ESPE Abstracts

Introduction: Anorexia nervosa (AN) is a psychiatric disorder affecting mainly adolescents and young women, characterized by a restriction of energy intake leading to malnutrition, serious medical complications and high mortality. Until now the etiology of AN remains unknown and seems to be multifactorial. Patients with AN develop endocrine disorders related to disturbances of energy metabolism. Nesfatin-1 and glucagon-like peptide-1 (GLP-1) are involved in the regulation of hunger and satiety. Nesfatin-1 is an anorexigenic neuropeptide, expressed in peripheral tissues and the central nervous system, highly associated with anxiety. It was shown that intracerebroventricular injection of nesfatin-1 decreases food intake whereas injection of an antibody-neutralizing nesfatin-1 promotes appetite. GLP-1 is an incretin hormone, released in response to nutrients in the small intestine and directly affects the satiety centre. Peripheral administration of GLP-1 slows gastric emptying and reduces food intake.

Aim: The main aim of the study was to assess the fasting concentrations of nesfatin-1 and GLP-1 in teenagers suffering from anorexia nervosa compared to the healthy population and obese individuals and to evaluate the relation of serum nesfatin-1 and GLP-1 levels with metabolic and anthropometric parameters in adolescents.

Materials and Methods: Fasting concentrations of nesfatin-1 and GLP-1 were measured in 3 groups of adolescent girls: normal weight (n = 88), obese (n = 52) and AN (n = 58). Median age was 14.9±1.55 for AN group, 14.4±2.34 for obese group and 16.6±1.21 for the healthy controls. Serum nesfatin-1 and GLP-1 concentrations were assayed by ELISA. Lipid profile, fasting blood glucose and insulin levels were measured as metabolic parameters. The study was approved by the Local Ethics Committee.

Results: AN girls had significantly lower nesfatin-1 level (1.7±0.22 vs 2.24±0.35 ng/ml, P <0.05) and higher GLP-1 concentration (9.94±1.9 vs 5.28±3.56 pmol/l, P <0.05) than those of the control subjects. Obese girls have significantly lower nesfatin-1 concentrations than AN group (1.56±0.34 vs 1.7±0.22 ng/ml, P <0.05) and the highest concentrations of GLP-1 (13.3±3.79 pmol/l). No significant correlation was found between nesfatin-1, GLP-1 values and BMI.

Conclusion: The present study is the first to evaluate nesfatin-1 levels in relation with anthropometric and metabolic parameters in adolescent girls with anorexia nervosa, who were subsequently found to have significantly lower nesfatin-1 levels, as we suggest in a response to starvation. Higher GLP-1 levels in AN group may contribute to reduced food intake in that group.