GDF15 Is Elevated in Eating Disorders and Is Involved in the Gut-Brain Axis via Ghrelin

Abstract

Objective: GDF15 induces anorexia and visceral discomfort, regulating appetite, food intake and potentially metabolic responses. However, its role in eating disorders remains unexplored.

Method: A total of 145 participants were recruited (60 patients with anorexia nervosa, 20 with bulimia nervosa, 13 with binge eating disorder, 52 participants from the general population). Ghrelin and GDF15 serum levels were measured with immunosorbent assay kits.

Results: Ghrelin was elevated in patients with an eating disorder compared to healthy controls (age and BMI-adjusted ANCOVA, F-value 4.084, p-value 0.008). GDF15 was significantly correlated with ghrelin (Spearman rho 0.430, p-value < 0.001) and BMI (rho = -0.176, p-value = 0.025). GDF15 predicted the BMI of patients with anorexia nervosa and individuals from the general population, again being elevated at lower BMI (linear regression beta -0.254, p-value 0.005). The effect of GDF15 on BMI was observed as under the mediation of ghrelin (direct effect -0.056, p-value 0.577; indirect effect -0.199, p-value < 0.001).

Conclusions: Present results provide novel insights into the role of GDF15 in eating disorders, describing its serum level in this clinical population for the first time. In addition, a positive correlation between GDF15 and ghrelin serum levels is also reported for the first time.

Keywords: MIC‐1; appetite control; metabolic regulation; neuroendocrine signalling; weight dysregulation.