Evidence mapPaperPMID 33672297Full record

SynthesisNutrients2021

A Systematic Review and Meta-Analysis Finds Increased Blood Levels of All Forms of Ghrelin in Both Restricting and Binge-Eating/Purging Subtypes of Anorexia Nervosa.

Maria Seidel, Signe Markmann Jensen, Darren Healy, Aakriti Dureja, Hunna J Watson, Birgitte Holst, Cynthia M Bulik, Jan Magnus Sjögren

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Nutrients, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
2.8field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.

  1. Pooled it
  2. Nutritional state-dependent changes in subcortical limbic structures in anorexia nervosa are linked to leptin, ghrelin, and neurofilament light.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026
    Article
  3. Review
  4. GDF15 Is Elevated in Eating Disorders and Is Involved in the Gut-Brain Axis via Ghrelin.European eating disorders review : the journal of the Eating Disorders Association · 2026
    Article
  5. Review
  6. Review
  7. Article
  8. Review
  9. Review
  10. Article
  11. Review
  12. Article
  13. Reframing anorexia nervosa as a metabo-psychiatric disorder.Trends in endocrinology and metabolism: TEM · 2021
    Review
  14. Article
  15. GIST and Ghrelin: To Be or Not to Be?Diagnostics (Basel, Switzerland) · 2021
    Article
  16. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 5 countries.

Maria SeidelDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 171 65 Solna, Sweden.ORCID 0000-0001-8995-6401
Signe Markmann JensenResearch Unit Eating Disorders, Psychiatric Center Ballerup, Maglevænget 32, 2750 Ballerup, Denmark.ORCID 0000-0002-9004-9873
Darren HealyResearch Unit Eating Disorders, Psychiatric Center Ballerup, Maglevænget 32, 2750 Ballerup, Denmark.
Aakriti DurejaResearch Unit Eating Disorders, Psychiatric Center Ballerup, Maglevænget 32, 2750 Ballerup, Denmark.
Hunna J WatsonDepartment of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
Birgitte HolstDepartment of Biomedical Sciences, University of Copenhagen, 1353 Copenhagen, Denmark.
Cynthia M BulikDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 171 65 Solna, Sweden.ORCID 0000-0001-7772-3264
Jan Magnus SjögrenResearch Unit Eating Disorders, Psychiatric Center Ballerup, Maglevænget 32, 2750 Ballerup, Denmark.ORCID 0000-0003-2060-1914
Center for Clinical & Basic Research · DKUniversity of Copenhagen · DKUniversity of North Carolina at Chapel Hill · USKarolinska Institutet · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Anorexia nervosa (AN) is a severe psychiatric condition associated with high mortality and chronicity. The hunt for state, trait, subtyping, and prognostic biomarkers is ongoing and the orexigenic hormone ghrelin and its different forms, acyl ghrelin and desacyl ghrelin, have been proposed to be increased in AN, especially in the restrictive subtype. A systematic literature search was performed using established databases up to 30 November 2020. Forty-nine studies met inclusion criteria for cross-sectional and longitudinal meta-analyses on total ghrelin, acyl ghrelin, and desacyl ghrelin. All forms of ghrelin were increased in the acute stage of anorexia nervosa during fasting compared to healthy controls. Previous notions on differences in ghrelin levels between AN subtypes were not supported by current data. In addition, a significant decrease in total ghrelin was observed pre-treatment to follow-up. However, total ghrelin levels at follow-up were still marginally elevated compared to healthy controls, whereas for acyl ghrelin, no overall effect of treatment was observed. Due to heterogeneity in follow-up designs and only few data on long-term recovered patients, longitudinal results should be interpreted with caution. While the first steps towards a biomarker in acute AN have been completed, the value of ghrelin as a potential indicator of treatment success or recovery status or its use in subtype differentiation are yet to be established.

Indexed as

Acute DiseaseAdolescentAdultAnorexia NervosaBiomarkersBulimiaCross-Sectional StudiesFastingFemaleGhrelinHumansLongitudinal StudiesMalePhenotypeYoung AdultBiomarkersGhrelinacyl ghrelinanorexia nervosadesacyl ghrelineating disordersghrelinmeta-analysissystematic review

Identifiers

PMID33672297
PMCPMC7926807
OpenAlexW3130646406

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.