Neurotensin and Xenin Show Positive Correlations With Perceived Stress, Anxiety, Depressiveness and Eating Disorder Symptoms in Female Obese Patients.

Ellen Wölk,Andreas Stengel,Matthias Rose,Tobias Hofmann,Selina Johanna Schaper

doi:10.3389/fnbeh.2021.629729

Abstract

ObjectiveNeurotensin and xenin are two closely related anorexigenic neuropeptides synthesized in the small intestine that exert diverse peripheral and central functions. Both act via the neurotensin-1-receptor. In animal models of obesity reduced central concentrations of these peptides have been found. Dysregulations of the acute and chronic stress response are associated with development and maintenance of obesity. Until now, associations of both peptides with stress, anxiety, depressiveness, and eating disorder symptoms have not been investigated. The aim of the present study was to examine associations of neurotensin and xenin with these psychological characteristics under conditions of obesity.Materials and MethodsFrom 2010 to 2016 we consecutively enrolled 160 inpatients (63 men and 97 women), admitted due to obesity and its mental and somatic comorbidities. Blood withdrawal und psychometric tests (PSQ-20, GAD-7, PHQ-9, and EDI-2) occurred within one week after admission. We measured levels of neurotensin and xenin in plasma by ELISA.ResultsMean body mass index was 47.2 ± 9.5 kg/m2. Concentrations of neurotensin and xenin positively correlated with each other (women: r = 0.788, p < 0.001; men: r = 0.731, p < 0.001) and did not significantly differ between sexes (p > 0.05). Women generally displayed higher psychometric values than men (PSQ-20: 58.2 ± 21.7 vs. 47.0 ± 20.8, p = 0.002; GAD-7: 9.7 ± 5.8 vs. 7.1 ± 5.3, p = 0.004; PHQ-9: 11.6 ± 6.6 vs. 8.8 ± 5.9, p = 0.008; EDI-2: 50.5 ± 12.8 vs. 39.7 ± 11.9, p < 0.001). Only women showed positive correlations of both neuropeptides with stress (neurotensin: r = 0.231, p = 0.023; xenin: r = 0.254, p = 0.013), anxiety (neurotensin: r = 0.265, p = 0.009; xenin: r = 0.257, p = 0.012), depressiveness (neurotensin: r = 0.281, p = 0.006; xenin: r = 0.241, p = 0.019) and eating disorder symptoms (neurotensin: r = 0.276, p = 0.007; xenin: r = 0.26, p = 0.011), whereas, men did not (p > 0.05).ConclusionNeurotensin and xenin plasma levels of female obese patients are positively correlated with perceived stress, anxiety, depressiveness, and eating disorder symptoms. These associations could be influenced by higher prevalence of mental disorders in women and by sex hormones. In men, no correlations were observed, which points toward a sex-dependent regulation.

Highlights

With a worldwide prevalence of 13.1%, which has increased threefold since 1975, obesity is a widespread and serious disease, mostly because of its physical and mental comorbidities (World Health Organization, 2017, 2020)
Neurotensin and xenin plasma levels of female obese patients are positively correlated with perceived stress, anxiety, depressiveness, and eating disorder symptoms
Age BMI Perceived Stress Questionnaire (PSQ)-20 total score - Worries - Tension - Joy - Demands Generalized Anxiety Disorder-7 (GAD-7) total score Patient Health Questionnaire (PHQ)-9 total score Eating Disorder Inventory (EDI)-2 total score - Drive for thinness - Bulimia - Body dissatisfaction - Ineffectiveness - Perfectionism - Interpersonal distrust - Interoceptive awareness - Maturity fears Neurotensin Xenin

Summary

Introduction

With a worldwide prevalence of 13.1%, which has increased threefold since 1975, obesity (body mass index, BMI ≥ 30 kg/m2) is a widespread and serious disease, mostly because of its physical and mental comorbidities (World Health Organization, 2017, 2020). In Europe, 23.3% of the adult population is obese (World Health Organization, 2017). Mental comorbidities are associated with obesity (Petry et al, 2008; Preiss et al, 2013; Herpertz, 2015). Depressive, anxiety, somatoform, and binge eating disorders (BED) are the most frequent ones (Petry et al, 2008; Preiss et al, 2013; Herpertz, 2015). Psychosocial risk factors are involved in the etiology of obesity and obesity itself is a risk factor of major depression (Herpertz, 2015)

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