This Article Full Text Full Text (PDF) All Versions of this Article: 91/3/1027    most recent Author Manuscript (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Misra, M. Articles by Klibanski, A. Search for Related Content PubMed PubMed Citation Articles by Misra, M. Articles by Klibanski, A. Pubmed/NCBI databases Gene GEO Profiles HomoloGene UniGene Compound via MeSH Substance via MeSH Medline Plus Health Information Eating Disorders Hazardous Substances DB ESTRADIOL HYDROCORTISONE LIOTHYRONINE Related Collections Neuroendocrinology and Pituitary Pediatric Endocrinology Female Endocrinology Metabolism

Elevated Peptide YY Levels in Adolescent Girls with Anorexia Nervosa

Neuroendocrine Unit (M.M., K.K.M., P.T., K.G., A.L., N.L., A.K.), Pediatric Endocrine Unit (M.M.), and Eating Disorders Unit (D.B.H.), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114

Address all correspondence and requests for reprints to: Anne Klibanski, M.D., BUL 457, Neuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts 02114. E-mail: aklibanski{at}partners.org.

Background: Peptide YY (PYY) is an intestinally derived anorexigen that acts via the Y2 receptor, and Y2 receptor deletion in rodents increases bone formation. Anorexia nervosa (AN) is associated with a deliberate reduction in food intake and low bone density, but endocrine modulators of food intake in AN are not known. In addition, known regulators of bone turnover, such as GH, cortisol, and estrogen, explain only a fraction of the variability in bone turnover marker levels.

Hypotheses: We hypothesized that PYY may be elevated in AN compared with controls and may contribute to decreased food intake and bone formation.

Methods: Fasting PYY was examined in 23 AN girls and 21 healthy adolescents 12–18 yr old. We also examined GH, cortisol, ghrelin, and leptin (overnight frequent sampling) and fasting IGF-I, estradiol, total T₃, and bone markers. Macronutrient intake and resting energy expenditure (REE) were measured.

Results: AN girls had higher PYY levels compared with controls (17.8 ± 10.2 vs. 4.8 ± 4.3 pg/ml; P < 0.0001). Predictors of log PYY were nutritional markers, including body mass index (r = –0.62; P < 0.0001), fat mass (r = –0.55; P = 0.0003), and REE (r = –0.51; P = 0.0006), and hormones, including GH (r = 0.38; P = 0.004) and T₃ (r = –0.59; P = 0.0001). Body mass index, fat mass, REE, GH, and T₃ explained 68% of the variability of log PYY. Log PYY predicted percentage of calories from fat (r = –0.56; P = 0.0002) and independently predicted osteocalcin (r = –0.45; P = 0.003), bone-specific alkaline phosphatase (r = –0.46; P = 0.003), N-telopeptide/creatinine (r = –0.55; P = 0.0003), and deoxypyridinoline/creatinine (r = –0.52; P = 0.001) on regression modeling.

Conclusion: Elevated PYY may contribute to reduced intake and decreased bone turnover in AN.

This article has been cited by other articles:

				M. Perez-Fontan, F. Cordido, A. Rodriguez-Carmona, M. Penin, H. Diaz-Cambre, A. Lopez-Muniz, S. Sangiao-Alvarellos, and J. Garcia-Buela Short-term regulation of peptide YY secretion by a mixed meal or peritoneal glucose-based dialysate in patients with chronic renal failure Nephrol. Dial. Transplant., November 1, 2008; 23(11): 3696 - 3703. [Abstract] [Full Text] [PDF]

				M. Misra, D. K. Katzman, J. Cord, S. J. Manning, N. Mendes, D. B. Herzog, K. K. Miller, and A. Klibanski Bone Metabolism in Adolescent Boys with Anorexia Nervosa J. Clin. Endocrinol. Metab., August 1, 2008; 93(8): 3029 - 3036. [Abstract] [Full Text] [PDF]

				R P Vincent and C W le Roux The satiety hormone peptide YY as a regulator of appetite J. Clin. Pathol., May 1, 2008; 61(5): 548 - 552. [Abstract] [Full Text] [PDF]

				M. Misra, R. Prabhakaran, K. K. Miller, M. A. Goldstein, D. Mickley, L. Clauss, P. Lockhart, J. Cord, D. B. Herzog, D. K. Katzman, et al. Weight Gain and Restoration of Menses as Predictors of Bone Mineral Density Change in Adolescent Girls with Anorexia Nervosa-1 J. Clin. Endocrinol. Metab., April 1, 2008; 93(4): 1231 - 1237. [Abstract] [Full Text] [PDF]

				M. Misra, R. Prabhakaran, K. K. Miller, M. A. Goldstein, D. Mickley, L. Clauss, P. Lockhart, J. Cord, D. B. Herzog, D. K. Katzman, et al. Prognostic Indicators of Changes in Bone Density Measures in Adolescent Girls with Anorexia Nervosa-II J. Clin. Endocrinol. Metab., April 1, 2008; 93(4): 1292 - 1297. [Abstract] [Full Text] [PDF]

				M. Misra, K. K. Miller, J. Cord, R. Prabhakaran, D. B. Herzog, M. Goldstein, D. K. Katzman, and A. Klibanski Relationships between Serum Adipokines, Insulin Levels, and Bone Density in Girls with Anorexia Nervosa J. Clin. Endocrinol. Metab., June 1, 2007; 92(6): 2046 - 2052. [Abstract] [Full Text] [PDF]

				N. Germain, B. Galusca, C. W Le Roux, C. Bossu, M. A Ghatei, F. Lang, S. R Bloom, and B. Estour Constitutional thinness and lean anorexia nervosa display opposite concentrations of peptide YY, glucagon-like peptide 1, ghrelin, and leptin Am. J. Clinical Nutrition, April 1, 2007; 85(4): 967 - 971. [Abstract] [Full Text] [PDF]

				P. T. Pfluger, J. Kampe, T. R. Castaneda, T. Vahl, D. A. D'Alessio, T. Kruthaupt, S. C. Benoit, U. Cuntz, H. J. Rochlitz, M. Moehlig, et al. Effect of Human Body Weight Changes on Circulating Levels of Peptide YY and Peptide YY3-36 J. Clin. Endocrinol. Metab., February 1, 2007; 92(2): 583 - 588. [Abstract] [Full Text] [PDF]

				O. B. Chaudhri, B. C. T. Field, and S. R. Bloom From gut to mind--hormonal satiety signals and anorexia nervosa. J. Clin. Endocrinol. Metab., March 1, 2006; 91(3): 797 - 798. [Full Text] [PDF]