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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Anorexia Nervosa | Active Comparator | 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 |
|
| Morbidly Obese | Active Comparator | 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) |
|
| Healthy Volunteer | No Intervention | Volunteers with normal BMI and without any additional chronic disease |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Bariatric surgery-RYGB | Procedure | 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). |
| 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 |
| 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Serum glucose change | Change in baseline glucose (mg/dl) at when decreasing by 10 percent or increasing by 10 percent from initial weight. | 3 months on average |
| Serum insulin change | Change in baseline insulin (µU/mL) at when decreasing by 10 percent or increasing by 10 percent from initial weight. |
Inclusion Criteria:
for Anorexia Nervosa group:
for Morbidly Obese group:
for Healthy Volunteers:
Exclusion Criteria:
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|
| Dietary intervention | Behavioral | High-calorie medical nutrition program to ensure weight gain |
|
| 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 |
| 3 months on average |
| Serum CRP change | Change in baseline CRP at when decreasing by 10 percent or increasing by 10 percent from initial weight. | 3 months on average |
| ID | Term |
|---|---|
| D000856 | Anorexia Nervosa |
| D001836 | Body Weight Changes |
| ID | Term |
|---|---|
| D001068 | Feeding and Eating Disorders |
| D001523 | Mental Disorders |
| D001835 | Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D004035 | Diet Therapy |
| ID | Term |
|---|---|
| D044623 | Nutrition Therapy |
| D013812 | Therapeutics |
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