Comparison of the Effects of Weight Changes on Serum Adipokines in Patients Diagnosed With Anorexia Nervosa and Morbid Obesity

Study Overview
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Brief Summary
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In this study, when patients diagnosed with AN started treatment and their weight increased by 10%; On the other hand, it was aimed to compare the changes in serum adipokine levels observed in morbidly obese patients before bariatric surgery and when they lost 10% of their post-op weight with both anthropometric measurements, biochemical parameters, and values of healthy volunteers.

Detailed Description
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The most characteristic feature of obesity is the increase in adipose tissue. On the contrary, in anorexia nervosa, there is a decrease in adipose tissue enough to impair neuroendocrine functions. Adipose tissue is formed by loosely binding lipid-filled cells called adipocytes and is now considered an important part of energy metabolism. Adipokines it secretes play a role in many physiological processes of the body such as nutrition, appetite, energy balance, insulin, and glucose metabolism, lipid metabolism, regulation of blood pressure, vascular remodeling, coagulation, and inflammation. Therefore, changes in the amount of body fat in these two patient groups, which are at the two ends of the spectrum, affect both the biochemical parameters and physiological functions of the patients in different ways. It is expected that both adipokine levels and biochemical parameters will approach the values of healthy subjects with a decrease in adipose tissue of clinically morbidly obese patients and an increase in adipose tissue of patients with AN. However, in some studies comparing the parameters of patients with constitutionally weak patients and patients with AN, results contrary to expectations were obtained. In this study, we compared the extent to which weight changes changed adipokines and correlated with biochemical parameters based on healthy and normal-weight volunteers.

Official Title
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Comparison of the Effects of Weight Changes on Serum Adipokines in Patients Diagnosed With Anorexia Nervosa and Morbid Obesity

Conditions
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Weight Change, Body, Anorexia Nervosa, Bariatric Surgery

Intervention / Treatment
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* Procedure: Bariatric surgery-RYGB
* Behavioral: Dietary intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: for Anorexia Nervosa group: Have been diagnosed with anorexia nervosa BMI <18 kg/m2 Good general health Volunteering to participate in the study for Morbidly Obese group: Who was diagnosed with morbid obesity and planned to undergo RYGB operation BMI> 40 kg/m2 Volunteering to participate in the study for Healthy Volunteers: Good general health BMI >20 and <30 kg/m2 Volunteering to participate in the study Exclusion Criteria: <13 and> 60 years old to had type 2 diabetes, hypertension, liver and kidney failure, cancer, or a chronic disease

Ages Eligible for Study
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Minimum Age: 13 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Anorexia Nervosa<br>Patients diagnosed with Anorexia Nervosa, having a BMI of <18, being followed up and treated in the Psychiatry Eating Disorders Polyclinic and endocrinology outpatient clinics, and who have approximately 10% weight gain during the treatment process | Behavioral: Dietary intervention<br>* High-calorie medical nutrition program to ensure weight gain<br>|
| Active Comparator: Morbidly Obese<br>Patients with a BMI> 40 diagnosed with Morbid Obesity and who lost approximately 10% of their weight by performing obesity surgery (gastric bypass or sleeve gastrectomy) | Procedure: Bariatric surgery-RYGB<br>* After the creation of a 15-25-cc gastric pouch from the upper stomach, transection of proximal jejunum 70 cm from Treitz ligament also called alimentary tract and anastomosis of the distal end of jejunum to the gastric pouch, and thereafter, anastomosis of the proximal end of transected jejunum to the distal part of the jejunum at 150 cm below the site of transection (jejunoileal anastomosis).<br>|
| No Intervention: Healthy Volunteer<br>Volunteers with normal BMI and without any additional chronic disease | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Plasma Leptin levels changes: | Change in baseline Leptin levels at when decreasing by 10 percent or increasing by 10 percent from initial weight. Measured by plasma samples. | 3 months on average | 
| Plasma Apelin levels changes | Change in baseline Apelin levels at when decreasing by 10 percent or increasing by 10 percent from initial weight. Measured by plasma samples. | 3 months on average | 
| Plasma Omentin levels changes | Change in baseline Omentin levels at when decreasing by 10 percent or increasing by 10 percent from initial weight. Measured by plasma samples. | 3 months on average | 
| Plasma Adiponectin levels changes | Change in baseline Adiponectin levels at when decreasing by 10 percent or increasing by 10 percent from initial weight. Measured by plasma samples. | 3 months on average | 
| Plasma IL-6 levels changes | Change in baseline IL-6 levels at when decreasing by 10 percent or increasing by 10 percent from initial weight. Measured by plasma samples. | 3 months on average | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Weight change | Change in baseline weight (kg) at when decreasing by 10 percent or increasing by 10 percent from initial weight. | 3 months on average | 
| Fat mass change | Change in baseline fat mass (kg) at when decreasing by 10 percent or increasing by 10 percent from initial weight. | 3 months on average | 
| Fat free mass changes | Change in baseline fat free mass (kg) at when decreasing by 10 percent or increasing by 10 percent from initial weight. | 3 months on average | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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adipocytokines, leptin, adiponectin, omentin, apelin, IL-6, Anorexia Nervosa, Bariatric Surgery, fat mass