ORIGINAL PAPER
Clinical features of the impact of eating disorders on the results of 13C-methacetin breath test for assessment of liver function in girls with anorexia nervosa
 
More details
Hide details
 
Submission date: 2018-09-04
 
 
Final revision date: 2019-01-18
 
 
Acceptance date: 2019-01-18
 
 
Publication date: 2019-02-27
 
 
Pediatr Pol 2019;94(1):6-12
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
This study was designed to assess the influence of chosen aspects of anorexia nervosa eating disorders (AN ED) on 13C-methacetin breath test (MBT) results.

Material and methods:
We investigated a group of 81 girls, including 41 patients with confirmed diagnosis of AN ED. The study group was divided in two subgroups. According to the DSM-5 classification, 25 underweight patients met the criteria of anorexia nervosa (AN), and 16 girls with BMI value > 5th percentile for age and sex were diagnosed as atypical anorexia nervosa (AAN). Laboratory tests assessing the liver function and the MBT were performed in all the participants of the study.

Results:
In all healthy females the values of anthropometric parameters and laboratory results concerning the liver function were normal. Girls with AN ED achieved higher cumulative 13CO2 dose salvage during the MBT than healthy controls. Also, DOB (delta over baseline) values were significantly higher in the study group, as well as in both ANN and AN subgroups, compared to controls. Comparison of the patients’ subgroups revealed higher elimination of the cumulative 13CO2 dose in females with AN compared to those with AAN. Among the study group there was a negative correlation between the DOB values in all time points of the test and the weight, weight percentile, BMI, and BMI percentile.

Conclusions:
Girls with weight deficiency in the course of AN achieved higher cumulative 13CO2 dose recovery during the MBT than healthy controls and other AN patients. The recovery of 13CO2 during the MBT was negatively correlated with parameters describing patients’ weight status. The obtained results suggest a significantly faster 13C-methacetin metabolism in girls with AN ED, which is probably a consequence of the characteristics of the primary disease. The presented observations suggest that MBT is not useful in monitoring liver function in patients with AN ED.
REFERENCES (20)
1.
Stravitz RT, Ilan Y. Potential use of metabolic breath tests to assess liver disease and prognosis: has the time arrived for routine use in the clinic? Liver Int 2017; 37: 328-336.
 
2.
Fierbinteanu-Braticevici C, Papacocea R, Tribus L, et al. Role of 13C methacetin breath test for non-invasive staging of liver fibrosis in patients with chronic hepatitis C. Indian J Med Res 2014; 140: 123.
 
3.
Candelli M, Armuzzi A, Nista EC, et al. 13C‐methacetin breath test for monitoring hepatic function in cirrhotic patients before and after liver transplantation. Aliment Pharmacol Ther 2004; 19: 243.
 
4.
Petrolati A, Festi D, De Berardinis G, et al. 13C‐methacetin breath test for monitoring hepatic function in cirrhotic patients before and after liver transplantation. Aliment Pharmacol Ther 2003; 18: 785-790.
 
5.
Fierbinteanu-Braticevici C, Plesca D-A, Tribus L, et al. Role of 13C-Methacetin Breath Test for the Non-Invasive Evaluation of Nonalcoholic Fatty Liver Disease. J Gastrointestin Liver Dis 2013; 22: 149-156.
 
6.
Afolabi P, Wright M, Wootton SA, Jackson AA. Clinical utility of 13C-liver-function breath tests for assessment of hepatic function. Dig Dis Sci 2013; 58: 33-41.
 
7.
Zipfel S, Giel KE, Bulik CM, et al. Anorexia nervosa: aetiology, assessment, and treatment. Lancet Psychiatry 2015; 2: 1099-1111.
 
8.
Edition F. Diagnostic and statistical manual of mental disorders. American Psychiatric Publishing, Arlington, VA 2013.
 
9.
Forney KJ, Brown TA, Holland‐Carter LA, et al. Defining “significant weight loss” in atypical anorexia nervosa. Int J Eat Disord 2017; 50: 952-962.
 
10.
Oshikoya KA, Sammons H, Smith K, Choonara I. Lack of a significant change in caffeine metabolism in underweight children as determined by the caffeine breath test. Arch Dis Child 2015; 100: 689-693.
 
11.
Kwiecień J, Oświęcimska J, Bąk-Drabik K, et al. Test oddechowy z użyciem metacetyny znakowanej izotopem węgla 13C w ocenie czynności wątroby u dziewcząt z jadłowstrętem psychicznym. Stand Med Pediatr 2014; 11: 760-766.
 
12.
Górowska-Kowolik K, Chobot A, Kwiecień J. Breath test using 13C methacetin does not seem to be useful in the assessment of liver function in girls with anorexia nervosa: a case control study. BMC Gastroenterol 2018; 18: 126.
 
13.
Silén Y, Raevuori A, Jüriloo E, et al. Typical Versus Atypical Anorexia Nervosa Among Adolescents: Clinical Characteristics and Implications for ICD‐11. Eur Eat Disord Rev 2015; 23: 345-351.
 
14.
Sawyer S M, Whitelaw M, Le Grange D, et al. Physical and psychological morbidity in adolescents with atypical anorexia nervosa. Pediatrics 2016; 137: e20154080.
 
15.
Rautou PE, Cazals-Hatem D, Moreau R, et al. Acute liver cell damage in patients with anorexia nervosa: a possible role of starvation-induced hepatocyte autophagy. Gastroenterology 2008; 135: 840-848.
 
16.
Kheloufi M, Boulanger CM, Durand F, et al. Liver autophagy in anorexia nervosa and acute liver injury. BioMed Res Int 2014; 2014: 701064.
 
17.
Akinyinka OO, Sowunmi A, Honeywell R, et al. The pharmacokinetics of caffeine in Nigerian children suffering from malaria and kwashiorkor. Eur J Clin Pharmacol 2000; 56: 153-158.
 
18.
Oshikoya KA, Smith K, Sammons H, Choonara I. Decreased metabolism of 13C-caffeine via hepatic CYP1A2 in marasmus and kwashiorkor based on breath test. J Basic Clin Physiol Pharmacol 2015; 26: 105-113.
 
19.
Forestier J, Dumortier J, Guillaud O, et al. Noninvasive diagnosis and prognosis of liver cirrhosis: a comparison of biological scores, elastometry, and metabolic liver function tests. Eur J Gastroenterol Hepatol 2010; 22: 532-540.
 
20.
Ciccocioppo R, Candelli M, Di Francesco D, et al. Study of liver function in healthy elderly subjects using the 13C‐methacetin breath test. Aliment Pharmacol Ther 2003; 17: 271-277.
 
Journals System - logo
Scroll to top