Association of macrophage inhibitory cytokine-1 with nutritional status, body composition and bone mineral density in patients with anorexia nervosa: the influence of partial realimentation

Abstract

BackgroundMacrophage inhibitory cytokine-1 (MIC-1) is a key inducer of cancer-related anorexia and weight loss. However, its possible role in the etiopathogenesis of nutritional disorders of other etiology such as anorexia nervosa (AN) is currently unknown.MethodsWe measured fasting serum concentrations of MIC-1 in patients with AN before and after 2-month nutritional treatment and explored its relationship with nutritional status, metabolic and biochemical parameters. Sixteen previously untreated women with AN and twenty-five normal-weight age-matched control women participated in the study. We measured serum concentrations of MIC-1 and leptin by ELISA, free fatty acids by enzymatic colorimetric assay, and biochemical parameters by standard laboratory methods; determined resting energy expenditure by indirect calorimetry; and assessed bone mineral density and body fat content by dual-energy X-ray absorptiometry. ANOVA, unpaired t-test or Mann-Whitney test were used for groups comparison as appropriate. The comparisons of serum MIC-1 levels and other studied parameters in patients with AN before and after partial realimentation were assessed by paired t-test or Wilcoxon Signed Rank Test as appropriate.ResultsAt baseline, fasting serum MIC-1 concentrations were significantly higher in patients with AN relative to controls. Partial realimentation significantly reduced serum MIC-1 concentrations in patients with AN but it still remained significantly higher compared to control group. In AN group, serum MIC-1 was inversely related to Buzby nutritional risk index, serum insulin-like growth factor-1, serum glucose, serum total protein, serum albumin, and lumbar bone mineral density and it significantly positively correlated with the duration of AN and age.ConclusionsMIC-1 concentrations in AN patients are significantly higher relative to healthy women. Partial realimentation significantly decreased MIC-1 concentration in AN group. Clinical significance of these findings needs to be further clarified.

Hyperinsulinemia acutely increases serum macrophage inhibitory cytokine‐1 concentration in anorexia nervosa and obesity

“…We reported higher fasting serum MIC‐1 levels in patients with AN in comparison with obese subjects and normal‐weight controls. Increased levels of MIC‐1 in AN were also observed in one recent study 11 . In our study, there were no differences in fasting MIC‐1 concentrations between obese women and controls.…”

“…In the present study, both baseline and postclamp MIC‐1 were inversely related to the body weight and BMI. Other investigators also found significant negative correlation between MIC‐1 concentration and BMI 11 . Additionally, elevated serum MIC‐1 concentrations in patients with AN were significantly reduced by partial realimentation, but it still remained significantly higher compared with controls 11 .…”

“…These data indicate that MIC‐1 is a potential regulator of food intake and body adiposity. The cachectic effect of MIC‐1 may be mediated via its specific interaction with the hypothalamic TGF‐β receptor II, stimulation of extracellular signal‐regulated kinase 1 and 2 and anorexigenic pro‐opiomelanocortin (POMC), and inhibition of orexigenic neuropeptide Y 11 . However, mechanisms regulating the endogenous MIC‐1 expression and the role of MIC‐1 in the modulation of energy homoeostasis are still unclear.…”

The Relationship between Insulin Resistance and the Cardiovascular Biomarker Growth Differentiation Factor-15 in Obese Patients

“…Nevertheless, these results suggest an indirect association between GDF-15 and insulin resistance, and the pathophysiological mechanisms that control postoperative GDF-15 concentrations remain unknown. It is interesting to note that GDF-15 concentrations also increase after diet-induced weight loss and in patients with anorexia nervosa (13,25 ). To date, it is not known whether circulating GDF-15 concentrations depend on albumin or any carrier proteins.…”

Study of salivary and serum vaspin and total antioxidants in anorexia nervosa

“…This is also reflected in measurements of single antioxidant markers such as albumin, apolipoprotein B, and uric acid [23,[25][26][27][28]. Diminished uric acid level was also observed in extended period of time after realimentation [29].…”