Abstract
PURPOSE: Based on the presence of early satiety in anorexia nervosa (AN), which may delay recovery, and given the dramatic impact of GLP-1 and GIP analog treatment on satiety and weight reduction in obesity by diminishing the sensation of hunger, we initiated this cross-sectional pilot study to explore fasting incretin levels in AN and to identify possible correlations between these hormones and psychiatric symptoms. METHODS: 17 female subjects aged 18-35 were enrolled; 10 previously diagnosed with AN (5 weight restored, 5 non-weight restored) and 7 healthy controls (HC). Fasting blood samples were analyzed for incretin levels using ELISA. Psychiatric symptoms were evaluated using self-assessment scales for eating disorders (EDI-3, EDE-Q), anxiety (STAI-S + T), depression (MADRS-S), and obsessive-compulsive disorder (OCI-R). RESULTS: Subjects with AN scored overall higher on psychiatric scales, indicating poorer psychological well-being than HC. In non-weight restored AN (non-WRAN) subjects both serum GLP-1 levels (29 (15-85) vs 16 (15-21) pg/mL; p = 0.048) as well as serum GIP levels (37 (14-163) vs 5 (2-58) pmol/L; p = 0.048) were elevated compared to HC. No differences were found in glucagon or PYY levels between groups. A strong correlation between serum GLP-1 levels and EDI-perfectionism independent of BMI (r = 0.768, p = 0.001) was found in the entire group. CONCLUSIONS: Independent of BMI, GLP-1 levels were associated with perfectionism, a typical characteristic of AN. Fasting GLP-1 levels were elevated in subjects with non-WRAN. Elevated GLP-1 levels may perpetuate AN symptoms, emphasizing the need for further research into their role in the metabolic and psychiatric dimensions of AN. LEVEL OF EVIDENCE: Level III: Evidence obtained from well-designed case-control analytic studies.