J Hebebrand, WF Blum, N Barth, H Coners, P Englaro, A Juul, A Ziegler, A Warnke, W Rascher, H Remschmidt Departments of Child and Adolescent Psychiatry and Medical Biometry, University of Marburg; Lilly GmbH, Germany; Children's Hospital, University of Giessen; Department of Child and Adolescent Psychiatry, University of WYrzburg, Germany, and Rikshospitalet, Copenhagen, Denmark.
In female patients with acute anorexia nervosa, plasma leptin concentrations are well below those of female controls matched for age, body mass index, and/or percent body fat. The low levels presumably reflect the restricted energy intake of these patients. The reduced leptin synthesis is likely to be involved in the pathogenesis of amenorrhea and the reduced metabolic state of acutely ill individuals. Weight gain leads to steep increases in leptin synthesis, resulting in leptin plasma levels that peak at values well in excess of those of female controls. This phenomenon might underlie increased energy expenditure which has previously been observed upon short-term weight restoration. At this stage patients might therefore be especially vulnerable to renewed weight loss. Leptin levels drop into the control range several weeks after attainment of the target weight, indicating normalization. In patients who subsequently lose weight anew leptin levels again drop below the control range.
For further information, please contact the corresponding author, Professor Johannes Hebebrand at the University of Marburg, Germany; e-mail: Hebebran@post.med.uni-marburg.de ; Tel.: +49-6421-286466; Fax: +49-6421-283056. The relevance of these findings is independently reviewed in an editorial to be published in the same issue of Molecular Psychiatry by the journal editor, Julio Licinio, M.D.; phone: 301-496-6885; FAX: 301-402-1561; e-mail: licinio@nih.gov
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Molecular Psychiatry