Very long chain fatty acids are an important marker of nutritional status in patients with anorexia nervosa: a case control study

Miki Shimizu,Tomokazu Hata,Shu Takakura,Nobuyuki Sudo,Masayasu Shoji,Keisuke Kawai,Makoto Yamashita,Kazunari Tanaka,Keita Tatsushima,Megumi Nakashima

doi:10.1186/s13030-020-00186-8

Abstract

BackgroundAnorexia nervosa (AN) is a disease resulting in extreme weight loss. It is caused by multiple factors, including psychosocial, environmental, and genetic factors. A genetic abnormality affecting lipid metabolism has been recently reported in patients with AN. However, it is unknown whether lipid metabolism abnormalities in AN are caused by eating behavior, undernutrition, and/or genetic factors. The meaning of lipid metabolism in AN remains unclear. In particular, differences in the profiles of very long-chain fatty acids (VLCFAs) in patients with various types of AN have not been studied. This study aimed to determine changes to the fatty acid profile over a 3-month period, specifically that of long-chain fatty acids (LCFAs) and VLCFAs in patients with various types of AN.MethodsWe evaluated 69 female patients with AN, subclassified as AN-restricting type (AN-R) and AN-Binge-Eating/Purging type (AN-BP). On admission and after 3 months of treatment, height, weight, body mass index, plasma and serum parameters, and plasma fatty acid concentrations were measured in all patients. The control group included 25 healthy, age-matched women. Comparisons between the groups were made using one-way ANOVA, while those between the various parameters at admission and after 3 months within each group were made using the Wilcoxon signed rank test.ResultsOn admission, the AN-R and the AN-BP groups had significantly higher levels of 18-24C and > 14C fatty acids (LCFAs and VLCFAs, respectively) than the control group. After 3 months of treatment, both groups showed high levels of 14-24C fatty acids. The levels of VLCFAs (C22:0 and C24:0) and LCFA (C18:3) after 3 months of treatment remained high in both AN groups relative to the control group.ConclusionsEating behaviors appear to be associated with levels of LCFAs. Lipid metabolism abnormalities under conditions of starvation in AN might have a genetic basis and appear to be associated with VLCFA (C22:0 and C24:0) and LCFA (C18:3) levels.

Highlights

Anorexia nervosa (AN) is a disease resulting in extreme weight loss
Eating behaviors appear to be associated with levels of long-chain fatty acids (LCFAs)
At the end of 3 months of treatment, the body weight of those in the AN-restricting type (AN-R) and AN-BingeEating/Purging type (AN-BP) groups had increased significantly, but they had still not reached the weight of the control group

Summary

Introduction

Anorexia nervosa (AN) is a disease resulting in extreme weight loss It is caused by multiple factors, including psychosocial, environmental, and genetic factors. Anorexia nervosa (AN) is a disease that arises from an intense fear of gaining weight and results in extreme weight loss It is caused by multiple factors, including psychosocial environmental, and genetic factors [1,2,3]. Shih et al and Scott-Van Zeeland reported that epoxide hydrolase 2 activity was associated with fat metabolism in a susceptibility gene study [11, 12]. These findings have caused a paradigm shift in the pathologic understanding of AN. Genetic/genomic studies have provided amble evidence that abnormalities in lipid metabolism may be an important factor underlying AN pathophysiology

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