Secondary type II hyperlipoproteinemia in patients with anorexia nervosa

Mordasini, R; Klose, Gerald; Greten, H.

doi:10.1016/0026-0495(78)90125-7

Cited by 55 publications

(28 citation statements)

References 23 publications

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“…The higher LDL-TG:LDL-ApoB ratio of our present AN patients could be explained by decreased TG hydrolysis because of decreased activities of hepatic TG lipase and/or lipoprotein lipase, probably because of loss of metabolically active peripheral tissues. In accordance with this hypothesis, Mordasini et al (1978) found in a selected group of four patients with AN significantly decreased activities of both enzymes. Furthermore, we showed that AN patients had a significantly lower BMR than CO. Lipoprotein composition influences their susceptibility to oxidation.…”

Section: Discussionsupporting

confidence: 69%

“…The higher concentrations were based on higher LDL-Chol levels, as also described in previous studies (Mordasini et al 1978), but not confirmed by others (Arden et al 1990;Mehler et al 1998). The mean difference between CO and AN in our present study was rather small, in contrast to markedly elevated Chol levels found in reasonably large cohorts in early reports in the literature (Klinefelter, 1965; Crisp et al 1968;Mehler et al 1998;Mordasini et al 1978). A high degree of selection of patients of certain subgroups in these studies could be the reason.…”

Section: Discussionsupporting

confidence: 63%

“…Its main characteristic, selfinduced weight loss, causes abnormalities in a number of organ systems and in multiple metabolic pathways and results in significant changes in body composition with severe loss of body fat. As a surprising metabolic consequence, elevated serum cholesterol (Chol) levels are often found, as first described by Klinefelter (1965) and later confirmed by several other authors Crisp et al 1968;Mordasini et al 1978). The food intake of these patients is usually hypoenergetic; the food consumed has a higher proportion of energy from protein and lower proportions from carbohydrate and fat compared with that consumed by control subjects.…”

Section: Anorexia Nervosa: Lipoprotein Metabolism: Hypercholesterolaemiamentioning

confidence: 87%

“…This has recently also been reported by others (Feillet et al 2000), although in a smaller number of patients. Mordasini et al (1978) suggested that the mobilization of body fat during phases of weight loss could be responsible for the higher LDL-Chol concentrations. Our present results support this hypothesis, because the results of our multiple regression analyses indicate that BMI and TBF ( %) are, besides the thyroid hormones and non-esterified glycerol, important predictor variables for the LDL-Chol levels, accounting for about 55 % of their variability.…”

Section: Discussionmentioning

confidence: 99%

“…The precise mechanisms underlying the increases in blood lipids are unknown, but a number of assumptions have been made. For instance, it was suggested that a diet rich in Chol or that carbohydrate binging in bulimic patients Crisp et al 1968;Mordasini et al 1978) might be responsible. Nestel (1974) proposed that hypercholesterolaemia may reflect reduced Chol and bile acid turnover, and Mordasini et al (1978) showed increased amounts of LDL as the major component of elevated Chol and suggested that they result from substantial mobilization of body fat for energy supply.…”

Section: Anorexia Nervosa: Lipoprotein Metabolism: Hypercholesterolaemiamentioning

confidence: 99%

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Lipoprotein metabolism in patients with anorexia nervosa: a case–control study investigating the mechanisms leading to hypercholesterolaemia

et al. 2004

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Hypercholesterolaemia is a common finding in patients with anorexia nervosa (AN). To investigate the type, frequency and pathophysiological mechanisms of changes in lipoprotein metabolism in AN we performed a cross-sectional study in fifty-eight female patients (mean age 24·2 years, BMI 15·3 (SD 1·5) kg/m 2 ) and fifty-eight healthy age-matched controls (CO; BMI 22·2 (SD 1·7) kg/m 2 ). Total cholesterol and LDL-cholesterol were higher in AN (5·5 (SD 1·3) v. 5·0 (SD 0·8) mmol/l, P¼0·023; 3·6 (SD 1·1) v. 3·2 (SD 0·7) mmol/l, P¼0·025 respectively). LDL particles were significantly more enriched in cholesterol and triacylglycerol in AN. In multiple regression analysis with LDL-cholesterol as the dependent and BMI, total body fat ( %), lathosterol:cholesterol ratio (endogenous cholesterol synthesis), 7a-hydroxy-4-cholesten-3-one (bile acid synthesis), non-esterified glycerol, free triiodothyronine and free thyroxine as independent variables, BMI was the only significant predictor in CO (R 2 0·36, overall P¼0·001). In AN the variability of LDL-cholesterol was significantly predicted by total body fat, free thyroxine, BMI, free triiodothyronine and non-esterified glycerol (R 2 0·55, overall P,0·001). Subgroup analysis between restricting (AN-R) and binge-eating -purging patients (AN-B) indicated that in AN-R changes in lipoproteins, BMI and total body fat were more pronounced. AN-R patients had lower bile acid synthesis than AN-B (P¼0·02). We conclude that elevated cholesterol concentrations in AN are generally due to an increase in LDL-cholesterol, which is mostly determined by the severe loss of body fat and the resulting changes in thyroid hormones, increased lipolysis and decreased endogenous cholesterol synthesis with resulting decrease in LDL removal. The clinical subtype of AN plays a major role in the mechanisms leading to hypercholesterolaemia.Anorexia nervosa: Lipoprotein metabolism: Hypercholesterolaemia

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Section: Discussionsupporting

confidence: 69%

Section: Discussionsupporting

confidence: 63%

Section: Anorexia Nervosa: Lipoprotein Metabolism: Hypercholesterolaemiamentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Anorexia Nervosa: Lipoprotein Metabolism: Hypercholesterolaemiamentioning

confidence: 99%

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Lipoprotein metabolism in patients with anorexia nervosa: a case–control study investigating the mechanisms leading to hypercholesterolaemia

et al. 2004

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Lipid levels in anorexia nervosa

Mehler

Lezotte

Eckel

1998

Int. J. Eat. Disord.

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Objective Anorexia nervosa is a chronic disorder characterized by the patient's refusal to maintain body weight and a myriad of medical complications. Two frequently cited and poorly understood complications are hypercholesterolemia and hypercarotenemia. We therefore measured fasting cholesterol and beta‐carotene levels in a cohort of moderately severe anorectics. Method: All subjects were female and met DSM‐IV criteria for anorexia nervosa. Lipid profiles and beta‐carotene levels were determined in 23 female anorexics. Results: The mean total cholesterol for this group of anorectics was 179.3 mg/dl. Low‐density lipoprotein values (LDL) ranged from 47 to 173, with a mean of 104.1 mg/dl. The mean high‐density lipoprotein value (HDL) was 51.5 mg/dl. Beta‐carotene levels were all normal. Discussion: We conclude that total and LDL cholesterol in anorexia are well within the range of normal, and HDL levels are favorably high. Further, hypercarotenemia was not associated with anorexia nervosa. © 1998 by John Wiley & Sons, Inc. Int J Eat Disord 24: 217–221, 1998.

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Elevated plasma lipids in patients with binge eating disorders are found only in those who are anorexic

Case

Lemieux

Kennedy

et al. 1999

Int. J. Eat. Disord.

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Objective We have previously shown that patients with restricting type anorexia nervosa (AN‐R) have low plasma lipid levels, which increase with refeeding. In this study, we investigated plasma lipid levels in patients with eating disorders, distinguishing between individuals with bulimia nervosa (BN) and anorexia nervosa of the binge eating/purging type (AN‐B). Methods We examined the fasting lipid levels in individuals with BN (n = 10) and AN‐B (n = 9), and compared these findings with a group of age‐matched normal weight healthy controls (C) (n = 10). Results The AN‐B group had significantly higher concentrations of total plasma cholesterol, apolipoprotein (apo) B, apoA1, and low‐density lipoprotein (LDL)‐cholesterol than both control and BN groups (p < .05). The AN‐B group also had higher plasma triglycerides and intermediate‐density lipoprotein (IDL)‐apo B levels (p < .05) than controls. Discussion In conclusion, the issue of hyperlipidemia in patients with eating disorders is a complex one and this study, taken together with the findings of our previous study, demonstrates the importance of carefully distinguishing between the major types of eating disorders (AN‐R, BN, and AN‐B) when examining plasma lipid levels. © 1999 by John Wiley & Sons, Inc. Int J Eat Disord 25: 187–193, 1999.

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Secondary type II hyperlipoproteinemia in patients with anorexia nervosa

Cited by 55 publications

References 23 publications

Lipoprotein metabolism in patients with anorexia nervosa: a case–control study investigating the mechanisms leading to hypercholesterolaemia

Lipoprotein metabolism in patients with anorexia nervosa: a case–control study investigating the mechanisms leading to hypercholesterolaemia

Lipid levels in anorexia nervosa

Elevated plasma lipids in patients with binge eating disorders are found only in those who are anorexic

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