Antineoplastics

55 Vol. 8: 55-61, March 2003 ORIGINAL RESEARCH PAPER Urinary peptide levels in women with eating disorders. A pilot study M. Hellzén*, J.O. Larsson*, K.L. Reichelt**, and P.A. Rydelius* *Department of Child and Adolescent Psychiatry, Astrid Lindgren’s Children’s Hospital, The Karolinska Hospital, Stockholm, Sweden, and **Institute of Pediatric Research, Rikshospitalet, Oslo, Norway ABSTRACT. The aim of this study was to evaluate whether the urinary excretion of low molecular weight peptides is increased in women with a history of anorexia nervosa/self starva- tion. The study group consisted of 12 women aged 20-38 years who were treated in a specialised day care unit for eating disorders in Stockholm between January and December 1998; the controls were eight women with primary bulimia treated in the same unit (A) and ten healthy women without any eating disorder (B). The chromatographically measured urinary peptide levels in the study group were significantly higher than those in control group A (and B when one highly influential individual with very low peptide excretion in the study group was excluded from the analyses). These findings offer some support to the speculative hypothesis that eating disorder symptoms may be linked to increased levels of neuroactive peptides, although it is necessary to define the peptides further before any definite conclu- sion can be drawn. Furthermore, the study group was characterised by many interpersonal differences in eating behaviour that could explain the increased urinary peptide levels. (Eating Weight Disord. 8: 55-61, 2003). © 2003, Editrice Kurtis INTRODUCTION The eating disorders (ED) include anorexia nervosa (AN) and bulimia nervosa (BN) according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (1) and are of largely unknown etiology (2, 3). Their origin is multifactorial with psycho- logical and personality factors being partic- ularly important. There is a great variation in the presence, severity, extent and persis- tence of the symptoms of ED, which cover a large number of somatic (4-7) and psycho- logical problems (8-11); the complications of ED may become very serious. It has been shown that ED patients have hypothalamic-pituitary-adrenal distur- bances that affect the endocrine system and lead to abnormalities in hormonal secretion (12). Abnormalities have also been found in both central and peripheral nervous system activities (13-15). One aspect of such abnormalities is the possibility that the symptoms of ED may be linked to increased levels of neuroactive peptides (16), which may play a neuromodulating role and contribute to the pathophysiological characteristics of ED. The gut contains many peptides in common with the central nervous system, where they have various functions (17), such as modulating transmitter uptake and release (18), and changing the metabolic turnover of neurotransmitters (19). It has been shown that neuropeptides from the urine and cerebrospinal fluid of ED patients affect feeding behaviour in ani- mals (17, 20), but the results of previous studies are contradictory and the findings concerning animal feeding behaviour have been difficult to replicate (21, 22). The rela- tionship between neuroactive peptides and ED has therefore not yet been clarified. The aim of the present study was to mea- sure the urinary excretion of low molecular weight peptides in women with ED and a history of severe AN, and compare it with that of women with a history of BN and healthy women without ED. SUBJECTS The subjects with ED were recruited from among the 32 female patients treated in a specialised day care unit for severe ED in Stockholm between January and December 1998. Twenty-eight patients agreed to par- ticipate, and 20 completed the main parts of the questionnaires and tests. The group was heterogeneous and consisted of more or less chronic ED patients, most of whom were bulimic. The majority had received Key words: Eating disorders, bulimia, anorexia, urinary peptides. Correspondence to: Maud Hellzén, M.D., Department of Child and Adolescent Psychiatry, Astrid Lindgren’s Children’s Hospital, The Karolinska Hospital, S-171 76 Stockholm, Sweden E-mail: [email protected]

Antineoplastics

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