An extremely poor nutritional status resulting from the eating disorder anorexia nervosa can result in acute and profound alterations in liver function, a new study indicates.
Dr Francois Durand, of Hopital Beaujon, Clichy and colleagues in France studied liver specimens from 12 people with anorexia nervosa. Most of them were women in their 20s.
The investigators observed signs of "profound alteration of liver function" and anorexia nervosa was the only cause for acute liver injury in these subjects, they report.
A constant finding was a marked depletion in liver cell glycogen, which is converted to glucose (sugar) for energy. Circulating levels of aspartate aminotransferase, an enzyme that signals liver injury, were 67 times normal, on average, while levels of alanine aminotransferase, another enzyme used to spot liver disease, were 56 times normal, on average.
Durand and colleagues also report that the liver cells of four patients showed signs of "autophagy" - a poorly understood process that leads to a sort of self-digestion of the cell. Autophagy is rarely observed in cells maintained under normal conditions.
The investigators think anorexia nervosa with severe undernutrition should be added to the list of conditions causing acute live problems. - Reuters Health
Source: Gastroenterology, September 2008.
A-Z of anorexia nervosa