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Screening for anorexia nervosa via measurement of serum leptin levels

  • Biological Child and Adolescent Psychiatry - Original Article
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Abstract

Due to their sub-normally low fat mass, leptin levels in patients with acute anorexia nervosa (AN) are well below reference levels for age and sex-matched controls. This hypoleptinemia entails endocrinological and behavioral characteristics observed in AN patients during starvation. We aimed to study the appropriateness of hypoleptinemia as a diagnostic marker for AN by assessing sensitivity, specificity and likelihood ratios for different referral serum leptin levels for predicting anorexia nervosa and healthy leanness. For prediction, we additionally generated a score based on a multivariate logistic model including body mass index (BMI; kg/m²) and leptin level. For this purpose, we measured leptin levels in 74 female patients with acute AN upon admission for inpatient or outpatient treatment. Adolescent and adult patients were recruited according to DSM-IV criteria from two multi-center studies. Additionally, leptin levels were measured in 65 female healthy, lean students. Mean serum leptin level was significantly decreased in patients with AN compared to underweight controls (0.87 ± 0.90 vs. 6.43 ± 3.55 μg/L, p < 0.001). Leptin predicted AN independently of BMI; we confirmed a cutoff value in the range of 2 μg/L as having both high specificity and sensitivity. Hypoleptinemia represents a state marker of acute AN and is useful for a laboratory-based diagnostic screening.

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Acknowledgments

The participation of the probands and their families is gratefully acknowledged. This work was supported by grants from the Federal Ministry of Education and Research (01GV0623, 01GV0624, 01GV0602, 01GV0905; NGFNPlus: 01GS0820). The research leading to these results has also received funding from the European Community’s Seventh Framework Programme (FP7/2007-2013) under grant agreement no. 245009. The skillful technical assistance of Sieglinde Düerkop is highly appreciated.

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Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry and Psychotherapy, University of Duisburg-Essen, Virchowstr. 174, 45147, Essen, Germany

    M. Föcker, S. Scherag & J. Hebebrand

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

    N. Timmesfeld & A. Dempfle

  3. Department of Child and Adolescent Psychiatry and Psychotherapy, RWTH Aachen University, Aachen, Germany

    K. Bühren & B. Herpertz-Dahlmann

  4. Mediagnost, Reutlingen, Germany

    M. Langkamp

  5. The Zucker Hillside Hospital, Psychiatry Research, Glen Oaks, NY, USA

    E. M. Sheridan

  6. Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Erlangen, Germany

    M. de Zwaan

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

    C. Fleischhaker

  8. Department of Psychosomatic and General Internal Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany

    W. Herzog

  9. Department of Child and Adolescent Psychiatry and Psychotherapy, University of Würzburg, Würzburg, Germany

    K. Egberts

  10. Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, University Tübingen, Tübingen, Germany

    S. Zipfel

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  1. M. Föcker
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  2. N. Timmesfeld
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  4. K. Bühren
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  8. M. de Zwaan
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  9. C. Fleischhaker
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  10. W. Herzog
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  11. K. Egberts
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  12. S. Zipfel
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  13. B. Herpertz-Dahlmann
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  14. J. Hebebrand
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Correspondence to M. Föcker.

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Föcker, M., Timmesfeld, N., Scherag, S. et al. Screening for anorexia nervosa via measurement of serum leptin levels. J Neural Transm 118, 571–578 (2011). https://doi.org/10.1007/s00702-010-0551-z

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  • DOI: https://doi.org/10.1007/s00702-010-0551-z

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