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. 2019 Oct 1;104(10):4931-4940.
doi: 10.1210/jc.2019-00926.

Disrupted Oxytocin-Appetite Signaling in Females With Anorexia Nervosa

Anna Aulinas  1   2 , Franziska Plessow  1   2 , Reitumetse L Pulumo  1 , Elisa Asanza  1 , Christopher J Mancuso  1 , Meghan Slattery  1 , Christiane Tolley  1 , Jennifer J Thomas  2   3 , Kamryn T Eddy  2   3 , Karen K Miller  1   2 , Anne Klibanski  1   2 , Madhusmita Misra  1   2   4 , Elizabeth A Lawson  1   2
Affiliations

Disrupted Oxytocin-Appetite Signaling in Females With Anorexia Nervosa

Anna Aulinas et al. J Clin Endocrinol Metab. .

Abstract

Context: In healthy females, oxytocin levels decrease postmeal, corresponding to increased satiety. The postprandial response of oxytocin in females with anorexia nervosa (AN)/atypical AN is unknown.

Objectives: To determine the pattern of postprandial serum oxytocin levels in females with AN/atypical AN, relationship with appetite, and effect of weight, eating behavior, and endogenous estrogen status.

Design: Cross-sectional.

Setting: Clinical research center.

Participants: 67 women (36 with AN [<85% expected body weight (EBW)]; 31 with atypical AN [≥ 85% EBW)]), age 22.4 ± 0.9 (mean ± SEM) years, categorized by weight, restricting vs binge/purge behavior, and estrogen status.

Interventions: Standardized mixed meal.

Main outcome measurements: Blood sampling for oxytocin occurred fasting and 30, 60, and 120 minutes postmeal. Subjective appetite was assessed using visual analog scales.

Results: In females with AN/atypical AN, oxytocin levels decreased from fasting to 60 (P = 0.002) and 120 (P = 0.005) minutes postmeal. The decrease in oxytocin from fasting to 120 minutes was greater in females with atypical AN than AN (P = 0.027) and did not differ by restricting vs binge/purge behavior or estrogen status. Controlling for caloric intake, the decrease in oxytocin was inversely related to the decrease in hunger postmeal in females with atypical AN (P = 0.04).

Conclusions: In females with AN/atypical AN, oxytocin levels decrease postmeal, as established in healthy females. Weight, but not restricting vs binge/purging nor endogenous estrogen status, affects postprandial oxytocin levels. The postprandial change in serum oxytocin levels is related to appetite in females with atypical AN only, suggesting a disconnect between oxytocin secretion and appetite in the undernourished state.

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Figures

Figure 1.
Figure 1.
Mean oxytocin levels at all time points after meal in all AN/atypical AN participants. *P < 0.05 (compared with baseline oxytocin levels).
Figure 2.
Figure 2.
Percentage change in oxytocin from baseline (fasting) to nadir in individual subjects. *Participants with atypical AN (N=31).
Figure 3.
Figure 3.
Postprandial oxytocin profile in AN/atypical AN participants according to body weight. AN, (%EBW <85); atypical AN, (%EBW ≥85). *P < 0.05 (compared with baseline oxytocin levels in atypical AN group).
Figure 4.
Figure 4.
Postprandial oxytocin profile in AN/atypical AN participants according to restricting vs binge/purge behaviors groups. *P < 0.05 (compared with baseline oxytocin levels in restricting behavior group).
Figure 5.
Figure 5.
Postprandial oxytocin profile in AN/atypical AN participants according to estrogen status. *P < 0.05 (compared with baseline oxytocin levels in the AN-LE group).
Figure 6.
Figure 6.
Correlation between percentage change in oxytocin from baseline to nadir and percentage change in ratings of hunger from pre- to postmeal in (a) AN patients (rs = 0.07, P = 0.65) and in (b) atypical AN (rs = 0.36, P = 0.05).
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