Endocrine Abstracts

Introduction: The ghrelin suppressive effect of food is well established in normal subjects, whereas the effectiveness of meals in decreasing plasma ghrelin in patients with anorexia nervosa (AN) is still debated. Based on the above, we elected to study the ghrelin dynamics after food or placebo in a group of anorectic girls at the moment of diagnosis and after weight recuperation.

Study design: Nine anorectic women (age 14–32 years) were studied. Both in the acute phase of the disease and after 2–6 months of nutritional rehabilitation, in each patient, on two separate occasions and in random order, plasma total ghrelin was measured along the two hours following the ingestion of a 585 kcal meal or fiber as placebo.

Results: Nutritional rehabilitation induced a significant increase in mean BMI (from 15.2±0.35 to 16.9±0.34 kg/m², P < 0.01). Both in the acute and recovery phases of AN, fiber consumption failed to significantly modify ghrelin levels (from 1433.5±393.00 to 1240.3±273.24 pg/ml, NS, and from 1090.0±279.86 to 1084.6±252.89 pg/ml, NS respectively). In both phases of the disease, food significantly reduced circulating ghrelin (from 1294.1±270.51 to 929.2±203.55 pg/ml, P< 0.01, and from 1294.3±320.66 to 927.8±252.07 pg/ml, P<0.01 respectively), and this decrease was of the same entity in the acute (to 74.3±5.32% of baseline) and the recovery (to 72.0±3.52% of baseline) phases. At diagnosis the mean absolute ghrelin decrease induced by meal was significantly greater than that following fiber (364.8±99.70 vs 193.1±125.09 pg/ml, P< 0.01), and the same held true after weight gain (366.4±82.84 vs 5.3±70.26 pg/ml, P<0.01).

Comment: The ghrelin suppressive effect of food appears to be maintained in the acute phase of AN and no changes can be seen after significant weight gain during nutritional rehabilitation.