Low Fasting Oxytocin Levels Are Associated With Psychopathology in Anorexia Nervosa in Partial Recovery

Abstract

Objective: Anorexia nervosa (AN), a psychiatric disorder characterized by restriction of food intake despite severe weight loss, is associated with increased comorbid anxiety and depression. Secretion of oxytocin, an appetite-regulating neurohormone with anxiolytic and antidepressant properties, is abnormal in AN. The link between oxytocin levels and psychopathology in AN has not been well explored. Methods: We performed a cross-sectional study of 79 women aged 18–45 years (19 AN, 26 AN in partial recovery [ANPR], and 34 healthy controls [HC]) investigating the relationship between basal oxytocin levels and disordered eating psychopathology, anxiety, and depressive symptoms. AN diagnoses were based on DSM-5 criteria. Data acquisition took place between December 2008 and March 2014. Fasting serum oxytocin levels were obtained, and the following self-report measures were used to assess psychopathology: Eating Disorder Examination Questionnaire, State-Trait Anxiety Inventory, and Beck Depression Inventory-II. Results: Fasting oxytocin levels were low in ANPR compared to HC (p=0.0004). In ANPR but not AN, oxytocin was negatively associated with disordered eating psychopathology (r=−0.39, p=0.0496) and anxiety symptoms (state anxiety: r=−0.53, p=0.006; trait anxiety: r=−0.49, p=0.01). Furthermore, ANPR with significant disordered eating psychopathology, anxiety symptoms, or depressive symptoms had lower oxytocin levels compared to those with minimal or no symptoms (p=0.04, 0.02, and 0.007, respectively). Conclusion: We speculate that a dysregulation of oxytocin pathways may contribute to persistent psychopathology after partial weight recovery from anorexia nervosa.

Low oxytocin levels are related to alexithymia in anorexia nervosa

“…Further, oxytocin administration increases the sharing of emotional experiences with others (Lane et al, ). We have reported low basal serum oxytocin levels (compared to healthy women, H) in women with AN (Lawson et al, ) and those with a history of AN who are now weight‐restored and in partial or full recovery (AN‐WR; Afinogenova et al, [same study sample as described here]; Lawson et al, ). These data imply that basal oxytocin levels may be low in women with AN regardless of weight status and raise the question of whether low oxytocin levels may contribute to symptoms.…”

“…Table shows clinical characteristics as reported in Afinogenova et al (). Self‐reported mean time since recovery of AN‐WR was 40.8 ± 6.6 months (range: 5–104 months).…”

“…Serum was stored at −80°C. Oxytocin was measured in unextracted serum by ELISA (Assay Designs, Inc., Ann Arbor, MI; Afinogenova et al, ). We have demonstrated a robust correlation between extracted and unextracted serum oxytocin levels (Lawson et al, ).…”

Oxytocin‐like signaling in ants influences metabolic gene expression and locomotor activity

“…OT is involved in the regulation of appetite (63, 64). Additionally, the eating disorder anorexia nervosa (65) and hyperphagia during pregnancy (66) are related to imbalanced OT levels. Here we determined that the OT/VP signaling system in ants is involved in locomotor activity, feeding, and metabolism: 1 ) high expression of the receptor was monitored throughout the body and especially in organs linked to food metabolism and energy storage (crop-proventriculus, rectum-gut, and fat body) in all castes; 2 ) dense, VP-positive branches were present in the contact area of the SEG and esophagus as well as in thoracic and abdominal ganglia, and presumably this allowed inotocin to be released into the hemolymph, acting as an endocrine hormone being capable of reaching all organs; 3 ) starvation and winter conditions led to down-regulation of IP expression; 4 ) mRNA-seq of IP-KD ants yielded information about several differentially expressed genes involved in fat, protein, and DNA metabolism; and 5 ) more IP-KD ants were found to be feeding as compared with controls.…”

Toward valid and reliable brain imaging results in eating disorders

“…For example, in restrictive eating disorders such as anorexia nervosa, chronic starvation may lead to hypothalamic amenorrhea with hypoestrogenemia, low testosterone levels, hypercortisolemia, growth hormone resistance (high growth hormone, but low downstream IGF‐1 levels), and altered secretion of appetite‐regulating hormones (e.g., low anorexigenic hormones leptin and oxytocin; high orexigenic ghrelin [Culbert, Racine, & Klump, ; Misra & Klibanski, ] and AGRP [Merle et al, ]). While many hormonal alterations in response to low‐weight are adaptive (i.e., to stimulate food consumption and/or conserve limited resources) and resolve with weight restoration, evidence of seemingly paradoxical hormone levels in some cases (e.g., high levels of anorexigenic PYY) and persistent abnormalities after weight gain (e.g., in PYY [Misra et al, ; Nakahara et al, ; Pfluger et al, ]), ghrelin (Holsen, Lawson, Christensen, Klibanski, & Goldstein, ; Nakahara et al, ), oxytocin (Afinogenova et al, ), hypothalamic–pituitary–adrenal axis (e.g., cortisol) (Grinspoon et al, ; Lawson et al, ; Mayer et al, ) argue for a potential etiologic role versus scar or delayed recovery from chronic starvation, or effects of residual psychopathology (Misra & Klibanski, ). Endocrine changes, including reproductive dysfunction, activation of the hypothalamic–pituitary–adrenal axis, and differences in secretion of appetite‐regulating hormones, have also been demonstrated in other eating disorders, such as bulimia nervosa and binge‐eating disorder (Culbert et al, ; Poyastro Pinheiro et al, ).…”