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Objective: We aimed to evaluate the serum ghrelin (GHR) levels and lipid profile in patients diagnosed with panic disorder (PD) and in patients with and without the PD agoraphobia subtypes, and to compare these parameters before and after treatment in patients diagnosed with PD in this study.
Method: The GHR, triglyceride (TRG), total cholesterol (total-C), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and very low density lipoprotein (VLDL-C) levels were measured in blood samples taken from 32 PD patients with agoraphobia, 22 PD patients without agoraphobia and 53 control group subjects in our study. Body mass indexes (BMI) was recorded in all groups. 23 of 53 patients who were started 20 to 40 mg/day paroxetine, a selective serotonin reuptake inhibitor (SSRI), continued treatment. The GHR levels and serum lipid profiles of the 23 patients who continued treatment were measured again at the end of twelve weeks.
Results: When the three groups of PD with agoraphobia, PD without agoraphobia and the control group were compared, the serum GHR, TRG, Total-C, LDL-C and VLDL-C levels were statistically significantly different between the groups (p<0.05). There was no statistically significant difference for HDL-K and BMI levels (p>0.05). The GHR and TRG, Total-C, LDL-C, and VLDL-C levels were found to be statistically significantly higher in the PD with agoraphobia group than the PD without agoraphobia and control groups in the comparison we conducted to determine the group that created the difference (p<0.05). However, there was no significant difference between the PD without agoraphobia and control groups in terms of the same parameters (p>0.05). When the serum GHR levels and the lipid profile of the 23 patients that continued their paroxetine 20- 40 mg/day treatment for twelve weeks were re-evaluated, the serum GHR, Total-C and BMI levels after treatment were found to be statistically significantly decreased compared to the values before treatment (p<0.05). A statistically significantly decrease was found in serum GHR, Total-C and BMI levels in the PD with agoraphobia group after treatment compared to the values before treatment (p<0.05). A statistically significant decrease was found in serum GHR and Total-C levels in the PD without agoraphobia group after treatment (p<0.05). Other parameters did not change significantly after the treatment (p>0.05).
Conclusions: There may be a pathophysiological relationship between the GHR and lipid profiles that interact with each other in PD In fact, this relationship was found to be more marked in PD with agoraphobia than in PD without agoraphobia. Neurobiological differences can therefore be used in addition to clinical symptoms for the differentiation of PD with and without agoraphobia. A reduction in these parameters with treatment may be effective in identifying disease activity and response to treatment.