T-LYMPHOCYTE SUBSETS IN PATIENTS WITH ABNORMAL BODY-WEIGHT - LONGITUDINAL-STUDIES IN ANOREXIA-NERVOSA AND OBESITY

Objective: In contrast to other types of starvation which are characte rized by low CD4+ counts and increased susceptibility to infection, an orexia nervosa is not associated with an increase in infectious compli cations. To determine why infection risk of anorectics differs from th at of other starving populations, we studied T-lymphocytes, including CD4+ and CD8+ phenotypes, in patients with anorexia nervosa, and for c omparison, in dieting obese subjects. Methods: T-lymphocyte phenotypes were determined by flow cytometric analysis of monoclonal antibody-la beled cells obtained from patients with anorexia nervosa before and af ter successful therapy and weight gain, and in obese subjects before a nd after weight loss on a very-low-calorie diet. Results: Weight loss in anorectics and obese dieters was associated with normal CD4+ counts . Unexpectedly, CD8+ counts were low in anorectics, both before and af ter weight gain, and in obese subjects after (but not before) dieting. Discussion: Normal CD4+ counts in anorectics and obese dieters, despi te marked weight loss, may explain the lack of increased infection ris k in these eating-disordered patients, in contrast to other starving p opulations. The observation that CD8+ counts are low in anorectics wit h low and restored body weight and in obese patients after dieting has not been previously reported. The persistence of low CD8+ counts in a norectics even after weight gain suggests that some factors other than weight loss per se may be involved, possibly including effects due to stress, comorbid psychiatric conditions, or unidentified aspects of d ysregulated pathophysiology secondary to disordered eating. (C) 1996 b y John Wiley & Sons, Inc.