Ghrelin activation and neuropeptide Y elevation in response to medium chain triglyceride administration in anorexia nervosa patients

Clin Nutr ESPEN. 2017 Feb;17:100-104. doi: 10.1016/j.clnesp.2016.10.001. Epub 2016 Oct 19.


Background & aims: Ghrelin, a peptide found in the stomach, increases appetite and fat-free mass while suppressing energy expenditure. Ghrelin requires modification by medium-chain triglycerides (MCTs) to exert its physiological effects. In this study, we investigated ghrelin activation and the resulting physiological changes following MCT administration.

Methods: Thirty participants were selected from among inpatients diagnosed with anorexia nervosa (AN). The patients were randomly divided into three groups by the MCT content of their nutritional supplement: (1) 'MCT high' (>6 g/day), (2) 'MCT moderate' (1-6 g/day), and (3) 'MCT low' (<1 g/day). Physical factors such as body weight and composition, as well as levels of nutrition-related serum factors such as acylated (active form) and desacyl (inactive form) ghrelin, leptin, growth hormone, insulin-like growth factor, and neuropeptide Y (NPY) were measured at weeks 0, 2, 4, and 6 of the treatment protocol.

Results: Significantly higher ghrelin activation was found in the 'MCT high' than in the 'MCT low' group (P < 0.05). The amount of consumed MCT had a curvilinear relationship with the active ghrelin level (P = 0.00). NPY levels in the 'MCT high' group were significantly more elevated than in the 'MCT low' group (P < 0.05). MCT administration did not significantly affect the remaining factors.

Conclusions: This study clearly demonstrated that MCT activates ghrelin and increases NPY, suggesting that nutritional supplementation with MCT may be effective for the treatment of AN patients in an emaciated state.

Keywords: Activation; Anorexia nervosa; Ghrelin; Medium-chain triglycerides; Neuropeptide Y.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Anorexia Nervosa / blood
  • Anorexia Nervosa / diagnosis
  • Anorexia Nervosa / physiopathology
  • Anorexia Nervosa / therapy*
  • Biomarkers / blood
  • Body Composition
  • Enteral Nutrition / adverse effects
  • Enteral Nutrition / methods*
  • Female
  • Ghrelin / blood*
  • Humans
  • Japan
  • Neuropeptide Y / blood*
  • Nutrition Assessment
  • Time Factors
  • Treatment Outcome
  • Triglycerides / administration & dosage*
  • Triglycerides / adverse effects
  • Up-Regulation
  • Weight Gain
  • Young Adult


  • Biomarkers
  • GHRL protein, human
  • Ghrelin
  • Neuropeptide Y
  • Triglycerides