Elevated Plasma Ghrelin Levels in Night-Eating Syndrome

Ms. A, a 27-year-old woman, reported that the first symptoms of night-eating syndrome appeared 1 year before she underwent our psychiatric examination. As in previous reports, administration of a selective serotonin reuptake inhibitor (citalopram, 100 mg/day) was started (3). A complete remission was obtained within 8 weeks. Medication was continued for another 8 weeks before withdrawal. About 8 weeks later, Ms. A described a relapse of night-eating syndrome.

Her plasma ghrelin concentrations were measured by radioimmunoassay (Phoenix Pharmaceuticals, Belmont, Calif.) at three times (before treatment, 8 weeks later [during drug treatment and full remission], and finally, after relapse). Specimens were collected on all three occasions: every 20 minutes between 10 p.m. and 7:00 a.m. by a long catheter.

Mean nocturnal ghrelin concentrations (10 p.m. to 7 a.m.) were 1051 pg/ml before treatment, 977 pg/ml 8 weeks later (during drug treatment and full remission), and 1013 pg/ml after relapse. The body mass index (kg/m²) of Ms. A was about 23.5 at all examinations.

As control subjects we investigated three healthy women, 22, 23, and 32 years old, with body mass indexes of 21.9, 22.4, and 20.8 kg/m². Their mean ghrelin concentrations were 372, 402, and 338 pg/ml, respectively.