Abstract
Abstract Introduction: Anorexia nervosa (AN) is a mental disorder with the highest death rate. The characteristic feature of AN is endocrine dysregulations, including changes in adipose-tissue secreted hormones, especially adipokines. The most widely studied of them is leptin whose role in the pathophysiology and prognosis of AN is confirmed in more and more studies. The aim of the study was to summarize the role of endocrine disruptions with particular emphasis on leptin in the pathophysiology of AN. Material and methods: For the literature review, the electronic databases PubMed, Cochrane and Google Scholar search were used with the following keywords: eating disorders, adipokines, leptin, metreleptin, satiety, hunger, anorexia, obesity, for studies listed from database inception to October 2021. Results: Leptin, produced mainly by white adipose tissue, inhibits the hunger center in the hypothalamus by negative feedback with ghrelin secreted by the gastrointestinal tract. Leptin is involved in numerous biological functions, including body weight regulation, innate and adaptive immunity regulation, reproduction, and bone formation. Studies confirm decreased leptin levels in AN individuals. In recent years, extensive experience has been gained with leptin as a drug in clinical trials. The studies suggested that treatment can restore menstrual function and bone health and improve mood with unclear body weight effects. Conclusions: Focusing on leptin-related changes is a promising approach to improve AN management. Assessment of leptin levels in AN patients could be a useful tool for therapy monitoring. Treatment with leptin could reverse unfavourable changes induced by diet restriction, including mood symptoms, loss of bone mass and menstrual function. However, the results of these studies need confirmation on larger groups of patients.
Highlights
Anorexia nervosa (AN) is a mental disorder with the highest death rate
This study aims to summarize the role of endocrine disruptions, with particular emphasis on leptin, in the pathophysiology of AN and the role of its levels on mental and physical states of malnourished patients
Individuals suffering from AN have abnormal serum leptin and other adipokine levels, consistent with too low body fat
Summary
Anorexia nervosa (AN) is a mental disorder with the highest death rate. The characteristic feature of AN is endocrine dysregulations, including changes in adipose-tissue secreted hormones, especially adipokines. The studies suggested that treatment can restore menstrual function and bone health and improve mood with unclear body weight effects. The World Day for Combating Eating Disorders has been celebrated on June 2, and the Day for Combating Anorexia on May 6. The intention of such campaigns is to raise global awareness of eating disorders (ED) as diseases that can be fatal if left untreated. At least one person in the world dies every 62 minutes due to an ED Both psychotherapeutic and pharmacological treatments of AN still need improvement [2]. A broad view of the problem of ED allows for a better explanation of the mechanism of action, more effective coping with the disease and its consequences
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