title: Are plasma homocysteine and methionine elevated when binging and purging behavior complicates anorexia nervosa? Evidence against the transdiagnostic theory of eating disorders.
abstract: OBJECTIVE
  To determine whether plasma total homocysteine (tHcy) and plasma methionine levels are different in anorexia nervosa restricting type (AN-R) compared to anorexia nervosa binge eating/purging type (AN-BP).
  
  
  METHODS
  Cross-sectional design.
  
  
  METHODS
  Subjects were recruited from the outpatient program of the Eating Disorders Program at St. Paul's Hospital, Vancouver, Canada. All subjects had a current Diagnostic and Statistical Manual of mental Disorders - Fourth Edition (DSM-IV) AN-R, or AN-BP diagnosis. Controls were recruited from staff and trainees of Child and Family Research Institute, and Children's and Women's Hospital, University of British Columbia.
  
  
  RESULTS
  Samples were obtained from AN-R (N=30), AN-BP (N=32) and control women (N=73) and men (N=33). The 5- 95th% confidence intervals from the control women were taken as the normal range. The plasma tHcy and methionine for the control group had a 5-95th percentile range of 5.66-10.57 and 15.3-40.2 microM, respectively. Plasma tHcy was elevated in women with AN-BP (9.24+/-0.85 microM, N=32) but not with AN-R (7.90+/-0.38 microM, N=30). Plasma methionine was decreased in women with AN-BP (22.2+/-1.43 microM, N=32) compared to the control group of women (25.1+/-0.89 microM). The plasma methionine/tHcy ratio was elevated in the women with AN-BP (0.50+/-0.09) but not in those with AN-R (0.34+/-0.03).
  
  
  CONCLUSIONS
  Elevated plasma tHcy and decreased plasma methionine are consistent with impaired homocysteine remethylation. Altered methyl transfer capacity or methyl deficiency could impair monoamine neurotransmitter metabolism potentially impacting cognitive and psychological function.We hypothesize that the treatment of AN-BP should consider the need for nutritional support of methyl metabolism.
authors.affiliation: The Nutrition Research Program, Child and Family Research Institute, Deaprtment of Paediatrics, University of British Columbia, Vancouver, BC V6T 2A1, Canada.
authors.forename: S M
authors.initials: SM
authors.lastname: Innis
authors.forename: C L
authors.initials: CL
authors.lastname: Birmingham
authors.forename: E J
authors.initials: EJ
authors.lastname: Harbottle
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D056912:Binge-Eating Disorder / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D002170:Canada / Q000453:epidemiology; D019317:Evidence-Based Medicine; D005260:Female; D006710:Homocysteine / Q000097:blood* / Q000378:metabolism; D006801:Humans; D054368:Laxatives / Q000008:administration & dosage; D008297:Male; D008715:Methionine / Q000097:blood* / Q000378:metabolism; D008875:Middle Aged; D014839:Vomiting
chemical_list: D015415:Biomarkers; D054368:Laxatives; D006710:Homocysteine; D008715:Methionine