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Leptin levels in patients with anorexia nervosa following day/inpatient treatment do not predict weight 1 year post-referral

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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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Author notes

    Authors and Affiliations

    1. Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital, RWTH University Aachen, Neuenhofer Weg 21, 52074, Aachen, Germany

      Jochen Seitz, Katharina Bühren & Beate Herpertz-Dahlmann

    2. Institute for Clinical Chemistry and Pathochemistry, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany

      Ronald Biemann

    3. Institute of Medical Biometry and Epidemiology, Philipps-University Marburg, Marburg, Germany

      Nina Timmesfeld

    4. Institute of Medical Informatics and Statistics, University Hospital Schleswig–Holstein, Christian Albrecht-University, Kiel, Germany

      Astrid Dempfle

    5. Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité-Universitätsmedizin, Berlin, Germany

      Sibylle Maria Winter

    6. Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany

      Karin Egberts

    7. Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Centre Freiburg, Freiburg, Germany

      Christian Fleischhaker

    8. Department of Child and Adolescent Psychiatry and Psychotherapy, Kliniken der Stadt Köln, Cologne, Germany

      Christoph Wewetzer

    9. Department of Child and Adolescent Psychiatry and Psychotherapy, University of Duisburg-Essen, Essen, Germany

      Johannes Hebebrand & Manuel Föcker

    Authors
    1. Jochen Seitz
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    2. Katharina Bühren
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    4. Nina Timmesfeld
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    10. Beate Herpertz-Dahlmann
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    Corresponding author

    Correspondence to Jochen Seitz.

    Ethics declarations

    Ethical standards

    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.

    Financial statements and conflicts of interest

    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.

    Additional information

    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

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