cholecalciferol and Anorexia-Nervosa

Young women with anorexia nervosa (AN) have a normal vitamin D status. The bioavailability of vitamin D during malnutrition is unknown.. The objective of the study was to examine the serum response to oral ergocalciferol in AN.. This was a prospective cohort study, conducted in 2007-2009 at a tertiary care center.. Twelve adolescents with AN (age 19.6 ± 2.0 yr, body mass index 16.5 ± 1.4 kg/m²) and 12 matched healthy controls (20.0 ± 2.4 yr, 22.7 ± 1.0 kg/m²) received one baseline 50,000 IU oral dose of ergocalciferol.. Serum D₂, D₃, 25-hydroxyvitamin D, and 1,25-dihydroxyvitamin D, collected before ingestion, at 6 and 24 h and weekly for 4 wk, and body composition measures were measured.. The AN group was severely malnourished (77.2 ± 6.3% median body weight), whereas the control group was normal weighted (106.2 ± 6.2%). From a common baseline D₂ (1.5 ± 1.6 nmol/liter, P =0.34) the groups diverged (time × group interaction P = 0.04), peaking at 70 ± 34 nmol/liter at 6 h in controls compared with 43 ± 28 nmol/liter in AN subjects (P = 0.008). The D₂ trajectories converged at 24 h (57 nmol/liter, P = 0.98) and returned to near baseline at 1 wk. Baseline D₃ was higher in AN subjects (12.1 ± 9.6 vs. 3.1 ± 2.3 nmol/liter, P < 0.001) and remained higher throughout. 25-Hydroxyvitamin D followed a common trajectory (time × group interaction P = 0.15), rising to 45 ± 10 nmol/liter at 24 h but returning to baseline by wk 3 (P = 0.36). Correlating vitamin D levels with fat measures (body mass index, body fat) produced similar findings.. Despite severe malnutrition, young women with AN had a similar bioavailability of oral ergocalciferol as the healthy-weighted controls. Vitamin D dosing for patients suffering from malnutrition may not differ from that for normal-weighted adolescents.

Topics: Administration, Oral; Adolescent; Anorexia Nervosa; Calcifediol; Cholecalciferol; Cohort Studies; Ergocalciferols; Female; Humans; Malnutrition; Parathyroid Hormone; Prospective Studies; Vitamins; Young Adult

Vitamin D3 has been described to have different extraskeletal roles by acting as parahormone in obesity, diabetes, cancer, cognitive impairment, and dementia and to have important regulatory functions in innate immunity. There are no studies showing extraskeletal changes associated with hypovitaminosis D3 in eating disorders. Methods. We have analyzed the blood of 18 patients affected by anorexia nervosa and bulimia nervosa collected over a 15-month period. We performed a panel of chemical and clinical analyses: the assay of vitamin D3, the immunoblotting of vitamin D receptor and peroxisome proliferator-activated receptor gamma, and the genotyping of 5-hydroxytryptamine transporter linked polymorphic region. Results. We choose 18 patients with a normal blood test profile such as thyroid hormones, hepatic and renal parameters, triglycerides, proteins, vitamin B12, and folic acid. Among these emerged the case of a woman with long-term anorexia nervosa and the case of a woman with long-term bulimia nervosa both complicated by anxiety and depression, severe hypovitaminosis D3, decrease of vitamin D receptor, leukopenia, and 5-hydroxytryptamine transporter linked polymorphic region short allele. Conclusion. The results induce hypothesising that the severe hypovitaminosis D3 might be responsible for the lack of the inflammatory response and the depressive symptoms in patients with long-term eating disorders.

Topics: Adolescent; Adult; Aged; Anorexia Nervosa; Bulimia Nervosa; Cholecalciferol; Female; Genotype; Humans; Leukopenia; Middle Aged; PPAR gamma; Receptors, Calcitriol; Serotonin Plasma Membrane Transport Proteins; Young Adult