Seitz Jochen, Bühren Katharina, Biemann Ronald, Timmesfeld Nina, Dempfle Astrid, Winter Sibylle Maria, Egberts Karin, Fleischhaker Christian, Wewetzer Christoph, Herpertz-Dahlmann Beate, Hebebrand Johannes, Föcker Manuel
Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital, RWTH University Aachen, Neuenhofer Weg 21, 52074, Aachen, Germany.
Institute for Clinical Chemistry and Pathochemistry, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.
Eur Child Adolesc Psychiatry. 2016 Sep;25(9):1019-25. doi: 10.1007/s00787-016-0819-4. Epub 2016 Feb 5.
Elevated serum leptin levels following rapid therapeutically induced weight gain in anorexia nervosa (AN) patients are discussed as a potential biomarker for renewed weight loss as a result of leptin-related suppression of appetite and increased energy expenditure. This study aims to analyze the predictive value of leptin levels at discharge as well as the average rate of weight gain during inpatient or day patient treatment for body weight at 1-year follow-up. 121 patients were recruited from the longitudinal Anorexia Nervosa Day patient versus Inpatient (ANDI) trial. Serum leptin levels were analyzed at referral and discharge. A multiple linear regression analysis to predict age-adjusted body mass index (BMI-SDS) at 1-year follow-up was performed. Leptin levels, the average rate of weight gain, premorbid BMI-SDS, BMI-SDS at referral, age and illness duration were included as independent variables. Neither leptin levels at discharge nor rate of weight gain significantly predicted BMI-SDS at 1-year follow-up explaining only 1.8 and 0.4 % of the variance, respectively. According to our results, leptin levels at discharge and average rate of weight gain did not exhibit any value in predicting weight at 1-year follow-up in our longitudinal observation study of adolescent patients with AN. Thus, research should focus on other potential factors to predict weight at follow-up. As elevated leptin levels and average rate of weight gain did not pose a risk for reduced weight, we found no evidence for the beneficial effect of slow refeeding in patients with acute AN.
神经性厌食症(AN)患者在快速治疗性体重增加后血清瘦素水平升高,被认为是体重再次下降的潜在生物标志物,因为瘦素相关的食欲抑制和能量消耗增加。本研究旨在分析出院时瘦素水平的预测价值,以及住院或日间住院治疗期间体重增加的平均速率对1年随访时体重的影响。从纵向神经性厌食症日间患者与住院患者(ANDI)试验中招募了121名患者。在转诊时和出院时分析血清瘦素水平。进行了多元线性回归分析,以预测1年随访时年龄校正的体重指数(BMI-SDS)。瘦素水平、体重增加的平均速率、病前BMI-SDS、转诊时的BMI-SDS、年龄和病程作为自变量。出院时的瘦素水平和体重增加速率均未显著预测1年随访时的BMI-SDS,分别仅解释了1.8%和0.4%的方差。根据我们的结果,在我们对青少年AN患者的纵向观察研究中,出院时的瘦素水平和体重增加的平均速率在预测1年随访时的体重方面没有任何价值。因此,研究应关注其他预测随访时体重的潜在因素。由于瘦素水平升高和体重增加的平均速率并未对体重减轻构成风险,我们没有发现急性AN患者缓慢重新进食有益效果的证据。