Endogenous ghrelin linked to weight gain in anorexia nervosa

Key takeaways:

• High ghrelin levels were associated with later weight gain in girls and women with anorexia nervosa.
• Additional research should assess ghrelin’s clinical utility in anorexia nervosa.

Among girls and women with anorexia nervosa, endogenous ghrelin was associated with weight gain, according to findings published in JAMA Network Open.

Youngjung R. Kim, MD, PhD, an instructor in psychiatry at the Center for Quantitative Health at Massachusetts General Hospital and Harvard Medical School in Boston, and colleagues prospectively enrolled girls and women aged 10 to 22 years from April 2014 to March 2020. At baseline, 9-month and 18-month study visits, researchers collected anthropometric measurements and fasting blood samples. After the fasting blood draw, participants ate a 400-kcal meal and provided blood samples 30 minutes, 1 hour and 2 hours after they began eating. Plasma from blood samples was used to measure ghrelin levels.

Among 68 participants who attended all visits, 35 (median age, 20.1 years) had anorexia nervosa and 33 (median age, 18.7 years) did not and were considered healthy controls. Participants with anorexia nervosa had lower BMI percentiles at all visits and higher ghrelin area under the curve (AUC) at baseline compared with healthy controls.

Multivariable analyses revealed that baseline ghrelin AUC was significantly associated with weight gain over the follow-up period (adjusted OR = 2.35; 95% CI, 1.43-3.73). Analyses were robust in regression modeling.

“Our finding that ghrelin is associated with longitudinal weight gain in anorexia nervosa is in stark contrast to prior longitudinal investigations in other human populations, and this is the first, to our knowledge, to report this association in those older than infants,” Kim and colleagues wrote.

Future studies should enroll larger, more diverse populations to confirm the findings, according to the researchers.