Malnutrition induces dissociated changes in lymphocyte count and subset proportion in patients with anorexia nervosa

Objective: The effect of nutritional state on lymphocytes in patients with anorexia nervosa (AN) was studied. Method: We studied total lymphocyte count (TLC), lymphocyte subsets, and nutritional markers [body mass index (BMI), insulin‐like growth factor‐1 (IGF‐I)], and serum zinc concentration) in 33 patients with AN and 10 healthy controls. Results: TLC positively correlated with BMI ( r = .680, p < .001), IGF‐I ( r = .609 p < .001), and zinc ( r = .589, p < .001). The CD4+ T‐lymphocyte (CD4) proportion correlated negatively with BMI ( r = −.301, p = .05) and IGF‐I ( r = −.346, p = .023), counteracting the effect of malnutrition on TLC. However, because this increase in CD4 proportion was weak, patients with very severe malnutrition (indicated by serum zinc less than 40 μg/dL) had critically low CD4 counts of less than 200 cells/μL. Conclusion: Our findings suggest that lymphocyte counts and subset proportion change in an opposite manner in patients with AN, and that decrease in serum zinc levels is nutrition‐related. © 2007 by Wiley Periodicals, Inc.