The Nutrition Research Program, Child and Family Research Institute, Deaprtment of Paediatrics, University of British Columbia, Vancouver, BC V6T 2A1, Canada.
Eat Weight Disord. 2009 Dec;14(4):e184-9. doi: 10.1007/BF03325115.
To determine whether plasma total homocysteine (tHcy) and plasma methionine levels are different in anorexia nervosa restricting type (AN-R) compared to anorexia nervosa binge eating/purging type (AN-BP).
Cross-sectional design.
Subjects were recruited from the outpatient program of the Eating Disorders Program at St. Paul's Hospital, Vancouver, Canada. All subjects had a current Diagnostic and Statistical Manual of mental Disorders - Fourth Edition (DSM-IV) AN-R, or AN-BP diagnosis. Controls were recruited from staff and trainees of Child and Family Research Institute, and Children's and Women's Hospital, University of British Columbia.
Samples were obtained from AN-R (N=30), AN-BP (N=32) and control women (N=73) and men (N=33). The 5- 95th% confidence intervals from the control women were taken as the normal range. The plasma tHcy and methionine for the control group had a 5-95th percentile range of 5.66-10.57 and 15.3-40.2 microM, respectively. Plasma tHcy was elevated in women with AN-BP (9.24+/-0.85 microM, N=32) but not with AN-R (7.90+/-0.38 microM, N=30). Plasma methionine was decreased in women with AN-BP (22.2+/-1.43 microM, N=32) compared to the control group of women (25.1+/-0.89 microM). The plasma methionine/tHcy ratio was elevated in the women with AN-BP (0.50+/-0.09) but not in those with AN-R (0.34+/-0.03).
Elevated plasma tHcy and decreased plasma methionine are consistent with impaired homocysteine remethylation. Altered methyl transfer capacity or methyl deficiency could impair monoamine neurotransmitter metabolism potentially impacting cognitive and psychological function.We hypothesize that the treatment of AN-BP should consider the need for nutritional support of methyl metabolism.
确定血浆总同型半胱氨酸（tHcy）和血浆蛋氨酸水平在限制型神经性厌食症（AN-R）与暴食/清除型神经性厌食症（AN-BP）患者中是否存在差异。
采用横断面设计。
从加拿大温哥华圣保罗医院饮食失调项目的门诊项目中招募受试者。所有受试者均符合当前的《精神障碍诊断与统计手册-第四版》（DSM-IV）AN-R 或 AN-BP 诊断标准。对照组受试者从儿童和家庭研究所的工作人员和受训人员以及不列颠哥伦比亚大学儿童医院招募。
从 AN-R 患者（n=30）、AN-BP 患者（n=32）和对照组女性（n=73）和男性（n=33）中获取样本。对照组女性的 5-95%置信区间被视为正常范围。对照组女性的血浆 tHcy 和蛋氨酸的 5-95%范围分别为 5.66-10.57 和 15.3-40.2 μM。血浆 tHcy 在 AN-BP 女性患者中升高（9.24±0.85 μM，n=32），但在 AN-R 女性患者中没有升高（7.90±0.38 μM，n=30）。与对照组女性（25.1±0.89 μM）相比，AN-BP 女性患者的血浆蛋氨酸降低（22.2±1.43 μM，n=32）。血浆蛋氨酸/同型半胱氨酸比值在 AN-BP 女性患者中升高（0.50±0.09），但在 AN-R 女性患者中没有升高（0.34±0.03）。
血浆 tHcy 升高和血浆蛋氨酸降低与同型半胱氨酸再甲基化受损一致。甲基转移能力改变或甲基缺乏可能会影响单胺神经递质代谢，从而潜在影响认知和心理功能。我们假设 AN-BP 的治疗应考虑到甲基代谢的营养支持需求。
