A case of anorexia nervosa with severe hyperlipoproteinemia.
OBJECTIVE
The complication of severe hyperlipoproteinemia with anorexia nervosa is very rare. We investigated the mechanisms of severe hyperlipoproteinemia in a patient with anorexia nervosa.


METHODS
The measurement of plasma levels of lipids, apolipoproteins (Apo), lipoprotein subfractions, free T3, and estrogen, apo (lipoprotein) E phenotyping, and the assay of lymphocyte low-density lipoprotein (LDL)-receptor activity were accomplished in a 40-year-old female patient with anorexia nervosa.


RESULTS
Her body mass index was 10.3 kg/m2. Her plasma levels of total cholesterol (C), triglyceride (TG), apoB, apoE, very-low-density lipoprotein (VLDL)-C, and intermediate-density lipoprotein (IDL)-C were 757 mg/dl, 526 mg/dl, 288 mg/dl, 13.6 mg/dl, 133 mg/dl, and 99 mg/dl, respectively. VLDL was cholesterol rich (C/TG ratio = 0.68; normal value = 0.2). The plasma LDL was high and skewed to less dense fractions. Her apoE phenotype was E 3/2. Her lymphocyte LDL-receptor activity was 79% of normal subjects. The plasma level of estradiol was low and that of free T3 was subnormal.


CONCLUSIONS
We concluded that the plasma lipoprotein abnormality of this anorexia nervosa patient was induced by the impaired removal of TG-rich lipoprotein remnants and less dense LDL due to apoE phenotype E 3/2, subnormal LDL-receptor activity, subnormal plasma level of free T3, and diminished secretion of estrogen.
Department of Internal Medicine, Tokai University School of Medicine, Boseidai, Isehara, 259-1193, Japan.
Yasuhiko
Y
Homma
Koichiro
K
Homma
Shinichi
S
Iizuka
Kamon
K
Iigaya
D000328:Adult; D000856:Anorexia Nervosa / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D001057:Apolipoproteins E / Q000097:blood / Q000235:genetics; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D004967:Estrogens / Q000097:blood; D005260:Female; D006801:Humans; D006951:Hyperlipoproteinemias / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D008079:Lipoproteins, VLDL / Q000097:blood; D010641:Phenotype; D012720:Severity of Illness Index; D013963:Thyroid Hormones / Q000097:blood
D001057:Apolipoproteins E; D004967:Estrogens; D008079:Lipoproteins, VLDL; D013963:Thyroid Hormones; D002784:Cholesterol