title: Metabolic abnormalities associated with skeletal myopathy in severe anorexia nervosa.
abstract: The aim of this study was to characterize the metabolic disturbance associated with the skeletal myopathy resulting from extreme weight loss in anorexia nervosa. Muscle function was examined in eight female patients with severe (40%) weight loss due to anorexia nervosa and histologically confirmed myopathy. A wide range of biochemical and hematologic investigations were carried out, including serum enzymes and the response of plasma lactate to ischemic exercise of forearm muscles. All patients showed proximal muscular weakness. A diminished lactate response to ischemic exercise was a consistent finding, and a reduction of serum carnosinase activity was also found. There were no other consistent biochemical or hematologic abnormalities apart from lymphopenia of no clinical consequence. These findings contribute to our understanding of severe protein-energy malnutrition on the musculoskeletal system. The resulting disorder is a metabolic myopathy from which the patients recover rapidly as their nutrition improves. Although the patients admitted to a variety of abnormal eating behaviors, no correlation was found between a specific type of abnormal eating behavior and subsequent biochemical abnormalities. Reinstating appropriate eating behavior will treat the myopathy.
authors.affiliation: Department of Psychiatry, Institute of Psychiatry, London, UK.
authors.forename: D M
authors.initials: DM
authors.lastname: McLoughlin
authors.forename: W S
authors.initials: WS
authors.lastname: Wassif
authors.forename: J
authors.initials: J
authors.lastname: Morton
authors.forename: E
authors.initials: E
authors.lastname: Spargo
authors.forename: T J
authors.initials: TJ
authors.lastname: Peters
authors.forename: G F
authors.initials: GF
authors.lastname: Russell
mesh_terms: D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000209:etiology; D000856:Anorexia Nervosa / Q000150:complications* / Q000378:metabolism; D004150:Dipeptidases / Q000097:blood; D015444:Exercise; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D019344:Lactic Acid / Q000097:blood; D008099:Liver / Q000201:enzymology; D007986:Luteinizing Hormone / Q000097:blood; D008231:Lymphopenia / Q000209:etiology; D018908:Muscle Weakness; D018482:Muscle, Skeletal / Q000378:metabolism*; D009135:Muscular Diseases / Q000209:etiology* / Q000378:metabolism; D013921:Thrombocytopenia / Q000209:etiology; D015431:Weight Loss
chemical_list: D019344:Lactic Acid; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D004150:Dipeptidases; C019673:aminoacyl-histidine dipeptidase