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Paradoxical increase of plasma vitamin B 12 and folates with disease severity in anorexia nervosa
Author(s) -
Corbetta Fabiola,
Tremolizzo Lucio,
Conti Elisa,
Ferrarese Carlo,
Neri Francesca,
Bomba Monica,
Nacinovich Renata
Publication year - 2015
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/eat.22371
Subject(s) - medicine , alkaline phosphatase , endocrinology , anorexia nervosa , vitamin b12 , vitamin , psychopathology , liver function , liver disease , reference range , gastroenterology , chemistry , enzyme , biochemistry , psychiatry , eating disorders
Objective Anorexia nervosa (AN) is a complex disorder involving severe psychological manifestations and multiple organ damage, including liver dysfunction. The primary aim of this study consisted in assessing plasma levels of vitamin B 12 and folates with respect to liver function enzymes considering the liver‐storage properties of this vitamin. Method We recruited 70 restrictive type AN adolescents and the severity of psychopathological traits was assessed using EDI‐3 scale. Plasma levels of vitamin B 12 , folates, transaminases (AST, ALT), gamma‐glutamyl transpeptidase (GGT) , alkaline phosphatase (ALP) and cholinesterase (CHE) were determined. Results About 38.5% of patients displayed vitamin B 12 values (H‐B12) above the upper range of normal reference; 4.3% of patients had increased values of folates; 20 and 11.4% of patients displayed ALT and AST values above reference limits; none had GGT values above normal range. Albeit low CHE and ALP values were found in 55 and 20% of patients, respectively, a linear correlation with both transaminases was present only for vitamin B 12 and folates; furthermore, H‐B12 patients had both higher AST and ALT values. EDI‐ 3 subscores significantly correlated with vitamin B 12 and folates plasma values and H‐B12 patients displayed EDI‐3 higher values. Discussion These data suggest that plasma levels of vitamin B 12 might be an early marker of liver dysfunction, possibly also related to more severe psychopathological aspects. The identification of patients with higher fasting plasma vitamin B 12 levels could therefore lead to earlier and more careful refeeding interventions. Further studies will clarify the potential role of this vitamin in AN clinical practice. © 2014 Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:317–322)