152 Chapter 7 Axes T-1 (Screening) T2 T3 T4 F-value P-value Reference range Appetite regulating hormones/gut peptides and adipokines Leptin (ng/ mL) 3∙75 ± 0.73 16.00 ± 12.45 16.00 ± 10.91 13.00 ± 6.72 1∙635 0∙309 2.2 – 27.9 for females with BMI 20-25 Adiponectin (µg/mL) 17∙13 ± 3∙82 15∙55 ± 3∙82 11∙28 ± 3∙82 10∙17 ± 3∙82 1∙523 0∙355 Posterior pituitary hormones and renal function ADH (pmol/L) 20∙72 ± 16∙30 12∙62 ± 2∙35 8∙57 ± 3∙40 9∙62 ± 4∙83 2∙049 0∙241 < 14 pmol/L Urine osmolality (mOsm./kg) 299∙50 ± 149∙81 454∙50± 149∙81 485∙25 ± 149∙81 552∙50 ± 149∙81 2∙087 0∙172 300 - 900 mOsm/ kg H2O Urine sodium (mmol/L) 23∙75 ± 15∙13 103∙00 ± 61∙46 44∙00 ± 14∙34 57∙00 ± 24∙92 1∙917 0∙274 40 - 220 mmol/24 hours Noradrenergic Adrenaline (nmol/L) 0∙12 ± 0∙03 0∙12 ± 0∙03 0∙10 ± 0∙03 0∙09 ± 0∙03 0∙321 0∙810 Noradrenaline (nmol/L) 8∙98 ± 2∙45 4∙79 ± 1∙05 3∙61 ± 1∙17 3∙19 ± 0∙10 2∙666 0∙219 Dopamine (nmol/L) 0∙36 ± 0∙13 0∙18 ± 0∙04 0∙13 ± 0∙01 0∙12 ± 0∙03 1∙776 0∙313 Furthermore, we saw a non-significant mean decrease of progesterone (37.43%), ACTH (41.72%), GH (44.07%), adiponectin (40.63%) and ADH (53.60%). Adrenaline (26.02%) and noradrenaline (64.49%) levels showed a non-significant decrease as well. At baseline, leptin in our patients was low (3.75±0.73 ng/mL), as would be expected in AN patients. We found a mean increase of leptin (247.67%) at the other time points, but this was not significant due to a large variability (67.4345.7%), with the most increase in weight-responders. IGF-1 (41.16%), urine osmolality (84.47%) and urine sodium (140.00%) also showed an increase after DBS, although these findings were not significant. Although our patients were all severely underweight at baseline and the mean T3 at baseline was below the reference value (0.96 ±0.25 nmol/L), there was no significant change in T3, free T4 and TSH levels over time. Also we did not find significant changes in GH, IGF 1, insulin and adiponectin levels over time. Catecholamines did not show any significant changes over time either, although in the individual charts there seems to be a downward trend in dopamine as well as noradrenaline (see supplement 2) over time. We found no significant changes in the three fatty acids indices, arachidonic acid (AA)/ eicosapentaenoic acid (EPA) ratio, or docosahexaenoic acid (DHA) as shown in table 3. Table 2. Continued
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