, serum visfatin levels in both patients with AN and BN did not differ from those of C group. We conclude that circulating visfatin levels are not affected by the presence of chronic malnutrition in AN or binge/purge eating behavior in BN.

Topics: Adiposity; Adult; Anorexia Nervosa; Biomarkers; Blood Glucose; Body Mass Index; Bulimia Nervosa; Cytokines; Female; Humans; Insulin; Leptin; Nicotinamide Phosphoribosyltransferase; Nutritional Status; Young Adult

Adipocyte fatty acid binding protein (A-FABP) has been suggested to play an important role in fat metabolism linking obesity and the metabolic syndrome. Increasing A-FABP plasma levels were observed during greatest weight loss after bariatric surgery suggesting that A-FABP may indicate changes in fat mass in dynamic situations.. As there are no data on weight gain, we investigated the effect of refeeding anorexic patients on body composition and A-FABP plasma levels.. Parameters of glucose and lipid metabolism as well as plasma levels of leptin and A-FABP were prospectively assessed in 16 female patients with anorexia nervosa during inpatient weight restoration. Body composition was determined by multifrequency body impedance analysis.. After 28 days, fat mass increased from 4.4 +/- 2.5 kg at baseline to 5.5 +/- 2.2 kg (P < 0.01), constituting 40% of total weight gain. Conversely, A-FABP concentrations decreased from 32.56 +/- 35.59 ng/ml at baseline to 21.27 +/- 13.68 ng/ml (P < 0.05), which corresponds to a significant decrease in the proportion of A-FABP per kilogram fat mass from 7.86 +/- 5.23 to 4.09 +/- 2.12 ng/ml/kg (P

Topics: Adipocytes; Adolescent; Adult; Anorexia Nervosa; Body Composition; Body Mass Index; Bulimia Nervosa; Electric Impedance; Enzyme-Linked Immunosorbent Assay; Fatty Acid-Binding Proteins; Female; Humans; Leptin; Matched-Pair Analysis; Middle Aged; Regression Analysis; Weight Gain; Young Adult

Ghrelin and leptin play important roles in the physiopathology of eating disorders, starting generally in infancy and adolescence. The aim of this study was to evaluate the effects of multidisciplinary short-term therapy on ghrelin and leptin concentrations, bulimia nervosa symptoms, binge eating disorder symptoms, body composition, and visceral and subcutaneous fat in obese adolescents.. Twenty obese adolescents with simple obesity (BMI >95th percentile, 36.93 +/- 4.14, CDC) were submitted to multidisciplinary (nutrition, psychology, exercise and clinical) therapy. Plasma ghrelin and leptin concentrations were measured by radioimmunoassay. Bulimic and binge eating behaviors were measured by the Bulimic Investigation Test Edinburgh and the Binge Eating Scale, respectively. Visceral and subcutaneous fat were measured by ultrasonography and body composition by plethysmography.. Significant reductions were observed in body weight (101.04 +/- 11.18 to 94.79 +/- 10.94 kg), BMI (36.93 +/- 4.14 to 34.27 +/- 4.78), fat% (41.96 +/- 6.28 to 39.14 +/- 7.62%), visceral fat (4.34 +/- 1.53 to 3.41 +/- 1.12 cm), leptin concentration (20.12 +/- 6.47 to 16.68 +/- 8.08 ng/ml), prevalence of bulimia nervosa (100 to 67%) and binge eating disorder symptoms (40 to 17%).. Short-term multidisciplinary therapy was effective in improving body composition, visceral fat, leptinemia and eating disorders in obese adolescents.

Topics: Adolescent; Adult; Body Composition; Brazil; Bulimia; Bulimia Nervosa; Combined Modality Therapy; Feeding and Eating Disorders; Female; Ghrelin; Humans; Leptin; Male; Obesity; Physical Therapy Modalities; Psychotherapy

Binge eating episodes in persons with bulimia nervosa may to some extent be a result of disturbed sensations of hunger and satiety. It has been hypothesized that abnormal appetite sensations may be due to bulimia nervosa-related alterations in the release of hormones that are known to be involved in the physiologic regulation of appetite and metabolism.. The objective was to investigate whether circulating concentrations of the appetite-regulating peptides leptin and ghrelin and markers of metabolism (glucose and insulin) are different in persons with bulimia nervosa than in controls before and after intake of a meal and whether these changes may be reflected in saliva.. Twenty women with bulimia nervosa and 20 age- and sex-matched healthy controls participated. After an overnight fast, the subjects ate a standardized carbohydrate-rich breakfast. Whole saliva and blood were collected, and visual analogue scales for hunger and satiety were completed once before and continuously for 5 h after the breakfast.. A lower pre- and postprandial whole saliva flow rate was found in subjects with bulimia nervosa, which might have been attributable to a concomitant intake of potentially xerogenic medication. Subjects with bulimia nervosa experienced reduced hunger, which could not be explained by pre- or postprandial alterations in circulating ghrelin, leptin, insulin, or glucose concentrations.. There were no apparent differences in the composition of blood and saliva between bulimia nervosa and control subjects, and meal-induced compositional changes in blood were not directly mirrored in saliva composition.

Topics: Adolescent; Adult; Blood Glucose; Bulimia Nervosa; Case-Control Studies; Eating; Female; Ghrelin; Humans; Hunger; Insulin; Leptin; Postprandial Period; Saliva; Satiety Response; Xerostomia

Changes in body composition, hormone secretions, and heart function with increased risk of sudden death occur in eating disorders. In this observational clinical study, we evaluated sympathovagal modulation of heart rate variability (HRV) and cardiovascular changes in response to lying-to-standing in patients with anorexia (AN) or bulimia nervosa (BN) to analyze: a) differences in autonomic activity between AN, BN, and healthy subjects; b) relationships between autonomic and cardiovascular parameters, clinical data and leptin levels in patients with eating disorders. HRV, assessed by power spectral analysis of R-R intervals, blood pressure (BP) and heart rate (HR) were studied by tilt-table test in 34 patients with AN, 16 with BN and 30 healthy controls. Autonomic and cardiovascular findings were correlated with clinical data, and serum leptin levels. Leptin levels were lowered in AN vs BN and healthy subjects (p<0.0001), but both AN and BN patients showed unbalanced sympathovagal control of HRV due to relative sympathetic failure, prevalent vagal activity, impaired sympathetic activation after tilting, independently from their actual body weight and leptin levels. No significant correlations were obtained between HRV data vs clinical data, BP and HR findings, and leptin levels in eating disorders. Body mass indices (BMI) (p<0.02), and leptin levels (p<0.04) correlated directly with BP values. Our data showed alterations of sympathovagal control of HRV in eating disorders. These changes were unrelated to body weight and BMI, diagnosis of AN or BN, and leptin levels despite the reported effects of leptin on the sympathetic activity.

Topics: Adult; Anorexia Nervosa; Autonomic Nervous System Diseases; Blood Pressure; Body Mass Index; Body Weight; Bulimia Nervosa; Female; Heart Rate; Humans; Leptin; Posture; Tilt-Table Test; Vagus Nerve

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.. 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.. 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.. The results raise the possibility of a direct effect of central regulatory mechanisms of food intake in the pathomechanism of anorexia nervosa.

Topics: Adult; Anorexia Nervosa; Blood Glucose; Body Mass Index; Bulimia Nervosa; C-Peptide; Case-Control Studies; Feeding and Eating Disorders; Female; Glucose Tolerance Test; Humans; Insulin; Leptin; Male; Middle Aged; Radioimmunoassay; Spectrometry, Fluorescence

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.

Topics: Adult; Bulimia Nervosa; Feeding and Eating Disorders; Female; Humans; Iran; Leptin; Polycystic Ovary Syndrome; Reference Values; Risk Assessment; Risk Factors; Surveys and Questionnaires; Twins, Dizygotic; Twins, Monozygotic