Abstract
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.
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Acknowledgments
The authors would like to thank all patients and their parents for their participation. Furthermore, they would like to thank Wolfgang Scharke for his support in analyzing the data.
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This study was approved by the Ethics Committee of the University Hospital of the Technical University of Aachen and by all participating centers and was conducted in accordance with the Declaration of Helsinki. The participants and their legal guardians provided informed written consent after receiving a complete description of the study.
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The ANDI-trial was supported by the German Federal Ministry of Education and Research (BMBF No. 01GV0602, ISRCTN67783402, DRKS00000101). None of the authors have conflicting interests to declare.
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Johannes Hebebrand and Manuel Föcker contributed equally to this work.
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Seitz, J., Bühren, K., Biemann, R. et al. Leptin levels in patients with anorexia nervosa following day/inpatient treatment do not predict weight 1 year post-referral. Eur Child Adolesc Psychiatry 25, 1019–1025 (2016). https://doi.org/10.1007/s00787-016-0819-4
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DOI: https://doi.org/10.1007/s00787-016-0819-4