PLASMA TOTAL-HOMOCYSTEINE IN ANOREXIA-NERVOSA

Objective: The measurement of plasma total-homocysteine (tHcy) as a ma rker of folate and cobalamin status in patients with anorexia nervosa. Design: Plasma tHcy, folate, cobalamin and other determinats of tHcy of a random group of patients with anorexia nervosa were compared with our own reference values. Setting: The study was performed at the ter tiary children's Hospital Sant Joan de Deu. Subjects: All the female a dolescents (n=43) coming to the Hospital during a one-year period, who were diagnosed with anorexia nervosa. Reference values for tHcy were simultaneously performed with apparently healthy adolescents (by histo ry and analytical data) who underwent presurgical analysis for minor i nterventions, and other magnitudes we used our own reference values. I nterventions: Plasma tHcy was measured by reverse fase HPLC with fluor escence detection of the SBDF derivatives, Folate and cobalamin concen trations were determined by radioimmunoassay. Results: tHcy was signif icantly increased in anorexic patients compared to reference values (M ann-Whitney, P < 0.0001-0.001). Values were above reference range in 3 4% of patients, and high-normal range in 53% of patients. tHcy concent rations lowered in 8 and 11 patients after nutritional rehabilitation. Cobalamin and folate were in the reference range except for one case. No significant correlation was found among tHcy, vitamins and other d eterminants of tHcy concentration. Conclusions: tHcy concentrations ap pear significantly increased in adolescents with anorexia nervosa, mos t probably owing to subclinical folate deficiency. This might be cause d by both, intracellular folate deficiency and impaired availability. Abnormal plasma tHcy values were completely corrected after nutritiona l rehabilitation.