{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T00:20:36Z","timestamp":1793751636954,"version":"4.6.1"},"reference-count":108,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T00:00:00Z","timestamp":1614038400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3390\/nu13020709","type":"journal-article","created":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T12:40:16Z","timestamp":1614084016000},"page":"709","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["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"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8995-6401","authenticated-orcid":false,"given":"Maria","family":"Seidel","sequence":"first","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 171 65 Solna, Sweden"},{"name":"Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universit\u00e4t Dresden, 1099 Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9004-9873","authenticated-orcid":false,"given":"Signe","family":"Markmann Jensen","sequence":"additional","affiliation":[{"name":"Research Unit Eating Disorders, Psychiatric Center Ballerup, Maglev\u00e6nget 32, 2750 Ballerup, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren","family":"Healy","sequence":"additional","affiliation":[{"name":"Research Unit Eating Disorders, Psychiatric Center Ballerup, Maglev\u00e6nget 32, 2750 Ballerup, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aakriti","family":"Dureja","sequence":"additional","affiliation":[{"name":"Research Unit Eating Disorders, Psychiatric Center Ballerup, Maglev\u00e6nget 32, 2750 Ballerup, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hunna J.","family":"Watson","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA"},{"name":"School of Psychology, Curtin University, Perth U1987, Australia"},{"name":"Division of Paediatrics, University of Western Australia, Perth 6907, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgitte","family":"Holst","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, University of Copenhagen, 1353 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7772-3264","authenticated-orcid":false,"given":"Cynthia M.","family":"Bulik","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 171 65 Solna, Sweden"},{"name":"Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA"},{"name":"Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2060-1914","authenticated-orcid":false,"given":"Jan Magnus","family":"Sj\u00f6gren","sequence":"additional","affiliation":[{"name":"Research Unit Eating Disorders, Psychiatric Center Ballerup, Maglev\u00e6nget 32, 2750 Ballerup, Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen, 2200 N Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). 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