Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul;29(4):588-599.
doi: 10.1002/erv.2831. Epub 2021 May 3.

Ghrelin as a possible biomarker and maintaining factor in patients with eating disorders reporting childhood traumatic experiences

Eleonora Rossi  1 , Emanuele Cassioli  1 , Veronica Gironi  1 , Eglantina Idrizaj  2 , Rachele Garella  2 , Roberta Squecco  2 , Maria Caterina Baccari  2 , Mario Maggi  3 , Linda Vignozzi  3 , Paolo Comeglio  3 , Valdo Ricca  1 , Giovanni Castellini  1
Affiliations

Ghrelin as a possible biomarker and maintaining factor in patients with eating disorders reporting childhood traumatic experiences

Eleonora Rossi et al. Eur Eat Disord Rev. 2021 Jul.

Abstract

Objective: The recent conceptualization of ghrelin as a stress hormone suggested that its chronic alterations may have a role in maintaining overeating behaviors in subjects with eating disorders (EDs) reporting childhood traumatic experiences. The aim of this study was to investigate the alterations of ghrelin levels in patients with EDs, their associations with early trauma, binge and emotional eating, and possible moderation/mediation models.

Method: Sixty-four patients with EDs and 42 healthy controls (HCs) had their plasma ghrelin levels measured and completed questionnaires evaluating general and ED-specific psychopathology, emotional eating, and childhood traumatic experiences.

Results: Participants with anorexia nervosa had higher ghrelin levels than HCs in body mass index (BMI)-adjusted comparisons. Moreover, patients reporting a history of childhood trauma had higher ghrelin levels. Childhood sexual abuse (CSA), BMI, and self-induced vomiting were independent predictors of ghrelin levels. Moderation analyses showed that ghrelin levels were associated with binge and emotional eating only for higher levels of childhood trauma. Elevated ghrelin was a significant mediator for the association of CSA with binge eating.

Conclusions: These results support the hypothesis that chronic alterations in ghrelin levels following childhood traumatic experiences could represent a neurobiological maintaining factor of pathological overeating behaviors in EDs.

Keywords: binge eating; childhood trauma; eating disorders; emotional eating; ghrelin.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

FIGURE 1
FIGURE 1
Bar graph showing the mean plasma values of ghrelin, divided by diagnostic groups. The error bars show the standard deviation. Statistically significant post hoc BMI‐adjusted comparisons are reported in the upper part of the graph, with the relative p‐value. AN, anorexia nervosa; BED, binge‐eating disorder; BMI, body mass index; BN, bulimia nervosa; HCs, healthy controls
FIGURE 2
FIGURE 2
Scatter plots illustrating the association of plasma ghrelin levels with binge eating (panel A) and emotional eating (panel C) adjusted for BMI (partial residues are shown on the y axis). The points are colored with a gradient indicating the moderator value (CTQ Total Score). Three regression lines are reported for three different levels of the moderator. Panels B and D report the interaction probing using Johnson–Neyman graphs, which show the regions of statistical significance and the transition point of the moderator. CTQ, Childhood Trauma Questionnaire; EES, Emotional Eating Scale
FIGURE 3
FIGURE 3
Mediation model for the relationship between childhood sexual abuse and frequency of objective binge eating, as mediated by ghrelin levels. Unstandardized regression coefficients and standard errors are reported; the total effect and the direct effect are reported as c and c’, respectively. The indirect effect is also reported, together with the bootstrapped 95% confidence interval. CI, confidence interval; CTQ, Childhood Trauma Questionnaire; SE, standard error
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. American Psychiatric Association . (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association. 10.1176/appi.books.9780890425596.744053 - DOI
    1. Arnow, B. , Kenardy, J. , & Agras, W. S. (1995). The emotional eating scale: The development of a measure to assess coping with negative affect by eating. International Journal of Eating Disorders, 18(1), 79–90. 10.1002/1098-108x(199507)18:1<79::aid-eat2260180109>3.0.co;2-v - DOI - PubMed
    1. Badaoui, A. , De Saeger, C. , Duchemin, J. , Gihousse, D. , De Timary, P. , & Stärkel, P. (2008). Alcohol dependence is associated with reduced plasma and fundic ghrelin levels. European Journal of Clinical Investigation, 38(6), 397–403. 10.1111/j.1365-2362.2008.01947.x - DOI - PubMed
    1. Baron, R. M. , & Kenny, D. A. (1986). The moderator‐mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182. 10.1037/0022-3514.51.6.1173 - DOI - PubMed
    1. Bernstein, D. P. , Stein, J. A. , Newcomb, M. D. , Walker, E. , Pogge, D. , Ahluvalia, T. , Zule, J. , Handelsman, L. , Medrano, M. , Desmond, D. , & Zule, W. (2003). Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse & Neglect, 27(2), 169–190. 10.1016/S0145-2134(02)00541-0 - DOI - PubMed