Low Levels of Serum Ghrelin and Nesfatin-1 Are Associated With Anxiety Disorders in Children

Abstract

Objectives: Because appetite-regulating hormones are implicated in neuronal survival, growth, and differentiation, they have been suggested to play a role in anxiety disorders. To date, few studies have focused on the association between these hormones and anxiety disorders in children. This study investigated the potential differences in leptin, ghrelin, and nesfatin-1 serum levels in drug-naïve children with anxiety disorders, including social anxiety disorder, separation anxiety disorder, and generalized anxiety disorder, and in healthy controls. Methods: This study included 45 children (14 boys and 31 girls) with anxiety disorders and 35 healthy controls (13 boys and 22 girls) aged 8–18 years. The severity of anxiety disorders and additional symptoms were evaluated using the Revised Child Anxiety and Depression Scales–Child Version. Enzyme-linked immunosorbent assay (ELISA) was used to evaluate leptin, ghrelin, and nesfatin-1 serum levels. Results: Leptin levels were significantly higher in children with anxiety disorders than in the control group, and ghrelin and nesfatin-1 levels were significantly lower in children with anxiety disorders than in the control group for girls and for the entire sample. However, only low nesfatin-1 levels were significantly associated with anxiety disorders in boys. In the entire sample, potential confounders such as age, sex, body mass index, and the severity of depressive symptoms were controlled for, and the results were the same for ghrelin and nesfatin-1 levels. However, the difference in leptin levels between groups was not significant. Conclusion: These findings suggest that dysregulation of ghrelin and nesfatin-1 concentrations may be related to the etiopathogenesis of childhood anxiety disorders. © 2025 Korean Academy of Child and Adolescent Psychiatry.