Abstract
Anorexia nervosa (AN) is a mental disorder characterized by an intense fear of weight gain that affects mainly young women. It courses with a negative body image leading to altered eating behaviors that have devastating physical, metabolic, and psychological consequences for the patients. Although its origin is postulated to be multifactorial, the etiology of AN remains unknown, and this increases the likelihood of chronification and relapsing. Thus, expanding the available knowledge on the pathophysiology of AN is of enormous interest. Metabolomics is proposed as a powerful tool for the elucidation of disease mechanisms and to provide new insights into the diagnosis, treatment, and prognosis of AN. A review of the literature related to studies of AN patients by employing metabolomic strategies to characterize the main alterations associated with the metabolic phenotype of AN during the last 10 years is described. The most common metabolic alterations are derived from chronic starvation, including amino acid, lipid, and carbohydrate disturbances. Nonetheless, recent findings have shifted the attention to gut-microbiota metabolites as possible factors contributing to AN development, progression, and maintenance. We have identified the areas of ongoing research in AN and propose further perspectives to improve our knowledge and understanding of this disease.
Highlights
The present review aims to present and discuss the information contained in the metabolomics studies that have been performed to date on Anorexia nervosa (AN) patients with two main objectives: (1) To clearly define the metabolic phenotype of individuals with anorexia nervosa, which is essential for providing new insight into the etiology and pathophysiology of the disease, and (2) To identify the areas that are still uncovered by metabolomics and need further research in the field, with the final purpose of improving disease management and prognosis
In a previous study, they determined that fucose, rhamnose, and xylose were diminished in patients, but normal levels were recovered after renourishment therapy [57,58]
Through targeted and untargeted metabolomics mainly based on 1H nuclear magnetic resonance (NMR) or mass spectrometry (MS), the metabolic phenotype of individuals with anorexia nervosa provided has shed light on the metabolic alterations beyond the classical tests
Summary
There has been a shift towards precision and personalized medicine that has led to the development of new ways to approach research in health and disease. Untargeted metabolomics focuses on the global detection and qualitative analysis of all the metabolites present in one sample These studies are usually performed under discovery stages, where the objective is to gather all the possible information to unveil compounds that could be of interest in a given alteration [1]. On the contrary, targeted metabolomics aims to cover a concrete set of chemically defined metabolites This is the classical metabolomics approach in which the compounds of interest are previously selected, and strategies for analysis are defined. The determining step in targeted metabolomics is to optimize the analytical conditions to enhance the method sensitivity and selectivity to measure the subset of compounds of interest This approach is usually employed in biomarker validation after a first discovery step, which implies the combination of both metabolomics strategies [3,4]. Metabolomics is a useful methodology to identify novel therapeutic targets and progression or severity biomarkers to develop effective strategies for the treatment or diagnosis of many different diseases, including anorexia nervosa (AN)
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