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American Journal of Clinical Nutrition, Vol. 69, No. 4, 672-678, April 1999
© 1999 American Society for Clinical Nutrition

Original Research Communications

Riboflavin and riboflavin-derived cofactors in adolescent girls with anorexia nervosa1,2

Callinice D Capo-chichi, Jean-Louis Guéant, Emmanuelle Lefebvre, Nabila Bennani, Elizabeth Lorentz, Colette Vidailhet and Michel Vidailhet

Background: Thyroid hormones, riboflavin, riboflavin cofactors, and organic acids were assessed in girls with anorexia nervosa.

Objective: The objective was to examine the effect of malnutrition and low thyroid hormone concentrations on erythrocyte and plasma riboflavin metabolism and their relation with urinary organic acid excretion.

Design: Seventeen adolescent girls with anorexia nervosa [body mass index (BMI; in kg/m2): 14.8 ± 2.2] and 17 age-matched, healthy girls (control subjects; BMI: 20.5 ± 2.2) took part in the feeding study. Erythrocyte and plasma riboflavin as well as riboflavin cofactors (flavin mononucleotide and flavin adenine dinucleotide) were assessed by HPLC, whereas urinary organic acids were assessed by gas chromatography–mass spectrometry.

Results: Anorectic patients who began a feeding program had higher erythrocyte riboflavin (3.5 ± 2.2 compared with <0.1 nmol/mol hemoglobin; P < 0.001), lower plasma flavin adenine dinucleotide (57.8 ± 18.5 compared with 78.5 ± 54.3 nmol/L; P < 0.05), and higher urinary ethymalonic acid (7.12 ± 4.39 compared with 1.3 ± 2.8 µmol/mmol creatinine; P < 0.001) and isovalerylglycine (7.65 ± 4.78 compared with 3.8 ± 0.9 µmol/mmol creatinine; P < 0.05) concentrations than did control subjects. Triiodothyronine concentrations were low and negatively correlated with plasma riboflavin concentrations (r = -0.69, P < 0.01). Not all patients showed improvements in these biochemical indexes after 30 d of refeeding.

Conclusions: The low triiodothyronine concentrations observed in anorexia nervosa could alter the extent of riboflavin conversion into cofactors, thus leading to high erythrocyte riboflavin concentrations, low plasma flavin adenine dinucleotide concentrations, and high rates of ethylmalonic acid and isovalerylglycine excretion.

Key Words: Anorexia nervosa • riboflavin • ethylmalonic acid • flavin mononucleotide • isovalerylglycine • triiodothyronine • adolescent girls • vitamin deficiency • flavin adenine dinucleotide






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