Liver and vitamin B12 parameters in patients with anorexia nervosa before and after short-term weight restoration. (August 2022)

• Record Type: Journal Article
• Authors: Tam, Friederike I.; Chocholi, Ilektra; Hellerhoff, Inger; Kloepfer, Malina; Weidner, Kerstin; Roessner, Veit; Mirtschink, Peter; Poitz, David M.; Ehrlich, Stefan
• Is Part Of: Psychiatry research. Volume 314(2022)
• Publication Date: 2022-08
• Subjects: Liver function tests -- Alanine aminotransferase -- Aspartate aminotransferase -- Gamma-glutamyltransferase -- Transaminases -- Holotranscobalamin -- Methylmalonic acid; ALT alanine aminotransferase -- AN anorexia nervosa -- AN_T1 patients with anorexia nervosa at timepoint 1 (admission) -- AN_T2 patients with anorexia nervosa at timepoint 2 (after short-term weight restoration) -- AST aspartate aminotransferase -- B12 vitamin B12 -- BDI-II Beck Depression Inventory Version 2 -- BMI body mass index -- BMI-SDS body mass index standard deviation score -- cB12 combined marker of vitamin B12 status -- EDI-2 Eating Disorder Inventory-2 -- gGT gamma-glutamyltransferase -- HC healthy control participants -- Holo-TC holotranscobalamin -- IQR interquartile range -- MMA methylmalonic acid -- SCL-90-R Symptom Checklist-90-Revised -- SIAB-EX Structured Interview for Anorexia and Bulimia Nervosa; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2022.114673
• Languages: English
• ISSNs: 0165-1781

Abstract

Highlights: Hepatic involvement in anorexia nervosa (AN) indicated by elevated ALT and gGT. Elevated holotranscobalamin likely due to leakage from damaged hepatocytes in AN. Elevated ALT associated with higher vitamin B12 and holotranscobalamin in AN. Refeeding-associated elevations of ALT and holotranscobalamin in some AN patients. Further exploration of effects of different refeeding protocols on liver/B12 needed. Abstract: Hepatic involvement in anorexia nervosa (AN) has been previously reported, but a link to elevated vitamin B12 concentrations, which can be a sign for liver damage, has not been thoroughly examined. We measured liver enzymes (alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltransferase) and vitamin B12 parameters (total B12, holotranscobalamin, methylmalonic acid) in the plasma of young female patients with acute AN ( n =77) and after short-term weight restoration ( n =58, median body mass increase=25%), in comparison to healthy control participants ( n =63). For a comprehensive assessment of vitamin B12 status, the combined marker cB12 was calculated. In acute AN, activities of alanine aminotransferase and gamma-glutamyltransferase as well as holotranscobalamin concentrations were elevated, and alanine aminotransferase activities positively correlated with total B12, holotranscobalamin and cB12 in patients with elevated liver enzyme activities. After weight restoration, alanine aminotransferase activities and holotranscobalamin concentrations were elevated, and cB12 increased above the level of the healthy control group. The present study provides further evidence for a hepatic involvement in acute AN in concert with vitamin B12 parameters and points to refeeding-associated alterations of liver and vitamin B12 parameters. Future studies should include non-invasive methods to characterize hepatic involvement and evaluate vitamin B12 status as a potential marker of liver damage/irritation.