Physical Activity and Restlessness Correlate with Leptin Levels in Patients with Adolescent Anorexia Nervosa

Department of Child and Adolescent Psychiatry and Psychotherapy, RWTH Aachen University, Aachen, Germany.
Biological Psychiatry (Impact Factor: 10.26). 09/2006; 60(3):311-3. DOI: 10.1016/j.biopsych.2005.11.001
Source: PubMed


In food-restricted rats, leptin suppresses semistarvation-induced hyperactivity (SIH) and decreases exploratory behavior. Leptin ameliorates anxiety-related movement in ob/ob mice. In this study, we assessed the relationship between leptin and qualities of physical activity and restlessness in acute anorexia nervosa (AN).
Serum leptin, body mass index (BMI), % body fat, and self- and expert-ratings of qualities of physical activity and restlessness were assessed in 26 inpatients with acute AN. Accelerometry was also performed. Regression analyses were used to predict activity and restlessness using BMI, % body fat, and leptin levels as predictor variables.
Leptin levels significantly contributed to the prediction of all measures of activity and restlessness.
This is the first study linking hypoleptinemia in AN patients to subjective and objective measures of higher physical activity and motor and inner restlessness. Leptin may directly or indirectly (or both) influence behaviors and cognitions contributing to hyperactivity and motor restlessness.

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    • "Three studies had both outpatients and inpatients in their study population (Kostrzewa et al., 2013; Carrera et al., 2012; Keyes et al., 2015). Two of the trials explicitly focused on long-standing patients (Bratland-Sanda, Sundgot-Borgen, et al., 2010b; Bratland-Sanda, Sundgot-Borgen, Rosenvinge, et al., 2010), and one focused on acute AN patients (Holtkamp et al., 2006). In two studies, patients with ED in general were assessed, comparing AN, bulimia nervosa and eating disorders not otherwise specified (Bratland-Sanda, Sundgot-Borgen, Rosenvinge, et al., 2010; Bratland-Sanda, Sundgot- Borgen, et al., 2010b). "
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    ABSTRACT: High level physical activity is a frequent symptom in patients with anorexia nervosa (AN), influencing the development, maintenance, complications, treatment success, relapse rate and severity of the disease. Accelerometry is assumed to be an objective method to assess physical activity (PA) in AN. We aimed to review objectively measured levels of PA in AN and to give an overview for clinical practice and future research. Data were searched in PubMed and PsychINFO until April 2015 following the preferred reporting items for systematic reviews and meta-analyses statement. Twenty studies fulfilled the inclusion criteria. A notable heterogeneity of measurements, outcomes, participants and settings was found. Overall, HLPA is not adressed enough by current evidence. A common valid terminology of HLPA is not available, and accurate criteria of different levels of PA must be defined to create comparability of future studies. Further objective PA assessments are needed to improve treatment outcome and relapse rate. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    European Eating Disorders Review 06/2015; 23(5). DOI:10.1002/erv.2377 · 2.46 Impact Factor
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    • "This finding is partly in contrast to other studies [31-33] and may be due to our limited sample size, and the fact that our patient sample demonstrated a heterogeneous sample of under/normal - and over exercisers. However, Holtkamp et al., 2006 [32] also showed an inverted U shape association so that the authors concluded that AN hyperactivity related to hypoleptinemia cannot be conceptualized as a single mode of behavior. "
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    ABSTRACT: Excessive physical activity is one of the most paradoxical features of anorexia nervosa (AN). However, there is individual variation in the degree of physical activity found in AN-patients. As a result, marked differences in energy expenditure may be expected. Furthermore, exercise has a positive impact on a variety of psychological disorders and the psychopathology may be different in AN displaying high exercise levels versus AN displaying low exercise levels. We analyzed the energy metabolism and psychological data in low-level exercise and high-level exercise AN-patients compared with healthy, age matched controls. REE was decreased in AN-patients compared with controls but not when adjusted for body surface area or lean body mass. No differences in TDEE between AN- patients and controls were observed. Subgroup analyses showed that the percentage of high-level AN- exercisers was higher compared with controls. This subgroup had increased resting EE, total daily EE and scored higher on depression and the EDI-item "Drive for thinness" compared with low-level AN-exercisers. We identified a significant subgroup of high-level AN-exercisers (66%) with consecutive increased energy requirements. An easy way for clinicians to assess the amount of exercise before and in the course of treatment is a single question in the established Eating Disorder Inventory-SC (EDI-SC).
    Journal of Eating Disorders 09/2013; 1(1):37. DOI:10.1186/2050-2974-1-37
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    • "Considering main physiologic characteristics, reduced body weight in AN, it is not surprising to see a significant reduction in leptin levels, as leptin is an adipose-derived hormone (Leibowitz and Wortley, 2004; Wynne et al., 2005). AN patients also exhibits reduced leptin levels in plasma and cerebrospinal fluid (CSF) (Exner et al., 2000; Holtkamp et al., 2006). Upon leptin administration to ABA rodents or AN patients, hyperactivity was suppressed (Hillebrand et al., 2005). "
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    ABSTRACT: Feeding is a fundamental process for basic survival and is influenced by genetics and environmental stressors. Recent advances in our understanding of behavioral genetics have provided a profound insight on several components regulating eating patterns. However, our understanding of eating disorders, such as anorexia nervosa, bulimia nervosa, and binge eating, is still poor. The animal model is an essential tool in the investigation of eating behaviors and their pathological forms, yet development of an appropriate animal model for eating disorders still remains challenging due to our limited knowledge and some of the more ambiguous clinical diagnostic measures. Therefore, this review will serve to focus on the basic clinical features of eating disorders and the current advances in animal models of eating disorders.
    Neuroscience 03/2012; 211:2-12. DOI:10.1016/j.neuroscience.2012.03.024 · 3.36 Impact Factor
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