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While the suppressive effect of food on circulating ghrelin is well recognized in normal humans, the integrity of this mechanism in anorexia nervosa (AN) is still a matter of debate. A few years ago lack of ghrelin suppression by a standardized breakfast was described in AN patients, who displayed baseline elevated levels of the peptide (Nedvidkova et al., J Clin Endocrinol Metab 2003). However, this finding was challenged by subsequent studies from the same group of researchers, demonstrating a decrease in plasma ghrelin following high-carbohydrate breakfast in anorectic women (Sedlackova et al., Physiol Res 2011). A similar decrease in both acyland desacyl-ghrelin was also reported by Harada et al. (Biol Psychiatry 2008) in another group of AN patients after an oral glucose load. The interpretation of the pathophysiology of these mechanisms has been made more difficult by the recent observation that hyperinsulinemia is even more effective in suppressing plasma ghrelin in AN women than in controls (KarczewskaKupczewska et al., Eur J Endocrinol 2010). Based on the above, we elected to study the ghrelin dynamics after ingestion of food or placebo in a group of anorectic patients at the moment of diagnosis and after weight recuperation.

Meal-induced plasma ghrelin suppression in different phases of anorexia nervosa