Adipokines, cortisol and cytokine alterations in recent onset anorexia nervosa. A case–control study

Abstract

Introduction: Psychological and neuroendocrine alterations are typical characteristics in anorexia nervosa patients. The role of adipokines and cytokines as mediators of body systems' adaptations to the patients' abnormal eating behavior is not well understood. The duration of disease seems to be a determinant of nutritional status and associated hormone changes. We aimed to assess whether alterations in adipokines, cytokines and cortisol do already exist in patients with a recent disease onset by means of a case-control study. Methods: Forty-one adolescent female patients on their first-episode and diagnosed with anorexia nervosa, were matched by age and socioeconomic status (SES) (1:1) with healthy girls.Leptin, soluble leptin receptor (sOB-R), adiponectin, cortisol, and the cytokines IL-1β, IL-2, IL-6 and TNF-α were examined. Results: The results showed reduced leptin and increased sOB-R and cortisol levels in AN patients. Adiponectin was also increased but opposite to the previous biomarkers did not correlate with BMI Z-score. Serum TNF-α and IL-2 showed significantly lower and higher values, respectively, in the AN patients than in the controls. Cortisol showed the strongest correlation with sOB-R (r= 0.436; P=0.005). Conclusions: Our study confirms previous findings on adipokine and cortisol alterations in AN patients, while overall cytokine results did not show a clear disruption in AN patients with short disease duration. The results highlight the need to disentangle the role of the sOB-R in the interactions between leptin and cortisol secretion.Introducción: Las alteraciones psicológicas y neuroendocrinas son típicas de las pacientes con anorexia nerviosa. El papel de las adipoquinas y citoquinas como mediadores de la adaptación del organismo al comportamiento alimentario alterado no es bien conocido. La duración de la enfermedad parece ser un determinante del estado nutricional y de los cambios hormonales asociados. Nuestro objetivo ha sido establecer si existen alteraciones de adipoquinas, citoquinas y cortisol en pacientes con un comienzo reciente de la enfermedad en un estudio caso-control. Métodos: Cuarenta y una chicas adolescentes diagnosticadas con anorexia nerviosa en su primer episodio fueron emparejadas por edad y estado socioeconómico (1:1) con adolescentes sanas. Se midieron leptina, receptor soluble de leptina, adiponectina, cortisol y las citoquinas IL-1β, IL-2, IL-6 y TNF-α. Resultados: Las pacientes con AN mostraron niveles reducidos de leptina y elevados de receptor de leptina y cortisol. La adiponectina también se observó elevada, pero al contrario que los otros marcadores no correlacionó con el Z-score del

Disease Characteristics and Psychiatric Comorbidities in Adolescents with Anorexia Nervosa Hospitalized During COVID-19 Pandemic

“…By contrast, other studies did not find any significant relationship between SES and AN [7,25,26]. In a Spanish cohort of patients with AN, 53.7% were in status V (highest SES), and 22% in status IV; the prevalence was not different from healthy adolescents, and no ethnic minority status was reported [27].…”

Lower serum levels of IL-1β and IL-6 cytokines in adolescents with anorexia nervosa and their association with gut microbiota in a longitudinal study

“…IL-1β and IL-6 were significantly increased in previous metanalyses ( 9 , 10 ) and some recent publications ( 19 , 47 , 55 ); however, several current studies could not reproduce these findings or only reproduced them partially ( 10 , 25 , 47 , 56 ). Again, findings in adolescents were mixed ( 20 , 36 , 37 ). Interestingly, while the study with the relatively older adolescent sample found an increase in IL-1β and IL-6 ( 20 ), in the two younger samples of the three with the shorter duration of illness, only IL-1β was increased ( 36 ) or IL-1β did not differ and IL-6 even showed a tendency to be decreased ( p = 0.152) ( 37 ).…”

“…This effect had been found in two large metanalyses ( 9 , 10 ) and several studies since ( 19 , 20 , 23 , 47 ). However, there is also a very well-controlled recent report challenging this finding ( 27 ), and adolescent findings are mixed ( 20 , 36 , 37 ). Elevated TNF-α serum levels decreased during short-term weight recovery in our sample and were no longer significantly altered at discharge.…”

“…Again, findings in adolescents were mixed (20,36,37). Interestingly, while the study with the relatively older adolescent sample found an increase in IL-1β and IL-6 (20), in the two younger samples of the three with the shorter duration of illness, only IL-1β was increased (36) or IL-1β did not differ and IL-6 even showed a tendency to be decreased (p = 0.152) (37). This might point toward younger and not so chronically ill patients with AN not (yet?)…”

“…However, there exist only three prior studies on cytokines in adolescents with AN. They, again, showed contradicting findings of increased IL-1β and TNF-α ( 36 ) and of increased TNF-α, IL-1β and IL-6 ( 20 ) vs. lower TNF-α and unchanged IL-1β and IL-6 in acutely ill patients ( 37 ).…”