[Leptin and inhibin B as predictors of reproductive recovery in patients with anorexia nervosa during weight gain].

INTRODUCTION: Anorexia nervosa represents an eating disorder that is associated with substantial psychological, social and physiological abnormalities, involving 0.5-2% of female population.

OBJECTIVE: The secretion patterns of inhibin B, as marker of gonadal activity, and leptin, as an indicator of energy balance and body composition, were analyzed in our cross-sectional study in order to asses the restoration of reproductive function in patients with anorexia nervosa (AN) during gaining of normal weight.

METHOD: The study included 20 patients with low weight AN (BMI 14.3 +/- 0.3 kg/m2), 22 partially recovered AN (BMI 17.4 +/- 0.1 kg/m2), and 29 gained regular weight, out of whom 16 had no restoration of menstrual cycle (BMI 19.5 +/- 0.1 kg/m2), and 13 had at least six consecutive menstrual cycles (BMI 19.3 +/- 1.0 kg/m2). Nineteen eumenorrheic females with BMI 19.8 +/- 0.4 kg/m2 were the controls.

RESULTS: Significant correlation between leptin and inhibin B (c = 0.446; p = 0.000), leptin and delta LH (c = 0.611; p < 0.001), and inhibin B and delta LH (c = 0.574; p < 0.001) was found in patients with anorexia nervosa during weight gain. Leptin (p = 0.0039), inhibin B (p = 0.0173), LH (p = 0.0323) and delta LH (p = 0.0087) were important predictors of reproductive recovery in patients with anorexia nervosa during gaining of normal weight. Among aforementioned parameters, leptin (p = 0.0057) appeared to be the most important.

CONCLUSION: Leptin is the most important predictor of reproductive recovery in patients with anorexia nervosa during weight normalization. These findings suggest that decreased leptin levels may be responsible for several neuroendocrine abnormalities seen in anorexia nervosa. Thus, interventional studies involving administration of recombinant leptin are required to fully clarify the physiologic and potentially therapeutic role of leptin in anorexia nervosa.