Plasma kisspeptin and ghrelin levels are independently correlated with physical activity in patients with anorexia nervosa

Appetite. 2017 Jan 1:108:141-150. doi: 10.1016/j.appet.2016.09.032. Epub 2016 Sep 28.


While physical hyperactivity represents a frequent symptom of anorexia nervosa and may have a deleterious impact on the course of the disease, the underlying mechanisms are poorly understood. Since several food intake-regulatory hormones affect physical activity, the aim of the study was to investigate the association of physical activity with novel candidate hormones (kisspeptin, ghrelin, oxyntomodulin, orexin-A, FGF-21, R-spondin-1) possibly involved in patients with anorexia nervosa. Associations with psychometric parameters and body composition were also assessed. We included 38 female anorexia nervosa inpatients (body mass index, BMI, mean ± SD: 14.8 ± 1.7 kg/m2). Physical activity was evaluated using portable armband devices, body composition by bioelectrical impedance analysis. Blood withdrawal (hormones measured by ELISA) and psychometric assessment of depressiveness (PHQ-9), anxiety (GAD-7), perceived stress (PSQ-20) and disordered eating (EDI-2) were performed at the same time. Patients displayed a broad spectrum of physical activity (2479-26,047 steps/day) which showed a negative correlation with kisspeptin (r = -0.41, p = 0.01) and a positive association with ghrelin (r = 0.42, p = 0.01). The negative correlation with oxyntomodulin (r = -0.37, p = 0.03) was lost after consideration of potential confounders by regression analysis. No correlations were observed between physical activity and orexin-A, FGF-21 and R-spondin-1 (p > 0.05). Kisspeptin was positively correlated with BMI and body fat mass and negatively associated with the interpersonal distrust subscale of the EDI-2 (p < 0.01). Depressiveness, anxiety, and perceived stress did not correlate with kisspeptin or any other of the investigated hormones (p > 0.05). In conclusion, kisspeptin is inversely and ghrelin positively associated with physical activity as measured by daily step counts in anorexia nervosa patients suggesting an implication of these peptide hormones in the regulation of physical activity in anorexia nervosa.

Keywords: Accelerometry; Eating disorder; Endocrine; Exercise; Psychosomatic; SenseWear™ armband.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Actigraphy
  • Adiposity
  • Adolescent
  • Adult
  • Amenorrhea / etiology
  • Anorexia Nervosa / blood*
  • Anorexia Nervosa / physiopathology
  • Anorexia Nervosa / psychology
  • Anxiety / etiology
  • Body Mass Index
  • Female
  • Germany
  • Ghrelin / blood*
  • Humans
  • Hyperkinesis / diagnosis*
  • Hyperkinesis / etiology
  • Kisspeptins / blood*
  • Middle Aged
  • Motor Activity*
  • Psychomotor Agitation / diagnosis*
  • Psychomotor Agitation / etiology
  • Severity of Illness Index
  • Thinness / etiology*
  • Young Adult


  • GHRL protein, human
  • Ghrelin
  • KISS1 protein, human
  • Kisspeptins