Abstract
Anorexia nervosa (AN) is a psychological illness with devastating physical consequences; however, its pathophysiological mechanism remains unclear. Because numerous reports have indicated the importance of gut microbiota in the regulation of weight gain, it is reasonable to speculate that AN patients might have a microbial imbalance, i.e. dysbiosis, in their gut. In this study, we compared the fecal microbiota of female patients with AN (n = 25), including restrictive (ANR, n = 14) and binge-eating (ANBP, n = 11) subtypes, with those of age-matched healthy female controls (n = 21) using the Yakult Intestinal Flora-SCAN based on 16S or 23S rRNA–targeted RT–quantitative PCR technology. AN patients had significantly lower amounts of total bacteria and obligate anaerobes including those from the Clostridium coccoides group, Clostridium leptum subgroup, and Bacteroides fragilis group than the age-matched healthy women. Lower numbers of Streptococcus were also found in the AN group than in the control group. In the analysis based on AN subtypes, the counts of the Bacteroides fragilis group in the ANR and ANBP groups and the counts of the Clostridium coccoides group in the ANR group were significantly lower than those in the control group. The detection rate of the Lactobacillus plantarum subgroup was significantly lower in the AN group than in the control group. The AN group had significantly lower acetic and propionic acid concentrations in the feces than the control group. Moreover, the subtype analysis showed that the fecal concentrations of acetic acid were lower in the ANR group than in the control group. Principal component analysis confirmed a clear difference in the bacterial components between the AN patients and healthy women. Collectively, these results clearly indicate the existence of dysbiosis in the gut of AN patients.
Highlights
Eating disorders are an important cause of physical and psychosocial morbidity in adolescent girls and adult women [1]
In the analysis based on Anorexia nervosa (AN) subtypes (Table 2), weight and body mass index in both the ANR and ANBP groups were significantly lower than those in the control group
Acetic acid and propionic acid levels were significantly lower in the AN group than in the control group
Summary
Eating disorders are an important cause of physical and psychosocial morbidity in adolescent girls and adult women [1]. Anorexia nervosa (AN), a type of eating disorder, is classified into two main sub-types. Gut Microbes and Anorexia Nervosa restrict their intake and have abnormal eating or purging behaviors, such as self-induced vomiting. In AN patients, the energy requirement for body-weight gain is higher than would be expected because of the cost of energy storage [2,3,4]. Factors such as increased physical activity [5] or diet-induced thermogenesis [6] are potentially involved in the poor weight gain response; the precise mechanism explaining this discrepancy remains to be clarified
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