title: Tumour necrosis factor alpha and oxidative stress as maintaining factors in the evolution of anorexia nervosa.
abstract: OBJECTIVE
  Aim of the study was to evaluate tumour necrosis factor α (TNF-α) axis and oxidative status in patients with anorexia nervosa (AN) seeking a possible correlation with both nutritional status and evolution of the disease.
  
  
  METHODS
  Thirty-nine consecutive women with AN and an age-matched healthy control group were studied. Patients were 26±9 yr, with a body mass index (BMI) of 13.9±2 kg/m(2). TNF-α, its receptors TNF-R55 and TNF-R75, and oxidative status markers (selenium, ascorbic/ dehydroascorbic acid, retinol, α-tocopherol, selenium-dependent gluthatione peroxidase, reduced/oxidated gluthatione) were measured. A correlation with both nutritional indexes (body weight, BMI, albumin, prealbumin, transferrin, lymphocyte count) and disease duration was investigated. Pearson's correlation and unpaired Student's t-test were used to compare patients and controls.
  
  
  RESULTS
  TNF-α and oxidative status markers were significantly higher in patients than controls and TNF-α was directly related to dehydroascorbic acid (p<0.05). Both TNF-R55 and TNF-R75 were higher in patients with duration of disease longer than one year as compared to controls and patients with shorter duration. Receptors inversely correlated with BMI (p<0.05 and p<0.01) and directly with disease duration (p<0.05). Inverse correlation between disease duration and BMI was present (p<0.01).
  
  
  CONCLUSIONS
  The study showed activation of TNF-α axis and oxidative stress in AN patients, as well as correlation between the two systems. Due to the correlation between TNF receptors and both BMI and disease duration, a possible role of pro-inflammatory cytokines in the evolution of the eating disorder is suggested.
authors.affiliation: Dietetics and Clinical Nutrition Unit, A.O.U. San Giovanni Battista of Turin, Turin, Italy. elenagnello@hotmail.com
authors.forename: E
authors.initials: E
authors.lastname: Agnello
authors.forename: G
authors.initials: G
authors.lastname: Malfi
authors.forename: A M
authors.initials: AM
authors.lastname: Costantino
authors.forename: P
authors.initials: P
authors.lastname: Massarenti
authors.forename: M
authors.initials: M
authors.lastname: Pugliese
authors.forename: N
authors.initials: N
authors.lastname: Fortunati
authors.forename: M G
authors.initials: MG
authors.lastname: Catalano
authors.forename: A
authors.initials: A
authors.lastname: Palmo
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000378:metabolism*; D015992:Body Mass Index; D001835:Body Weight; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D009752:Nutritional Status; D018384:Oxidative Stress; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000378:metabolism*; D047889:Receptors, Tumor Necrosis Factor, Type II / Q000378:metabolism*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
chemical_list: D047888:Receptors, Tumor Necrosis Factor, Type I; D047889:Receptors, Tumor Necrosis Factor, Type II; D014409:Tumor Necrosis Factor-alpha