Iron overload may be critical for liver dysfunction in anorexia nervosa, and the role of haematocrit-adjusted albumin in assessing nutritional status: a case report
Abstract Background Anorexia nervosa (AN) is frequently associated with liver dysfunction, but the precise mechanism remains undefined. Since the nutritional marker albumin has a low correlation with changes in body weight in AN, and patients with AN often have dehydration as a complication, we also...
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Pediatrics |
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| Online Access: | https://doi.org/10.1186/s12887-023-04367-6 |
| _version_ | 1797636693070708736 |
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| author | Tomohiko Yoshida Toshiki Namiki Masaya Yamaga Shunichiro Onishi Minoru Takemoto |
| author_facet | Tomohiko Yoshida Toshiki Namiki Masaya Yamaga Shunichiro Onishi Minoru Takemoto |
| author_sort | Tomohiko Yoshida |
| collection | DOAJ |
| description | Abstract Background Anorexia nervosa (AN) is frequently associated with liver dysfunction, but the precise mechanism remains undefined. Since the nutritional marker albumin has a low correlation with changes in body weight in AN, and patients with AN often have dehydration as a complication, we also examined whether haematocrit (HCT)-adjusted serum albumin could be a better nutritional marker in AN. Case presentation We describe a 15-year-old girl with severe weight loss and liver damage whose liver enzymes normalized after 1.5 months of hospitalization and weight gain. We found a significant correlation between body weight (BW) and HCT-adjusted serum albumin (Spearman’s rank correlation coefficient (rs) = 0.66, P = 5.28 × 10−3) and between BW and alanine aminotransferase (ALT) (rs = -0.825, P = 8.45 × 10−5). After division by HCT, correlations between serum albumin and ALT (rs = -0.835, P = 5.24 × 10−5) and between the iron-storage protein ferritin and the liver enzyme gamma-glutamyl transferase (rs = 1.0, P = 0.017) were also statistically significant. Conclusion These results suggest that improvement of the nutritional status in AN could relieve liver dysfunction and facilitate iron transport. Since a decrease in the iron-transport protein transferrin presumably increases labile non-transferrin-bound iron, resulting in excess reactive oxygen species production, a defect in iron transport due to malnutrition could be one of the causes of liver injury in AN. In addition, HCT-adjusted albumin could be a better marker than its raw data to assess changes in nutritional status in AN. |
| first_indexed | 2024-03-11T12:37:47Z |
| format | Article |
| id | doaj.art-8ce1599b7173461d85a39ee541fa4248 |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-03-11T12:37:47Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-8ce1599b7173461d85a39ee541fa42482023-11-05T12:29:42ZengBMCBMC Pediatrics1471-24312023-10-012311610.1186/s12887-023-04367-6Iron overload may be critical for liver dysfunction in anorexia nervosa, and the role of haematocrit-adjusted albumin in assessing nutritional status: a case reportTomohiko Yoshida0Toshiki Namiki1Masaya Yamaga2Shunichiro Onishi3Minoru Takemoto4Department of Diabetes, Metabolism, and Endocrinology, International University of Health and Welfare, Narita HospitalDepartment of Diabetes, Metabolism, and Endocrinology, International University of Health and Welfare, Narita HospitalDepartment of Diabetes, Metabolism, and Endocrinology, International University of Health and Welfare, Narita HospitalDepartment of Diabetes, Metabolism, and Endocrinology, International University of Health and Welfare, Narita HospitalDepartment of Diabetes, Metabolism, and Endocrinology, International University of Health and Welfare, Narita HospitalAbstract Background Anorexia nervosa (AN) is frequently associated with liver dysfunction, but the precise mechanism remains undefined. Since the nutritional marker albumin has a low correlation with changes in body weight in AN, and patients with AN often have dehydration as a complication, we also examined whether haematocrit (HCT)-adjusted serum albumin could be a better nutritional marker in AN. Case presentation We describe a 15-year-old girl with severe weight loss and liver damage whose liver enzymes normalized after 1.5 months of hospitalization and weight gain. We found a significant correlation between body weight (BW) and HCT-adjusted serum albumin (Spearman’s rank correlation coefficient (rs) = 0.66, P = 5.28 × 10−3) and between BW and alanine aminotransferase (ALT) (rs = -0.825, P = 8.45 × 10−5). After division by HCT, correlations between serum albumin and ALT (rs = -0.835, P = 5.24 × 10−5) and between the iron-storage protein ferritin and the liver enzyme gamma-glutamyl transferase (rs = 1.0, P = 0.017) were also statistically significant. Conclusion These results suggest that improvement of the nutritional status in AN could relieve liver dysfunction and facilitate iron transport. Since a decrease in the iron-transport protein transferrin presumably increases labile non-transferrin-bound iron, resulting in excess reactive oxygen species production, a defect in iron transport due to malnutrition could be one of the causes of liver injury in AN. In addition, HCT-adjusted albumin could be a better marker than its raw data to assess changes in nutritional status in AN.https://doi.org/10.1186/s12887-023-04367-6Anorexia NervosaLiver dysfunctioniron overloadHematocrit-adjusted albuminNutritional marker |
| spellingShingle | Tomohiko Yoshida Toshiki Namiki Masaya Yamaga Shunichiro Onishi Minoru Takemoto Iron overload may be critical for liver dysfunction in anorexia nervosa, and the role of haematocrit-adjusted albumin in assessing nutritional status: a case report BMC Pediatrics Anorexia Nervosa Liver dysfunction iron overload Hematocrit-adjusted albumin Nutritional marker |
| title | Iron overload may be critical for liver dysfunction in anorexia nervosa, and the role of haematocrit-adjusted albumin in assessing nutritional status: a case report |
| title_full | Iron overload may be critical for liver dysfunction in anorexia nervosa, and the role of haematocrit-adjusted albumin in assessing nutritional status: a case report |
| title_fullStr | Iron overload may be critical for liver dysfunction in anorexia nervosa, and the role of haematocrit-adjusted albumin in assessing nutritional status: a case report |
| title_full_unstemmed | Iron overload may be critical for liver dysfunction in anorexia nervosa, and the role of haematocrit-adjusted albumin in assessing nutritional status: a case report |
| title_short | Iron overload may be critical for liver dysfunction in anorexia nervosa, and the role of haematocrit-adjusted albumin in assessing nutritional status: a case report |
| title_sort | iron overload may be critical for liver dysfunction in anorexia nervosa and the role of haematocrit adjusted albumin in assessing nutritional status a case report |
| topic | Anorexia Nervosa Liver dysfunction iron overload Hematocrit-adjusted albumin Nutritional marker |
| url | https://doi.org/10.1186/s12887-023-04367-6 |
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