Skip to main content
Top
Published in: Journal of Neural Transmission 4/2011

01-04-2011 | Biological Child and Adolescent Psychiatry - Original Article

Screening for anorexia nervosa via measurement of serum leptin levels

Authors: M. Föcker, N. Timmesfeld, S. Scherag, K. Bühren, M. Langkamp, A. Dempfle, E. M. Sheridan, M. de Zwaan, C. Fleischhaker, W. Herzog, K. Egberts, S. Zipfel, B. Herpertz-Dahlmann, J. Hebebrand

Published in: Journal of Neural Transmission | Issue 4/2011

Login to get access

Abstract

Due to their sub-normally low fat mass, leptin levels in patients with acute anorexia nervosa (AN) are well below reference levels for age and sex-matched controls. This hypoleptinemia entails endocrinological and behavioral characteristics observed in AN patients during starvation. We aimed to study the appropriateness of hypoleptinemia as a diagnostic marker for AN by assessing sensitivity, specificity and likelihood ratios for different referral serum leptin levels for predicting anorexia nervosa and healthy leanness. For prediction, we additionally generated a score based on a multivariate logistic model including body mass index (BMI; kg/m²) and leptin level. For this purpose, we measured leptin levels in 74 female patients with acute AN upon admission for inpatient or outpatient treatment. Adolescent and adult patients were recruited according to DSM-IV criteria from two multi-center studies. Additionally, leptin levels were measured in 65 female healthy, lean students. Mean serum leptin level was significantly decreased in patients with AN compared to underweight controls (0.87 ± 0.90 vs. 6.43 ± 3.55 μg/L, p < 0.001). Leptin predicted AN independently of BMI; we confirmed a cutoff value in the range of 2 μg/L as having both high specificity and sensitivity. Hypoleptinemia represents a state marker of acute AN and is useful for a laboratory-based diagnostic screening.
Literature
go back to reference American Psychiatric Association (APA) (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington text revision American Psychiatric Association (APA) (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington text revision
go back to reference Blum WF, Englaro P, Hanitsch S, Juul A, Hertel NT, Muller J, Skakkebaek NE, Heiman ML, Birkett M, Attanasio AM, Kiess W, Rascher W (1997) Plasma leptin levels in healthy children and adolescents: dependence on body mass index, body fat mass, gender, pubertal stage, and testosterone. J Clin Endocrinol Metab 82(9):2904–2910PubMedCrossRef Blum WF, Englaro P, Hanitsch S, Juul A, Hertel NT, Muller J, Skakkebaek NE, Heiman ML, Birkett M, Attanasio AM, Kiess W, Rascher W (1997) Plasma leptin levels in healthy children and adolescents: dependence on body mass index, body fat mass, gender, pubertal stage, and testosterone. J Clin Endocrinol Metab 82(9):2904–2910PubMedCrossRef
go back to reference Buyukberber M, Koruk M, Savas MC, Gulsen MT, Pehlivan Y, Deveci R, Sevinc A, Gergerlioglu S (2007) Leptin levels in the differential diagnosis between benign and malignant ascites. World J Gastroenterol 13(3):398–402PubMed Buyukberber M, Koruk M, Savas MC, Gulsen MT, Pehlivan Y, Deveci R, Sevinc A, Gergerlioglu S (2007) Leptin levels in the differential diagnosis between benign and malignant ascites. World J Gastroenterol 13(3):398–402PubMed
go back to reference Considine RV, Sinha MK, Heiman ML, Kriauciunas A, Stephens TW, Nyce MR, Ohannesian JP, Marco CC, McKee LJ, Bauer TL et al (1996) Serum immunoreactive-leptin concentrations in normal-weight and obese humans. N Engl J Med 334(5):292–295PubMedCrossRef Considine RV, Sinha MK, Heiman ML, Kriauciunas A, Stephens TW, Nyce MR, Ohannesian JP, Marco CC, McKee LJ, Bauer TL et al (1996) Serum immunoreactive-leptin concentrations in normal-weight and obese humans. N Engl J Med 334(5):292–295PubMedCrossRef
go back to reference Estour B, Germain N, Diconne E, Frere D, Cottet-Emard JM, Carrot G, Lang F, Galusca B (2010) Hormonal profile heterogeneity and short-term physical risk in restrictive anorexia nervosa. J Clin Endocrinol Metab 95(5):2203–2210PubMedCrossRef Estour B, Germain N, Diconne E, Frere D, Cottet-Emard JM, Carrot G, Lang F, Galusca B (2010) Hormonal profile heterogeneity and short-term physical risk in restrictive anorexia nervosa. J Clin Endocrinol Metab 95(5):2203–2210PubMedCrossRef
go back to reference Fichter M, Quadflieg N (2001) The structured interview for anorexic and bulimic disorders for DSM-IV and ICD-10 (SIAB-EX): reliability and validity. Eur Psychiatry 16(1):38–48PubMedCrossRef Fichter M, Quadflieg N (2001) The structured interview for anorexic and bulimic disorders for DSM-IV and ICD-10 (SIAB-EX): reliability and validity. Eur Psychiatry 16(1):38–48PubMedCrossRef
go back to reference Fichter MM, Herpertz S, Quadflieg N, Herpertz-Dahlmann B (1998) Structured interview for anorexic and bulimic disorders for DSM-IV and ICD-10: updated (third) revision. Int J Eat Disord 24(3):227–249PubMedCrossRef Fichter MM, Herpertz S, Quadflieg N, Herpertz-Dahlmann B (1998) Structured interview for anorexic and bulimic disorders for DSM-IV and ICD-10: updated (third) revision. Int J Eat Disord 24(3):227–249PubMedCrossRef
go back to reference Fichter MM, Quadflieg N, Georgopoulou E, Xepapadakos F, Fthenakis EW (2005) Time trends in eating disturbances in young Greek migrants. Int J Eat Disord 38(4):310–322PubMedCrossRef Fichter MM, Quadflieg N, Georgopoulou E, Xepapadakos F, Fthenakis EW (2005) Time trends in eating disturbances in young Greek migrants. Int J Eat Disord 38(4):310–322PubMedCrossRef
go back to reference Greenhalgh T (1997) How to read a paper. Papers that report diagnostic or screening tests. BMJ 315(7107):540–543PubMed Greenhalgh T (1997) How to read a paper. Papers that report diagnostic or screening tests. BMJ 315(7107):540–543PubMed
go back to reference Grinspoon S, Gulick T, Askari H, Landt M, Lee K, Anderson E, Ma Z, Vignati L, Bowsher R, Herzog D, Klibanski A (1996) Serum leptin levels in women with anorexia nervosa. J Clin Endocrinol Metab 81(11):3861–3863PubMedCrossRef Grinspoon S, Gulick T, Askari H, Landt M, Lee K, Anderson E, Ma Z, Vignati L, Bowsher R, Herzog D, Klibanski A (1996) Serum leptin levels in women with anorexia nervosa. J Clin Endocrinol Metab 81(11):3861–3863PubMedCrossRef
go back to reference Haas V, Onur S, Paul T, Nutzinger DO, Bosy-Westphal A, Hauer M, Brabant G, Klein H, Muller MJ (2005) Leptin and body weight regulation in patients with anorexia nervosa before and during weight recovery. Am J Clin Nutr 81(4):889–896PubMed Haas V, Onur S, Paul T, Nutzinger DO, Bosy-Westphal A, Hauer M, Brabant G, Klein H, Muller MJ (2005) Leptin and body weight regulation in patients with anorexia nervosa before and during weight recovery. Am J Clin Nutr 81(4):889–896PubMed
go back to reference Haluzik M, Papezova M, Nedvidkova J, Kabrt J (1999) Serum leptin levels in patients with anorexia nervosa before and after partial refeeding, relationships to serum lipids and biochemical nutritional parameters. Physiol Res 48(3):197–202PubMed Haluzik M, Papezova M, Nedvidkova J, Kabrt J (1999) Serum leptin levels in patients with anorexia nervosa before and after partial refeeding, relationships to serum lipids and biochemical nutritional parameters. Physiol Res 48(3):197–202PubMed
go back to reference Hebebrand J, Bulik C (2010) Critical appraisal of the provisional DSM-5 criteria for anorexia nervosa and an alternative proposal. Int J Eat Disord [Epub ahead of print] Hebebrand J, Bulik C (2010) Critical appraisal of the provisional DSM-5 criteria for anorexia nervosa and an alternative proposal. Int J Eat Disord [Epub ahead of print]
go back to reference Hebebrand J, van der Heyden J, Devos R, Kopp W, Herpertz S, Remschmidt H, Herzog W (1995) Plasma concentrations of obese protein in anorexia nervosa. Lancet 346(8990):1624–1625PubMedCrossRef Hebebrand J, van der Heyden J, Devos R, Kopp W, Herpertz S, Remschmidt H, Herzog W (1995) Plasma concentrations of obese protein in anorexia nervosa. Lancet 346(8990):1624–1625PubMedCrossRef
go back to reference Hebebrand J, Blum WF, Barth N, Coners H, Englaro P, Juul A, Ziegler A, Warnke A, Rascher W, Remschmidt H (1997) Leptin levels in patients with anorexia nervosa are reduced in the acute stage and elevated upon short-term weight restoration. Mol Psychiatry 2(4):330–334PubMedCrossRef Hebebrand J, Blum WF, Barth N, Coners H, Englaro P, Juul A, Ziegler A, Warnke A, Rascher W, Remschmidt H (1997) Leptin levels in patients with anorexia nervosa are reduced in the acute stage and elevated upon short-term weight restoration. Mol Psychiatry 2(4):330–334PubMedCrossRef
go back to reference Hebebrand J, Exner C, Hebebrand K, Holtkamp C, Casper RC, Remschmidt H, Herpertz-Dahlmann B, Klingenspor M (2003) Hyperactivity in patients with anorexia nervosa and in semistarved rats: evidence for a pivotal role of hypoleptinemia. Physiol Behav 79(1):25–37PubMedCrossRef Hebebrand J, Exner C, Hebebrand K, Holtkamp C, Casper RC, Remschmidt H, Herpertz-Dahlmann B, Klingenspor M (2003) Hyperactivity in patients with anorexia nervosa and in semistarved rats: evidence for a pivotal role of hypoleptinemia. Physiol Behav 79(1):25–37PubMedCrossRef
go back to reference Hinney A, Lentes KU, Rosenkranz K, Barth N, Roth H, Ziegler A, Hennighausen K, Coners H, Wurmser H, Jacob K, Romer G, Winnikes U, Mayer H, Herzog W, Lehmkuhl G, Poustka F, Schmidt MH, Blum WF, Pirke KM, Schafer H, Grzeschik KH, Remschmidt H, Hebebrand J (1997) Beta 3-adrenergic-receptor allele distributions in children, adolescents and young adults with obesity, underweight or anorexia nervosa. Int J Obes Relat Metab Disord 21(3):224–230PubMedCrossRef Hinney A, Lentes KU, Rosenkranz K, Barth N, Roth H, Ziegler A, Hennighausen K, Coners H, Wurmser H, Jacob K, Romer G, Winnikes U, Mayer H, Herzog W, Lehmkuhl G, Poustka F, Schmidt MH, Blum WF, Pirke KM, Schafer H, Grzeschik KH, Remschmidt H, Hebebrand J (1997) Beta 3-adrenergic-receptor allele distributions in children, adolescents and young adults with obesity, underweight or anorexia nervosa. Int J Obes Relat Metab Disord 21(3):224–230PubMedCrossRef
go back to reference Hoek HW (2006) Incidence, prevalence and mortality of anorexia nervosa and other eating disorders. Curr Opin Psychiatry 19(4):389–394PubMedCrossRef Hoek HW (2006) Incidence, prevalence and mortality of anorexia nervosa and other eating disorders. Curr Opin Psychiatry 19(4):389–394PubMedCrossRef
go back to reference Holtkamp K, Hebebrand J, Mika C, Grzella I, Heer M, Heussen N, Herpertz-Dahlmann B (2003a) The effect of therapeutically induced weight gain on plasma leptin levels in patients with anorexia nervosa. J Psychiatr Res 37(2):165–169PubMedCrossRef Holtkamp K, Hebebrand J, Mika C, Grzella I, Heer M, Heussen N, Herpertz-Dahlmann B (2003a) The effect of therapeutically induced weight gain on plasma leptin levels in patients with anorexia nervosa. J Psychiatr Res 37(2):165–169PubMedCrossRef
go back to reference Holtkamp K, Mika C, Grzella I, Heer M, Pak H, Hebebrand J, Herpertz-Dahlmann B (2003b) Reproductive function during weight gain in anorexia nervosa. Leptin represents a metabolic gate to gonadotropin secretion. J Neural Transm 110(4):427–435PubMedCrossRef Holtkamp K, Mika C, Grzella I, Heer M, Pak H, Hebebrand J, Herpertz-Dahlmann B (2003b) Reproductive function during weight gain in anorexia nervosa. Leptin represents a metabolic gate to gonadotropin secretion. J Neural Transm 110(4):427–435PubMedCrossRef
go back to reference Köpp W, Blum WF, von Prittwitz S, Ziegler A, Lubbert H, Emons G, Herzog W, Herpertz S, Deter HC, Remschmidt H, Hebebrand J (1997) Low leptin levels predict amenorrhea in underweight and eating disordered females. Mol Psychiatry 2(4):335–340PubMedCrossRef Köpp W, Blum WF, von Prittwitz S, Ziegler A, Lubbert H, Emons G, Herzog W, Herpertz S, Deter HC, Remschmidt H, Hebebrand J (1997) Low leptin levels predict amenorrhea in underweight and eating disordered females. Mol Psychiatry 2(4):335–340PubMedCrossRef
go back to reference Laxman B, Morris DS, Yu J, Siddiqui J, Cao J, Mehra R, Lonigro RJ, Tsodikov A, Wei JT, Tomlins SA, Chinnaiyan AM (2008) A first-generation multiplex biomarker analysis of urine for the early detection of prostate cancer. Cancer Res 68(3):645–649PubMedCrossRef Laxman B, Morris DS, Yu J, Siddiqui J, Cao J, Mehra R, Lonigro RJ, Tsodikov A, Wei JT, Tomlins SA, Chinnaiyan AM (2008) A first-generation multiplex biomarker analysis of urine for the early detection of prostate cancer. Cancer Res 68(3):645–649PubMedCrossRef
go back to reference Machado PP, Machado BC, Goncalves S, Hoek HW (2007) The prevalence of eating disorders not otherwise specified. Int J Eat Disord 40(3):212–217PubMedCrossRef Machado PP, Machado BC, Goncalves S, Hoek HW (2007) The prevalence of eating disorders not otherwise specified. Int J Eat Disord 40(3):212–217PubMedCrossRef
go back to reference Mantzoros C, Flier JS, Lesem MD, Brewerton TD, Jimerson DC (1997) Cerebrospinal fluid leptin in anorexia nervosa: correlation with nutritional status and potential role in resistance to weight gain. J Clin Endocrinol Metab 82(6):1845–1851PubMedCrossRef Mantzoros C, Flier JS, Lesem MD, Brewerton TD, Jimerson DC (1997) Cerebrospinal fluid leptin in anorexia nervosa: correlation with nutritional status and potential role in resistance to weight gain. J Clin Endocrinol Metab 82(6):1845–1851PubMedCrossRef
go back to reference Matejek N, Weimann E, Witzel C, Molenkamp G, Schwidergall S, Bohles H (1999) Hypoleptinaemia in patients with anorexia nervosa and in elite gymnasts with anorexia athletica. Int J Sports Med 20(7):451–456PubMedCrossRef Matejek N, Weimann E, Witzel C, Molenkamp G, Schwidergall S, Bohles H (1999) Hypoleptinaemia in patients with anorexia nervosa and in elite gymnasts with anorexia athletica. Int J Sports Med 20(7):451–456PubMedCrossRef
go back to reference Misra M, Miller KK, Almazan C, Ramaswamy K, Aggarwal A, Herzog DB, Neubauer G, Breu J, Klibanski A (2004) Hormonal and body composition predictors of soluble leptin receptor, leptin, and free leptin index in adolescent girls with anorexia nervosa and controls and relation to insulin sensitivity. J Clin Endocrinol Metab 89(7):3486–3495PubMedCrossRef Misra M, Miller KK, Almazan C, Ramaswamy K, Aggarwal A, Herzog DB, Neubauer G, Breu J, Klibanski A (2004) Hormonal and body composition predictors of soluble leptin receptor, leptin, and free leptin index in adolescent girls with anorexia nervosa and controls and relation to insulin sensitivity. J Clin Endocrinol Metab 89(7):3486–3495PubMedCrossRef
go back to reference Mistry K, Cable G (2003) Meta-analysis of prostate-specific antigen and digital rectal examination as screening tests for prostate carcinoma. J Am Board Fam Pract 16(2):95–101PubMedCrossRef Mistry K, Cable G (2003) Meta-analysis of prostate-specific antigen and digital rectal examination as screening tests for prostate carcinoma. J Am Board Fam Pract 16(2):95–101PubMedCrossRef
go back to reference Monteleone P, Martiadis V, Colurcio B, Maj M (2002) Leptin secretion is related to chronicity and severity of the illness in bulimia nervosa. Psychosom Med 64(6):874–879PubMedCrossRef Monteleone P, Martiadis V, Colurcio B, Maj M (2002) Leptin secretion is related to chronicity and severity of the illness in bulimia nervosa. Psychosom Med 64(6):874–879PubMedCrossRef
go back to reference Müller TD, Föcker M, Holtkamp K, Herpertz-Dahlmann B, Hebebrand J (2009) Leptin-mediated neuroendocrine alterations in anorexia nervosa: somatic and behavioral implications. Child Adolesc Psychiatr Clin N Am 18(1):117–129PubMedCrossRef Müller TD, Föcker M, Holtkamp K, Herpertz-Dahlmann B, Hebebrand J (2009) Leptin-mediated neuroendocrine alterations in anorexia nervosa: somatic and behavioral implications. Child Adolesc Psychiatr Clin N Am 18(1):117–129PubMedCrossRef
go back to reference Nakai Y, Hamagaki S, Takagi R, Taniguchi A, Kurimoto F (1999) Plasma concentrations of tumor necrosis factor-alpha (TNF-alpha) and soluble TNF receptors in patients with anorexia nervosa. J Clin Endocrinol Metab 84(4):1226–1228PubMedCrossRef Nakai Y, Hamagaki S, Takagi R, Taniguchi A, Kurimoto F (1999) Plasma concentrations of tumor necrosis factor-alpha (TNF-alpha) and soluble TNF receptors in patients with anorexia nervosa. J Clin Endocrinol Metab 84(4):1226–1228PubMedCrossRef
go back to reference Rastam M, Gillberg C, Garton M (1989) Anorexia nervosa in a Swedish urban region. A population-based study. Br J Psychiatry 155:642–646PubMed Rastam M, Gillberg C, Garton M (1989) Anorexia nervosa in a Swedish urban region. A population-based study. Br J Psychiatry 155:642–646PubMed
go back to reference Robins LN, Wing J, Wittchen HU, Helzer JE, Babor TF, Burke J, Farmer A, Jablenski A, Pickens R, Regier DA et al (1988) The composite international diagnostic interview, an epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Arch Gen Psychiatry 45(12):1069–1077PubMed Robins LN, Wing J, Wittchen HU, Helzer JE, Babor TF, Burke J, Farmer A, Jablenski A, Pickens R, Regier DA et al (1988) The composite international diagnostic interview, an epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Arch Gen Psychiatry 45(12):1069–1077PubMed
go back to reference Rosenbaum M, Goldsmith R, Bloomfield D, Magnano A, Weimer L, Heymsfield S, Gallagher D, Mayer L, Murphy E, Leibel RL (2005) Low-dose leptin reverses skeletal muscle, autonomic, and neuroendocrine adaptations to maintenance of reduced weight. J Clin Invest 115(12):3579–3586PubMedCrossRef Rosenbaum M, Goldsmith R, Bloomfield D, Magnano A, Weimer L, Heymsfield S, Gallagher D, Mayer L, Murphy E, Leibel RL (2005) Low-dose leptin reverses skeletal muscle, autonomic, and neuroendocrine adaptations to maintenance of reduced weight. J Clin Invest 115(12):3579–3586PubMedCrossRef
go back to reference Smiechowska J, Utech A, Taffet G, Hayes T, Marcelli M, Garcia JM (2010) Adipokines in patients with cancer anorexia and cachexia. J Investig Med 58(3):554–559PubMed Smiechowska J, Utech A, Taffet G, Hayes T, Marcelli M, Garcia JM (2010) Adipokines in patients with cancer anorexia and cachexia. J Investig Med 58(3):554–559PubMed
go back to reference Stoving RK, Vinten J, Handberg A, Ebbesen EN, Hangaard J, Hansen-Nord M, Kristiansen J, Hagen C (1998) Diurnal variation of the serum leptin concentration in patients with anorexia nervosa. Clin Endocrinol (Oxf) 48(6):761–768CrossRef Stoving RK, Vinten J, Handberg A, Ebbesen EN, Hangaard J, Hansen-Nord M, Kristiansen J, Hagen C (1998) Diurnal variation of the serum leptin concentration in patients with anorexia nervosa. Clin Endocrinol (Oxf) 48(6):761–768CrossRef
go back to reference Takahashi M, Terashima M, Takagane A, Oyama K, Fujiwara H, Wakabayashi G (2009) Ghrelin and leptin levels in cachectic patients with cancer of the digestive organs. Int J Clin Oncol 14(4):315–320PubMedCrossRef Takahashi M, Terashima M, Takagane A, Oyama K, Fujiwara H, Wakabayashi G (2009) Ghrelin and leptin levels in cachectic patients with cancer of the digestive organs. Int J Clin Oncol 14(4):315–320PubMedCrossRef
go back to reference Thornton C, Russell J, Hudson J (1998) Does the Composite International Diagnostic Interview underdiagnose the eating disorders? Int J Eat Disord 23(3):341–345PubMedCrossRef Thornton C, Russell J, Hudson J (1998) Does the Composite International Diagnostic Interview underdiagnose the eating disorders? Int J Eat Disord 23(3):341–345PubMedCrossRef
go back to reference Tolle V, Kadem M, Bluet-Pajot MT, Frere D, Foulon C, Bossu C, Dardennes R, Mounier C, Zizzari P, Lang F, Epelbaum J, Estour B (2003) Balance in ghrelin and leptin plasma levels in anorexia nervosa patients and constitutionally thin women. J Clin Endocrinol Metab 88(1):109–116PubMedCrossRef Tolle V, Kadem M, Bluet-Pajot MT, Frere D, Foulon C, Bossu C, Dardennes R, Mounier C, Zizzari P, Lang F, Epelbaum J, Estour B (2003) Balance in ghrelin and leptin plasma levels in anorexia nervosa patients and constitutionally thin women. J Clin Endocrinol Metab 88(1):109–116PubMedCrossRef
go back to reference Vaisman N, Hahn T, Karov Y, Sigler E, Barak Y, Barak V (2004) Changes in cytokine production and impaired hematopoiesis in patients with anorexia nervosa: the effect of refeeding. Cytokine 26(6):255–261PubMedCrossRef Vaisman N, Hahn T, Karov Y, Sigler E, Barak Y, Barak V (2004) Changes in cytokine production and impaired hematopoiesis in patients with anorexia nervosa: the effect of refeeding. Cytokine 26(6):255–261PubMedCrossRef
go back to reference von Prittwitz S, Blum WF, Ziegler A, Scharmann S, Remschmidt H, Hebebrand J (1997) Restrained eating is associated with low leptin levels in underweight females. Mol Psychiatry 2(5):420–422CrossRef von Prittwitz S, Blum WF, Ziegler A, Scharmann S, Remschmidt H, Hebebrand J (1997) Restrained eating is associated with low leptin levels in underweight females. Mol Psychiatry 2(5):420–422CrossRef
go back to reference Wabitsch M, Ballauff A, Holl R, Blum WF, Heinze E, Remschmidt H, Hebebrand J (2001) Serum leptin, gonadotropin, and testosterone concentrations in male patients with anorexia nervosa during weight gain. J Clin Endocrinol Metab 86(7):2982–2988PubMedCrossRef Wabitsch M, Ballauff A, Holl R, Blum WF, Heinze E, Remschmidt H, Hebebrand J (2001) Serum leptin, gonadotropin, and testosterone concentrations in male patients with anorexia nervosa during weight gain. J Clin Endocrinol Metab 86(7):2982–2988PubMedCrossRef
go back to reference Welt CK, Chan JL, Bullen J, Murphy R, Smith P, DePaoli AM, Karalis A, Mantzoros CS (2004) Recombinant human leptin in women with hypothalamic amenorrhea. N Engl J Med 351(10):987–997PubMedCrossRef Welt CK, Chan JL, Bullen J, Murphy R, Smith P, DePaoli AM, Karalis A, Mantzoros CS (2004) Recombinant human leptin in women with hypothalamic amenorrhea. N Engl J Med 351(10):987–997PubMedCrossRef
go back to reference Wild B, Friederich HC, Gross G, Teufel M, Herzog W, Giel KE, de Zwaan M, Schauenburg H, Schade-Brittinger C, Schafer H, Zipfel S (2009) The ANTOP study: focal psychodynamic psychotherapy, cognitive-behavioural therapy, and treatment-as-usual in outpatients with anorexia nervosa—a randomized controlled trial. Trials 10:23PubMedCrossRef Wild B, Friederich HC, Gross G, Teufel M, Herzog W, Giel KE, de Zwaan M, Schauenburg H, Schade-Brittinger C, Schafer H, Zipfel S (2009) The ANTOP study: focal psychodynamic psychotherapy, cognitive-behavioural therapy, and treatment-as-usual in outpatients with anorexia nervosa—a randomized controlled trial. Trials 10:23PubMedCrossRef
go back to reference Wittchen HU (1994) Reliability and validity studies of the WHO—Composite International Diagnostic Interview (CIDI): a critical review. J Psychiatr Res 28(1):57–84PubMedCrossRef Wittchen HU (1994) Reliability and validity studies of the WHO—Composite International Diagnostic Interview (CIDI): a critical review. J Psychiatr Res 28(1):57–84PubMedCrossRef
go back to reference Wittchen HU, Nelson CB, Lachner G (1998) Prevalence of mental disorders and psychosocial impairments in adolescents and young adults. Psychol Med 28(1):109–126PubMedCrossRef Wittchen HU, Nelson CB, Lachner G (1998) Prevalence of mental disorders and psychosocial impairments in adolescents and young adults. Psychol Med 28(1):109–126PubMedCrossRef
go back to reference Wolter H, Schneider N, Pfeiffer E, Lehmkuhl U (2009) Diagnostic crossover from obesity to atypical anorexia nervosa—a case report. Obes Facts 2(1):52–53PubMedCrossRef Wolter H, Schneider N, Pfeiffer E, Lehmkuhl U (2009) Diagnostic crossover from obesity to atypical anorexia nervosa—a case report. Obes Facts 2(1):52–53PubMedCrossRef
go back to reference World Health Organization (WHO) (1990) Composite international diagnostic interview (CIDI). World Health Organization, Geneva World Health Organization (WHO) (1990) Composite international diagnostic interview (CIDI). World Health Organization, Geneva
Metadata
Title
Screening for anorexia nervosa via measurement of serum leptin levels
Authors
M. Föcker
N. Timmesfeld
S. Scherag
K. Bühren
M. Langkamp
A. Dempfle
E. M. Sheridan
M. de Zwaan
C. Fleischhaker
W. Herzog
K. Egberts
S. Zipfel
B. Herpertz-Dahlmann
J. Hebebrand
Publication date
01-04-2011
Publisher
Springer Vienna
Published in
Journal of Neural Transmission / Issue 4/2011
Print ISSN: 0300-9564
Electronic ISSN: 1435-1463
DOI
https://doi.org/10.1007/s00702-010-0551-z

Other articles of this Issue 4/2011

Journal of Neural Transmission 4/2011 Go to the issue

Basic Neurosciences, Genetics and Immunology - Original Article

The effect of acetylcholine on pain-related electric activities in the hippocampal CA3 of rats