Maged Muhammed, Helen Burton-Murray, Franziska Plessow, Kendra R Becker, Lauren Breithaupt, Meghan Lauze, Meghan Slattery, Hang Lee, Jennifer J Thomas, Kamryn T Eddy, Elizabeth A Lawson, Madhusmita Misra
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AN was differentiated from Atypical AN by BMI < 10th percentile for age and sex (if <18 years) or < 18.5 kg/m<sup>2</sup>(if ≥18 years). Blood samples were collected fasting and 30, 60 and 120 minutes following a standardized meal to assess total PYY, CCK, and total ghrelin concentrations.</p><p><strong>Results: </strong>Median fasting and post-prandial PYY concentrations were significantly higher in AN vs. HC with medium differences (p = .001-.006, r = .34-.43). Atypical AN had significantly higher PYY concentrations compared to HC at T-0 (p = .027, r = .29) only, and did not significantly differ from concentrations in AN (p = .105-.413, r = .11-.22). Area under the curve (AUC; p = .001; r = .41) and peak PYY concentrations (p = .003; r = .41) were also significantly higher in AN vs. HC with medium differences. There were no significant differences in fasting (p = .885) or post-prandial (p = .846-.993) CCK concentrations across groups. AN and Atypical AN each had significantly higher ghrelin concentrations than HC with small to medium effect (AN vs HC p = .004-.025, r = .27-.36; Atypical AN vs HC p = .004-.033; r = .28-.28).</p><p><strong>Conclusions: </strong>Higher peak postprandial concentrations of anorexigenic PYY in AN (compared to HC) may facilitate dietary restriction and contribute to maintenance of lower weight. Lack of CCK suppression in AN is maladaptive in the context of undernutrition. 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We aimed to investigate fasting and post-prandial concentrations of appetite-regulating hormones - peptide YY (PYY), cholecystokinin (CCK), and ghrelin - among adolescent and young adult females across the AN weight spectrum, specifically those with AN and Atypical AN, and healthy controls (HC).</p><p><strong>Methods: </strong>Participants (N = 95; ages 11-22 years) included 33 with AN, 25 with Atypical AN, and 37 HC. AN was differentiated from Atypical AN by BMI < 10th percentile for age and sex (if <18 years) or < 18.5 kg/m<sup>2</sup>(if ≥18 years). Blood samples were collected fasting and 30, 60 and 120 minutes following a standardized meal to assess total PYY, CCK, and total ghrelin concentrations.</p><p><strong>Results: </strong>Median fasting and post-prandial PYY concentrations were significantly higher in AN vs. HC with medium differences (p = .001-.006, r = .34-.43). Atypical AN had significantly higher PYY concentrations compared to HC at T-0 (p = .027, r = .29) only, and did not significantly differ from concentrations in AN (p = .105-.413, r = .11-.22). Area under the curve (AUC; p = .001; r = .41) and peak PYY concentrations (p = .003; r = .41) were also significantly higher in AN vs. HC with medium differences. There were no significant differences in fasting (p = .885) or post-prandial (p = .846-.993) CCK concentrations across groups. AN and Atypical AN each had significantly higher ghrelin concentrations than HC with small to medium effect (AN vs HC p = .004-.025, r = .27-.36; Atypical AN vs HC p = .004-.033; r = .28-.28).</p><p><strong>Conclusions: </strong>Higher peak postprandial concentrations of anorexigenic PYY in AN (compared to HC) may facilitate dietary restriction and contribute to maintenance of lower weight. Lack of CCK suppression in AN is maladaptive in the context of undernutrition. 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引用次数: 0
摘要
背景：食欲调节激素与神经性厌食症（AN）的病理生理有关，然而，关于AN体重谱上食欲调节激素的数据有限。我们的目的是调查空腹和餐后食欲调节激素的浓度-肽YY (PYY)，胆囊收缩素（CCK）和胃饥饿素-在青春期和年轻成年女性的AN体重谱中，特别是那些AN和非典型AN，以及健康对照（HC）。方法：参与者(N = 95；年龄11-22岁)，其中AN 33例，非典型AN 25例，HC 37例。AN与非典型AN的区别是BMI 2（≥18岁）。空腹和标准化餐后30,60和120 分钟采集血液样本，以评估总PYY， CCK和总胃饥饿素浓度。结果：AN组空腹和餐后PYY浓度中位数明显高于HC组，差异中等（p = .001-）。006年,r = .34点)。非典型AN在T-0时PYY浓度明显高于HC （p = ）。0.027, r = .29)，与AN浓度无显著差异（p = .105-）。413年,r = .11 .22)。曲线下面积(AUC；p = 措施;r = .41)和PYY峰值浓度(p = .003；r = .41)在AN和HC中也有显著升高，差异中等。各组间空腹（p = .885）和餐后（p = .846- 0.993）CCK浓度无显著差异。AN和非典型AN的ghrelin浓度均显著高于HC，且有小到中等的影响（AN vs HC p = .004-）。025年,r = 低位36;非典型AN vs HC p = .004-.033；r = 陈霞陈霞)。结论：与HC相比，AN中厌氧性PYY的餐后峰值浓度更高，可能有助于饮食限制并有助于维持较低体重。在营养不良的情况下，AN缺乏CCK抑制是不适应的。尽管持续的限制，胃饥饿素在AN中总体上是适应性较高的，可能不会因体重状况而有所区别。
Gut-derived appetite regulating hormones across the anorexia nervosa spectrum.
Background: Appetite-regulating hormones are implicated in anorexia nervosa (AN) pathophysiology, however, data are limited for appetite-regulating hormones across the AN weight spectrum. We aimed to investigate fasting and post-prandial concentrations of appetite-regulating hormones - peptide YY (PYY), cholecystokinin (CCK), and ghrelin - among adolescent and young adult females across the AN weight spectrum, specifically those with AN and Atypical AN, and healthy controls (HC).
Methods: Participants (N = 95; ages 11-22 years) included 33 with AN, 25 with Atypical AN, and 37 HC. AN was differentiated from Atypical AN by BMI < 10th percentile for age and sex (if <18 years) or < 18.5 kg/m2(if ≥18 years). Blood samples were collected fasting and 30, 60 and 120 minutes following a standardized meal to assess total PYY, CCK, and total ghrelin concentrations.
Results: Median fasting and post-prandial PYY concentrations were significantly higher in AN vs. HC with medium differences (p = .001-.006, r = .34-.43). Atypical AN had significantly higher PYY concentrations compared to HC at T-0 (p = .027, r = .29) only, and did not significantly differ from concentrations in AN (p = .105-.413, r = .11-.22). Area under the curve (AUC; p = .001; r = .41) and peak PYY concentrations (p = .003; r = .41) were also significantly higher in AN vs. HC with medium differences. There were no significant differences in fasting (p = .885) or post-prandial (p = .846-.993) CCK concentrations across groups. AN and Atypical AN each had significantly higher ghrelin concentrations than HC with small to medium effect (AN vs HC p = .004-.025, r = .27-.36; Atypical AN vs HC p = .004-.033; r = .28-.28).
Conclusions: Higher peak postprandial concentrations of anorexigenic PYY in AN (compared to HC) may facilitate dietary restriction and contribute to maintenance of lower weight. Lack of CCK suppression in AN is maladaptive in the context of undernutrition. Despite continued restriction, ghrelin is adaptively higher in AN overall and may not be differentiated by weight status.
期刊介绍：
Psychoneuroendocrinology publishes papers dealing with the interrelated disciplines of psychology, neurobiology, endocrinology, immunology, neurology, and psychiatry, with an emphasis on multidisciplinary studies aiming at integrating these disciplines in terms of either basic research or clinical implications. One of the main goals is to understand how a variety of psychobiological factors interact in the expression of the stress response as it relates to the development and/or maintenance of neuropsychiatric illnesses.
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