Entero-insular axis in children with anorexia nervosa

Tomasik, Przemysław; Sztefko, Krystyna; Starzyk, Jerzy; Rogatko, Iwona; Szafran, Z

doi:10.1016/j.psyneuen.2004.10.003

Cited by 35 publications

(29 citation statements)

References 24 publications

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“…Persistently elevated levels of PP in response to food intake in AN may suggest alterations in vagal responsivity to food ingestion in this patient population and are consistent with a possible role for PP as a contributor to the pathophysiology and maintenance of AN. Further evidence for alterations in meal-related PP release in AN comes from two studies, by Tomasik et al (42) and Uhe et al (45), in which elevated PP release was observed in response to a solid meal in underweight AN subjects. Both of these studies, however, failed to specify the subtype of AN subjects tested.…”

Section: Discussionmentioning

confidence: 96%

“…In the case of glucose levels and insulin secretion in AN, for example, mixed results may be attributed to the use of oral glucose tolerance tests (OGTT) or liquid meals (10,39,47) rather than a mixed macronutrient solid meal representative of what patients are fed in a standard behavioral treatment program for AN. Furthermore, most studies have administered a test meal or OGTT only at the start of treatment in the starved state (39,47) or have failed to specify at what point in refeeding subjects were tested (42). When studies have examined responses to a solid meal they have often been limited to sample sizes of less than 10 subjects per group (see Ref.…”

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confidence: 99%

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Insulin, glucose, and pancreatic polypeptide responses to a test meal in restricting type anorexia nervosa before and after weight restoration

Kinzig¹,

Coughlin²,

Redgrave³

et al. 2007

American Journal of Physiology-Endocrinology and Metabolism

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Prolonged malnutrition in individuals with anorexia nervosa (AN) has been associated with alterations in endocrine function that may play a sustaining role in the disorder. We hypothesized that abnormalities in endocrine responses to ingestion of a meal in AN are reversible and depend on weight restoration. We measured meal-induced endocrine responses in AN subjects at three time points during hospitalization: before refeeding (n ϭ 13, mean BMI 16.7 kg/m 2 ), after 2 wk of refeeding (mean BMI 18.0 kg/m 2 ), and in the weight-restored state (mean BMI 20.3 kg/m 2 ). Control subjects (n ϭ 13, BMI 19 -24.9 kg/m 2 ) were tested once. Tests were 2.5-h sessions in which blood was drawn every 15 min before, during, and after a ϳ650-kcal test breakfast. Relative to controls, peak levels of glucose were depressed and peak levels of insulin in response to ingestion of the test meal were delayed, with response patterns in the third trial most similar to controls. Pancreatic polypeptide (PP) levels were increased in AN relative to controls regardless of weight status. The delay in insulin release and elevated PP levels did not correct with short-term refeeding and may contribute to the high relapse rates and maintenance of AN.eating disorders; pancreatic function; refeeding ANOREXIA NERVOSA (AN) is a highly morbid pathological condition with the highest mortality rate among psychiatric disorders (35,46). This disorder is characterized by multiple metabolic and endocrine abnormalities, including failure of the homeostatic responses to malnutrition and semistarvation. Although most of these alterations are believed to be state related and to reverse with weight restoration, some may be traitrelated vulnerability factors that differentiate at-risk individuals. Whether trait or state related, some of these alterations may play a role in sustaining the rewarding nature of restricting behavior, thereby acting as mediators for AN.Unlike starvation, AN is characterized by an excess of both orexigenic and anorexigenic signaling, indicating dysregulation of hunger and satiety (25). Reduced hunger and desire to eat, coupled with increased fullness and satiety after a test meal, have been reported in AN (21, 31), although the capacity to respond to physiological hunger and satiety cues may not be entirely absent (11,32). Delayed gastric emptying and intestinal transit times are likely contributors to the reports of increased fullness and satiety after meals (8,13,22,24,26). Some investigators argue that these findings reflect tight cognitive control of normal appetite. However, relative to healthy comparison women, those with AN show reduced salivation, a heightened autonomic response to food, and fear and disgust in response to images of food (27,43), suggesting conditioned responses similar to those seen in simple phobias.Knowledge regarding signals and systems involved in mealto-meal regulation of food intake is rapidly expanding. Although newly found systems are studied exhaustively as they relate to obesity, their roles and respons...

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Section: Discussionmentioning

confidence: 96%

mentioning

confidence: 99%

Insulin, glucose, and pancreatic polypeptide responses to a test meal in restricting type anorexia nervosa before and after weight restoration

Kinzig¹,

Coughlin²,

Redgrave³

et al. 2007

American Journal of Physiology-Endocrinology and Metabolism

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“…Tomasik et al . demonstrated higher [53], and Stock et al . demonstrated lower [54], mean fasting GIP levels in adolescents with anorexia nervosa compared to controls.…”

Section: Discussionmentioning

confidence: 99%

Reduced amylin levels are associated with low bone mineral density in women with anorexia nervosa

Wojcik

Meenaghan

Lawson

et al. 2010

Bone

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Context-Anorexia nervosa, characterized by extreme low body weight due to reduced nutrient intake, is associated with severe bone loss. Peptide hormones, including amylin, GIP, and GLP2, are released immediately after nutrient intake and may be involved in the regulation of bone turnover.Objective-To investigate fasting levels of amylin, GIP, and GLP2 and their relationships with bone mineral density (BMD) in women with anorexia nervosa compared to healthy controls. Design-Cross-sectional Setting-Clinical Research CenterStudy Participants-15 women with anorexia nervosa and 16 healthy controls Intervention-NoneMain Outcome Measures-Fasting serum amylin, GIP, and GLP2, and BMD Results-Women with anorexia nervosa had significantly lower fasting serum amylin and GIP levels than healthy controls. Fasting serum GLP2 levels were not significantly different between groups. Fasting amylin levels were positively associated with BMD and Z-score at the PA spine, total hip, and femoral neck. Fasting amylin levels were also positively associated with weight and percent fat; after controlling for these variables, amylin was still a significant predictor of BMD and Z-score at the femoral neck and of Z-score at the total hip. In the anorexia nervosa group, there was a trend toward an inverse association between amylin and C-terminal telopeptide (CTX) levels (R = −0.47, p = 0.08). GIP and GLP2 levels did not predict BMD at any site.Conclusion-Decreased secretion of amylin may be a mechanism through which reduced nutrient intake adversely affects BMD in anorexia nervosa.

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“…In the oral glucose tolerance test, insulin output has been demonstrated to be lower in AN than in controls (Tomasik, Sztefko, Starzyk, Rogatko, & Szafran, 2005). These alterations resolve after refeeding and weight gain (Dostálová et al, 2007).…”

Section: Insulinmentioning

confidence: 99%

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

Tortorella

Brambilla

Fabrazzo

et al. 2014

Euro Eating Disorders Rev

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A large body of literature suggests the occurrence of a dysregulation in both central and peripheral modulators of appetite in patients with anorexia nervosa (AN) and bulimia nervosa (BN), but at the moment, the state or trait-dependent nature of those changes is far from being clear. It has been proposed, although not definitively proved, that peptide alterations, even when secondary to malnutrition and/or to aberrant eating behaviours, might contribute to the genesis and the maintenance of some symptomatic aspects of AN and BN, thus affecting the course and the prognosis of these disorders. This review focuses on the most significant literature studies that explored the physiology of those central and peripheral peptides, which have prominent effects on eating behaviour, body weight and energy homeostasis in patients with AN and BN. The relevance of peptide dysfunctions for the pathophysiology of eating disorders is critically discussed.

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Entero-insular axis in children with anorexia nervosa

Cited by 35 publications

References 24 publications

Insulin, glucose, and pancreatic polypeptide responses to a test meal in restricting type anorexia nervosa before and after weight restoration

Insulin, glucose, and pancreatic polypeptide responses to a test meal in restricting type anorexia nervosa before and after weight restoration

Reduced amylin levels are associated with low bone mineral density in women with anorexia nervosa

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

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