Increase in Energy Intake Leads to a Decrease in Obestatin in Restricting-Type of Anorexia Nervosa

Abstract

Restricting-type of anorexia nervosa (AN-R) is a serious disorder affecting adolescents and young adults, and decreases quality of life over 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. Obestatin plays an important role in the regulation of growth hormone release, appetite, and energy metabolism. However, the progress of these patients and changes in the levels of obestatin during treatment were not reported. The purpose of this study was to determine the changes in obestatin levels when energy intake increases in AN-R patients. As a result, obestatin was higher in AN-R patients than in control subjects as well as acyl ghrelin and des-acyl ghrelin. An increase in the intake calorie has decreased obestatin as well as des-acyl ghrelin. These findings indicate that the obestatin is an important factor in the diagnosis and treatment of AN-R, similarly to acyl ghrelin and des-acyl ghrelin. In the future, the research on the clinical application of the ghrelin peptide family and the receptor will be expected to progress.

Central and Peripheral Peptides Regulating Eating Behaviour and Energy Homeostasis in Anorexia Nervosa and Bulimia Nervosa: A Literature Review

“…Glucagon-like peptides (GLP) Tomasik et al (2002Tomasik et al ( , 2004, Brambilla et al (2009) Gendall et al (1999), Monteleone, Di Lieto, Tortorella, Longobardi, and Maj (2000), Monteleone, Bortolotti, et al (2000), Monteleone, Fabrazzo, et al (2002), Monteleone, Martiadis, et al (2002), Djurovic et al (2004), Haas et al (2005) Plasma leptin ↓ → →↓↑ Plasma leptin (response to test meal) → Plasma leptin (response to acute fasting) ↓ Monteleone, Castaldo, et al (2008), Monteleone, Serritella, et al (2008), Nakahara et al (2008), Germain et al (2010), Harada et al (2008), Uehara et al (2011) Gendall et al (1999), Kojima et al (2005), Stock et al (2005), , Misra et al (2006), Nakahara et al (2007), Germain et al (2007Germain et al ( , 2010 synaptic connectivity and neuronal repair. Subsequent research has unequivocally demonstrated that this neurotrophin has a role also in energy homeostasis, because it acts as an inhibitor of food intake.…”

The Role of “Mixed” Orexigenic and Anorexigenic Signals and Autoantibodies Reacting with Appetite-Regulating Neuropeptides and Peptides of the Adipose Tissue-Gut-Brain Axis: Relevance to Food Intake and Nutritional Status in Patients with Anorexia Nervosa and Bulimia Nervosa

“…Germain et al [93] revealed that total and acylated ghrelin and obestatin circadian levels are increased in patients with AN restrictive type compared with the controls but decreased in patients with AN binge eating/purging type and those with BN. Recently, Uehara et al [137] reported that an increase in energy intake leads to a decrease in plasma obestatin levels in patients with AN restrictive type (Table 2). …”

The Role of Ghrelin, Salivary Secretions, and Dental Care in Eating Disorders

“…Previous studies have shown that the total plasma ghrelin levels in AN patients (of both subtypes) are higher than those of controls [71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87]. In one study, acyl ghrelin levels were decreased after an oral glucose tolerance test in both subsets of AN patients and control subjects, whereas postprandial decline of plasma acyl ghrelin response to the oral glucose tolerance test was blunted in female patients with AN relative to control subjects [88].…”

“…Plasma obestatin was also found to be significantly higher in AN-R patients, whereas they were decreased during increased food intake in patients with AN-R [75,88,92]. In addition, plasma obestatin levels were higher in AN patients than in thin, body mass index-matched women with normal obestatin levels [87].…”

“…However, recent evidence suggests that an effective pharmacotherapeutic strategy for AN has yet to be established. Recent studies have shown that the acyl ghrelin/des-acyl ghrelin obestatin balance could be essential for adaptation of the body to nutritional changes [75,88,140]. The aforementioned ghrelin gene products are likely to be part of the promising pharmacotherapeutic approach for achieving energy homeostasis in eating disorder patients.…”