Comparison of a high-carbohydrate and high-protein breakfast effect on plasma ghrelin, obestatin, NPY and PYY levels in women with anorexia and bulimia nervosa

Abstract

BackgroundThe present study investigated plasma levels of gut-brain axis peptides ghrelin, obestatin, NPY and PYY after consumption of a high-carbohydrate (HC) and high-protein (HP) breakfast in patients with anorexia nervosa, bulimia nervosa and in healthy controls. These peptides play an important role in regulation of energy homeostasis and their secretion is disturbed under condition of eating disorders. As various types of consumed macronutrients may induce different plasma hormone responses, so we examined these responses in women patients with eating disorders and compared them with those of healthy controls.MethodsWe examined plasma hormone responses to HC and HP breakfast in patients with AN (n = 14; age: 24.6 ± 1.8 years, BMI: 15.3 ± 0.7), BN (n = 15; age: 23.2 ± 1.7 years, BMI: 20.5 ± 0.9) and healthy controls (n = 14; age: 24.9 ± 1.4 years, BMI: 21.1 ± 0.8). Blood samples were drawn from the cubital vein, the first blood drawn was collected before meal, and then 30, 60, 90, 120 and 150 min after breakfast consumption. Plasma hormone levels were determined by commercially available RIA kits.ResultsFasting and postprandial plasma obestatin levels were significantly increased in both AN and BN patients, while plasma ghrelin levels were significantly increased in AN patients only. After breakfast consumption, plasma levels of ghrelin and obestatin decreased, although they were still above the range of values of healthy controls. Fasting NPY plasma levels were significantly increased in AN and BN patients and did not change postprandially. Fasting PYY levels were comparable in AN, BN and healthy controls, but postprandially significantly increased after HP breakfast in AN and BN patients. Different reactions to breakfast consumption was found for ghrelin and PYY among investigated groups, while for obestatin and NPY these reactions were similar in all groups.ConclusionsSignificant increase of obestatin and NPY in AN and BN patients may indicate their important role as the markers of eating disorders. Different reactions of ghrelin and PYY to breakfast consumption among groups suggest that role of these hormones in regulation of energy homeostasis can be adjusted in dependence to acute status of eating disorder.

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

“…However, significantly elevated plasma concentrations of NPY in patients with BN as compared with matched controls have been repeatedly reported by one research group (Sedlackova et al, 2011(Sedlackova et al, , 2012. CSF concentrations of NPY were found to be normal during both the symptomatic phase and after recovery from BN (Gendall et al, 1999).…”

Endocrine consequences of anorexia nervosa

“…It is unknown whether all changes in these peptides are adaptive to starvation and return to normal with sustained weight recovery, or whether some may play a role in the pathogenesis of AN. Levels of ghrelin and peptide YY (PYY) are higher in AN compared with normal-weight controls 34, 42, 58 , although studies have also reported unchanged 59 or lower 60 PYY. Ghrelin is an orexigenic hormone (in addition to being a GH secretagogue), and is secreted by the oxyntic cells of the stomach 61 .…”

“…Higher fasting and overnight ghrelin levels have been reported in AN 34, 42, 62 , associated inversely with BMI, fat mass, and insulin. Studies have reported differences in ghrelin levels in restrictive vs. binge-purge forms of AN (AN-R vs. AN-BP) vs. bulimia nervosa (BN), with ghrelin levels (compared to controls) being higher in AN-R 59, 60 , unchanged in BN 59 , and lower in AN-BP 60 . Obestatin, a ghrelin gene product that inhibits appetite and gastric motility, is also increased in adults with AN 59, 60 , and positively associated with ghrelin 63, 64 .…”

Anorexia Nervosa and Its Associated Endocrinopathy in Young People

“…PYY , an anorexigenic hormone, is increased in adults and adolescents with AN compared with controls (44, 47), although some studies in adults report unchanged (48) or lower (49) levels. Lower fat mass correlates with higher PYY levels (47).…”