Riboflavin and riboflavin-derived cofactors in adolescent girls with anorexia nervosa

• Published in: The American journal of clinical nutrition Vol. 69; no. 4; pp. 672 - 678
• Main Authors: Capo-chichi, Callinice D, Guéant, Jean-Louis, Lefebvre, Emmanuelle, Bennani, Nabila, Lorentz, Elizabeth, Vidailhet, Colette, Vidailhet, Michel
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Elsevier Inc 01.04.1999; American Society for Clinical Nutrition; American Society for Clinical Nutrition, Inc
• Subjects: Absorptiometry, Photon; Adolescent; adolescent girls; Adult and adolescent clinical studies; Amino Acids - blood; Amino Acids - urine; Anorexia; Anorexia nervosa; Anorexia Nervosa - blood; Anorexia Nervosa - therapy; Biological and medical sciences; Child; Chromatography, High Pressure Liquid; Diet; Eating behavior disorders; Energy Intake; ethylmalonic acid; Female; flavin adenine dinucleotide; flavin mononucleotide; Flavins - blood; Gas Chromatography-Mass Spectrometry; Girls; Humans; isovalerylglycine; Medical sciences; Nutrition; Nutritional Status; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Reference Values; riboflavin; Riboflavin - blood; Riboflavin - metabolism; Teenagers; triiodothyronine; Triiodothyronine - blood; vitamin deficiency; Vitamins; flavin mononucleotide; ethylmalonic acid; isovalerylglycine; triiodothyronine; Anorexia nervosa; vitamin deficiency; adolescent girls; riboflavin; flavin adenine dinucleotide; Human; Excretion; Vitamin; Red blood cell; Riboflavin; Eating disorder; Metabolism; Organic acids; Blood cell; Adolescent; Female; Thyroid hormone; Malnutrition
• ISSN: 0002-9165; 1938-3207
• DOI: 10.1093/ajcn/69.4.672

Thyroid hormones, riboflavin, riboflavin cofactors, and organic acids were assessed in girls with anorexia nervosa. The objective was to examine the effect of malnutrition and low thyroid hormone concentrations on erythrocyte and plasma riboflavin metabolism and their relation with urinary organic acid excretion. Seventeen adolescent girls with anorexia nervosa [body mass index (BMI; in kg/m2): 14.8 ± 2.2] and 17 age-matched, healthy girls (control subjects; BMI: 20.5 ± 2.2) took part in the feeding study. Erythrocyte and plasma riboflavin as well as riboflavin cofactors (flavin mononucleotide and flavin adenine dinucleotide) were assessed by HPLC, whereas urinary organic acids were assessed by gas chromatography–mass spectrometry. Anorectic patients who began a feeding program had higher erythrocyte riboflavin (3.5 ± 2.2 compared with <0.1 nmol/mol hemoglobin; P < 0.001), lower plasma flavin adenine dinucleotide (57.8 ± 18.5 compared with 78.5 ± 54.3 nmol/L; P < 0.05), and higher urinary ethymalonic acid (7.12 ± 4.39 compared with 1.3 ± 2.8 μmol/mmol creatinine; P < 0.001) and isovalerylglycine (7.65 ± 4.78 compared with 3.8 ± 0.9 μmol/mmol creatinine; P < 0.05) concentrations than did control subjects. Triiodothyronine concentrations were low and negatively correlated with plasma riboflavin concentrations (r = −0.69, P < 0.01). Not all patients showed improvements in these biochemical indexes after 30 d of refeeding. The low triiodothyronine concentrations observed in anorexia nervosa could alter the extent of riboflavin conversion into cofactors, thus leading to high erythrocyte riboflavin concentrations, low plasma flavin adenine dinucleotide concentrations, and high rates of ethylmalonic acid and isovalerylglycine excretion.