Biochemical Abnormalities in Anorexia Nervosa and Bulimia

Abstract

SUMMARY.We report the biochemical results in 90 women presenting to an eating disorders clinic: 61 who had bulimia, 22 with anorexia nervosa and seven unclassified. The results were compared with 30 control women. The group of women with an eating disorder had significantly higher concentrations of total CO 2 , calcium, AST, ALT. ALP, albumin and cholesterol and significantly lower concentrations of potassium, chloride and phosphate in the plasma. The elevated calcium could be accounted for in part by an increase in total CO 2 and an increase in albumin. Hypokalaemia was strongly associated with self-induced vomiting and laxative abuse. Biochemical abnormalities occurred in both forms of eating disorders; however. hypercholesterolaemia was more common in anorexia nervosa and abnormal liver enzymes were more common in bulimia.Anorexia ncrvosa and bulimia arc psychosomatic conditions with associated abnormal behaviour related to weight control. 1 The most notable feature of anorexia nervosa is marked weight loss and maintenance of low body weight. 2 Bulimia is characterised by episodes of binge eating 'and severe weight fluctuation.: ': 4 A range of weight-controlling behaviours are used by both anorexia nervosa and bulimia patients, including self-induced vomiting, laxative and diuretic abuse, starvation and dieting. I. 3. 4 The diagnosis is now believed to be more common than previously thought. with an incidence in the Australian young female population of I'Yc, with anorexia nervosa and in the order of 10% with bulimia."There are considerable data available on the biochemical changes associated with anorexia nervosa." These have usually been reported in ill or hospitalised patients who might be expected to have significant metabolic derangement. The association of hypokalaemic, hypochloraemic metabolic alkalosis on the basis of self-induced vomiting, purgative or diuretic abuse with anorexia nervosa has been implicated

Elevation of Serum Aminotransferase as a Sign of Multiorgan-Disorders in Severely Emaciated Anorexia Nervosa.

“…Cravario et al (5) reported that only one of27 patients with an average BMIof 14.4 ± 2.0 (mean ± SD) showed elevated serum aminotransferase levels. Mira et al (6) reported that 2 of 22 anorectic patients, with body weight 73.2 ± 9.6% of standard body weight, showed elevated serum aminotransferase levels. In the report of Fichter and Pirke (7), there was no difference in ALTand ASTbetween groups of patients with less than 60%, 61-90%, and 91-1 10% of ideal body weight.…”

“…Thus, we started a prospective study to clarify the clinical implication of serum aminotransferase elevation in anorexia nervosa. To date, numerous studies have discussed the elevation of serum aminotransferase levels in the patients with anorexia nervosa (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). However, there have been no consistent patterns in the results and the clinical implication has not been clarified (2).…”

Association of Components of Metabolic Syndrome with Depression and Anxiety in Patients Undergoing Weight Reduction Surgery~!2009-09-21~!2009-12-23~!2010-08-27~!

“…In the literature, certain eating disorders can cause transaminitis, including anorexia, bulimia and eating disorder not otherwise specified [29][30][31]. However, a large study of patients with eating disorders determined that hepatic dysfunction was not common among eating disorders and liver damage could often be attributed to low weight [32].…”

Evidence-based Nutritional Support in the Intensive Care Unit

“…Hence, contrary to popular belief, hypoalbuminemia is rarely present in cases of isolated calorie malnutrition. 12 Rather, hypoalbuminemia is a marker of the systemic inflammatory response and is associated with increase morbidity and mortality among hospitalized patients. 13 Therefore, serum albumin concentration can be used as a nutrition screening tool at the time of ICU admission.…”