Liver and vitamin B12 parameters in patients with anorexia nervosa before and after short-term weight restoration

Research output: Contribution to journalResearch articleContributedpeer-review



Hepatic involvement in anorexia nervosa (AN) has been previously reported, but a link to elevated vitamin B12 concentrations, which can be a sign for liver damage, has not been thoroughly examined. We measured liver enzymes (alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltransferase) and vitamin B12 parameters (total B12, holotranscobalamin, methylmalonic acid) in the plasma of young female patients with acute AN (n=77) and after short-term weight restoration (n=58, median body mass increase=25%), in comparison to healthy control participants (n=63). For a comprehensive assessment of vitamin B12 status, the combined marker cB12 was calculated. In acute AN, activities of alanine aminotransferase and gamma-glutamyltransferase as well as holotranscobalamin concentrations were elevated, and alanine aminotransferase activities positively correlated with total B12, holotranscobalamin and cB12 in patients with elevated liver enzyme activities. After weight restoration, alanine aminotransferase activities and holotranscobalamin concentrations were elevated, and cB12 increased above the level of the healthy control group. The present study provides further evidence for a hepatic involvement in acute AN in concert with vitamin B12 parameters and points to refeeding-associated alterations of liver and vitamin B12 parameters. Future studies should include non-invasive methods to characterize hepatic involvement and evaluate vitamin B12 status as a potential marker of liver damage/irritation.


Original languageEnglish
Article number114673
JournalPsychiatry research
Publication statusPublished - Aug 2022

External IDs

Scopus 85132779068
unpaywall 10.1016/j.psychres.2022.114673
Mendeley cd4e0f18-c6d9-3a3f-ad08-00d02d29d6d7
WOS 000822939700002
PubMed 35751997
ORCID /0000-0001-7803-1972/work/142235070
ORCID /0000-0003-2132-4445/work/142236345
ORCID /0000-0002-6152-5834/work/142241981
ORCID /0000-0001-8333-867X/work/142251382


Sustainable Development Goals


  • Alanine Transaminase, Anorexia Nervosa/complications, Biomarkers, Female, Humans, Liver, Transcobalamins, Vitamin B 12, Vitamins, gamma-Glutamyltransferase, Gamma-glutamyltransferase, Holotranscobalamin, Methylmalonic acid, Transaminases, Alanine aminotransferase, Aspartate aminotransferase, Liver function tests, FUNCTION TESTS, EATING-DISORDERS, PREVALENCE, INDICATORS, ENZYMES, SERUM VITAMIN-B12, DISEASE SEVERITY, COBALAMIN, DAMAGE, BODY-MASS INDEX

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